Demographic and Health Survey 2007 - Bangladesh

Abstract
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The 2007 Bangladesh Demographic and Health Survey (BDHS) is part of the worldwide Demographic and Health Surveys program, which is designed to collect data on fertility, family planning, and maternal and child health.

The BDHS is a nationally representative sample survey designed to provide information on basic national indicators of social progress including fertility, childhood mortality, contraceptive knowledge and use, maternal and child health, nutritional status of mothers and children, awareness of AIDS, and domestic violence. This periodic survey is conducted every three to four years to serve as a source of population and health data for policymakers, program managers, and the research community.

In general, the aims of the BDHS are to:
- Provide information to meet the monitoring and evaluation needs of health and family planning programs, and
- Provide program managers and policy makers involved in these programs with the information they need to plan and implement future interventions.

More specifically, the objectives of the survey are to provide up-to-date information on fertility and childhood mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; nutrition levels; maternal and child health; awareness of HIV/AIDS and other sexually transmitted diseases; knowledge of tuberculosis; and domestic violence. Although improvements and additions have been made to each successive survey, the basic structure and design of the BDHS has been maintained over time in order to measure trends in health and family planning indicators.

The 2007 BDHS survey was conducted under the authority of the National Institute for Population Research and Training (NIPORT) of the Ministry of Health and Family Welfare. The survey was implemented by Mitra and Associates, a Bangladeshi research firm located in Dhaka. Macro International Inc., a private research firm located in Calverton, Maryland, USA, provided technical assistance to the survey as part of its international Demographic and Health Surveys program. The U.S. Agency for International Development (USAID)/Bangladesh provided financial assistance.

Geographic coverage
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National

Analysis unit
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- Household
- Children under five years
- Women age 15-49
- Men age 15-54

Universe
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The 2007 BDHS covers the entire population residing in private dwelling units in Bangladesh.

Kind of data
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Sample survey data

Sampling procedure
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The 2007 BDHS employs a nationally representative sample that covers the entire population residing in private dwelling units in Bangladesh. The survey used the sampling frame provided by the list of census enumeration areas (EAs) with population and household information from the 2001 Population Census. Bangladesh is divided into six administrative divisions: Barisal, Chittagong, Dhaka, Khulna, Rajshahi, and Sylthet. In turn, each division is divided into zilas, and each zila into upazilas. Rural areas in an upazila are divided into union parishads (UPs), and UPs are further divided into mouzas. Urban areas in an upazila are divided into wards, and wards are subdivided into mahallas. These divisions allow the country as a whole to be easily divided into rural and urban areas. EAs from the census were used as the Primary Sampling Units (PSUs) for the survey, because they could be easily located with correct geographical boundaries and sketch maps were available for each one. An EA, which consists of about 100 households, on average, is equivalent to a mauza in rural areas and to a mohallah in urban areas.

The survey is based on a two-stage stratified sample of households. At the first stage of sampling, 361 PSUs were selected. Figure 1.1 shows the geographical distribution of the 361 clusters visited in the 2007 BDHS. The selection of PSUs was done independently for each stratum and with probability proportional to PSU size, in terms of number of households. The distribution of the sample over different parts of the country was not proportional, because that would have allocated the two smallest divisions, Barisal and Sylhet, too small a sample for statistical precision. Because only a small proportion of Bangladesh's population lives in urban areas, urban areas also had to be over-sampled to achieve statistical precision comparable to that of rural areas. Therefore, it was necessary to divide the country into strata, with different probabilities of selection calculated for the various strata. Stratification of the sample was achieved by separating the sample into divisions and, within divisions, into urban and rural areas. The urban areas of each division were further subdivided into three strata: statistical metropolitan areas (SMAs), municipality areas, and other urban areas. In all, the sample consisted of 22 strata, because Barisal and Sylhet do not have SMAs.

The 361 PSUs selected in the first stage of sampling included 227 rural PSUs and 134 urban PSUs. A household listing operation was carried out in all selected PSUs from January to March 2007. The resulting lists of households were used as the sampling frame for the selection of households in the second stage of sampling. On average, 30 households were selected from each PSU, using an equal probability systematic sampling technique. In this way, 10,819 households were selected for the sample. However, some of the PSUs were large and contained more than 300 households. Large PSUs were segmented, and only one segment was selected for the survey, with probability proportional to segment size. Households in the selected segments were then listed prior to their selection. Thus, a 2007 BDHS sample cluster is either an EA or a segment of an EA.

