In 2024, almost one in five young women were married before their 18th birthday worldwide. Sub-Saharan Africa had the largest share of girls married before the age of 18, but also the largest share of girls married before 15 (9.4 percent).

As of 2018, 7.3 percent of women between the ages of 15 and 19 had been married before reaching 15 years and were still in their marital union, and this represented an average number of 214 women. Five percent of respondents between ages 20 and 24 years (2,195 women) had been married before attaining age 15, representing an average number of 110 women. There are more female child marriages in Ghana than male ones. Even though the rate of child marriage in Ghana has decreased over the last three decades, it still remains an issue in the country. Reasons for this include teenage pregnancy, poverty, and established social norms.

Four out of five married women in France used their husband's last name in 2022. However, this proportion was higher among women from a working class environment, the non-working population, and retired women. On the other hand, only a little more than half of the executives and higher intellectual professions bear their husband's family name. 21 percent to bear the name they were born with (usually their father's), and 22 percent bear their own name in addition to their husband's. In general, younger French women are less likely to bear only their husband's last name.

Niger has the highest child marriage rate in the world among girls. According to the most recent data, in this West African country, more than three-fourths of girls aged under 18 were married, with nearly 30 percent of them being younger than 15 years old. The Central African Republic, Chad, and Mali followed behind with rates ranging from 61 to 54 percent. This issue is globally spread, particularly in African countries. In many of these countries, the legal age to get married is lower for females than for males. In Niger and Chad, for instance, the legal age is 15 years for females and 18 for males. In Guinea, instead, the legal age for marriage is 17 for females and 18 for males. Child marriage is often related to poverty, with poor families choosing to marry away their girls, both to earn money as a wedding gift and as this means fewer mouths to feed.

The Sudan Demographic and Health Survey (SDHS) was conducted in two phases between November 15, 1989 and May 21, 1990 by the Department of Statistics of the Ministry of Economic and National Planning. The survey collected information on fertility levels, marriage patterns, reproductive intentions, knowledge and use of contraception, maternal and child health, maternal mortality, and female circumcision. The survey findings provide the National Population Committee and the Ministry of Health with valuable information for use in evaluating population policy and planning public health programmes. A total of 5860 ever-married women age 15-49 were interviewed in six regions in northern Sudan; three regions in southern Sudan could not be included in the survey because of civil unrest in that part of the country. The SDHS provides data on fertility and mortality comparable to the 1978-79 Sudan Fertility Survey (SFS) and complements the information collected in the 1983 census. The primary objective of the SDHS was to provide data on fertility, nuptiality, family planning, fertility preferences, childhood mortality, indicators of maternal health care, and utilization of child health services. Additional information was coUected on educational level, literacy, source of household water, and other housing conditions. The SDHS is intended to serve as a source of demographic data for comparison with the 1983 census and the Sudan Fertility Survey (SFS) 1978-79, and to provide population and health data for policymakers and researchers. The objectives of the survey are to: assess the overall demographic situation in Sudan, assist in the evaluation of population and health programmes, assist the Department of Statistics in strengthening and improving its technical skills for conducting demographic and health surveys, enable the National Population Committee (NPC) to develop a population policy for the country, and measure changes in fertility and contraceptive prevalence, and study the factors which affect these changes, and examine the basic indicators of maternal and child health in Sudan. MAIN RESULTS Fertility levels and trends Fertility has declined sharply in Sudan, from an average of six children per women in the Sudan Fertility Survey (TFR 6.0) to five children in the Sudan DHS survey flTR 5.0). Women living in urban areas have lower fertility (TFR 4.1) than those in rural areas (5.6), and fertility is lower in the Khartoum and Northern regions than in other regions. The difference in fertility by education is particularly striking; at current rates, women who have attained secondary school education will have an average of 3.3 children compared with 5.9 children for women with no education, a difference of almost three children. Although fertility in Sudan is low compared with most sub-Saharan countries, the desire for children is strong. One in three currently married women wants to have another child within two years and the same proportion want another child in two or more years; only one in four married women wants to stop childbearing. The proportion of women who want no more children increases with family size and age. The average ideal family size, 5.9 children, exceeds the total fertility rate (5.0) by approximately one child. Older women are more likely to want large families than younger women, and women just beginning their families say they want to have about five children. Marriage Almost all Sudanese women marry during their lifetime. At the time of the survey, 55 percent of women 15-49 were currently married and 5 percent were widowed or divorced. Nearly one in five currently married women lives in a polygynous union (i.e., is married to a man who has more than one wife). The prevalence of polygyny is about the same in the SDHS as it was in the Sudan Fertility Survey. Marriage occurs at a fairly young age, although there is a trend toward later marriage among younger women (especially those with junior secondary or higher level of schooling). The proportion of women 15-49 who have never married is 12 percentage points higher in the SDHS than in the Sudan Fertiliy Survey. There has been a substantial increase in the average age at first marriage in Sudan. Among SDHS. Since age at first marriage is closely associated with fertility, it is likely that fertility will decrease in the future. With marriages occurring later, women am having their first birth at a later age. While one in three women age 45-49 had her first birth before age 18, only one in six women age 20-24 began childbearing prior to age 18. The women most likely to postpone marriage and childbearing are those who live in urban areas ur in the Khartoum and Northern regions, and women with pest-primary education. Breastfeeding and postpartum abstinence Breastfeeding and postpartum abstinence provide substantial protection from pregnancy after the birth uf a child. In addition to the health benefits to the child, breastfeeding prolongs the length of postpartum amenorrhea. In Sudan, almost all women breastfeed their children; 93 percent of children are still being breastfed 10-11 months after birth, and 41 percent continue breastfeeding for 20-21 months. Postpartum abstinence is traditional in Sudan and in the first two months following the birth of a child 90 percent of women were abstaining; this decreases to 32 percent after two months, and to 5 percent at~er one year. The survey results indicate that the combined effects of breastfeeding and postpartum abstinence protect women from pregnancy for an average of 15 months after the birth of a child. Knowledge and use of contraception Most currently married women (71 percent) know at least one method of family planning, and 59 percent know a source for a method. The pill (70 percent) is the most widely known method, followed by injection, female sterilisation, and the IUD. Only 39 percent of women knew a traditional method of family planning. Despite widespread knowledge of family planning, only about one-fourth of ever-married women have ever used a contraceptive method, and among currently married women, only 9 percent were using a method at the time of the survey (6 percent modem methods and 3 percent traditional methods). The level of contraceptive use while still low, has increased from less than 5 percent reported in the Sudan Fertility Survey. Use of family planning varies by age, residence, and level of education. Current use is less than 4 percent among women 15-19, increases to 10 percent for women 30-44, then decreases to 6 percent for women 45-49. Seventeen percent of urban women practice family planning compared with only 4 percent of rural women; and women with senior secondary education are more likely to practice family planning (26 percent) than women with no education (3 percent). There is widespread approval of family planning in Sudan. Almost two-thirds of currently married women who know a family planning method approve of the use of contraception. Husbands generally share their wives's views on family planning. Three-fourths of married women who were not using a contraceptive method at the time of the survey said they did not intend to use a method in the future. Communication between husbands and wives is important for successful family planning. Less than half of currently married women who know a contraceptive method said they had talked about family planning with their husbands in the year before the survey; one in four women discussed it once or twice; and one in five discussed it more than twice. Younger women and older women were less likely to discuss family planning than those age 20 to 39. Mortality among children The neonatal mortality rate in Sudan remained virtually unchanged in the decade between the SDHS and the SFS (44 deaths per 1000 births), but under-five mortality decreased by 14 percent (from 143 deaths per 1000 births to 123 per thousand). Under-five mortality is 19 percent lower in urban areas (117 per 1000 births) than in rural areas (144 per 10(30 births). The level of mother's education and the length of the preceding birth interval play important roles in child survival. Children of mothers with no education experience nearly twice the level of under-five mortality as children whose mother had attained senior secondary or nigher education. Mortality among children under five is 2.7 times higher among children born after an interval of less than 24 months than among children born after interval of 48 months or more. Maternal mortality The maternal mortality rate (maternal deaths per 1000 women years of exposure) has remained nearly constant over the twenty years preceding the survey, while the maternal mortality ratio (number of maternal deaths per 100,000 births), has increased (despite declining fertility). Using the direct method of estimation, the maternal mortality ratio is 352 maternal deaths per 100,000 births for the period 1976-82, and 552 per 100,000 births for the period 1983-89. The indirect estimate for the maternal mortality ratio is 537. The latter estimate is an average of women's experience over an extended period before the survey centred on 1977. Maternal health care The health care mothers receive during pregnancy and delivery is important to the survival and well-being of both children and mothers. The SDHS results indicate that most women in Sudan made at least one antenatal visit to a doctor or trained health worker/midwife. Eighty-seven percent of births benefitted from professional antenatal care in urban areas compared with 62 percent in rural areas. Although the proportion of pregnant mothers seen by trained health workers/midwives are similar in urban and rural areas, doctors provided antenatal care for 42 percent and 19 percent of births in urban and rural areas, respectively. Neonatal tetanus, a major cause of infant deaths in developing countries, can be prevented if mothers receive tetanus toxoid vaccinations.

