Instructor Guide dhsc9

INSTRUCTOR’S GUIDE
Understanding and Using

the Demographic and Health Surveys
DHS Curriculum
Facilitator’s Guide
March 2014
About the DHS Curriculum Facilitator’s Guide
The following persons (in alphabetical order) have contributed to developing, reviewing, and
editing Understanding and Using the Demographic and Health Surveys – DHS Curriculum
Facilitator’s Guide: Sarah Balian, Thada Bornstein, Sarah Bradley, Anne Cross, Joy Fishel, Lia
Florey, Debbie Gachuhi, Hannah Guedenet, Kiersten Johnson, Shane Khan, Laurie Liskin, Erica
Nybro, Cameron Taylor, and Sally Zweimueller
The DHS Curriculum Facilitator’s Guide is a comprehensive package of ready-made training

materials about understanding and using Demographic and Health Survey reports. The
curriculum is designed for use in African universities and with public health program staff. Over
25 hours of instruction are divided into eight stand-alone modules designed to be a course on
its own or customized and integrated into existing curricula. Each module is complete with
instructor guides, Power Point slides, exercises, handouts, pre and post tests and answer keys.
The DHS Curriculum Facilitator’s Guide is available in both print and electronic versions.
Questions and comments regarding the DHS Curriculum can be sent to

curriculum@dhsprogram.com
About The DHS Program

The DHS Program assists countries worldwide in the collection and use of data to monitor and
evaluate population, health, and nutrition programs. Funded by the U.S. Agency for
International Development (USAID) under the terms of Contract No. GPO-C-00-08-00008-00,
The DHS Program is implemented by ICF Macro in Rockville, Maryland. The opinions expressed
herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for
International Development.
The main objectives of The DHS Program are:

1) to provide decision makers in survey countries with information useful for informed
policy choices
2) to expand the international population and health database
3) to advance survey methodology
4) to develop in participating countries the skills and resources necessary to conduct
quality demographic and health surveys
Information about The DHS Program or the status of The DHS Program surveys is available on
the Internet at http://www.dhsprogram.com or by contacting:
ICF International
530 Gaither Road, Suite 500
Rockville, MD 20705 USA
Telephone: 301-572-0200
Fax: 301-572-0999
Email: info@dhsprogram.com
Suggested citation
2014. Understanding and Using the Demographic and Health Surveys – DHS Curriculum
Facilitator’s Guide: Instructor’s Guide, March 2014. Rockville, Maryland, USA: ICF International.
Module Description Time
1 Introduction to Demographic and Health 4 hours, 45
Surveys (DHS) minutes
2 Basic Statistics and Demographic and 2.5 hours
Health Terms for Understanding DHS
Data
3 Indicators and the DHS 4 hours
4 Conducting a DHS 3 hours
5 Understanding DHS Tables and Figures 3 hours
6 Collecting Data on HIV/AIDS in National 4.5–6.5 hours
Surveys
7 Collecting Data on Malaria in National 3 hours
Surveys
8 Dissemination and Using Data for 4 hours
Change
Tips for the Instructor
Introduction
Welcome to a five-day course on “Understanding and Using Demographic and

Health Surveys.” This course was designed for the African Network for Strategic
Communication in Health and Development (AfriComNet). It was developed by
ICF International (www.icfi.com) and the Johns Hopkins Bloomberg School of
Public Health Center for Communication Programs (JHU/CCP) (www.jhuccp.org).
The development of the course was funded by the United States Agency for
International Development (USAID).
This course is part of a certificate program in Strategic Communication for

Health and Development with a Special Emphasis on HIV and AIDS. The course
will be offered at several universities in sub-Saharan Africa.
Audience
This course is intended primarily for undergraduate or graduate students in

African university programs who are specializing in health and social
development studies. It is also intended for government and non-governmental
program managers working in health and development who would like to update
their skills and knowledge in using DHS surveys.
Prerequisites
• Basic university course work in social sciences
• Skills in arithmetic, including computing fractions, percentages, and
averages
• Interest in public health and development
Goal
The goal of this course is to introduce potential users to the DHS and help them
use DHS results in their schoolwork and professional work.
A secondary goal is to enable developers of health communication campaigns to

improve the way they analyze, design, and develop materials and interventions
by learning how to interpret and use data from the DHS.
Understanding and Using Demographic and Health Surveys i

Overall Course Objectives
By the end of this course, participants should be able to:

• Describe the DHS and other national surveys supported through The DHS
Program
• Describe how DHS surveys are carried out
• Define common statistical and public health terms used in the DHS
• Correctly read and interpret DHS tables and figures
• Describe types of information collected about HIV and malaria in the DHS
• Identify methods for disseminating and using survey results for public
health and development programs
Organization of the Course
This is a five-day course designed in modular form. Each module includes an

