Burgert, Clara R., and Debra Prosnitz. 2014. Linking DHS Household and SPA Facility Surveys: Data Considerations and Geospatial Methods. DHS Spatial Analysis Reports No. 10. Rockville, Maryland, USA: ICF International.
This report examines the potential benefits of linking Demographic and Health Surveys (DHS) data and Service Provision Assessment (SPA) survey data to answer research questions. A case study using Haiti DHS and SPA datasets demonstrates the practical application of linkage to delivery of obstetric services. Individually, the DHS household survey and the SPA facility-based survey are able to answer many relevant questions on access, utilization, and quality of health services. However, being able to link data from the two sources may offer greater insight into 1) how and why individuals access health care and 2) how the type and quality of care at facilities in their service environment can influence care-seeking
behavior. The DHS and SPA survey datasets are ideal sources of information on the targeting and impact of health programs. However, for a long time, issues of sampling, geographic data accuracy, access, and operationalization of methodology have prevented effective linkage of DHS and SPA datasets. In 2013, Skiles et al. presented an in-depth methodological study of the issues surrounding geographic
displacement of DHS clusters and the sampling of SPA facilities. The work presented here builds on the research carried out by Skiles et al. and outlines specific considerations that need to be examined before
linkage of DHS and SPA survey data can take place. The data and linked analyses discussed here may be a starting point for further investigation of care-seeking behaviors, access to health services, and issues of
quality of services that require additional quantitative and qualitative study.