An Assessment of the Quality of DHS Anthropometric Data, 2005-2014

82 Pages·2015·1.05 MB·English

An Assessment of the QuAlity
of Dhs Anthropometric DAtA,
2005-2014
DHS METHODOLOGICAL
REPORTS 16
septemBer 2015
This publication was produced for review by the United States Agency for International Development. It was prepared by
Shireen Assaf, Monica T. Kothari, and Thomas Pullum of ICF International.

DHS Methodological Reports No. 16
An Assessment of the Quality of DHS
Anthropometric Data, 2005-2014

Shireen Assaf
Monica T. Kothari
Thomas Pullum

ICF International
Rockville, Maryland, USA

September 2015

Corresponding author: Monica Kothari, International Health and Development Division, ICF International,
530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: [phone]; fax: [phone];
email: [email protected]
Acknowledgment:
The authors are grateful for the comments provided by Justine Kavle and Fred Arnold on an earlier version
of the report. Special thanks go to Sidney Moore for editing the text and to Natalie La Roche for formatting
the report. Finally, we would like to acknowledge all DHS survey managers and others who are responsible
for the collection and processing of the data used to produce this analysis.

Editor: Sidney Moore
Document Production: Natalie La Roche

This study was carried out with support provided by the United States Agency for International
Development (USAID) through The DHS Program (#AIDOAA-C-13-00095). The views expressed are
those of the authors and do not necessarily reflect the views of USAID or the United States Government.

The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate
population, health, and nutrition programs. For additional information about the DHS Program contact:
DHS Program, ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA. Phone: +1
301-407-6500; fax: [phone]; email: [email protected]; Internet: www.dhsprogram.com.

Recommended citation:

Assaf, Shireen, Monica T. Kothari, and Thomas Pullum. 2015. An Assessment of the Quality of DHS
Anthropometric Data, 2005-2014. DHS Methodological Reports No. 16. Rockville, Maryland, USA: ICF
International.
Contents
Tables ......................................................................................................................................................... v
Figures ....................................................................................................................................................... vii
Preface ........................................................................................................................................................ ix
Abstract ........................................................................................................................................................ xi
Executive Summary ................................................................................................................................... xiii
1. Introduction ...................................................................................................................................... 1
1.1 Growth Reference Standards and Flags .............................................................................. 2
1.2 Anthropometry Data Quality Measures .............................................................................. 3
2. Methods and Data ............................................................................................................................ 7
2.1 Data ..................................................................................................................................... 7
2.2 Methods Used for Assessing Data Quality in This Analysis .............................................. 8
3. Results ............................................................................................................................................ 11
3.1 Anthropometric Estimates ................................................................................................ 11
3.2 Z-score SDs ....................................................................................................................... 18
3.3 Heaping of Height, Weight, and Age ................................................................................ 26
3.4 DHS Flags ......................................................................................................................... 30
3.5 Summarizing the Data Quality Indicators ......................................................................... 32
3.6 Bivariate SD Results ......................................................................................................... 34
3.7 Regression Results ............................................................................................................ 38
4. Discussion ............................................................................................................................................... 43
5. Conclusion and Recommendations ......................................................................................................... 45
References ................................................................................................................................................... 47
Appendix A: Standard deviations of height-for-age z-scores (HAZ) ......................................................... 49
Appendix B: Standard deviations of weight-for-height z-scores (WHZ) ................................................... 51
Appendix C: Heaping indices for height and weight measurements in 52 DHS surveys ........................... 53
Appendix D: Myers’ heaping Index of age in 52 DHS surveys ................................................................. 55
Appendix E: WHO flags and height out of plausible limits in 52 DHS surveys ........................................ 57
Appendix F: Mean and standard deviations of the z-scores by background variables in
7 DHS countries ..................................................................................................................... 59
Appendix G: HAZ linear regressions for 52 DHS surveys ........................................................................ 61
Appendix H: WAZ linear regressions for 52 DHS surveys ........................................................................ 63
Appendix I: WHZ linear regressions for 52 DHS surveys ......................................................................... 65
iii

