How Reliable Are Reports of Early Adolescent Reproductive and Sexual Health Events in Demographic and Health Surveys?

CONTEXT: Age at sexual debut, age at first marriage or first union and age at first birth are among the most widely used indicators of health and well-being for female adolescents. However, the accuracy of estimates for these indicators, particularly for younger adolescents, is poorly understood. METHODS: For each of nine countries in Africa and Latin America, Demographic and Health Survey (DHS) data from two surveys conducted five years apart were used to examine women's reports of age at sexual debut, marriage or first union, and first birth. The consistency of estimates between surveys and across birth cohorts is described, focusing particularly on the reporting of events occurring before age 15 and age 16. RESULTS: Marked differences in estimates for very early first births and marriage were found. Women aged 15-19 were much less likely to report marriages and first births before age 15 than were women from the same birth cohort when asked five years later at ages 20-24. Early sexual debut was reported more consistently in consecutive surveys than early marriages or births. CONCLUSIONS: Caution should be exercised when inferring changes in early adolescent sexual and reproductive health on the basis of estimates from the DHS. Greater effort should be made to develop data collection instruments that reduce misreporting of self-reported data from women sampled in household surveys.