Published here is a Stata Do-File in which all data transformations and calculations for the reference publication are included (replication material).

Abstract

The RHS 2003 has the following objectives: - Gather information on fertility and family planning; - Determine knowledge and use of contraceptive methods by region; - Determine knowledge of family planning by age and other background characteristics; - Gather information on specific health issues, including child immunization, breastfeeding practices, prenatal and postnatal care; - Prepare baseline information required for tracking changes in family planning, health situation, fertility and mortality levels; - Enrich the database on reproductive health and use of family planning within the country and internationally, and provide conclusions and recommendations; - Provide policy makers, researchers and other users with necessary data.

Geographic coverage

The RHS 2003 is nationally and regionally (5 regions - West, Central, East, South, Ulaanbaatar) representative and covers the whole of Mongolia.

Analysis unit

• Household
• Women aged 15-49
• Husband of the women
• Children

Universe

All women between the ages of 15 and 49, inclusive, who slept in the household’s dwelling the night prior to interview, were eligible to be interviewed using the women’s interview schedule. Three husbands out of five married women interviewed in each PSU were interviewed using the husband’s interview schedule. Children above 5 years old.

Kind of data

Sample survey data [ssd]

Sampling procedure

The survey was conducted using a two-stage sampling method, which gives an equal probability of selection of households. This means that the data are fully comparable with the RHS 1998. The sample frame comprised the listings of households prepared annually in bags and khoroo across the country. Activities designed for improving the quality of data of the sample frame were conducted in the fourth quarter of 2002 and the first quarter of 2003. The actual sampling was based on the 2003 first half-year data.

Distribution of the RHS Household Sampling by Aimag, Mongolia 2003

-- Aimag, Clusters, Number of Households 1) Arhangai, 1-13, 390 2) Bayan-Olgii, 14-23, 300 3) Bayanhongor, 24-34, 330 4) Bulgan, 35-42, 240 5) Gobi-Altai, 43-50, 240 6) Dornogobi, 51-56, 180 7) Dornod, 57-64, 240 8) Dundgobi, 65-70, 180 9) Zavhan, 71-80, 300 10) Ovorhangai, 81-94, 420 11) Omnogobi, 95-100, 180 12) Suhbaatar, 101-107, 210 13) Selenge, 108-118, 330 14) Tov, 119-129, 330 15) Uvs, 130-139, 300 16) Hovd, 140-149, 300 17) Hovsgol, 150-164, 450 18) Hentii, 165-173, 270 19) Darhan-Uul, 174-182, 270 20) Ulaanbaatar, 183-269, 2610 21) Orhon, 270-279, 300 22) Gobisumber, 280,30 Total number of households 8400

It was determined from the experience of RHS 1998, and of other countries which have conducted similar surveys, that 25-30 households per cluster would provide an optimum representation. Therefore, this time 30 households were selected for a cluster (The best cluster "take" depends upon the intra-cluster versus inter-cluster heterogeneity of the principal variables being measured; this can only be determined after carrying out a survey). For the survey it was planned to select 8,400 households, which is a 1.47 percent sample of all households in the country. This implied the selection of 280 clusters of households. Baghs and horoos were the primary sampling units (PSUs). All 1,674 PSUs were stratified implicitly by aimag and soum, and the selection of the 280 sample PSUs (or clusters) was done systematically with a random start, with probability proportional to the number of registered households. Households were then selected systematically with a random start within each PSU, using an interval directly proportional to the number of households in the PSU. The selected households were interviewed using the household schedule. All women between the ages of 15 and 49, inclusive, who slept in the household's dwelling the night prior to interview, were eligible to be interviewed using the women's interview schedule. Three husbands out of five married women interviewed in each PSU were interviewed using the husband's interview schedule.

Mode of data collection

Face-to-face [f2f]

Research instrument

There were three questionnaires used in the RHS. For the development of women's questionnaire, the model 'B' of the Demographic and Health Surveys Program served as a base, with some adjustments that reflect Mongolia's specific needs. The contents of the three questionnaires are outlined briefly below: Household Questionnaire: - Relationship to the household head; - Age; - Sex; - Educational level; - Marital status. These questions were asked from all household members nad people who slept in the household prior to the interview. The household questionnaire was developed in order to obtain general demographic information, information on household amenities and housing conditions, household income and expenditure, and as a tool for selecting women and husbands for individual interview.

Woman's Questionnaire: - Background questions, marital status; - Reproduction; - Maternal health, pregnancy, breastfeeding, child health, abortion, miscarriage and stillbirth in the last five years; - Knowledge, access to and use of contraceptive methods; - Fertility preferences; - Employment, and questions concerning the husband - Knowledge about STIs and AIDS.

Husband's Questionnaire: - Background questions; - Reproduction; - Knowledge, access to and use of contraceptive methods; - Knowledge about STIs and AIDS.