Tables
Table 1. Anthropometric indicators of children age 0-59 months using WHO flags, DHS surveys
2005-2014 ................................................................................................................................ 11
Table 2. Countries with the highest values on the 10 measures of z-score standard deviations,
height, weight and age, Myers’ index, and flagged cases, ranked from highest to lowest
values, DHS surveys 2005-2014 ............................................................................................. 33
Table 3. Countries with the lowest values on the 10 measures of z-score standard deviations,
height, weight and age, Myers’ index, and flagged cases, ranked from lowest to highest
values, DHS surveys 2005-2014 ............................................................................................. 33
Table 4. Summary of HAZ linear regressions for 52 DHS surveys 2005-2014 .................................... 38
Table 5. Summary of WAZ linear regression for 52 DHS surveys 2005-2014..................................... 39
Table 6. Summary of WHZ linear regression for 52 DHS surveys 2005-2014..................................... 39
Table 7. R-squared values of the HAZ regressions before and after including the cluster variable
with the adjusted HAZ SD, 52 DHS surveys 2005-2014 ........................................................ 41
Table A. Standard deviations of height-for-age z-scores (HAZ) for measured children under
two years of age and measured children two years of age and over in 52 DHS surveys
(2005-2014) ............................................................................................................................. 49
Table B. Standard deviations of weight-for-height z-scores (WHZ) for measured children under
two years of age and measured children two years of age and over in 52 DHS surveys
(2005-2014) ............................................................................................................................. 51
Table C. Heaping indices for height and weight measurements in 52 DHS surveys (2005-2014) ........ 53
Table D. Myers’ heaping Index of age in 52 DHS surveys (2005-2014) ............................................... 55
Table E. WHO flags and height out of plausible limits in 52 DHS surveys (2005-2014) ..................... 57
Table F. Mean and standard deviations of the z-scores by background variables in 7 DHS countries
(2005-2014) ............................................................................................................................. 59
Table G. HAZ linear regressions for 52 DHS surveys (2005-2014) ...................................................... 61
Table H. WAZ linear regressions for 52 DHS surveys (2005-2014) ..................................................... 63
Table I. WHZ linear regressions for 52 DHS surveys (2005-2014) ..................................................... 65

v

Figures
Figure 1. Percentage of children age 0-59 months who are stunted, DHS surveys 2005-2014 .............. 13
Figure 2. Percentage of children age 0-59 months who are underweight, DHS surveys 2005-2014 ..... 14
Figure 3. Percentage of children age 0-59 months who are wasted, DHS surveys 2005-2014 .............. 15
Figure 4. Percentage of children age 0-59 months who are overweight, DHS surveys 2005-2014 ....... 17
Figure 5. Standard deviations of height-for-age (HAZ) z-scores, DHS surveys 2005-2014 .................. 19
Figure 6. Standard deviations of weight-for-age (WAZ) z-scores, DHS surveys 2005-2014 ................ 21
Figure 7. Standard deviations of weight-for-height (WHZ) z-scores, DHS surveys 2005-2014 ............ 22
Figure 8. Standard deviations of height-for-age z-scores (HAZ) for children under 2 years and
children 2 years and over, DHS surveys 2005-2014 ............................................................... 24
Figure 9. Standard deviations of weight-for-height z-scores (WHZ) for children under 2 years and
children 2 years and over, DHS surveys 2005-2014 ............................................................... 25
Figure 10. Myers’ Index for height and weight for children 0-59 months, DHS surveys 2005-2014 ...... 27
Figure 11. Myers’ Index for age for children age 0-59 months, DHS surveys 2005-2014 ...................... 29
Figure 12. Percentage of children 0-59 months with WHO flags and flags for height out of plausible
limits, DHS surveys 2005-2014 .............................................................................................. 31
Figure 13. Standard deviations of height-for-age (HAZ) by background variables, DHS surveys
2005-2014 ................................................................................................................................ 35
Figure 14. Standard deviations of weight-for-age (WAZ) by background variables, DHS surveys
2005-2014 ................................................................................................................................ 36
Figure 15. Standard deviations of weight-for-height (WHZ) by background variables, DHS surveys
2005-2014 ................................................................................................................................ 37
Figure 16. Standard deviations of height-for-age (HAZ) z-scores before and after adjusting for cluster
heterogeneity with percent reduction, 52 DHS surveys 2005-2014 ........................................ 42

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