The 2001 Nepal Demographic and Health Survey (NDHS) is a nationally representative survey of 8,726 women age 15-49 and 2,261 men age 15-59. This Survey is the sixth in a series of national-level population and health surveys conducted in Nepal. It is the second nationally representative comprehensive survey conducted as part of the global Demographic and Health Survey (DHS) program, the first being the 1996 Nepal Family Health Survey (NFHS). The 2001 NDHS is the first in the history of demographic and health surveys conducted in Nepal that included a male sample. The 2001 NDHS was carried out under the aegis of the Family Health Division of the Department of Health Services, Ministry of Health, and was implemented by New ERA, a local research organization, which also conducted the 1996 NFHS. ORC Macro provided technical support through its MEASURE DHS+ project. The survey was funded by the United States Agency for International Development (USAID) through its mission in Nepal.
The principal objective of the 2001 NDHS is to provide current and reliable data on fertility and family planning, infant and child mortality, children's and women's nutritional status, the utilization of maternal and child health services, and knowledge of HIV/AIDS. This information is essential for informed policy decisions, planning, monitoring, and evaluation of programs on health in general and reproductive health in particular at both the national and regional levels.
A long-term objective of the survey is to strengthen the technical capacity of the Family Health Division of the Ministry of Health to plan, conduct, process, and analyze data from complex national population and health surveys. The 2001 NDHS data is comparable to data collected in the 1996 NFHS and similar to survey data conducted in other developing countries. This allows for temporal and spatial comparisons of demographic health information. The 2001 NDHS also adds to the vast and growing international database on demographic and health variables. The inclusion of data on men adds to the richness of this data.
Kind of Data
Sample survey data
Unit of Analysis
- Women age 15-49
- Men age 15-59
The 2001 NDHS collected demographic and health information from a nationally representative sample of ever-married women and men in the reproductive age groups of 15-49 and 15-59, respectively. The primary focus of the 2001 NDHS was to provide estimates of key population and health indicators, including fertility and mortality rates, for the country as a whole and for urban and rural areas separately.
Unit of Analysis
- Women age 15-49
- Men age 15-59
The population covered by the 2008 DHS is defined as the universe of all women ever-married women and men in the reproductive age groups of 15-49 and 15-59
Producers and sponsors
Authoring entity/Primary investigators
Ministry of Health/New ERA
United States Agency for International Development
The survey was designed to obtain completed interviews of 8,400 ever-married women age 15-49. In addition, all ever-married males age 15-59 in every third household were interviewed. To take nonresponse into account, a total of 8,700 households nationwide were selected. The sample size was allocated to each district by urban and rural areas and the numbers of PSUs were calculated based on an average sample "take" (the number of ultimate sampled units in a cluster) of 34 completed interviews per PSU.
The 2001 NDHS collected demographic and health information from a nationally representative sample of ever-married women and men in the reproductive age groups of 15-49 and 15-59, respectively. The primary focus of the 2001 NDHS was to provide estimates of key population and health indicators, including fertility and mortality rates, for the country as a whole and for urban and rural areas separately. In addition, the sample was designed to provide estimates of most key variables for the 13 domains obtained by cross-classifying the three ecological zones (mountains, hills, and terai) with the five development regions (Eastern, Central, Western, Mid-western, and Far-western). Due to their small size, the mountain areas of the Western, Mid-western, and Far-western regions were combined.
The 2001 NDHS used the sampling frame provided by the list of census enumeration areas (EAs) with population and household information from the 1991 Population Census. Administratively, Nepal is divided into 75 districts. Each district is subdivided into village development committees (VDCs), and each VDC is divided into wards. The primary sampling unit (PSU) for the 2001 NDHS is a ward or group of wards in rural areas and subwards in urban areas. In rural areas, the ward is small enough for a complete household listing, but in urban areas, the ward size is large. It was therefore necessary to subdivide each urban ward into subwards. Information on the subdivision of the urban wards was obtained from the Living Standards Measurement Survey, a project funded by the World Bank.
The sample for the survey is based on a two-stage, stratified, nationally representative sample of households. At the first stage of sampling, 257 PSUs - 42 in urban areas and 215 in rural areas were selected using systematic sampling with probability proportional to size. During fieldwork, six PSUs in the Mid-western region were dropped from the sample due to security issues, reducing the total number of PSUs covered to 251 and reducing the number of rural PSUs to 209. This also reduced the expected number of completed interviews to 8,170 from 8,400.
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. Sketch maps were constructed to identify the relative position of housing units in an EA to help interviewers locate selected households during fieldwork. Table A.1 shows the sample distribution of PSUs.