Cleaning operations

The computer data entry work was initiated on 20 October 2003 and terminated 1 March 2004. The editing of the computer files was finished by the middle of April. The computer software package, “Integrated System for Survey Analysis” (ISSA), created by Macro International, Inc. was used in data entry and processing. During February 2004, output tables were produced over a period of 4 months.Activities such as data entry, quality control and production of output tables were accomplished by the national staff under the supervision and guidance of an adviser from the UNFPA Country Support Team in Bangkok. The main report of RHS was prepared jointly by the experts of the NSO, MOH, and the researchers working in agencies under the MOH.

Response rate

Results of the Household and Individual Interviews (Women and Husbands), Mongolia 2003

Number of Dwellings Sampled: Urban 4350, Rural 4050, and Total 8400 Number of Households Interviewed: Urban 4349, Rural 4050, and Total 8399 Household Response Rate: Urban 100.0, Rural 100.0, and Total 100.0

Number of Eligible Women: Urban 5005, Rural 4377, and Total 9382 Number of Eligible Women Interviewed: Urban 4972, Rural 4342, and Total 9314 Eligible Women Response Rate: Urban 99.3, Rural 99.2, and Total 99.3

Number of Husbands Selected: Urban 2134, Rural 2095, and Total 4229 Number of Husbands Interviewed: Urban 2121, Rural 2091, and Total 4212 Husbands Response Rate: Urban 99.4, Rural 99.8, and Total 99.6

Sampling error estimates

Sampling errors are presented in Tables B.02 - B.16 (refer final survey report) for variables considered to be of major interest. Results are presented for the whole country, for urban and rural areas separately, for each of four education groups, for each of five regions, and for each of three age groups. For each variable, the type of statistic (percentage, mean or rate) and the base population are given in Table B.01 (refer final survey report) . For each variable, Tables B.02 - B.16 (refer final survey report) present the value of the statistic (R), its standard error (SE), the number of cases (N) where relevant, the design effect (DEFT) where applicable, the relative standard error (SE/R), and the 95 percent confidence limits (R-2SE, R+2SE).

The confidence limits have the following interpretation. For the percentage of currently married women using the contraceptive intrauterine device (IUD), the overall value for the full sample is 32.8%, and its standard error is 0.7%. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, which means that there is a high probability (95 percent) the true percentage currently using the IUD is between 31.3% and 34.2%.

The relative standard errors for most estimates for the country as a whole are small, except for estimates of very small percentages. The magnitude of the error increases as estimates for sub-populations such as geographical areas are considered. For the variable IUD, for instance, the relative standard error (as a percentage of the estimated parameter) for the whole country and for urban and rural areas is 2.2 percent, 3.2 percent, and 3.0 percent, respectively. For the five regions, the relative standard error of the variable IUD varies between 3.9 percent and 7.4 percent.

Special mention should be made of the sampling errors for rates. The denominators are exposure-years, and the numerators are either births or deaths in the population under consideration during the indicated period of time. Estimates of sampling errors are shown for the TFR in the three years prior to the survey, presented in Chapter 3, and for the various 3-year mortality rates presented in Chapter 7. These estimates are calculated at the national level, and by urban-rural residence, region, and mother's educational level. (They are irrelevant for age groups)

It should be noted that the survey indicates, with a 95 percent level of confidence, that the TFR for the 3-year period prior to the survey lay between 2,4 and 2,6 children per woman,

This collection contains standard data on labor force activity for the week prior to the survey. Comprehensive data are available on the employment status, occupation, and industry of persons 14 years old and over. Also supplied are personal characteristics such as age, sex, race, marital status, veteran status, household relationship, educational background, and Spanish origin. In addition, supplemental data pertaining to birth history, birth expectations, and child care arrangements are included in this file. Data on birth history were collected for unmarried women ages 18-49 and for married women ages 14-49 and include variables such as total number of children ever born, dates of birth of the first and most recent child, and date of first marriage. Questions on birth expectations, asked of unmarried women ages 18-44 and currently married women ages 14-44, included number of children they expect to have and ages of all children living in the household. Currently married women were asked the number of children they expect to have within the next five years and when they expected their first/next child to be born within the next five years. Questions on child care arrangements were asked of all currently employed women ages 18-44 with a child under the age of five living in the household. Data are provided on child care arrangements for the two youngest children and include items such as whether regular day care arrangements are made, location of day care facility, who provides and pays for care, and types of activities occupying the mother while day care is provided. Respondents were also asked whether they would work more hours or have more children if they could make additional child care arrangements at a reasonable cost.

The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program. Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries. The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country. MAIN RESULTS Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila. Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women. Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l. The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom. Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage. Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate, More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively). Information on various aspects of maternal and child health-antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home. Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy. Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases-polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis. During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids. Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months. Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19. The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution. Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility.

Note:aIncludes rural samples only.bIncludes both urban and rural samples.

Associations between child marriage and maternal care use among currently married Nepali women aged 15–49 years who had a live birth in the past five years (n = 3,970).

Abstract

The Sudan Demographic and Health Survey (SDHS) was conducted in two phases between November 15, 1989 and May 21, 1990 by the Department of Statistics of the Ministry of Economic and National Planning. The survey collected information on fertility levels, marriage patterns, reproductive intentions, knowledge and use of contraception, maternal and child health, maternal mortality, and female circumcision. The survey findings provide the National Population Committee and the Ministry of Health with valuable information for use in evaluating population policy and planning public health programmes.

A total of 5860 ever-married women age 15-49 were interviewed in six regions in northern Sudan; three regions in southern Sudan could not be included in the survey because of civil unrest in that part of the country. The SDHS provides data on fertility and mortality comparable to the 1978-79 Sudan Fertility Survey (SFS) and complements the information collected in the 1983 census.

The primary objective of the SDHS was to provide data on fertility, nuptiality, family planning, fertility preferences, childhood mortality, indicators of maternal health care, and utilization of child health services. Additional information was coUected on educational level, literacy, source of household water, and other housing conditions.

The SDHS is intended to serve as a source of demographic data for comparison with the 1983 census and the Sudan Fertility Survey (SFS) 1978-79, and to provide population and health data for policymakers and researchers. The objectives of the survey are to: - assess the overall demographic situation in Sudan, - assist in the evaluation of population and health programmes, - assist the Department of Statistics in strengthening and improving its technical skills for conducting demographic and health surveys, - enable the National Population Committee (NPC) to develop a population policy for the country, and - measure changes in fertility and contraceptive prevalence, and study the factors which affect these changes, and - examine the basic indicators of maternal and child health in Sudan.

MAIN RESULTS

Fertility levels and trends

Fertility has declined sharply in Sudan, from an average of six children per women in the Sudan Fertility Survey (TFR 6.0) to five children in the Sudan DHS survey flTR 5.0). Women living in urban areas have lower fertility (TFR 4.1) than those in rural areas (5.6), and fertility is lower in the Khartoum and Northern regions than in other regions. The difference in fertility by education is particularly striking; at current rates, women who have attained secondary school education will have an average of 3.3 children compared with 5.9 children for women with no education, a difference of almost three children.

