Description |
The Household Questionnaire was used to list all usual residents in each sample household plus any visitors who stayed in the household the night before the interview. Some basic information was collected on the characteristics of each person listed, including age, sex, marital status, education, occupation, and relationship to the head of the household, as well as health status? The main purpose of this section of the Household Questionnaires (Ever-married women age 13-49 years). In addition, the Household Questionnaire collected information on household conditions, such as the source of water, type of toilet facilities, materials used in the construction of the house, source of lighting, cooking fuel, ownership of agricultural land and livestock, ownership of various consumer durable goods, and characteristics of the head of the household such as religion, caste or tribe. The Household Questionnaire also included household birth and death records wherein all the live births and deaths that took place within the last two years in the household were recorded.
Biomarker Measurement: The Household Questionnaire also included several biomarker measurements. Two health investigators on each survey team measured the height and weight of women age 15-49, men age 15-54, and children born since January 2000 (in states where fieldwork started in 2005) or January 2001 (in states where fieldwork started in 2006) [see Table
1.2 for the month and year of fieldwork in each state]. Height and weight data are used for assessing nutritional levels of the population. The health investigators also took blood samples from women age 15-49, men age 15-54, and children age 6-59 months to measure haemoglobin levels, which indicate the prevalence of anaemia. Haemoglobin levels were measured in the field using portable HemoCue instruments that provide test results in less than one minute. All respondents were given an informational brochure about anaemia and proper nutrition. Severely anaemic adults and children were referred to local public health facilities for treatment.
HIV testing: One of the major biomarker components incorporated in NFHS-3 was the collection of Dried Blood Spots (DBS) on filter paper cards to test for HIV. This component of the survey was included in response to the urgent need to have nationally-representative data on HIV prevalence and comprehensive information on knowledge and attitudes about HIV/AIDS, high-risk sexual behaviour, and practices related to HIV testing in India. Blood spots from a finger prick were collected on filter paper cards for HIV testing. If the respondent gave consent for blood collection for both HIV and anaemia testing, the standard protocol was to first collect 3-5 blood spots on the filter paper card for HIV testing, and then to collect an additional drop of blood from the same finger prick in a microcuvette for anaemia testing. The blood spots on filter paper cards were dried overnight in special drying boxes. The packaged filter paper cards were delivered to SRL Ranbaxy blood collections centres throughout the country, and they were shipped by courier from the blood collection centres to the SRL Ranbaxy laboratory in Mumbai for HIV testing. DBS were collected from consenting women age 15-49 and men age 15-54 to provide HIV prevalence estimates at the national level and for each of the six high HIV prevalence states identified by the National AIDS Control Organization (NACO), namely Andhra Pradesh, Karnataka, Maharashtra, Manipur, Nagaland, and Tamil Nadu. However, blood for HIV testing and anaemia testing could not be collected in Nagaland due to local opposition. It was also decided to provide estimates of HIV prevalence for one low HIV prevalence state, Uttar Pradesh.
The HIV testing was anonymous. No names or other contact information were recorded on the DBS samples. Instead, a bar code label with randomly generated numbers was pasted on the filter paper sample and on the questionnaires. Respondents were not given the HIV test results since the protocol design made it impossible for the survey staff to know the HIV status of individual participants. All of the information obtained from the household and individual interviews, however, can be linked to the HIV test results through the bar codes. In order to preserve the anonymity of the results, the original cluster and household identifiers were replaced in the data set by randomly generated cluster and household numbers. All individuals who were eligible for testing in the survey, whether they accepted the testing or not, received referrals for free HIV counseling and testing at a local health facility. |