Instructor Guide, PowerPoint presentation, handouts, pre-test, and post-test.
If you plan to use all of the modules in the course, following the existing order is
recommended. However, any of the modules can be used individually and
adapted as needed. You can use specific modules to meet learners’ needs. If
they need information on indicators, for example, you can use Module 3. If they
need information on what surveys are and what the DHS is, you can use Module
1. Pre-tests and post-tests provide sample questions for each module. The
instructor is at liberty to use all the test questions or pick and choose among
questions.
A suggested daily agenda follows this introduction. It estimates how much time
each session might take, but the time given is approximate. Depending on the
level and competence of the participants, you may want to increase or decrease
the time allocated. Use your best judgment to determine this.
How to Use This Course
The course includes eight modules, each of which is divided into sessions. The
average session lasts one to two hours. Course materials contain both the
content as well as methods to present it. The course is designed to be
participatory, because participants learn better when taking an active role.
Each module requires some preparation on the instructor’s part; this is listed at
the beginning of the Instructor Guide for each module. Some activities have
accompanying handouts that should be photocopied for participants. All of the
PowerPoint presentations have accompanying notes that can be found in the
Instructor Guide or in the PowerPoint electronic files.
Understanding and Using Demographic and Health Surveys ii

To tailor the course to the needs of your participants:
• Familiarize yourself with the entire course prior to conducting any
sessions. Although the content is scripted, it is better to put it into your
own words. You know your students best; reading through the material
and anticipating their potential questions can help ensure that the
sessions move smoothly. Feel free to use the margins in the Instructor
Guide and handouts to write additional notes to yourself.
• Decide which questions you will use for the pre- and post-tests for each of
the eight modules.
• Prepare materials beforehand for activities. Most require no more than
flipchart paper and markers, but some activities also require index cards,
masking tape, extra paper, scissors, or a basket or a container of some
sort.
• Make a “Question Box” or “Suggestion Box” available to participants
throughout the duration of the training. (You can use a plain or decorated
cardboard box with a slot in the top.) Encourage participants to write
down any questions they have and drop them in the box. Assure them
that there is no such thing as a “dumb question.” Giving participants an
opportunity to ask questions anonymously can help you address any
concerns promptly and appropriately. Check the box daily, and address
any questions submitted on the following day.
• Have a sheet of flipchart paper known as the “parking lot,” where you
write down issues that you do not wish to address immediately but that
require further discussion and clarification. Cross off each issue as it is
handled or resolved.
• The course is designed to be as interactive as possible. The curriculum
includes many different ways to do this. However certain activities may
need to be modified based on the number of students in the classroom.
The course materials are available in both soft (electronic) and hard copies. Feel
free to adapt the materials to suit the needs of the participants.
This course is based on the following premises:
• Participants are responsible for their own learning.
• A collegial relationship among participants and between participants and
the instructor is crucial.
• Feedback from the instructor guides participant learning.
• Feedback from participants provides valuable information about how well
learning is taking place.
• People differ in their learning styles and the additional knowledge and
skills they need to learn.
Understanding and Using Demographic and Health Surveys iii

• The instructor should be able to present
information effectively using interactive
techniques, facilitate small group The modules take varying lengths
activities, and maintain a positive learning of time to complete. You may end a
environment. day halfway through a module. It is
• Classroom activities are the beginning of a good idea to do an “Eyes and
learning and not the end. Ears” activity (see Annex) to start
each day. This can help participants
While effective facilitation may be an art, several
key insights and principles can be drawn from process and recall important
experience: concepts from the day before.
• Effective discussion takes place in an
atmosphere of trust.
• Material learned in-depth with heart and head stays. Broad-based lists of
facts, techniques, and theories tend to fade. Thoroughness and depth
compensate for the sacrifice in breadth.
• Participants learn best when they are actively involved: they learn by
doing.
• Learning is a team activity.
Setting the Tone for the Course
As all good instructors know, setting an appropriate tone is one of the most
important tasks in creating an effective learning environment. That environment
includes both the physical setting and an atmosphere of collegiality and safety.
Physically, the classroom is best arranged so that participants can work in
groups at tables, rather than in a traditional classroom style with rows of
individual desks facing front.
Participant-centered learning: This course has been designed with a

participant-centered orientation. When participants feel their needs and concerns
are being addressed, they are more interested and engaged in learning. The
participant asks, "What's in it for me?" or "How does this help me?" As the
instructor, you should look at the course from the perspective of the participants
and how it benefits them. Be open to their needs and make adjustments to help
them as the training unfolds.
Status: Probably the most important element in setting the tone for the course
is helping participants leave their status at the door. Every participant—including
the youngest and the oldest, men and the women, the shy and the outgoing—
must feel that their contribution to the learning process is necessary and
wanted. Encourage participants to enter the course as people ready to learn
from each other, ready to gain new insights, and ready to take away new ideas.
It is difficult to achieve this openness and sharing if participants are worried
Understanding and Using Demographic and Health Surveys iv