Although fertility in Sudan is low compared with most sub-Saharan countries, the desire for children is strong. One in three currently married women wants to have another child within two years and the same proportion want another child in two or more years; only one in four married women wants to stop childbearing. The proportion of women who want no more children increases with family size and age. The average ideal family size, 5.9 children, exceeds the total fertility rate (5.0) by approximately one child. Older women are more likely to want large families than younger women, and women just beginning their families say they want to have about five children.

Marriage

Almost all Sudanese women marry during their lifetime. At the time of the survey, 55 percent of women 15-49 were currently married and 5 percent were widowed or divorced. Nearly one in five currently married women lives in a polygynous union (i.e., is married to a man who has more than one wife). The prevalence of polygyny is about the same in the SDHS as it was in the Sudan Fertility Survey.

Marriage occurs at a fairly young age, although there is a trend toward later marriage among younger women (especially those with junior secondary or higher level of schooling). The proportion of women 15-49 who have never married is 12 percentage points higher in the SDHS than in the Sudan Fertiliy Survey.

There has been a substantial increase in the average age at first marriage in Sudan. Among SDHS. Since age at first marriage is closely associated with fertility, it is likely that fertility will decrease in the future. With marriages occurring later, women am having their first birth at a later age. While one in three women age 45-49 had her first birth before age 18, only one in six women age 20-24 began childbearing prior to age 18. The women most likely to postpone marriage and childbearing are those who live in urban areas ur in the Khartoum and Northern regions, and women with pest-primary education.

Breastfeeding and postpartum abstinence

Breastfeeding and postpartum abstinence provide substantial protection from pregnancy after the birth uf a child. In addition to the health benefits to the child, breastfeeding prolongs the length of postpartum amenorrhea. In Sudan, almost all women breastfeed their children; 93 percent of children are still being breastfed 10-11 months after birth, and 41 percent continue breastfeeding for 20-21 months. Postpartum abstinence is traditional in Sudan and in the first two months following the birth of a child 90 percent of women were abstaining; this decreases to 32 percent after two months, and to 5 percent at~er one year. The survey results indicate that the combined effects of breastfeeding and postpartum abstinence protect women from pregnancy for an average of 15 months after the birth of a child.

Knowledge and use of contraception

Most currently married women (71 percent) know at least one method of family planning, and 59 percent know a source for a method. The pill (70 percent) is the most widely known method, followed by injection, female sterilisation, and the IUD. Only 39 percent of women knew a traditional method of family planning.

Despite widespread knowledge of family planning, only about one-fourth of ever-married women have ever used a contraceptive method, and among currently married women, only 9 percent were using a method at the time of the survey (6 percent modem methods and 3 percent traditional methods). The level of contraceptive use while still low, has increased from less than 5 percent reported in the Sudan Fertility Survey.

Use of family planning varies by age, residence, and level of education. Current use is less than 4 percent among women 15-19, increases to 10 percent for women 30-44, then decreases to 6 percent for women 45-49. Seventeen percent of urban women practice family planning compared with only 4 percent of rural women; and women with senior secondary education are more likely to practice family planning (26 percent) than women with no education (3 percent).

There is widespread approval of family planning in Sudan. Almost two-thirds of currently married women who know a family planning method approve of the use of contraception. Husbands generally share their wives's views on family planning. Three-fourths of married women who were not using a contraceptive method at the time of the survey said they did not intend to use a method in the future.

Communication between husbands and wives is important for successful family planning. Less than half of currently married women who know a contraceptive method said they had talked about family planning with their husbands in the year before the survey; one in four women discussed it once or twice; and one in five discussed it more than twice. Younger women and older women were less likely to discuss family planning than those age 20 to 39.

Mortality among children

The neonatal mortality rate in Sudan remained virtually unchanged in the decade between the SDHS and the SFS (44 deaths per 1000 births), but under-five mortality decreased by 14 percent (from 143 deaths per 1000 births to 123 per thousand). Under-five mortality is 19 percent lower in urban areas (117 per 1000 births) than in rural areas (144 per 10(30 births).

The level of mother's education and the length of the preceding birth interval play important roles in child survival. Children of mothers with no education experience nearly twice the level of under-five mortality as children whose mother had attained senior secondary or nigher education. Mortality among children under five is 2.7 times higher among children born after an interval of less than 24 months than among children born after interval of 48 months or more.

Maternal mortality

The maternal mortality rate (maternal deaths per 1000 women years of exposure) has remained nearly constant over the twenty years preceding the survey, while the maternal mortality ratio (number of maternal deaths per 100,000 births), has increased (despite declining fertility). Using the direct method of estimation, the maternal mortality ratio is 352 maternal deaths per 100,000 births for the period 1976-82, and 552 per 100,000 births for the period 1983-89. The indirect estimate for the maternal mortality ratio is 537. The latter estimate is an average of women's experience over an extended period before the survey centred on 1977.

Maternal health care

The health care mothers receive during pregnancy and delivery is important to the survival and well-being of both children and mothers. The SDHS results indicate that most women in Sudan made at least one antenatal visit to a doctor or trained health worker/midwife. Eighty-seven percent of births benefitted from professional antenatal care in urban areas compared with 62 percent in rural areas. Although the proportion of pregnant mothers seen by trained health workers/midwives are similar in urban and rural areas, doctors provided antenatal care for 42 percent and 19 percent of births in urban and rural areas, respectively.

Neonatal tetanus, a major

Research hypothesis was to use the Registers of Deeds for the North Riding of Yorkshire (held at North Yorkshire County Record Office, Northallerton, England) to advance knowledge about women's involvement with property transfer and the wider property market in the 18th & 19th centuries. Registers began in 1736 and ceased in 1970; there are 89 Index Ledgers and 2,328 Deeds Registers. The system for recording data changed in 1885 so one Index Ledger was selected from pre/ post this date and 100 years apart to incorporate impact of Marriage Acts. Stage 1 - Two Index Ledgers were transcribed in full: 1) Index of Lands Vol 9 (1784-90) covers a seven-year period and contains 6,868 unique transactions (31,966 lines); and 2) Index of Lands 1885-1889 covers a five-year period and contains 14,481 unique transactions (52,741 lines). Each line represents a person's name. Core data from Index showed Township, unique reference and names of parties, but the 18th century Index Ledger did not show date of transaction or all parties. To analyse by gender this information was required so was added by using the Deeds Registers. Information from the individual Deeds Registers was then used to add to the core datasets: Stage 2 - The gender of all parties ('male', 'female' and 'not applicable' (for businesses) was added. Stage 3 - The usual residence, occupation (if any), marital status and any details of family relationships or inheritance rights of every women was added. Stage 4 - The 18th century dataset was then reduced to a five-year period covering 1785-1789 ONLY to provide a direct comparison with the 19th century dataset. Comparative analysis by: gender, marital status and number of transactions. (See different dataset). Each transaction has a unique reference number but can contain multiple parties and cover more than one township. To identify the true number of transactions, the data had to be controlled for these factors. A control for uniqueness was also required for those individuals and organisations involved in multiple transactions and to avoid assuming that everyone with the same name was actually the same person. Where women were involved, additional data e.g. marital status, residence or family relationships was used to differentiate between like women.

