District Level Household
Survey
Dr K. Sushma
Introduction

The District Level Household and Facility Survey is one of the
largest demographic and health surveys carried out in India,
with a sample size of about seven lakh households covering all
the districts of the country.

The Ministry of Health and Family Welfare (MOHFW),
Government of India, initiated District Level Household
Surveys (DLHS) in 1997.

To provide district level estimates on health indicators to assist
policy makers and program administrators in decentralized
planning, monitoring and evaluation.
Introduction

DLHS -1 in 1998-99 and DLHS-2 in 2002-04. DLHS-3 in
2007-08

In addition, DLHS-3 provided information related to the
programmes of National Rural Health Mission (NRHM).

In DLHS-3, along with ever-married women age 15-49, never
married women (age 15-24) were also included as respondents.
Methodology: Rapid Household Survey(RCH)



In 1st phase of survey 50% of total districts were selected
Systematic random sampling was used for selection of
districts
Second phase covered all the remaining districts
Methodology: Rapid Household Survey(RCH)





A systematic multi-stage stratified sampling was used
40 primary sampling units (PSUs) either villages/ urban
wards were selected from each district using Probability
Proportionate to Size (PPS) sampling
The target sample size in each district was set at 1,000
complete residential households from 40 selected PSUs.
In the second stage, within each PSU, 28 residential
households were selected with Circular Systematic
Random Sampling (CSRS) procedure after house listing.
In order to take care of non-response due to various
reasons, sample was inflated by 10 percent (i.e. 1,100).
DLHS:2


DLHS II was designed to provide the district level
estimates separately for urban and rural areas.
The number of PSUs in rural and urban areas was
decided on the basis of percent of urban population in
the district. However, a minimum of 12 urban PSUs was
selected in case the percent urban population was low.
Methodology:
 Rural sampling was done with stratification of villages
into 3 strata
 <50 household
 50-300 household
 >300 household
 As per 2001 census villages with <50 household linked
with one or more adjoining villages to form PSUs with a
minimum of 50 household
 Villages with <5 households were excluded from the
sampling frame
 No replacement was made if selected household was
absent during data collection.
Instruments:


Household questionnaire:
 Information on age, sex, marital status, relationship with the
head of household, education & prevalence/ incidence of TB,
blindness & malaria
 Information on main source of drinking water, source of
lightening, type of cooking fuel, religion & caste of household
head, ownership of other durable goods in the household.
 Details of marriage & deaths, maternal deaths
 Assessment was done to see whether household used cooking
salt has been fortified with iodine
Women questionnaire:
To collect information from currently married women age 1544yrs who are usual residents of the sample household or visitors
who stayed in the sample household the night before the
interview

1)
2)
3)
Women questionnnaire
Background characteristics: Age, educational status & births
& deaths, H/O biological children including still birth, induced
& spontaneous abortion
Antenatal , natal & postnatal care: Information from only
women who have live birth, still birth, induced & spontaneous
abortion during last 3yrs preceding the survey date. Also
information on whether women received ANC & postpartum
care & who attended the delivery & nature of complications
during pregnancy for recent births were also collected.
Immunization & childcare: Feeding practices, length of
breastfeeding, immunization coverage & recent episodes of
diarrhoea& pneumonia for young children(<3yrs)
4. Contraception:
-Knowledge & use of specific family planning methods
-Reasons for non-use, intensions about future use, desire for
additional child, sex preferences for next child
5. Assessment of quality of government health services & client
satisfaction
- Assessment of quality of family planning & health services
provided by Govt
-Rating of government health facilities & staff
-Reasons for not visiting government health facilities by eligible
women
6. Awareness about RTI/ STI & HIV/ AIDs:
-Women’s knowledge about RTI/ STI & HIV/ AIDs
-Source of knowledge, awareness about modes of transmission,
curability, symptoms & t/t seeking behaviour
7. Husband questionnaire:
- In first round male questionnaire (20-54yrs) was used
instead of husband questionnaire
- In second round husband questionnaire was used
- Information was collected from eligible women’s
husband
- Husband’s age, educational status, knowledge &
source of knowledge of RTI/ STI & HIV/ AIDs,
reported symptoms of RTI/ STI & HIV/ AIDs
- Information on desires for children, reasons for not
using any family planning methods, future intension to
use any family planning methods & knowledge about
no scalpel vasectomy
Health questionnaire:
•
•
•
•
•
In 2nd round of DLHS It was included
Information on weight of children (0-72) months were taken
Haemoglobin estimation of adolesents 10-19 yrs & pregnant
women was done.
All such information helps in assessing the levels of nutrition in
the population
Prevalence of anaemia in adolescent girls & children
Village questionnaire:
Information on availability & accessibility of various facilities
in the village more focus on accessibility of educational &
health facilities
Non-response were categorized under following
conditions