about status, rank, and hierarchy. It is up to the instructor to model that
everyone is here to share and that there is no place for status in a true learning
environment. This issue is more relevant for participants who are already in the
workforce than for university students, although gender issues certainly apply to
both groups.
Making it your own: Good curricula are dynamic and should always be
reviewed prior to each use so that you can adapt them to the specific needs of
each set of participants. The curriculum should be fluid; the instructor should not
read from the text notes verbatim. Be sure to set aside enough time to prepare
for each module by reviewing the materials carefully and thoroughly. The
curriculum provides as much information as possible, but it is up to you, the
instructor, to make it your own, to be committed to learning the material, and to
become a resident expert for the class. Please add your own experience, stories,
and complementary content to enhance the learning for participants.
Important Advice: Some sessions may be relatively long or challenging, so it

is important to recognize when participants need a break. Use your discretion to
decide when to conduct energizers to keep your participants engaged; this will
help ensure the success of the course. A wide variety of energizers and warm-
ups can be found in the Annex.
Good luck and enjoy the course!
Understanding and Using Demographic and Health Surveys v

Proposed Daily Agenda (times are approximate)
Day 1 Day 2 Day 3 Day 4 Day 5

Word of Module 3 Pre- Module 4 Module 6 Module 7
welcome test (continued) (continued) (continued)
official opening
Module 3: Module 4 Post- Module 7 Post-
Module 1 Pre- Indicators and test test
8:00-
test the DHS (4
10:00
hours) Module 5 Pre-
Module 1: test
Introduction to
DHS (4 hours,
45 min.)
10:00-
Nutrition break Nutrition break Nutrition break Nutrition break Nutrition break
10:30
Module 8 Pre-
Module 3
Module 1 test
(continued)
(continued) Module 5: Module 6
10:30- Understanding (continued) Module 8:
Module 3 Post-
1:00 Module 1 Post- DHS Tables and Disseminating
test
test Figures (3 hours) and Using Data
for Change (4
hours)
1:00-
Lunch Lunch Lunch Lunch Lunch
2:00
Module 2 Pre- Module 4 Pre- Module 5 Module 6
test test (continued) (continued) Module 8
(continued)
Module 2: Basic Module 4: Module 5 Post- Module 6 Post-
2:00- Statistics and Conducting a test test
4:00 DHS Terms for DHS (3 hours)
Understanding Module 7 Pre-
DHS Data (2.5 test
hours)
4:00-
Nutrition break Nutrition break Nutrition break Nutrition break Nutrition break
4:15
Module 6 Pre- Module 7: Module 8
test Collecting Data (continued)
Module 2 on Malaria in
Module 4
(continued) Module 6: National Surveys Module 8 Post-
4:15- (continued)
Collecting Data (3 hours) test
5:15
Module 2 Post- on HIV/AIDS in
test National Surveys
(4.5 to 6.5
hours)
5:15- Daily evaluation Daily evaluation Daily evaluation Daily evaluation Final evaluation
5:30
Understanding and Using Demographic and Health Surveys vi

Annex
Icebreakers and Energizers
The first day of a course is essential to its success. It is important to start the
course on a positive note by making sure all of the participants feel comfortable
and get to know one another quickly. Even when participants already know one
another, they must still be introduced to the instructor. Activities known as
icebreakers can help the instructor and participants get to know one another at
the beginning of a course.
It is also important to keep participants alert and engaged throughout the
course. They may need some breaks to help maintain their interest in the
material. Activities known as energizers can encourage high levels of
participation and interest among participants. Some of the energizers include
activities that can help participants recap material already covered in the course;
these are especially helpful when a module or session is split over the course of
two days, and participants need to refresh their memories.
The following series of icebreakers and energizers can be used throughout the
course. Remember, it is your job as the instructor to keep the participants
comfortable and energized, so be sure to use these fun activities!
Icebreakers
1. Unique Characteristics
The instructor divides the participants into pairs and gives them a few minutes
to interview each other. Then each participant introduces her/his partner by
name and shares at least two unique characteristics about her/him with the
group.
2. Your Favorite Things

The instructor divides the participants into pairs and asks them to tell each other
their favorite food or name the animal they feel best describes themselves and
why. Then each participant introduces her/his partner and shares this
information with the group.
3. Ball Toss
Participants and the instructor form a circle and toss a soft ball around the circle.
As each person catches the ball, s/he states her/his name. After a few minutes,
the game shifts and participants call out the name of the person who tossed the
ball to them instead.
This activity can be used throughout the course for other kinds of quick
information exchanges. For example, the instructor may ask, "What are
examples of behavior change indicators?" As the ball is tossed around the circle,
participants who catch it call out different indicators.
Understanding and Using Demographic and Health Surveys A-1

