DOI: 10.57761/4h2m-3179
title: District Level Household & Facility Survey (DLHS)

description: The District Level Household and facility Survey (DLHS) is a household survey at the district level and in DLHS-3, the survey covered 611 districts in India. The total number of households representing a district varies from 1000 to 1500 households. The DLHS-3 is designed to provide information on family planning, maternal and child health, reproductive health of ever married women and adolescent girls, utilization of maternal and child healthcare services at the district level for India. In addition, DLHS-3 also provides information on new-born care, post-natal care within 48 hours, role of ASHA in enhancing the reproductive and child health care and coverage of Janani Suraksha Yojana (JSY). An important component of DLHS-3 is the integration of Facility Survey of health institution (Sub centre, Primary Health Centre, Community Health Centre and District Hospital) accessible to the sampled villages. The focus of DLHS-3 is to provide health care and utilization indicators at the district level for the enhancement of the activities under National Rural Health Mission (NRHM).
description: #Documentation  
You can access the data at the [International Institute for Population Sciences](<http://rchiips.org/obtainingdata.html>).\



**Methodology**

**Survey design and sample size**

The survey as well as the preparation of reports was carried out in two separate phases. Approximately 50 percent of the districts from each state and union territory were covered in each phase. The survey for phase I was carried out from May to November, 1998 and for phase II it was carried out from to October, 1999. In the first phase of the RHS, 50 percent of the total districts in India as existing in 1995 were selected for the survey. Systematic random sampling was adopted for the selection of the districts for phase1. For selection purposes, districts within the state were arranged alphabetically, and starting at random from either first or second district, alternative districts were selected. The second phase covered all the remaining districts of the country.

In each of the selected districts, 50 Primary Sampling Units (PSUs), i.e. either villages or urban wards were selected adopting probability proportional to size (PPS) sampling. The village/ ward level population as per the 1991 census was used for this purpose. The sample size for DLHS-DLHS was fixed at 1000 households with 20 households from each PSU. In order to take care of non-response due to various reasons, 10 percent over sampling was done. In other words, 22 households from each PSU were selected. The selection of the households in a PSU was done after listing of all the households in the PSUs. For the selection of households circular systematic random sampling was adopted. In the first phase the work of drawing sample of PSUs was entrusted to the Institute of Research in Medical Statistics (IRMS), New Delhi and in the second phase IIPS did the sampling of PSUs in all the districts.

**House listing**

House listing involved the preparation of a location map of each PSU and layout sketch of the structures and recording details of the households in the village/census enumeration block. An independent team comprising of one lister and one mapper carried out the houselisting exercise.

Complete listing was carried out in villages with population up to 1500. In the case of larger villages, with more than 1500 population, the village was divided into two or more segments of equal size, one segment was selected at random for listing and in the selected segment complete listing was carried out. In the urban wards with population exceeding 1500 one census enumeration block was selected at random.

** ****Questionnaires**

Two types of questionnaires were used in the survey: the household questionnaire and the woman’s questionnaire. IIPS in consultation with MoHFW and World Bank decided the overall contents of the questionnaires. These questionnaires were discussed and finalized in training-cum-workshop organized at IIPS during the third week of May 1998. Representatives of Regional Agencies, MoHFW, IIPS and World Bank participated in this workshop. IIPS carried out pre-testing of these questionnaires in Maharashtra. Questionnaires were also pre-tested in different languages by regional agencies. Though the overall contents of questionnaire for both the phases were the same, there were some changes in the second phase. The changes were mainly regarding ordering and phrasing of the questions. The household questionnaire was used to list all the eligible women in the selected households (*de jure*) and to collect information on marriages and births among the usual residents. In the first phase the reference period for the recording of marriages and births was from 1st January 1995 to survey date and in the second phase it was from 1st January 1996 to survey date. For all the marriages reported in the survey, age at marriage of boy/ girl of that household who got married was recorded. Besides, details of births like, date of birth, sex of the child, order of the birth, survival status and age at death in case if child was dead were also collected. In addition, the questionnaire contained questions on socio-economic characteristics of the households, and the incidence/ prevalence of malaria, tuberculosis and leprosy. In the second phase of the survey more details of household economic conditions like possession of some of the consumer durables were collected. The information on an Auxiliary Nurse Midwife’s (ANM’s) visit to counsel unmarried adolescent girls on reproductive health issues and distribution of Iron and Folic Acid (IFA) tablets to the girls having anemia was also collected in the household questionnaire.

The household questionnaire had a separate section for males age 20-54 years (irrespective of their marital status), which was administered to one male from each sampled household. The information covered in this section includes knowledge of RTI, STI and HIV/AIDS, reported symptom(s) of RTI/STI and attitude towards male participation in family planning. The woman’s questionnaire was administered to all the eligible women in the household (listed in the household questionnaire). In DLHS an eligible woman has been defined as a currently married woman aged 15-44 years who is a usual resident of the sampled household and whose marriage has been consummated. The woman’s questionnaire had the following sections:

- Woman’s characteristics and summary of fertility history
- Antenatal, natal and post natal care
- Immunization and child care
- Contraception
- Utilization of government health services and client satisfaction
- Awareness of RTI, STI and HIV/AIDS

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The questionnaires were both in English and in regional languages.

IIPS prepared the survey questionnaires and a manual for house listing and one for field investigators. The software package for data entry was developed at IIPS. IIPS prepared tabulation plans for the district, state and national reports. The software package for district level tabulation was developed by IRMS, New Delhi and for the state level it was developed at IIPS. The model district-level and state level reports were prepared at IIPS and were given to the regional agencies. This report presents the status of DLHS services and indicators in India, combining data collected in both the phases.