1784-1790 findings include: distinctive patterns of female property involvement by gender and marital status. Married women represent more than 52.19% of unique female transactions despite having little, if any, legal status (coverture). Although 3,033 women transacted during this period, only less than 5% did so without husband's involvement; this increased to 45.47% by 1885-1889 period, reinforcing that Married Women's Property Acts were beginning to make an impact, treating married women as if 'feme sole'. More parity of involvement across marital status groups in 1885-1889 data, with spinsters' involvement increasing the most (from 17.58% to 31.37%).

Abstract

The 2006-07 Sri Lanka Demographic and Health Survey (SLDHS) is the fourth in a series of DHS surveys to be held in Sri Lanka-the first three having been implemented in 1987, 1993, and 2000. Teams visited 2,106 sample points across Sri Lanka and collected data from a nationally representative sample of almost 20,000 households and over 14,700 women age 15-49.

A nationally representative sample of 21,600 housing units was selected for the survey and 19,872 households were enumerated to give district level estimates (excluding Northern Province). Detailed information was collected from all ever-married women aged 15-49 years and about their children below five years at the time of the survey. Within the households interviewed, a total of 15,068 eligible women were identified, of whom 14,692 were successfully interviewed.

The Department of Census and Statistics (DCS) carried out the 2006-07 SLDHS for the Health Sector Development Project (HSDP) of the Ministry of Healthcare and Nutrition, a project funded by the World Bank. The objective of the survey is to provide data needed to monitor and evaluate the impact of population, health, and nutrition programmes implemented by different government agencies. Additionally, it also aims to measure the impact of interventions made under the HSDP towards improving the quality and efficiency of health care services as a whole.

All 25 districts of Sri Lanka were included at the design stage. The final sample has only 20 districts, however, after dropping the 5 districts of the Northern Province (Jaffna, Kilinochchi, Mannar, Vavuniya, and Mullativu), due to the security situation there.

OBJECTIVES

The objective of this report is to publish the final findings of the 2006-07 SLDHS. This final report provides information mainly on background characteristics of respondents, fertility, reproductive health and maternal care, child health, nutrition, women's empowerment, and awareness of HIV/AIDS and prevention. It is expected that the content of this report will satisfy the urgent needs of users of this information.

MAIN RESULTS

FERTILITY Survey results indicate that there has been a slight upturn in the total fertility rate since the 2000 SLDHS. The total fertility rate for Sri Lanka is 2.3, meaning that, if current age-specific fertility rates were to remain unchanged in the future, a woman in Sri Lanka would have an average of 2.3 children by the end of her childbearing period. This is somewhat higher than the total fertility rate of 1.9 measured in the 2000 SLDHS.

Fertility is only slightly lower in urban areas than in rural areas (2.2 and 2.3 children per woman, respectively); however, it is higher in the estate areas (2.5 children per woman). Interpretation of variations in fertility by administrative districts is limited by the small samples in some districts. Nevertheless, results indicate that Galle and Puttalam districts have fertility rates of 2.1 or below, which is at what is known as “replacement level” fertility, i.e., the level that is necessary to maintain population size over time. Differences in fertility by level of women's education and a measure of relative wealth status are minimal.

FAMILY PLANNING According to the survey findings, knowledge of any method of family planning is almost universal in Sri Lanka and there are almost no differences between ever-married and currently married women. Over 90 percent of currently married women have heard about pills, injectables, female sterilization, and the IUD. Eight out of ten respondents know about some traditional method of delaying or avoiding pregnancies.

Although the proportion of currently married women who have heard of at least one method of family planning has been high for some time, knowledge of some specific methods has increased recently. Since 1993, knowledge of implants has increased five-fold-from about 10 percent in 1993 to over 50 percent in 2006-07. Awareness about pill, IUD, injectables, implants, and withdrawal has also increased. On the other hand, awareness of male sterilization has dropped by 14 percentage points.

CHILD HEALTH The study of infant and child mortality is critical for assessment of population and health policies and programmes. Infant and child mortality rates are also regarded as indices reflecting the degree of poverty and deprivation of a population. Survey data show that for the most recent five-year period before the survey, the infant mortality rate is 15 deaths per 1,000 live births and under-five mortality is 21 deaths per 1,000 live births. Thus, one in every 48 Sri Lankan children dies before reaching age five. The neonatal mortality rate is 11 deaths per 1,000 live births and the postneonatal mortality rate is 5 deaths per 1,000 live births. The child mortality rate is 5 deaths per 1,000 children surviving to age one year.

REPRODUCTIVE HEALTH The survey shows that virtually all mothers (99 percent) in Sri Lanka receive antenatal care from a health professional (doctor specialist, doctor, or midwife). The proportion receiving care from a skilled provider is remarkably uniform across all categories for age, residence, district, woman's education, and household wealth quintile. Even in the estate sector, antenatal care usage is at the same high level. Although doctors are the most frequently seen provider (96 percent), women also go to public health midwives often for prenatal care (44 percent).

BREASTFEEDING AND NUTRITION Poor nutritional status is one of the most important health and welfare problems facing Sri Lanka today and particularly affects women and children. The survey data show that 17 percent of children under five are stunted or short for their age, while 15 percent of children under five are wasted or too thin for their height. Overall, 21 percent of children are underweight, which may reflect stunting, wasting, or both. As for women, at the national level, 16 percent of women are considered to be thin (with a body mass index < 18.5); however, only 6 percent of women are considered to be moderately or severely thin.

Poor breastfeeding and infant feeding practices can have adverse consequences for the health and nutritional status of children. Fortunately, breastfeeding in Sri Lanka is universal and generally of fairly long duration; 97 percent of newborns are breastfed within one day after delivery and 76 percent of infants under 6 months are exclusively breastfed, lower than the recommended 100 percent exclusive breastfeeding for children under 6 months. The median duration of any breastfeeding is 33 months in Sri Lanka and the median duration of exclusive breastfeeding is 5 months.

HIV/AIDS The HIV/AIDS pandemic is a serious health concern in the world today because of its high case fatality rate and the lack of a cure. Awareness of AIDS is almost universal among Sri Lankan adults, with 92 percent of ever-married women saying that they have heard about AIDS. Nevertheless, only 22 percent of ever-married women are classified as having “comprehensive knowledge” about AIDS, i.e., knowing that consistent use of condoms and having just one faithful partner can reduce the chance of getting infected, knowing that a healthy-looking person can be infected, and knowing that AIDS cannot be transmitted by sharing food or by mosquito bites. Such a low level of knowledge about AIDS implies that a concerted effort is needed to address misconceptions about HIV transmission. Programs might be focused in the estate sector and especially in Batticaloa, Ampara, and Nuwara Eliya districts where comprehensive knowledge is lowest.

Moreover, a composite indicator on stigma towards HIV-infected people shows that only 8 percent of ever-married women expressed accepting attitudes toward persons living with HIV/AIDS. Overall, only about one- half of ever-married women age 15-49 years know where to get an HIV test.

WOMEN'S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES The 2006-07 SLDHS collected data on women's empowerment, their participation in decisionmaking, and attitudes towards wife beating. Survey results show that more than 90 percent of currently married women, either alone or jointly with their husband, make decisions on how their income is used. However, husbands' control over women's earnings is higher among women with no education (15 percent) than among women with higher education (4 percent).