Annex: Icebreakers and Energizers
Annex
4. Three Questions
Each participant writes down three questions and then finds someone in the
room they do not know well. These pairs pose their questions to each other.
Then each participant introduces her/his partner to the group by sharing the
questions and the answers.
5. Nametags
The instructor prepares a nametag for each participant and places the nametags
in a box. Participants pick a nametag from the box, locate the person whose
nametag they drew, and introduce themselves. (This is especially useful for
larger groups of 20 or more.)
6. Find the Missing Piece

The instructor prepares enough pieces of paper for everybody in the group. Each
piece of paper has half of a larger word written on it. For example:
COCOA BUTTER
MILE STONE
ICE CREAM
Participants pick a piece of paper and then begin to look for the person who has
the matching word. After finding their match, participants get to know the other
person. Afterwards participants introduce one another to the rest of the group.
An alternative is to use words that are opposites. For example:
BLACK WHITE
UP DOWN
LEFT RIGHT
HOT COLD
7. Fact or Fiction
Each participant writes down four facts about themselves, one of which is not
true. Participants take turns reading their lists aloud, and the rest of the group
tries to guess which “fact” is not true. Repeat until each participant has shared
their list.
8. Everyone's a Liar
(This is a variation on #7: Fact or Fiction)
Step 1: The instructor writes three statements about her/himself on the board.
Two are true, and one is a lie.

Annex
For example:
• I have been training for 10 years.
• I have a pet dog called "Dog."
• I lived in Switzerland for a year.
Step 2: Participants ask "lie detector" questions to get further information in
order to determine which statement is false. For example:
• Training: Where have you conducted training? What have you taught?
What year did you start?
• Pet: How old is Dog? What does Dog eat? Where do you keep Dog?
• Switzerland: Where did you live in Switzerland? What language was
spoken in that part of Switzerland?
Step 3: Participants vote on which statement is a lie. The instructor reveals
which statements are true and which is a lie.
Then the instructor divides participants into small groups of three or four. Each
group repeats Steps 1–3. Afterwards, the participants introduce each other to
the larger group.
9. What's the Question?

Step 1: The instructor writes some personal facts on the board. For example:
• Purple
• 16 months
• Kenya
Step 2: Participants try to think of the question that matches each fact. For
example:
• Purple: What's your favorite color? What color is your car? What color
is your favorite clothing?
• 16 months: How long have you lived in this city? How old is your child?
How long have you been married?
• Kenya: Where were you born? Where have you worked? Where are
you going on vacation?
Step 3: After participants have discovered all of the questions, the instructor
divides them into small groups of three or four. Each group repeats Steps 1 and
2. Afterwards, the participants introduce each other to the larger group.
10. Nonsense Name Game

The instructor introduces her/himself to the group with a sentence based upon
the first letter of her/his name.

Annex
For example:
"I'm kooky Katherine. I like kissing kittens."
"I'm darling Dorothy. I like dancing daily."
(Pattern: I'm ADJECTIVE NAME. I like ACTION-ing NOUN)
Then the instructor asks each participant to introduce her/himself to the group
with a similar sentence; for example, "I'm generous George. I like giving gifts."
You can play Name Chain as a follow-up to the Nonsense Name Game.
Participants stand in a circle. The instructor introduces her/himself and the
person to the right: "I'm kooky Katherine. This is darling Dorothy." The person
standing to the instructor’s right then repeats the previous introductions and
introduces the person to her/his right: "She's kooky Katherine. I'm darling
Dorothy. He's generous George." The game continues around the circle, moving
right, until all of the names have been repeated. The instructor can challenge
volunteers to see who can rhyme off all of the names the quickest.
11. The Magic Wand

The instructor asks participants what they would do if they found a magic wand
that allowed them to change three work-related activities. Participants can
change anything they want—including themselves, their job, their supervisor,
the people they work with, an important project, etc. The instructor has the
participants discuss why it is important to make the change.
Another variation on this game is to ask participants what they would change if
they became the supervisor for a month.
This activity helps participants learn about each others' desires and frustrations.
12. Marooned
The instructor divides the participants into teams and asks them to pretend they
are marooned on an island. Each team must choose which five items they would
have brought with them if they knew they were going to be stranded. (The
instructor can substitute a different number of items, such as seven, depending
upon the size of each team.) Note that participants are only allowed five items
per team, not per person. Each team writes down their list of items on a flipchart
and discusses and defends their choices with the whole group.
This activity helps participants learn about others’ values and problem-solving
styles and promotes teamwork.
13. The Interview

The instructor asks participants to pick the person they know least about. These
pairs interview each other for about 20 minutes. The instructor can prepare
interview questions ahead of time or just provide general guidelines for the
interview. The goal is for participants to learn about their partner’s current and

Annex
past jobs (including what they like about their job), as well as their family life,
hobbies, favorite sports, and the like. Afterwards, each participant introduces
her/his partner to the group.
14. Finish the Sentence

