Biological and Physiological Measurements in Population-Based Surveys in Less Developed Countries: Recent Innovations in the DHS (Demographic and Health Survey)

Gregory Pappas, Macro International Inc.

Health information needs in developing countries have increased to include data on broad array of diseases, conditions, and risk factors in populations. The Demographic and Health Survey (DHS) has evolved to help meet these needs. The paper reviews recent methodological innovations that have been incorporated into the DHS including the use of biological and physiological measures (biomarkers). Presentation of data resulting from these new efforts includes prevalence estimates of HIV, syphilis, and lead. The paper addresses the issue of criteria for inclusion of biomarkers in national surveys. Interview based estimates based on self-reported disease and estimates of disease derived from biomarkers are compared empirically (kappa scores) and within the broader context of data policy. The paper presents other biomarkers in surveys currently in the field for which data will be available in the near future.