The Bangladesh Demographic and Health Survey 2011 (BDHS 2011) was the sixth DHS undertaken in Bangladesh, following those implemented by Mitra in 2006-2007, 1993-94, 1996-97, 1999-2000, and 2003-04. BDHSs were a complex surveys. The 2011 BDHS was even more complex including a larger sample and adding the biomarker component. 

The main objectives of the BDHS-2011 survey were 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. The specific objectives were to provide up-to-date data on demographic rates, particularly fertility and infant mortality rates, at the national and sub-national level; analyze the direct and indirect factors that determine the level of and trends in fertility and mortality; to measure the level of contraceptive use of currently married women; to provide data on knowledge and attitudes of women and men about sexually transmitted infections and HIV/AIDS; to assess the nutritional status of children (under age 5), women, and men by means of anthropometric measurements (weight and height), and to assess infant and child feeding practices; to provide data on maternal and child health, including antenatal care, assistance at delivery, breastfeeding, immunizations, and prevalence and treatment of diarrhea and other diseases among children under age 5; to measure biomarkers, such as hemoglobin level for women and children, and blood pressure, and blood glucose for women and men 35 years and older; to measure key education indicators, including school attendance ratios and primary school grade repetition and dropout rates; to provide information on the causes of death among children under age 5; to provide community-level data on accessibility and availability of health and familyplanning services; and to measure food security.

The sample for the 2011 BDHS was nationally representative and covers the entire population residing in non institutional dwelling units in the country. The survey used as a sampling frame the list of enumeration areas (EAs) prepared for the 2011 Population and Housing Census, provided by the Bangladesh Bureau of Statistics (BBS). The primary sampling unit (PSU) for the survey is an EA that was created to have an average of about 120 households. Bangladesh has seven administrative divisions: Barisal, Chittagong, Dhaka, Khulna, Rajshahi, Rangpur, and Sylhet. Each division is subdivided into zilas, and each zila into upazilas. Each urban area in an upazila is divided into wards, and into mohallas within a ward. A rural area in the upazila is divided into union parishads (UP) and mouzas within a UP. These divisions allow the country as a whole to be easily 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 clusters in urban areas and 393 in rural areas. A complete household listing operation was then carried out in all 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. In addition, in a subsample of one-third of the households, all ever married men age 15-54 were selected and interviewed for the male survey. In this subsample, a group of eligible members were selected to participate in testing of the biomarker component, including blood pressure measurements, anemia, blood glucose testing, and height and weight measurements.

The major tasks carried out were: selection of cluster, conducting household listing and drawing of sample for household interview; translation of survey questionnaires; pre-testing and finalization of questionnaires; recruitment and training of the field staff; preparation of manual; data collection through face-to-face interview, testing of bio-marker component including blood pressure measurements, anemia, blood glucose testing, and height and weight measurements; data processing, analysis of data and assisting writing of the final report.

Training and Fieldwork

Forty-seven people were trained to carry out the listing of households, to delineate Enumeration Areas (EAs), and to administer Community Questionnaires. They were also trained in the use of global positioning system (GPS) units, to obtain locational coordinates for each selected EA. The training lasted a total of seven days from May 11-21, 2011. A household listing operation was carried out in all selected EAs from May 22 to October 5, 2011 in four phases, each about three weeks in length. Initially, 19 teams of two persons each were deployed to carry out the listing of households and to administer the Community Questionnaires. The number of teams was reduced to 15 in the second and third phases and to 6 in the final phase. In addition, six supervisors were deployed to check and verify the work of the listing teams.

The Household, Woman’s and Man’s Questionnaires were pre-tested in March 2011. Four supervisors, 10 interviewers, and 4 biomarker staff were trained for the pretest. The questionnaires were pre-tested on 100 households, 100 women, and 70 men in one urban and one rural cluster in Comilla District and one urban and one rural cluster in Dhaka. Based on observations in the field and suggestions made by the pretest teams, revisions were made to the wording and translations of the questionnaires. Training for the main survey was conducted for four weeks from June 6 to July 5, 2011. A total of 173 fieldworkers were recruited based on their educational level, prior experience with surveys, maturity, and willingness to spend up to six months on the project. Training included (1) lectures on how to conduct an interview and complete the questionnaires, (2) mock interviews by participants, and (3) field practice.

Fieldwork for the 2011 BDHS was carried out by 16 interviewing teams, each consisting of one supervisor, one field editor, five female interviewers, two male interviewers, and one logistics staff member. Data collection was implemented in five phases, starting on July 8, 2011 and ending on December 27, 2011. In addition, from January 2-19, 2012 there were re-visits to collect blood samples from respondents interviewed during Ramadan who had agreed to participate in blood testing, but declined to be tested during Ramadan. 

Data quality was ensured through four quality control teams, each comprised of one male and one female staff person. In addition, NIPORT monitored fieldwork by using extra quality control teams. Data quality was also monitored through field check tables generated concurrently with data processing. This was an advantage because the quality control teams were able to advise field teams of problems detected during data entry. In particular, tables were generated to check various data quality parameters. Fieldwork was also monitored through visits by representatives from USAID, ICF International, and NIPORT.

Data Processing

The completed 2011 BDHS questionnaires were periodically returned to Dhaka for data processing at Mitra and Associates offices. The data processing began shortly after the start of fieldwork. Data processing consisted of office editing, coding of open-ended questions, data entry, and editing of inconsistencies found by the computer program. The data were processed by 16 data entry operators and two data entry supervisors. Data processing commenced on July 23, 2011 and ended on January 15, 2012. Data processing was carried out using the Census and Survey Processing System (CSPro), a joint software product of the U.S. Census Bureau, ICF International, and Serpro S.A.

Coverage of the Sample

Table 1.3 shows the results of the household and individual women’s and men’s interviews. From a total of 17,964 selected households, 17,511 were found to be occupied. Interviews were successfully completed in 17,141 households, or 98 percent of all the occupied households. A total of 18,222 ever married women age 12-49 were identified in these households, and 17,842 were interviewed, yielding a response rate of 98 percent. In one-third of the households, ever-married men over age 15 were eligible for interview. Of the 4,343 eligible men, 3,997, or 92 percent, were successfully interviewed. The 2011response rates were similar to those in the 2007 BDHS. The principal reason for non-response among women and men was their absence from home despite repeated visits to the household. The response rates do not vary notably by urban-rural residence.

Under a contract awarded by ICF Macro International, USA, Mitra implemented the survey under the authority of NIPORT/Govt. of Bangladesh and funded by USAID. Duration of the project was from December 15, 2010 to April 01, 2012 and contract value was US $449,622.

Contact reference:

ICF Macro International Inc; USA and funded by USAID. Ref: Anne Cross, Demographic and Health Surveys, ICF Macro, 11785 Beltsville Drive #300, Calverton, MD  20705, USA, Tel: (301) 572-0939, Fax: (301) 572-0999, Email: across@icfi.com,