The instructor asks each participant to complete one of the following sentences
(or something similar):
• The best job I ever had was...
• The worst project I ever worked on was...
• The riskiest thing I ever did was...
During introductions at the beginning of a course, the instructor can ask
participants to complete the sentence "I am in this course because..."
The instructor can also use this technique to move on to a new subject. If
training instructors, for example, the instructor could ask participants to
complete the sentence "The one time I felt most stressed because I did not plan
was..."
15. Spider Web

Participants stand in a circle. The instructor gives a ball of yarn to one
participant, who tells the group something about her/himself. This introduction
might include the participant’s name, home country, type of work, and reason
for attending the course. The instructor can decide how much information to
include in the introduction, depending on the size of the group and the time
allotted for the activity.
The participant with the ball of yarn holds onto the end of the yarn and throws
the ball to another person in the circle, who introduces her/himself in turn.
Participants continue tossing the ball around the circle and introducing
themselves until all of the participants form part of this spider web.
As soon as everyone has introduced themselves, have the ball of yarn reverse
course. The participant holding the ball returns it to the person who threw it to
her/him and repeats the information (name, country, work, etc.) that the
thrower volunteered the first time around. After rewinding the yarn, that person
returns the ball to the person who tossed it to them the first time around,
repeating the thrower’s information. This continues, with the ball following its
previous path in reverse order, until it reaches the participant who first
introduced her/himself.
Note: The instructor should warn participants beforehand of the importance of
paying attention to each introduction, since they will not know who will be
throwing the ball to them.

Annex
Energizers
When to use these energizers is not
indicated in the Instructor Guide for
1. National Anthem each module. Use your judgment
This warm-up works best when there are and take a break from the written
participants from a number of different curriculum to include some of these
countries. The activity requires a ball and a activities to keep participants
source of music, such as a tape player or
engaged.
radio. Participants stand in a circle. The
instructor turns on the music, and the
participants dance and pass the ball around
the circle until the instructor turns the music off. Whenever the music stops,
whoever is holding the ball must step into the circle and sing the first verse of
his/her national anthem. If, as sometimes happens, a person cannot remember
the national anthem, then s/he must sing a love song. The instructor turns the
music back on, and the participants begin passing the ball around the circle
again. The game continues until most participants have had the opportunity to
sing, or until the instructor feels that everyone has been energized.
2. Tell a Story
Participants stand in a circle. A volunteer leads off with the first sentence of a
story. One by one, the other participants add a sentence to help build the story.
Each sentence must:
• Make sense and at the same time add some fun to the activity,
• Build on the last sentence, and
• Be grammatically correct.
For example:
1. "I was walking to breakfast this morning."
2. "A dog came up to me."
3. "I said good morning to the dog."
4. "The dog asked me what I was going to have for breakfast."
3. The Last Word

Participants stand in a circle. One participant moves to stand in front of another
person and makes a statement (for example, "It is such a lovely day"). The
person spoken to then moves in front of another participant and makes a
statement that starts with the last word of the previous statement (for example,
"Day 1 of the course was very tiring"). Each participant takes turns to ensure
that everybody gets a chance to participate.

Annex
4. The Telephone
Participants sit or stand in a circle. The instructor quickly whispers a message to
one participant. This participant passes the message in a whisper to the next
person and so on. The last person shouts out the message. Chances are the final
message will be different from the original. Here is an example of an initial
message (note how two different activities are blended into the initial statement,
a sure cause for confusion when whispered quickly): "I had rice for dinner and
then dressed in blue to go dancing."
5. Brainstorming
The instructor divides participants into teams of five people and asks the teams
to list items in a category the instructor has chosen (for example, things that are
square, things associated with a holiday, or things that are red). The teams are
not allowed to discuss, just list items on a sheet of paper. The team with the
most items on their list wins.
6. Topic Lead-Ins
Sometimes when a group is meeting for a workshop on a specific topic,
participants already know each other well. In this situation, it may be better to
use an icebreaker that leads into the content of the gathering. Topic lead-in
questions are also appropriate throughout a course, at the start of each session.
A topic lead-in can play a number of functions. It can:
• Generate interest in the topic,
• Activate participants' prior knowledge of the subject,
• Help the instructor and participants identify individual learning needs
and goals,
• Encourage the sharing of information and resources, and
• Reveal resistance to discussion or learning.
For example, the instructor could ask participants about a time they used data to
make a decision in their personal lives. The instructor should lead with an
example, such as “I had to decide where to go on vacation one year. I only had
one week off in August, so I checked on the average temperature and rainfall in
three locations for that week and discovered that good weather was only likely in
one of my three choices! So of course, I chose that location.”
Instructors should use topic lead-ins liberally. They can pose different types of
questions in a single session—some for the group to answer collectively and
others for participants to answer individually.