In Sri Lanka, the husband is usually the main source of household income; two-thirds of women earn less than their husband. Although the majority of women earn less than their husband, almost half have autonomy in decisions about how to spend their earnings.

The survey also collected information on who decides how the husband's cash earnings are spent. The majority of couples (60 percent) make joint decisions on how the husband's cash income is used. More than 1 in 5 women (23 percent) reported that they decide how their husband's earnings are used; another 16 percent of the women reported that their husband mainly decides how his earnings are spent.

Geographic coverage

A nationally representative sample of 21,600 housing units was selected for the survey and 19,872 households were enumerated to give district level estimates (excluding Northern Province).

Analysis unit

• Household
• Women age 15-49
• Children under five

Universe

In principle, the sample was designed to cover private households in the areas sampled. The population residing in institutions and institutional households was excluded. For the detailed individual interview, the eligibility criteria wereall ever-married women aged 15-49 years who slept in the household the previous night and about their children below five years at the

Abstract

The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program.

Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries.

The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country.

MAIN RESULTS

Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila.

Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women.

Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l.

The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom.

Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage.

Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate,

More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively).

Information on various aspects of maternal and child health---antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home.

Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy.

Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases---polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis.

During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids.

Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months.

Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19.

The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution.

Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility.

Geographic coverage

National. The main objective of the 1993 NDS sample is to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region.

Analysis unit

• Household
• Women age 15-49

Universe

The population covered by the 1993 Phillipines NDS is defined as the universe of all females age 15-49 years, who are members of the sample household or visitors present at the time of interview and had slept in the sample households the night prior to the time of interview, regardless of marital status.

Kind of data

Sample survey data

Sampling procedure

The main objective of the 1993 National Demographic Survey (NDS) sample is to provide estimates with an acceptable precision for sociodemographics characteristics, like fertility, family planning, health and mortality variables and to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region.

The sample is nationally representative with a total size of about 15,000 women aged 15 to 49. The Integrated Survey of Households (ISH) was used as a frame. The ISH was developed in 1980, and was comprised of samples of primary sampling units (PSUs) systematically selected and with a probability proportional to size in each of the 14 regions. The PSUs were reselected in 1991, using the 1990 Population Census data on

The 2001 Nepal Demographic and Health Survey (NDHS) is a nationally representative survey of 8,726 women age 15-49 and 2,261 men age 15-59. This Survey is the sixth in a series of national-level population and health surveys conducted in Nepal. It is the second nationally representative comprehensive survey conducted as part of the global Demographic and Health Survey (DHS) program, the first being the 1996 Nepal Family Health Survey (NFHS). The 2001 NDHS is the first in the history of demographic and health surveys conducted in Nepal that included a male sample. The 2001 NDHS was carried out under the aegis of the Family Health Division of the Department of Health Services, Ministry of Health, and was implemented by New ERA, a local research organization, which also conducted the 1996 NFHS. ORC Macro provided technical support through its MEASURE DHS+ project. The survey was funded by the United States Agency for International Development (USAID) through its mission in Nepal. The principal objective of the 2001 NDHS is to provide current and reliable data on fertility and family planning, infant and child mortality, children's and women's nutritional status, the utilization of maternal and child health services, and knowledge of HIV/AIDS. This information is essential for informed policy decisions, planning, monitoring, and evaluation of programs on health in general and reproductive health in particular at both the national and regional levels. A long-term objective of the survey is to strengthen the technical capacity of the Family Health Division of the Ministry of Health to plan, conduct, process, and analyze data from complex national population and health surveys. The 2001 NDHS data is comparable to data collected in the 1996 NFHS and similar to survey data conducted in other developing countries. This allows for temporal and spatial comparisons of demographic health information. The 2001 NDHS also adds to the vast and growing international database on demographic and health variables. The inclusion of data on men adds to the richness of this data. MAIN RESULTS FERTILITY Comparison of data from the 2001 NDHS with earlier surveys conducted in Nepal indicates that fertility has declined steadily from 5.1 births per woman in 1984-1986 to 4.1 births per woman in 1998-2000. Further evidence of recent fertility decline is obtained from the pregnancy history information collected in the 2001 NDHS. There has been an 18 percent decline in fertility among women below age 30, from 3.6 births per woman during the period 15-19 years before the survey to 2.9 births per woman during the period 0-4 years before the survey, with the largest decline in fertility (14 percent) occurring between 5-9 and 0-4 years before the survey. Differences by place of residence are marked, with rural women having more than twice as many children (4.4) as urban women (2.1). Fertility is highest in the mountains (4.8 births per woman), with little difference in fertility between the hills (4.0 births per woman) and the terai (4.1 births per woman). Education is strongly related to fertility, with uneducated women having more than twice as many children (4.8) as women with at least some secondary education (2.3). Data from the national censuses and the 2001 NDHS indicate that the proportion never married among women and men below age 25 has increased gradually over time. Only one in four women age 15-19 was not married in 1961, compared with three in five women in 2001. Similarly in 1961, 5 percent of women age 20-24 had never married, compared with more than three times as many in the same age group five decades later. A similar pattern of decline in nuptiality is observed among men as well, with a proportionately larger change again observed among the youngest age group. FAMILY PLANNING Findings from the 2001 NDHS show that knowledge of family planning is nearly universal among Nepalese women and men. Knowledge of modern methods is generally much higher than knowledge of traditional methods, with women and men being most familiar with female and male sterilization. The mass media are important sources of information on family planning. Three in five women and seven in ten men have heard or seen messages about family planning on the radio, on television, or in print media. The majority of couples approve of family planning. Discussion of family planning between spouses continues to be relatively uncommon, with only two in five women and one in two men who know of a contraceptive method having discussed family planning with their spouse in the year before the survey. The contraceptive prevalence rate among currently married Nepalese women is 39 percent. There has been an impressive increase in the use of contraception in Nepal over the last 25 years, with the increase in current use highest in the most recent five-year period?a 35 percent increase between 1996 and 2001. During this period, the use of modern methods increased from 26 percent to 35 percent among currently married women, with the increase largely attributed to the increase in the use of injectables and female sterilization. There has been a twofold increase in the share of temporary methods over all modern methods in the last decade and a decline in the share of permanent methods overall. Nevertheless, there continues to be a marked discrepancy between ever use of contraception and current use. One in two currently married women has ever used a modern method of family planning, compared with only one in three who is currently using. Similarly, three-fifths of currently married men have ever used a modern, method compared with slightly more than two-fifths who are current users. The most widely used modern method is female sterilization (15 percent among currently married women), followed by injectables (8 percent) and male sterilization (6 percent). Currently married men report a higher use of contraceptives with the largest male/female discrepancy in the use of condoms, with twice as many currently married men as currently married women reporting using condoms (6 percent versus 3 percent). Men also report a much higher use of female sterilization (17 percent) and injectables (10 percent). CHILD HEALTH One in every 11 children born in Nepal dies before reaching age five. Slightly more than two in three under-five deaths occur in the first year of life?infant mortality is 64 deaths per 1,000 live births, and child mortality is 29 deaths per 1,000 live births. During infancy, the risk of neonatal deaths (39 per 1,000) is one and a half times as high as the risk of postneonatal death (26 per 1,000). According to data collected in the 2001 NDHS, mortality levels have declined rapidly since the early 1980s. Under-five mortality in the five years before the survey is 58 percent of what it was 10-14 years before the survey. Comparable data for child mortality (50 percent) and infant mortality (60 percent) indicate that the pace of decline is somewhat faster for child mortality than for infant mortality. The corresponding figures for neonatal and postneonatal mortality are 61 percent and 58 percent, respectively. This decline in childhood mortality levels is confirmed by data from other sources. Sixty percent of children are fully vaccinated by 12 months of age, 83 percent have received the BCG vaccination, and 64 percent have been vaccinated against measles. Coverage for the first dose of DPT is 83 percent, but this drops to 77 percent for the second dose and further to 71 percent for the third dose. Polio coverage is much higher at 97 percent for the first dose, 96 percent for the second dose, and 90 percent for the third dose. The percentage of children age 12-23 months fully immunized by age one has increased in the last five years by 67 percent. The corresponding increases in the third dose of DPT and polio are 39 percent and 87 percent, respectively, while BCG coverage increased by 13 percent and measles vaccination increased by 41 percent. The much higher increase in polio coverage was primarily due to the success of the intensive national immunization day campaigns and other polio eradication activities. MATERNAL HEALTH One in two pregnant women receives antenatal care in Nepal, with 28 percent receiving care from a doctor or nurse, midwife, or auxiliary nurse midwife. In addition, 11 percent of women receive antenatal care from a health assistant or auxiliary health worker, 3 percent receive care from a maternal and child health worker, and 6 percent receive care from a village health worker. Most Nepalese women who receive antenatal care get it at a relatively late stage in their pregnancy and do not make the minimum recommended number of antenatal visits. Only one in seven women (14 percent) makes four or more visits during their entire pregnancy, while 16 percent of women report that their first visit occurred at less than four months of pregnancy. About half of mothers who receive antenatal care report that they were informed about the signs of pregnancy complications, while three in five women report that their blood pressure was measured as part of their routine antenatal care checkup. Forty-five percent of women receive two or more doses of tetanus toxoid injections during their most recent pregnancy. Institutional deliveries are not common in Nepal. Less than one in ten births in the five years preceding the survey took place in a health facility. Thirteen percent of births were attended at delivery by a medical professional, with only 8 percent of births attended by a doctor and 3 percent attended by a nurse, midwife, or auxiliary nurse midwife. Nearly one in four births was attended by a traditional birth attendant. Safe delivery kits were used in 9 percent of births delivered at home. Postnatal care, an important

