Demographic and Health Survey 2014 - Bangladesh

Abstract
---------------------------

The 2014 Bangladesh Demographic and Health Survey (BDHS) is the seventh DHS undertaken in Bangladesh, following those implemented in 1993-94, 1996-97, 1999-2000, 2004, 2007, and 2011. The main objectives of the 2014 BDHS are to:
• Provide information to meet the monitoring and evaluation needs of the health, population, and nutrition sector development program (HPNSDP)
• Provide program managers and policy makers involved in the program with the information they need to plan and implement future interventions

The specific objectives of the 2014 BDHS were as follows:
• To provide up-to-date data on demographic rates, particularly fertility and infant, and child mortality rates, at the national and divisional level
• To measure the level of contraceptive use of currently married women
• To provide data on maternal and child health, including antenatal care, assistance at delivery, postnatal care, newborn care, breastfeeding, immunizations, and prevalence and treatment of diarrhea and other diseases among children under age 5
• To assess the nutritional status of children (under age 5) and women by means of anthropometric measurements (weight and height), and to assess infant and child feeding practices
• To provide data on knowledge and attitudes of women about sexually transmitted infections and HIV/AIDS
• To measure key education indicators, including school attendance ratios
• To provide community-level data on accessibility and availability of health and family planning services

Geographic coverage
---------------------------

National coverage
The survey was designed to produce representative results for the country as a whole, for the urban and the rural areas separately, and for each of the seven administrative divisions.

Analysis unit
---------------------------

- Household
- Individual
- Children age 0-5
- Ever married Women age 15-49

Kind of data
---------------------------

Sample survey data [ssd]

Sampling procedure
---------------------------

Sample Design
The sample for the 2014 BDHS is nationally representative and covers the entire population residing in noninstitutional dwelling units in the country. The survey used a sampling frame from the list of enumeration areas (EAs) of the 2011 Population and Housing Census of the People's Republic of Bangladesh, provided by the Bangladesh Bureau of Statistics (BBS). The primary sampling unit (PSU) for the survey is an EA created to have an average of about 120 households.

Bangladesh is divided into seven administrative divisions: Barisal, Chittagong, Dhaka, Khulna, Rajshahi, Rangpur, and Sylhet. Each division is divided into zilas, and each zila into upazilas. Each urban area in an upazila is divided into wards, which are further subdivided into mohallas. A rural area in an upazila is divided into union parishads (UPs) and, within UPs, into mouzas. These divisions allow the country as a whole to be separated into rural and urban areas.

The survey is based on a two-stage stratified sample of households. In the first stage, 600 EAs were selected with probability proportional to the EA size, with 207 EAs in urban areas and 393 in rural areas. A complete household listing operation was then carried out in all of the selected EAs to provide a sampling frame for the second-stage selection of households. In the second stage of sampling, a systematic sample of 30 households on average was selected per EA to provide statistically reliable estimates of key demographic and health variables for the country as a whole, for urban and rural areas separately, and for each of the seven divisions. With this design, the survey selected 18,000 residential households, which were expected to result in completed interviews with about 18,000 ever-married women.

For further details of the sample design, see Appendix A of the final report.

Mode of data collection
---------------------------

Face-to-face [f2f]

Research instrument
---------------------------

The 2014 BDHS used three types of questionnaires: a Household Questionnaire, a Woman’s Questionnaire, and a Community Questionnaire. The contents of the Household and Woman’s questionnaires 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 Working Group (TWG) that consisted of representatives from NIPORT, Mitra and Associates, International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B), USAID/Bangladesh, and ICF International. Draft questionnaires were then circulated to other interested groups and were reviewed by the 2014 BDHS Technical Review Committee. The questionnaires were developed in English and then translated into and printed in Bangla.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, current work status, birth registration, and individual possession of mobile phones. The main purpose of the Household Questionnaire was to identify women who were eligible for the individual interview. Information was collected about the dwelling unit, such as the source of water, type of toilet facilities, materials used to construct the floor, roof, and walls, ownership of various consumer goods, and availability of hand washing facilities. In addition, this questionnaire was used to record the height and weight measurements of ever-married women age 15-49 and children under age 6.

The Woman’s Questionnaire was used to collect information from ever-married women age 15-49.

The Community Questionnaire was administered in each selected cluster during the household listing operation and included questions about the existence of development organizations in the community and the availability and accessibility of health services and other facilities. The Community Questionnaire was administered to a group of four to six key informants who were knowledgeable about socioeconomic conditions and the availability of health and family planning services/facilities in the cluster. Key informants included community leaders, teachers, government officials, social workers, religious leaders, traditional healers, and health care providers among others.