Annex
7. Word Tree
The instructor asks participants to generate a list of words related to a topic. In
this course, for example, the instructor could ask participants for words related
to the phrase “public health indicators.” Participants might suggest: reporting,
fertility rate, statistics, mortality, surveys, etc. The instructor writes all of the
words on the board, clustering by theme where possible. The instructor can also
use this opportunity to introduce essential terms.
8. Multiple Choice or True/False Quiz

Rather than giving participants a multiple choice or true/false quiz at the end of
a session, instructors may try giving a quiz at the beginning of a session. The
instructor should walk around and discreetly scan participants' responses to help
decide where to focus attention during the session. At the end of the session,
the instructor reviews the answers to the quiz with the group. Note that
participants should check their own answers.
9. Ball Toss Brainstorming

This activity begins by having participants stand in a circle. The instructor
announces a topic, such as a holiday or a subject covered in the course (for
example, HIV/AIDS or surveys). Participants toss around a ball. Whoever
catches the ball shouts out something related to the topic and then tosses the
ball on to someone else. The exercise continues until everyone has had a chance
to speak.
Variation 1: When participants catch the ball, they say an important learning
concept. The exercise continues until everyone has caught the ball at least once
and explained an important concept related to the material just covered.
Variation 2: When participants catch the ball, they recite steps in a process or
concept. To the best of their ability, they should recite the steps in order. The
instructor or the participant writes it down on a flipchart. For example, after
discussing how to conduct a DHS survey, the instructor could start the ball toss
and ask everyone to list one step in the process.
10. Calm Down

Sometimes after intensive material is presented, participants need to calm down
or return to reality. Some introspective time can also help participants get the
full benefit of new material.
Participants lay their heads on the table, lie on the floor, or get in a comfortable
position. Then the instructor asks them to reflect on what they have just
learned. After about five minutes, the instructor says a key word or short phrase
and asks the participants to reflect on it for a couple of minutes. After repeating
this one or two more times, the instructor gathers participants into a circle and
asks them to share the most important points of a concept and how they can
best use it at their place of work.

Annex
Note: This may seem like a waste of time to many, but reflection is one of the
most powerful learning techniques available.
11. Boom!
Participants sit in a circle and count out loud as they go around the circle. Each
person whose number is a multiple of 3 (3, 6, 9, 12, etc.) or a number that ends
with 3 (13, 23, 33, etc.) must say “BOOM!” instead of the number. The next
person continues with the normal sequence of numbers. For example:
• The first person says 1
• The second person says 2
• The third person says “BOOM!” (instead of 3)
• The fourth person says 4
Anyone who fails to say “BOOM!” or who makes a mistake with the number that
follows “BOOM!” is disqualified.
The numbers must be said rapidly—at no more than five-second intervals. If a
participant takes too long to call out her/his number, s/he is disqualified. The
last two participants left are the winners.
Note: Instead of saying BOOM!, the participants can clap their hands once. To
make this energizer more interesting, participants can start counting backwards
towards zero when a specific number, such as 30, is reached. The game can be
made more complex by using multiples of bigger numbers or by combining
multiples of three with multiples of five.
12. Unique Sayings

This is a two-part activity. At the beginning of the course, the instructor divides
participants into groups of three or four. Each group records some familiar
sayings from their countries or regions. (In the US, for example, we say “An
apple a day keeps the doctor away” or “It’s raining cats and dogs”). After five to
seven minutes, the groups share their sayings, and the instructor checks that
the other participants understand each one. The activity continues until all of the
participants have contributed or until the instructor feels that the group has
been energized.
The instructor keeps the list of sayings for another warm-up later in the week,
writing each saying on a separate piece of paper and placing it in an envelope.
On the third or fourth day of the course, the instructor divides participants into
two groups and sends one group to each end of the room. A representative from
each group comes to the center of the room and receives an envelope containing
a saying. The two representatives read their sayings silently and return to their
groups. Without speaking, each representative draws a picture on a flipchart to
communicate the saying; the drawings cannot contain any words or parts of
words.

Annex
Members of each group try to guess what saying their representative has drawn.
The first team to guess correctly receives one point. Each group then sends a
new representative to the center to receive another envelope with a saying, and
the activity continues as described above. The activity continues for 10 minutes
or until all the sayings have been drawn and identified. The group with the
higher number of points wins.
13. Hot Pepper

Participants sit in a circle away from the tables and close their eyes. The
instructor gives a small ball to one participant who is instructed to pass the ball
quickly to the next person saying "Hot!" Participants continue to pass the ball
quickly around the group.
As the ball is passed from participant to participant, the instructor turns her/his
back, closes her/his eyes and calls out "Pepper!" The person who is holding the
ball when "Pepper!" is called leaves the circle. The ball continues to be passed
until only one person is left.
14. Words
The instructor divides the participants into three or four small groups and writes
the word INTERACTIVE on the flipchart. Each group has five minutes to create as
many words as possible from the word INTERACTIVE. All words must contain at
least three letters. For example, the words could include:
• Ate
• Rat
• Treat
• Retain
When the time is up, the group with the most words wins. Note: Depending on
the topic, other words can be used in this way. Some possibilities include:
DEMONSTRATION, COUNSELING, PREVALENCE, and DEMOGRAPHIC.
15. The Post Office

