BACKGROUND Demographic and Health Survey (DHS) data are an important source of maternal, newborn, and child health as well as nutrition information for low- and middle-income countries. However, DHSs are often unavailable at the administrative unit that is most interesting or useful for program planning. In addition, the location of DHS survey clusters are geomasked within 10 km, and prior to 2009, may have crossed district boundaries. We aim to use DHS surveyed information with these geomasked coordinates to estimate district assignments for use in health program planning and evaluation. METHODS We developed three methods to assign a district to a geomasked survey cluster in two DHS surveys from Malawi: 2000 and 2004. Method A assigns districts of origin in proportion to the likelihood that results from repeated simulated geomasking, allowing more than one possible district of origin. Method B assigns a single district of origin which contains the greatest proportion of simulated geomasked survey clusters. Method C maps the geomasked survey cluster's location to a district polygon. We used these method assignments to estimate a selection of commonly used coverage indicators for each district. We compared the district coverage estimates, confidence intervals, and concordance correlation coefficients, by each of the methods, to those which used validated district assignments in 2004, and we looked at coverage change from 2000 to 2004. RESULTS The methods we tested each approximated the validated estimates in 2004 by confidence interval comparison and concordance correlation coefficient. Estimated agreement for method A was between .14 and .98, for method B the estimated agreement was between .97 and .99, and for method C the agreement ranged from .93 to .99 when compared with the validated district assignments. Therefore, we recommend the protocol which is the simplest to implement-method C-overlaying geomasked survey cluster within district polygon. CONCLUSIONS Using geomasked survey clusters from DHSs to assign districts provided district level coverage rates similar to those using the validated surveyed locations. This method may be applied to data sources where survey cluster centroids are available and where district level estimates are needed for program implementation and evaluation in low- and middle-income settings. This method is of special interest to those using DHSs to study spatiotemporal trends as it allows for the utilization of historic DHS data where geomasking hinders the generation of reliable subnational estimates of health in areas smaller than the first-order administrative unit (ADM1).

中文翻译：

---

使用人口统计和健康调查数据中的地理掩蔽位置来获取地区级别的健康估计。

背景技术人口统计和健康调查（DHS）数据是低收入和中等收入国家的孕产妇，新生儿和儿童健康以及营养信息的重要来源。但是，对于计划规划而言，最有趣或最有用的行政部门通常不提供DHS。此外，国土安全部调查群的位置在10公里以内被屏蔽，并且在2009年之前可能已经越过地区边界。我们的目标是将DHS调查的信息与这些经过地理屏蔽的坐标一起使用，以估计用于医疗计划和评估的地区分配。方法在2000年和2004年的两次马拉维DHS调查中，我们开发了三种方法来将地区分配给地理遮罩调查群集。方法A根据重复进行的模拟地理遮罩产生的可能性按比例分配原产地，允许不止一个原产地。方法B分配了一个单一的原产地，其中包含最大比例的模拟地理掩盖的调查群集。方法C将地理遮罩的测量群集的位置映射到区域多边形。我们使用这些方法分配来估计每个地区常用的覆盖指标。我们将每种方法的地区覆盖率估计值，置信区间和一致性相关系数与2004年使用经过验证的地区分配的方法进行了比较，并研究了2000年至2004年的覆盖率变化。结果我们测试的每种方法都近似于通过置信区间比较和一致性相关系数验证了2004年的估计值。方法A的估算一致度介于.14和.98之间，对于方法B，与经过验证的地区分配相比，估计的协议介于0.97至.99之间，对于方法C，协议的范围介于0.93至.99之间。因此，我们建议使用最简单的协议，以在区域多边形内实施方法C覆盖的地理掩盖测量群集。结论使用来自DHS的地理掩盖的调查群集来分配地区，所提供的地区级别覆盖率类似于使用经过验证的调查地点的覆盖率。此方法可以应用于数据源，在这些数据源中，可以使用调查类集质心，并且在中低收入环境中，计划的实施和评估需要区域级别的估计。