Cleaning operations
---------------------------

The completed 2014 BDHS questionnaires were periodically returned to Dhaka for data processing at Mitra and Associates. The data processing began shortly after fieldwork commenced. Data processing consisted of office editing, coding of open-ended questions, data entry, and editing of inconsistencies found by the computer program. Eight data entry operators and two data entry supervisors processed the data. Data processing commenced on July 24, 2014, and ended on November 20, 2014. The task was carried out using the Census and Survey Processing System (CSPro), a software jointly developed by the U.S. Census Bureau, ICF Macro, and Serpro S.A.

Response rate
---------------------------

Among a total of 17,989 selected households, 17,565 were found occupied. Interviews were successfully completed in 17,300, or 99 percent of households. A total of 18,245 ever-married women age 15-49 were identified in these households and 17,863 were interviewed, for a response rate of 98 percent. Response rates for households and eligible women are similar to those in the 2011 BDHS. The principal reason for nonresponse among women was their absence from home despite repeated visits to the household. The response rates do not vary notably by urban-rural residence.

Sampling error estimates
---------------------------

The estimates from a sample survey are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling 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 2014 Bangladesh DHS (BDHS) to minimize this type of error, non-sampling 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 2014 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.

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 2014 BDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. Sampling errors are computed in either ISSA or SAS, using programs developed by ICF International. These programs use the Taylor linearization method of variance estimation for survey estimates that are means, proportions or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

Note: A more detailed description of estimate of sampling error is presented in APPENDIX B of the survey report.

Data appraisal
---------------------------

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

Note: See detailed data quality tables in APPENDIX C of the report.

摘要
---------------------------
2014年孟加拉国人口与健康调查（BDHS）是孟加拉国自1993-94年、1996-97年、1999-2000年、2004年、2007年和2011年以来的第七次DHS调查。2014年BDHS的主要目标如下：
• 提供信息以满足健康、人口和营养部门发展计划（HPNSDP）的监测和评估需求
• 为参与该计划的计划经理和政策制定者提供他们所需的信息，以规划和管理未来的干预措施

2014年BDHS的具体目标如下：
• 提供关于人口比率、尤其是生育率和婴儿、儿童死亡率的国家和分区最新数据
• 测量目前已婚女性的避孕使用水平
• 提供关于孕产妇和儿童健康的数据，包括产前护理、分娩援助、产后护理、新生儿护理、母乳喂养、免疫接种以及5岁以下儿童中腹泻和其他疾病的患病率和治疗方法
• 通过人体测量学测量（体重和身高）评估儿童（5岁以下）和妇女的营养状况，并评估婴儿和儿童的喂养习惯
• 提供关于女性对性传播感染和艾滋病病毒/艾滋病的知识和态度的数据
• 测量关键教育指标，包括学校入学率
• 提供关于健康和家庭规划服务的可及性和可用性的社区级数据

地理覆盖范围
---------------------------
全国覆盖
本调查旨在产生针对整个国家、城市和农村地区以及七个行政分区分别具有代表性的结果。
分析单元
---------------------------
- 家庭
- 个人
- 0-5岁儿童
- 15-49岁已婚女性

数据类型
---------------------------
样本调查数据 [ssd]

抽样程序
---------------------------
抽样设计
2014年BDHS的样本是全国代表性的，涵盖了居住在该国非机构住宅单元中的所有人口。调查使用了孟加拉国统计局（BBS）提供的2011年人口和住房普查的普查区（EA）名单作为抽样框架。调查的初级抽样单位（PSU）是为拥有约120户家庭的普查区而创建的。
孟加拉国分为七个行政分区：巴里萨尔、吉大港、达卡、库尔纳、拉杰沙希、朗布尔和锡尔赫特。每个分区分为县，每个县分为乡。每个乡的城市地区分为街区，街区进一步分为摩拉。每个乡的农村地区分为联合乡议会（UP）和，在UP内，分为穆扎。这些分区使得整个国家可以根据农村和城市地区进行划分。
调查基于家庭的两阶段分层抽样。在第一阶段，根据普查区的大小以概率比例选择了600个普查区，其中207个位于城市地区，393个位于农村地区。然后在所有选定的普查区进行了完整的家庭清单操作，为第二阶段的家庭选择提供抽样框架。在抽样的第二阶段，每个普查区平均选择了30户家庭，以提供对整个国家、城市和农村地区以及七个分区中关键人口和健康变量的统计可靠估计。据此设计，调查选择了18,000户住宅家庭，预计将完成约18,000名已婚女性的访谈。
有关抽样设计的更多细节，请参阅最终报告的附录A。

数据收集方式
---------------------------
面对面 [f2f]