Multivariable multilevel logistic regression analysis of individual-level and community level factors associated with partner and family pressure to be pregnant among women in five Sub-Saharan Africa, DHS 2021–2023.

Model comparison and random effect analysis for partner and family pressures among women in the Sub-Saharan Africa countries.

Abstract

Domestic Violence Survey 2005 was designed to provide data and indicators about the types and acts of violence against women, children, unmarried females, and the elderly.

Geographic coverage

The sample is cluster, random, and systematic of two stages: First stage: Selecting cluster, random, and systematic sample of 234 enumeration areas. Second stage: Selecting random sample of households from the selected enumeration areas of the first stage; 18 households were selected from each enumeration area selected during the first stage.

Analysis unit

Household, individual

Universe

·Ever-married women aged (15-64) Years ·Children aged (5-17) Years ·Unmarried women aged (18 years and over) ·Elderly 65 years and Over

Kind of data

Sample survey data [ssd]

Sampling procedure

The number of households in the sample was 4,212 households: 2,772 in the West Bank and 1,440 in the Gaza Strip.

The sampling frame consists of a comprehensive sample selected from the Population, Housing, and Establishment Census 1997. The comprehensive sample consists of geographic areas of close size (with an average of 150 households); these are the enumeration areas used in the Census. These areas where used as PSUs at the first stage of sample selection.

The sample is cluster, random, and systematic of two stages: First stage: Selecting cluster, random, and systematic sample of 234 enumeration areas. Second stage: Selecting random sample of households from the selected enumeration areas of the first stage; 18 households were selected from each enumeration area selected during the first stage.

The selection of individuals from the household was so that one married female using the tables of Kish if more than one exist, the selection of one child aged 5-17 years using the tables of Kish, the selection of one unmarried female aged 18 to 64 years using the tables of Kish and the selection of all the elderly 65 years and over.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire of the Domestic Violence Survey consists of five main sections; they are:

Section one: Contains introductory data, quality control items, and a list of the household members including data about demographic, social, and economic characteristics such as age, sex, education, employment status, marital status, and refugee status.

Section two: Deals with ever-married women aged 15-64. This section measures types and forms of physical, psychological, and sexual violence a husband subjects his wife to and the types and forms of physical, psychological, and sexual violence a wife subjects her husband to. The section also deals with the political violence of the Israeli forces and settlers.

Section three: Deals with children aged 5-17 and measures the psychological and physical abuse a child is exposed to according to mother's perspective.

Section four: This section deals with unmarried women aged 18 and over and measures the physical and psychological violence females are exposed to by household member.

Section five: This section deals with elderly people aged 65 and over and measures the psychological and physical abuse they are exposed to by household member whom they reside or do not reside with, and the diseases and disabilities they suffer from.

Cleaning operations

Data editing took place at a number of stages through the processing including: 1. office editing and coding 2. during data entry 3. structure checking and completeness 4. structural checking of SPSS data files

Response rate

" The overall response rate for the survey was %98.5

Sampling error estimates

Detailed information on the sampling Error is available in the Survey Report.

Data appraisal

The advisor of the Domestic Violence Survey reviewed the data for the purpose of evaluating its quality and logic. Some specialist on violence also reviewed the data; they affirmed the data quality. Also, the data evaluation was done through reviewing some regional and international studies and comparison with their results. In general, the entire stages of checks proved the accuracy and high quality of the data.

Abstract

The objective of this survey was to gather detailed information related to reproductive health indicators such as fertility, infant and child mortality, factors affecting mortality, child health, family planning and STI/HIV/AIDS, among others. This survey collected information and data on women's knowledge regarding the prevention of breast and cervical cancers. This survey aimed to enrich the content of previous reproductive health surveys.

The results of this survey show increasing levels of fertility and improved quality of services during pregnancy and childbirth. In addition, the survey indicates a significant decrease in newborn and child mortality rates. Although women's knowledge on contraceptive methods is quite high, actual use of these methods among married women has decreased. This can be explained by the increase in the wanted total fertility rate. However, it is alarming to note a decrease in the knowledge on STI/HIV/AIDS prevention and women's lack of knowledge about common gynecological cancers.

Geographic coverage

The RHS 2008 is nationally and regionally (5 regions - West, Central, East, South, Ulaanbaatar) representative and covers the whole of Mongolia.