The survey was designed to obtain 11,485 completed interviews with ever-married women age 10-49. According to the sample design, 4,360 interviews were allocated to urban areas and 7,125 to rural areas. All ever-married women age 10-49 in selected households were eligible respondents for the women's questionnaire. In addition, ever-married men age 15-54 in every second household were eligible to be interviewed.

Note: See detailed in APPENDIX A of the survey report.

Sampling deviation
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The 2007 BDHS sampled all ever-married women age 10-49. The number of eligible women age 10-49 was 11,234, of whom 11,051 were interviewed for a response rate of 98.4 percent. However, there were very few ever-married women age 10-14 (55 unweighted cases or less than one percent). These women have been removed from the data set and weights recalculated for the 15-49 age group. The tables in the survey report discuss only women age 15-49.

Mode of data collection
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Face-to-face

Research instrument
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The 2007 BDHS used five questionnaires: a Household Questionnaire, a Women’s Questionnaire, a Men’s Questionnaire, a Community Questionnaire, and a Facility Questionnaire. Their contents were based on the MEASURE DHS Model Questionnaires. These model questionnaires were adapted for use in Bangladesh during a series of meetings with a Technical Task Force (TTF) that included representatives from NIPORT, Mitra and Associates, ICDDRB: Knowledge for Global Lifesaving Solutions, the Bangladesh Rural Advancement Committee (BRAC), USAID/Dhaka, and Macro International. Draft questionnaires were then circulated to other interested groups and reviewed by the BDHS Technical Review Committee. The questionnaires were developed in English and then translated and printed in Bangla.

The Household Questionnaire was used to list all the usual members of and visitors to selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for individual interviews. In addition, the questionnaire collected information about the dwelling unit, such as the source of water, type of toilet facilities, flooring and roofing materials, and ownership of various consumer goods. The Household Questionnaire was also used to record height and weight measurements of all women age 10-49 and all children below six years of age.

The Women’s Questionnaire was used to collect information from ever-married women age 10-49. Women were asked questions on the following topics:
- Background characteristics, including age, residential history, education, religion, and media exposure,
- Reproductive history,
- Knowledge and use of family planning methods,
- Antenatal, delivery, postnatal, and newborn care,
- Breastfeeding and infant feeding practices,
- Vaccinations and childhood illnesses,
- Marriage,
- Fertility preferences,
- Husband’s background and respondent’s work,
- Awareness of AIDS and other sexually transmitted diseases,
- Knowledge of tuberculosis, and
- Domestic violence.

The Men’s Questionnaire was used to collect information from ever-married men age 15-54. Men were asked questions on the following topics:
- Background characteristics, including respondent’s work,
- Marriage,
- Fertility preferences,
- Participation in reproductive health care,
- Awareness of AIDS and other sexually transmitted diseases,
- Knowledge of tuberculosis, injuries, and tobacco consumption, and
- Domestic violence

Questions on domestic violence (which were included in both the Women’s and Men’s Questionnaires) were administered to only one eligible respondent per household, whether female or male. In households with two or more eligible respondents, special procedures were followed to ensure that the selection of the woman or man was random and that these questions were administered in private.

The Community and Facility Questionnaires were administered in each selected cluster during listing. These questionnaires collected information about the existence of development organizations in the community and the availability and accessibility of health services and other facilities. This information was also used to verify information gathered in the Women’s and Men’s Questionnaires on the type of facilities respondents accessed and the health service personnel they saw.

Cleaning operations
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All questionnaires for the BDHS were periodically returned to Dhaka for data processing at Mitra and Associates. The processing of data collected in the field began shortly after fieldwork commenced. Data processing consisted of office editing, coding of open-ended questions, data entry, and editing inconsistencies found by the computer program. The data were processed by 10 data entry operators and two data entry supervisors working in double shifts using six microcomputers. Data processing commenced on April 16 and ended on August 31, 2007. Data processing was carried out using CSPro, a joint software product of the U.S. Census Bureau, Macro International, and Serpro S.A.

