Have Biomarkers Enhanced the Quality of Demographic Health Survey Data in India?

Biomarkers as innovations look very attractive for inclusion in routine demographic health surveys. Biomarkers are highly sensitive biochemical indicators akin to routine investigations used in clinical diagnosis, are relatively new to demographic surveys. Such investigations are generally performed in laboratory situations with rigorous training and performance to predict with specificity and sensitivity. The paraphernalia and backup needs to be robust and dependable to get consistent output in tropical weather conditions in India with wide seasonal variations in temperature. Humidity and other atmospheric conditions affect the outcome of indicators. This paper reviews closely the methodological perspectives, human resources recruitment, choice of techniques and equipment for assays used in several recent surveys in India. An effort is made to understand the problems of logistics, quality of data and implications of such data used for policy perspectives. The issues of oversimplify a clinical parameter to fit a demographic survey intended to seek good data are discussed. Suggestions to remedy shortcoming based on long term clinical and practical field experiences are discussed, drawing comparisons with several very well acknowledged biomarkers surveys.