研究工具
---------------------------
2014年BDHS使用了三种类型的问卷：家庭问卷、女性问卷和社区问卷。家庭问卷和女性问卷的内容基于MEASURE DHS模型问卷。这些模型问卷在孟加拉国使用时，通过一系列与技术工作组（TWG）的会议进行了调整，技术工作组由NIPORT、Mitra and Associates、孟加拉国国际腹泻病研究中心（ICDDR,B）、USAID/Bangladesh和ICF International的代表组成。然后将草拟的问卷分发给其他感兴趣的团体，并由2014年BDHS技术审查委员会进行审查。问卷是用英语编写的，然后翻译成孟加拉语并打印。
家庭问卷用于列出选定家庭中的所有通常成员和访客。收集了关于列出的每个人的基本信息的某些信息，包括年龄、性别、教育、当前工作状态、出生登记和个人的手机拥有情况。家庭问卷的主要目的是确定有资格进行个人访谈的女性。收集了有关住宅单元的信息，例如水源、厕所设施类型、建造地板、屋顶和墙壁的材料、各种消费品的所有权以及洗手设施的可用性。此外，此问卷还用于记录15-49岁已婚女性和6岁以下儿童的身高和体重测量。
女性问卷用于收集15-49岁已婚女性的信息。
社区问卷在家庭清单操作期间对每个选定群体进行管理，包括关于社区中是否存在发展组织以及健康服务和其他设施的可及性和可用性的问题。社区问卷由对集群社会经济状况以及健康和家庭规划服务/设施的可及性有知识的四到六名关键知情者进行管理。关键知情者包括社区领导人、教师、政府官员、社会工作者、宗教领袖、传统治疗师和医疗保健提供者等。

数据清理操作
---------------------------
完成后的2014年BDHS问卷定期返回达卡，在Mitra and Associates进行数据处理。数据处理始于实地工作开始后不久。数据处理包括办公室编辑、开放式问题的编码、数据录入和计算机程序发现的矛盾的一致性编辑。八名数据录入操作员和两名数据录入监督员处理了数据。数据处理始于2014年7月24日，结束于2014年11月20日。该任务使用美国人口普查局、ICF Macro和Serpro S.A.共同开发的普查和调查处理系统（CSPro）进行。
应答率
---------------------------
在总共17,989个选定的家庭中，发现17,565个家庭有人居住。在17,300户家庭中成功完成了访谈，占99％。在这些家庭中，确定了18,245名15-49岁的已婚女性，其中17,863人接受了访谈，应答率为98％。家庭和有资格女性的应答率与2011年BDHS中的应答率相似。女性非应答的主要原因是在多次访问家庭后，她们仍然不在家中。应答率在城市和农村居住地之间没有明显差异。
抽样误差估计
---------------------------
样本调查的估计受到两种类型误差的影响：非抽样误差和抽样误差。非抽样误差是实施数据收集和数据处理过程中出现的错误的结果，例如未能找到和访谈正确的家庭、访谈员或受访者对问题的误解以及数据录入错误。尽管在实施2014年孟加拉国人口与健康调查（BDHS）期间采取了众多措施来最大限度地减少此类错误，但非抽样误差是无法避免且难以从统计上评估的。
另一方面，抽样误差可以统计评估。2014年BDHS中选定的受访者样本只是可以从同一人口中选出的许多样本之一，使用相同的设计和预期规模。这些样本中的每一个都会产生与实际选定的样本结果略有不同的结果。抽样误差是衡量所有可能样本之间差异的指标。虽然变异程度并不完全清楚，但可以从调查结果中估计出来。
抽样误差通常以特定统计量（均值、百分比等）的标准误差来衡量，这是方差的平方根。标准误差可用于计算置信区间，其中可以合理地假设真实人口的真实值落在这个区间内。例如，对于从样本调查中计算的任何给定统计量，该统计量的值将在95％的所有可能样本的相同大小和设计中落在该统计量的标准误差的两倍范围内。
如果受访者样本被选为简单随机样本，则可以使用简单的公式来计算抽样误差。然而，2014年BDHS样本是多层分层设计的产物，因此有必要使用更复杂的公式。抽样误差在ISSA或SAS中使用ICF International开发的程序计算，这些程序使用泰勒线性化方法进行方差估计，用于调查估计的均值、比例或比率。用于更复杂的统计数据（如生育率和死亡率）的方差估计使用Jackknife重复复制方法。
注意：关于抽样误差估计的更详细描述见调查报告附录B。

数据评估
---------------------------
数据质量表
- 家庭年龄分布
- 有资格和接受访谈女性的年龄分布
- 报告的完整性
- 日历年度出生
- 死亡年龄按天报告
- 死亡年龄按月报告

注意：请参阅报告附录C中的详细数据质量表。