Analysis unit

• Households
• Women aged 15-49
• Husbands
• Children

Universe

All women between the ages of 15 and 49, inclusive, who slept in the household’s dwelling the night prior to interview, were eligible to be interviewed using the women’s interview schedule. Three husbands out of five married women interviewed in each PSU were interviewed using the husband’s interview schedule. Children above 5 years old.

Kind of data

Sample survey data [ssd]

Sampling procedure

The 2008 Mongolian Reproductive Health Survey (RHS) has a nationally representative sample of 8382 households, in which 9402 women of reproductive age 15-49 years and a subsample of 3362 husbands were interviewed.

Complete national representation is key for any sample to give results that are truly generalizable to an entire population. The current RHS used the same sampling techniques as the 1998 and 2003 surveys to achieve national representation with minimal sampling errors. The survey was conducted using a two-stage sampling method, which gives an equal probability of selection of households. As this is the same method used in previous surveys, this means that the data are fully comparable with the RHS 1998 and RHS 2008 data sets. The sample frame was comprised of the listings of households prepared annually by bags and horoo across the country. Activities, such as improving household listing, designed for improving the quality of data of the first-stage sample frame were conducted in the fourth quarter of 2007 and the first quarter of 2008. Based on that the actual sampling was based on data from the first half of 2008.

It was determined from the experience of RHS 1998 and RHS 2003 and the similar surveys conducted in other countries that 25 to 30 households per cluster would provide an optimum representation; therefore, 30 households were selected for a cluster. It was decided select to 8,400 households (the lower limit was 7,560), which is 1.3 percent of all households in the country. Dividing this number by the 30 households by cluster gave the result of needing 280 primary sampling units (PSUs). Baghs and horoos were chosen as the primary sampling units (PSUs), resulting in a total of 1,676 PSUs. These PSUs were stratified implicitly by aimag and soum, and the selection of the 280 sample PSUs (or clusters) was done systematically with a random start and probability proportional to the number of registered households in each PSU. Households were then selected systematically with a random start within each PSU, using an interval directly proportional to the number of households in the PSU. The selected households were interviewed using the household questionnaire. All women between the ages of 15 and 49 (inclusive) who slept in the household's dwelling the night prior to the interview were eligible to be interviewed using the women's interview schedule. Three husbands out of every five married women were interviewed in each PSU using the husband's interview schedule.

Distribution of the RHS Household Sampling by Aimag, Mongolia 1998, 2003, 2008

-- Number of households in 1998, 2003, 2008 and Clusters 1) Arhangai, 300, 390, 330, 1-11 2) Bayan-Olgii, 200, 300, 270, 12-20 3) Bayanhongor, 250, 330, 270, 21-29 4) Bulgan, 175, 240, 210, 30-36 5) Gobi-Altai, 175, 240, 210, 37-43 6) Dornogobi, 125, 180, 180 ,44-49 7) Dornod, 200, 240, 270, 50-58 8) Dundgobi, 150, 180, 150, 59-63 9) Zavhan, 250, 300, 270, 64-72 10) Ovorhangai, 350, 420, 390, 73-85 11) Omnogobi, 125, 180, 180, 86-91 12) Suhbaatar, 150, 210, 180, 92-97 13) Selenge, 250, 330, 300, 98-107 14) Tov, 275, 330, 330, 108-118 15) Uvs, 249, 300, 240, 119-126 16) Hovd, 200, 300, 270, 127-135 17) Hovsgol, 325, 450, 420, 136-149 18) Hentii, 200, 270, 240, 150-157 19) Darhan-Uul, 250, 270, 300, 158-167 20) Ulaanbaatar, 1607, 2610, 3060, 168-269 21) Orhon, 149, 300, 300, 270-279 22) Govisumber, 50, 30, 30 ,280 Total number of households in 1998, 2003, and 2008 respectively 6005, 8400, 8400

Mode of data collection

Face-to-face [f2f]

Research instrument

Model 'B' of the Demographic and Health Surveys Program served as a basis for the development of the women's questionnaire, with some adjustments made to reflect Mongolia's specific needs, including the addition of two sets of questions related to breast and vaginal cancer and family violence. There were three questionnaires used in the RHS: the household questionnaire, the woman's questionnaire, and the husband's questionnaire.

The contents of these three questionnaires are outlined briefly below: 1. Household Questionnaire • Age; • Sex; • Educational level; • Marital status; • Relationship to head of household; • Employment status; • Type of income; • Status of civil registration at their residing bags and horoos (new question); • Expenses for health services (new question); • Per capita monthly average income, and; • Household housing conditions. 2. Woman's Questionnaire • Background questions, marital status; • Maternal health, pregnancy, breastfeeding, child health, abortion, miscarriage and stillbirth in the last five years; • Knowledge, access to, and use of contraceptive methods; • Fertility preferences; • Employment and questions concerning the husband; • Knowledge about STIs and AIDS; • Breast and vaginal cancer (new question); • Family violence. 3. Husband's Questionnaire • Background questions; • Reproductive health; • Knowledge, access to, and use of contraceptive methods; • Knowledge about STIs and HIV/AIDS.

Cleaning operations

The computer data entry work began on 15 October 2008 and was completed by 15 February 2009. Editing of the computer files was completed by the middle of March 2009. The "CSPro" computer software package created by Macro International, Inc. was used in data entry and processing. From March to May of 2009 output tables were produced. The RHS main report was prepared jointly by experts from the NSO, MoH, researchers working in agencies under the MoH, researchers from the PTRC of NUM, and other researchers.

Sampling error estimates

Sampling errors are presented in Tables B.02 - B.16 of the RHS National Report 2008, for variables considered to be of major interest. Results are presented for the whole country, for urban and rural areas separately, for each of four education groups, for each of five regions, and for each of three age groups. For each variable, the type of statistic (percentage, mean or rate) and the base population are given in Table B.01 of the RHS National Report 2008. For each variable, Tables B.02 - B.16 of the RHS National Report 2008 present the value of the statistic (R), its standard error (SE), the number of cases (N) where relevant, the design effect (DEFT) where applicable, the relative standard error (SE/R), and the 95 percent confidence limits (R-2SE, R+2SE).

The confidence limits have the following interpretation. For the percentage of currently married women using the contraceptive intrauterine device (IUD), the overall value for the full sample is 22.3%, and its standard error is 0.6%. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, which means that there is a high probability (95 percent) the true percentage currently using the IUD is between 21.1% and 23.5%.

The relative standard errors for most estimates for the country as a whole are small, except for estimates of very small percentages. The magnitude of the error increases as estimates for sub-populations such as geographical areas are considered. For the variable IUD, for instance, the relative standard error (as a percentage of the estimated parameter) for the whole country and for urban and rural areas is 2.7 percent, 4.1 percent, and 4.0 percent, respectively. For the five regions, the relative standard error of the variable IUD varies between 5.4 percent and 10.8 percent.

Special mention should be made of the sampling errors for rates. The denominators are exposure-years, and the numerators are either births or deaths in the population under consideration during the indicated period of time.

It should be noted that the survey indicates, with a 95 percent level of confidence, that the TFR for the 3-year period prior to the survey lay between 3.046