The instructor asks one participant to volunteer to begin the activity. The rest of
the participants sit in a circle that contains one chair less than the total number
of participants. The volunteer stands in the center of the circle and says
something like:
"I bring a letter for all of my colleagues who have brown hair."
All of the participants with that characteristic (e.g., brown hair) stand up, and
they and the person in the center of the circle change places. Whoever ends up
without a chair stands in the center of the circle and starts the next turn by
announcing that s/he is bringing a letter for colleagues with some different
characteristic, for example, those wearing black shoes.

Annex
This activity can continue as long as the group is interested and enthusiastic, but
no longer than five minutes.
16. Pick a Side

The participants stand in the middle of the room. The instructor yells out two
statements, each corresponding to opposite walls of the room. Participants
decide which statement they agree with more and run to the corresponding wall.
Statements can be purely fun, work-related, or controversial, depending on the
group. The goal is to recognize differences and energize the group.
Examples:
• I like chocolate (one wall) / I like vanilla (the opposite wall)
• I like dogs / I like cats
• I like George Bush / I like Bill Clinton
• I like watching TV / I like reading books
• I like working with data / Working with data scares me!
• I am comfortable speaking in front of others / I get nervous talking in
front of groups
• This is my first time working with DHS data / I have worked with DHS
data before
17. Make Someone Laugh

Participants stand in a circle. A volunteer starts in the middle of the circle and
approaches someone on the outside of the circle. The goal is to make this person
laugh, while the person on the outside of the circle is trying his/her hardest NOT
to laugh. Once the outside person breaks down, s/he winds up in the middle.
18. Eyes and Ears

This activity is a fun way to start each day and provides a brief review of what
happened the day before. “Eyes and Ears” begins on the morning of the second
day. The instructor explains that everyone’s eyes and ears see and hear things
differently and tells participants that this daily activity provides an opportunity to
review yesterday’s events from a different perspective. The instructor then
models an “Eyes and Ears” activity.
Ask three or four participants to give a review of the material covered in the
previous day. It is important that everyone be an “eye/ear” at least once during
the course. Encourage participants to be creative, to involve the audience (i.e.,
the other participants), to make it active, and to have fun. It is good to start the
day with a laugh and a smile. Possibilities include doing an exercise that involves
the whole group, a role play, a song, a poem, or some other creative activity.
Participants should NOT read a report of what happened the day before.

Annex
19. Moodmeter
At the beginning of the session, the instructor draws a chart called “The
Moodmeter.” This is an instrument that subjectively measures the mood and
atmosphere of the group. It is not directly related to the content of the session.
The instructor writes each of the days or sessions in the course horizontally
across the top of the chart. Down the left-hand side of the chart, the instructor
draws at least three different mood symbols. These could be faces showing
happiness, indifference, sadness, frustration, or anger. Alternatively, they could
be temperature indicators, such as 15 degrees, 25 degrees, and 35 degrees.
At the end of each day or session, participants mark the chart with an X or a dot
in line with the mood they are feeling. The instructor can draw a line through the
marks for that session or that day to reflect the “ups” and “downs” of the group.
The Moodmeter can be used to discuss the energy level of the group, course
successes, or sources of dissatisfaction.
20. Flash
The instructor and participants stand in a circle. The instructor asks the group a
direct question, for example, “Tell me how you felt about the day today?” or
“What two new things did you learn today?” Each participant very briefly states
her/his personal opinion, going around the circle. This exercise is called “flash”
because of the speed with which opinions are given. No one should talk for more
than 30 seconds, and no discussion is allowed as the flash is going on.
The instructor’s role is to seek the participants’ opinions and permit a variety of
ideas to be stated. However, the instructor should remind the group to be
constructive in their criticism and to look for ways to improve the training.

List of Abbreviations
ACT Artemisinin-based Combination
Therapies
AIDS Acquired Immunodeficiency

Syndrome
AIS AIDS Indicator Survey
ANC Antenatal care
ARI Acute respiratory infection
ARV/ART Antiretroviral Therapy/Treatment
BCG A vaccine against tuberculosis
BMI Body Mass Index
CDC Centers for Disease Control and

Prevention
COC Combined oral contraceptive
CPR Contraceptive prevalence rate
DBS Dried blood spots
DFID Department for International

Development
DHS Demographic and Health Surveys
DPT A vaccine against diphtheria,

pertussis (whooping cough) and
tetanus
DV Domestic violence
EA Enumeration Area
ELISA Enzyme-linked immunosorbent

serologic assay
FGC Female genital cutting
FBO Faith-based organization
GBV Gender-based violence
HepB A vaccine against Hepatitis B
Understanding and Using Demographic and Health Surveys 1