Global positioning system (GPS) units were used to calculate latitude and longitude coordinates for each selected ward (or subward) during the household listing stage. One latitude/longitude coordinate was taken for the center of each settlement or community within the ward. The altitude reading was also taken with the GPS units. The positional accuracy of the GPS readings is approximately 5 to 10 meters for latitude/longitude and approximately 30 meters for altitude. This geographic information allows the 2001 NDHS data to be integrated into a geographic information system (GIS) along with other spatial data collected in the same localities and adds to the depth of information available from the 2001 NDHS.
At the second stage of sampling, systematic samples of 34 households per PSU on average were selected in all the regions in order to provide statistically reliable estimates of key demographic and health variables. However, since Nepal is predominantly rural, in order to obtain statistically reliable estimates for urban areas, it was necessary to oversample the urban areas. As such, the total sample is weighted and a final weighting procedure was applied to provide estimates for the different domains and for the urban and rural areas of the country as a whole.
A total of 8,864 households were selected for the 2001 NDHS, of which 8,633 were found to be occupied. Household interviews were completed for 8,602 households or more than 99 percent of the occupied households. A total of 8,885 eligible women from these households and 2,353 eligible men from every third household were identified for the individual interviews. Interviews were successfully completed for 8,726 women and 2,261 men. The response rate for eligible women is slightly higher than for eligible men (98 percent and 96 percent, respectively).
Response rates for women and men vary by urban-rural residence. Rural women and especially men are slightly more likely than urban women and men to have completed an interview. There is little difference in the response rate among women by ecological zone, but men residing in the mountain region are more likely to have completed an interview (98 percent) than men residing in the hills (95 percent) and terai (96 percent).
Dates of Data Collection (YYYY/MM/DD)
Mode of data collection
The main fieldwork started in mid-January 2001 and lasted until the end of June. Throughout the survey, senior staff from the Ministry of Health, New ERA, USAID/Nepal, and ORC Macro maintained constant contact with the teams through direct communication and spot checking. To ensure high-quality data, teams were closely supervised through field visits, observations of interviews, and checking of completed questionnaires. In addition, the quality control team visited every team in the field to followup on the quality of the data collected. Data quality was also ensured by providing feedback to individual teams on the results of field check tables. These tables were computer generated at regular intervals from data obtained in the completed questionnaires. These results were discussed with the teams to improve their performance.
Type of Research Instrument
The 2001 NDHS used three questionnaires: the Household Questionnaire, the Women's Questionnaire, and the Men's Questionnaire. The content and design of the questionnaires were based on the MEASURE DHS+ Model 'B' Questionnaire. The questionnaires were specifically geared toward obtaining the kind of information needed by health and family planning program managers and policymakers. The model questionnaires were then adapted to local conditions and a number of additional questions specific to ongoing health and family planning programs in Nepal were added. These questionnaires were developed in English and translated into the three principal languages in use in the country: Nepali (the national language), Bhojpuri, and Maithili. They were then independently translated back to English and appropriate changes were made in the translation of questions in which the back-translated version did not compare well with the original English version. A pretest of all three questionnaires was conducted in the three local languages in September 2000.
a) All usual members in a selected household and visitors who stayed there the previous night were enumerated using the Household Questionnaire. Specifically, the Household Questionnaire obtained information on the relationship to the head of the household, residence, sex, age, marital status, and education of each usual resident or visitor. This information was used to identify eligible women and men for the individual interview. Ever-married women age 15-49 in all selected households and ever-married men age 15-59 in every third selected household, whether usual residents or visitors, were deemed eligible and were interviewed. The Household Questionnaire also obtained information on some basic socioeconomic indicators such as the source of drinking water, the type of toilet facilities, the ownership of a variety of consumer durable items, and the flooring material. All eligible women and all children born since Baisakh 2052 in the Nepali calendar (which roughly corresponds to April 1995 in the Gregorian calendar) were weighed and measured.
b) The Women's Questionnaire collected information on female respondent's background characteristics; reproductive history; contraceptive knowledge and use; antenatal, delivery, and postnatal care; infant feeding practices; child immunization and health; marriage; fertility preferences; attitudes about family planning; husband's background characteristics; women's work; and knowledge of HIV/AIDS.
c) The Men's Questionnaire collected information on the male respondent's background characteristics, contraceptive knowledge and use, marriage, fertility preferences, attitudes about family planning, and knowledge of HIV/AIDS.
Family Health Division, Department of Health Services, Ministry of Health
The completed questionnaires were returned to the New ERA office in Kathmandu for data processing. The office editing staff first checked that questionnaires for all selected households and eligible respondents had been received from the field. In addition, the few questions that had not been precoded (example, occupation, ethnicity) were coded at this time. The data were then entered and edited using microcomputers and the new software CSPro, developed jointly by ORC Macro, the U.S. Bureau of Census, and SerPro Ltda. Office editing and data processing activities were initiated soon after the beginning of fieldwork and were completed by mid-July.
Nonsampling 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 2001 NDHS to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
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Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.