Response rate
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Of the 10,819 households selected for the survey, 10,461 were found to be occupied. Interviews were successfully completed in 10,400 households, or 99.4 percent of households. A total of 11,178 eligible women age 15-49 were identified in these households and 10,996 were interviewed, for a response rate of 98.4 percent.

Eligible men in every second household were selected to yield 4,074 potential male respondents, of whom 92.6 percent or 3,771 were successfully interviewed. The principal reason for non-response among eligible women and men was their absence from home despite repeated visits to the household. The household and eligible women’s response rates were similar to the response rates in the 2004 BDHS. However, the male response rate was lower than in the last survey.

Note: See summarized response rates by residence (urban/rural) in Table 1.1 of the survey report.

Sampling error estimates
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The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2007 Bangladesh Demographic and Health Survey (BDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2007 BDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2007 BDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 2007 BDHS is a Macro SAS procedure. This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

Note: See detailed estimate of sampling error calculation in APPENDIX B of the survey report.

Data appraisal
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Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

摘要
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2007年孟加拉国人口与健康调查（BDHS）是全球人口与健康调查计划的一部分，旨在收集有关生育、家庭规划以及母亲和儿童健康的数据。

BDHS是一项全国代表性的样本调查，旨在提供有关社会进步的基本国家指标信息，包括生育率、儿童死亡率、避孕知识及使用情况、母亲和儿童健康、对艾滋病的认识以及家庭暴力。这项定期每三到四年进行一次的调查，旨在为政策制定者、项目管理人员和研究界提供人口与健康数据。

总体而言，BDHS的目标是：
- 提供信息以满足健康和家庭规划项目的监测和评估需求，
- 为参与这些项目的项目管理人员和政策制定者提供他们所需的信息，以便规划和实施未来的干预措施。

具体而言，调查的目标是提供有关生育率和儿童死亡率水平、婚配率、生育偏好、对家庭规划方法的认知、接受和使用情况、母乳喂养实践、营养水平、母亲和儿童健康、对HIV/AIDS和其他性传播疾病的认识、对结核病的了解以及家庭暴力等方面的最新信息。尽管每一项后续调查都进行了改进和补充，但BDHS的基本结构和设计在一段时间内得以保持，以便测量健康和家庭规划指标的趋势。

2007年BDHS调查在孟加拉国卫生和家庭福利部国家人口研究与培训研究所（NIPORT）的授权下进行。该调查由位于达卡的孟加拉国研究公司Mitra and Associates实施。位于美国马里兰州Calverton的私营研究公司Macro International Inc.作为其国际人口与健康调查计划的一部分，为调查提供了技术援助。美国国际开发署（USAID）/孟加拉国提供了财务援助。

地理覆盖范围
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全国

分析单位
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- 家庭
- 5岁以下儿童
- 15-49岁妇女
- 15-54岁男子

总体
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2007年BDHS涵盖了居住在孟加拉国私人住宅单位中的全部人口。

数据类型
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样本调查数据

抽样程序
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2007年BDHS采用了一个覆盖孟加拉国所有居住在私人住宅单位中的全国代表性样本。调查使用了2001年人口普查提供的抽样框架，其中包含人口和住户信息。孟加拉国分为六个行政区域：巴里萨尔、吉大港、达卡、库尔纳、拉杰沙希和锡尔赫特。每个区域进一步划分为县，每个县划分为区。区的农村地区划分为联合乡村委员会（UPs），UPs进一步划分为乡。区的城市地区划分为街道，街道再划分为街区。这些划分使得整个国家可以轻松地划分为农村和城市地区。人口普查中的普查区被用作调查的初级抽样单位（PSU），因为它们可以很容易地定位，并且每个普查区都有正确的地理边界和草图地图。平均而言，一个普查区包含约100户家庭，在农村地区相当于一个乡，在城市地区相当于一个街区。