Hib A vaccine developed for the
prevention of invasive disease
caused by Haemophilus influenzae
type b bacteria
HIV Human Immunodeficiency Virus
IMCI Integrated Management of Childhood

Illnesses (WHO)
IMR Infant mortality rate
IPTp Intermittent Preventive Treatment

during pregnancy
IRS Indoor Residual Spraying
ITN Insecticide-Treated Net
IUD/IUCD Intrauterine Device/Intrauterine

Contraceptive Device
IYCF Infant and Young Child Feeding
KIS Key Indicators Survey
LAM Lactational amenorrhea method
LLIN Long Lasting Insecticide-Treated Net
MCH Maternal and Child Health
MDG Millennium Development Goal
MEASURE DHS The USAID-funded project which

implemented the Demographic and
Health Surveys from 1998-2013; in
2013 the name of the project
MERG changed to The DHS Program.
Monitoring and Evaluation Reference

MIS group
NGO Malaria Indicator Survey
No. Non-governmental organization
ORS/ORT Number

Oral rehydration salts/Oral
rehydration therapy
OVC Orphans and Vulnerable Children
PDA Personal digital assistant
PEPFAR President’s Emergency Plan for AIDS

Relief
PLWA/PLWHA People living with AIDS/People living

with HIV/AIDS
PMI President’s Malaria Initiative
PMTCT Prevention of Mother-to-Child

Transmission
PNC Postnatal care
PSU Primary sampling units
RBM Roll Back Malaria
RDT Rapid Diagnostic Test
SPA Service Provision Assessment
SP/Fansidar Sulfadoxine-pyrimethamine, trade

name Fansidar
SRS Simple random sample
STI Sexually Transmitted Infection
TB Tuberculosis
TBA Traditional birth attendant
TFR Total fertility rate
TT Tetanus toxoid vaccine
UNAIDS The Joint United Nations Programme

on HIV and AIDS
UNDP United Nations Development

Programme
UNESCO

United Nations Educational Scientific
and Cultural Organization
UNGASS United Nations General Assembly

Special Session on HIV and AIDS
UNICEF United Nations Children’s Fund
USAID United States Agency for

International Development
VCT Voluntary Counseling and Testing
WFfC World Fit for Children Indicators

(UNICEF)
WFS World Fertility Survey
WHO World Health Organization


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INSTRUCTOR’S GUIDE

Understanding and Using

The DHS Curriculum Facilitator’s Guide is a comprehensive package of ready-made training

Questions and comments regarding the DHS Curriculum can be sent to

About The DHS Program

The main objectives of The DHS Program are:

Welcome to a five-day course on “Understanding and Using Demographic and

This course is part of a certificate program in Strategic Communication for

This course is intended primarily for undergraduate or graduate students in

A secondary goal is to enable developers of health communication campaigns to

Understanding and Using Demographic and Health Surveys i

By the end of this course, participants should be able to:

Organization of the Course

This is a five-day course designed in modular form. Each module includes an

How to Use This Course

Understanding and Using Demographic and Health Surveys ii

Understanding and Using Demographic and Health Surveys iii

Setting the Tone for the Course

Participant-centered learning: This course has been designed with a

Understanding and Using Demographic and Health Surveys iv

Important Advice: Some sessions may be relatively long or challenging, so it

Good luck and enjoy the course!

Understanding and Using Demographic and Health Surveys v

Day 1 Day 2 Day 3 Day 4 Day 5

Understanding and Using Demographic and Health Surveys vi

Icebreakers and Energizers

2. Your Favorite Things

Understanding and Using Demographic and Health Surveys A-1

6. Find the Missing Piece

Understanding and Using Demographic and Health Surveys A-2

9. What's the Question?

10. Nonsense Name Game

Understanding and Using Demographic and Health Surveys A-3

11. The Magic Wand

13. The Interview

Understanding and Using Demographic and Health Surveys A-4

14. Finish the Sentence

15. Spider Web

Understanding and Using Demographic and Health Surveys A-5

3. The Last Word

Understanding and Using Demographic and Health Surveys A-6

Understanding and Using Demographic and Health Surveys A-7

8. Multiple Choice or True/False Quiz

9. Ball Toss Brainstorming

10. Calm Down

Understanding and Using Demographic and Health Surveys A-8

12. Unique Sayings

Understanding and Using Demographic and Health Surveys A-9

13. Hot Pepper

15. The Post Office

Understanding and Using Demographic and Health Surveys A-10

16. Pick a Side

17. Make Someone Laugh

18. Eyes and Ears

Understanding and Using Demographic and Health Surveys A-11

Understanding and Using Demographic and Health Surveys A-12

AIDS Acquired Immunodeficiency

AIS AIDS Indicator Survey

ANC Antenatal care