Not at home
Dwelling not found
Refusal
Deliberate incapability of investigators
Hb estimation was done with Whatman No.1
filter paper
Indicator
India
Maharashtra
Wardha
DLHS
III
II
III
II
III
II
Toilet
facility
46.8
36.2
41.8
41.7
53.3
32.6
Piped
Drinking
water
39.6
88.1
52.7
62.6
56.8
52.2
Any
method
54.1
52.5
63.8
63.3
78.6
74.1
Any
modern
method
47.3
45.2
62.6
60.8
78.1
74
Female
34.4
sterilizatio
n
34.3
51.5
48.3
65.2
63.9
Male
1.0
sterilizatio
n
0.9
2.5
2.0
3.7
4.7
Indicator
India
DLHS
III
II
Maharashtra
Wardha
III
II
III
II
Mean age
f (boys)
24.2
24.5
24.5
24.6
NA
NA
Mean age
(girls)
19.9
19.4
19.4
19.1
NA
NA
Boys(<21
22.1
21.1
12.4
12.4
NA
NA
Girls(<18
21.5
28.5
17.7
21.1
0
5.5
Antenatal care (women who had live/still birth during
reference period)
Indicator
India
DLHS
III
Maharashtra
II
Wardha
III
II
III
II
Any ANC
checkup
75.3
73.6
91.8
92.9
NA
NA
ANC 1st tri
45.0
40.4
61.6
51.7
80.7
79.0
ANC checkups
3 0r more
51.0
50.4
76.0
69.2
88.2
82.2
1 TT
73.5
80.2
89.6
87.6
99.2
88.4
Full ANC
checkup
19.1
16.5
33.9
32.6
NA
NA
Delivery care (women who had live/still birth during
reference period)
Indicator
India
DLHS
Maharashtra
III
II
III
Wardha
II
III
II
Institutional
delivery
47.0
40.9
63.6
57.9
81.4
61.7
Home delivery
52.2
58.6
35.8
41.7
NA
NA
Home delivery
by skilled birth
attendant
5.6
13.5
16.0
11.3
10
15.9
PNC care within
2wks
50.8
NA
79.7
NA
NA
NA
JSY
13.6
NA
8.2
NA
NA
NA
Child Immunization
India
Indicator
III
Maharashtra
II
III
Wardha
II
III
II
Fully immunized
54.1
45.9
69.1
70.9
87.9
60.7
No vaccine
11.3
19.8
2.5
2.6
NA
NA
BCG vaccine
86.9
75.0
95.7
96.2
100
95.3
3 DTP doses
63.6
58.3
78.9
88.2
92.6
88.4
3 Polio doses
66.2
57.3
86.2
80.2
91.1
70.9
Measles
69.6
56.1
84.5
85.4
NA
NA
1 dose of Vit A at
9months
23.9
NA
70.5
71.5
90.5
NA
Children under 3
year’s breastfed
within one hour of
birth10
39.4
NA
53.3
44.3
67.7
NA
6-9mon semisolid&
breast milk
23.9
NA
46.6
NA
97.4
NA