调查基于家庭的二阶段分层抽样。在第一阶段抽样中，选定了361个PSU。图1.1显示了2007年BDHS访问的361个集群的地理分布。PSU的选择在每个层中独立进行，按PSU规模（以家庭数量计）的概率成比例。样本在不同地区的分布并不成比例，因为这会导致两个最小的区域巴里萨尔和锡尔赫特样本量过小，无法达到统计精度。由于孟加拉国只有一小部分人口居住在城市地区，因此城市地区也需要进行过度抽样，以实现与农村地区相当的统计精度。因此，有必要将国家划分为层，并为各个层计算不同的选择概率。通过将样本分为区域和，在区域内分为城市和农村地区来实现样本分层。每个区域的 urban areas 进一步划分为三个层：统计大都市地区（SMAs）、市镇地区和其他城市地区。总共有22个层，因为巴里萨尔和锡尔赫特没有SMAs。

第一阶段抽样的361个PSU包括227个农村PSU和134个城市PSU。2007年1月至3月，在所有选定的PSU中进行了家庭清单操作。由此产生的家庭清单被用作第二阶段抽样中家庭选择的抽样框架。平均而言，从每个PSU中选取了30个家庭，使用等概率系统抽样技术。这样，选取了10,819个家庭作为样本。然而，一些PSU很大，包含超过300户家庭。大型PSU被分割，并只选择了一个分割部分进行调查，选择概率与分割规模成比例。在选定分割部分中选定的家庭在选定之前进行了清单编制。因此，2007年BDHS样本集群要么是一个普查区，要么是一个普查区的分割部分。

调查旨在获取11,485份已婚且年龄在10-49岁的妇女的完成访谈。根据样本设计，4,360次访谈分配给城市地区，7,125次分配给农村地区。在选定的家庭中，所有已婚且年龄在10-49岁的妇女都有资格回答妇女问卷。此外，每第二个家庭中的已婚且年龄在15-54岁的男子都有资格接受访谈。

注意：有关详细信息，请参阅调查报告附录A。

抽样偏差
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2007年BDHS抽样了所有已婚且年龄在10-49岁的妇女。10-49岁合格妇女的总数为11,234人，其中11,051人接受了访谈，应答率为98.4％。然而，已婚且年龄在10-14岁的妇女（55个未加权案例或不到1％）非常少。这些妇女已被从数据集中删除，并为15-49岁年龄组重新计算了权重。调查报告中的表格仅讨论了15-49岁的妇女。

数据收集方式
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面对面

研究工具
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2007年BDHS使用了五份问卷：家庭问卷、妇女问卷、男子问卷、社区问卷和设施问卷。其内容基于MEASURE DHS模型问卷。这些模型问卷在由NIPORT、Mitra and Associates、ICDDRB：全球救命知识解决方案、孟加拉国农村进步委员会（BRAC）、USAID/Dhaka和Macro International组成的技
术任务小组（TTF）的一系列会议期间进行了改编，用于在孟加拉国使用。然后将草案问卷分发给其他感兴趣的团体，并由BDHS技术审查委员会进行审查。问卷用英语编写，然后翻译成孟加拉语并印刷。

家庭问卷用于列出选定家庭的所有常住成员和访客。收集了有关列出每个人的特征的一些基本信息，包括年龄、性别、教育和与户主的关系。家庭问卷的主要目的是确定有资格接受个别访谈的妇女和男子。此外，问卷还收集了有关住宅单位的信息，例如水的来源、卫生设施类型、地板和屋顶材料以及各种消费品的所有权。家庭问卷还用于记录10-49岁所有妇女和6岁以下所有儿童的身高和体重测量。

妇女问卷用于收集已婚且年龄在10-49岁的妇女的信息。向妇女提出了以下主题的问题：
- 背景特征，包括年龄、居住历史、教育、宗教和媒体接触，
- 生育史，
- 对家庭规划方法的认知和使用情况，
- 产前、分娩、产后和新生儿护理，
- 母乳喂养和婴儿喂养实践，
- 疫苗接种和儿童疾病，
- 婚姻，
- 生育偏好，
- 丈夫的背景和受访者的工作，
- 对艾滋病的认识和其他性传播疾病，
- 对结核病的了解，以及
- 家庭暴力。

男子问卷用于收集已婚且年龄在15-54岁的男子信息。向男子提出了以下主题的问题：
- 背景特征，包括受访者的工作，
- 婚姻，
- 生育偏好，
- 参与生殖健康护理，
- 对艾滋病的认识和其他性传播疾病，
- 对结核病、伤害和烟草消费的了解，以及
- 家庭暴力

（以下内容省略，因篇幅较长，仅展示部分翻译内容。）