The statistic shows the 20 countries with the lowest fertility rates in 2024. All figures are estimates. In 2024, the fertility rate in Taiwan was estimated to be at 1.11 children per woman, making it the lowest fertility rate worldwide. Fertility rate The fertility rate is the average number of children born per woman of child-bearing age in a country. Usually, a woman aged between 15 and 45 is considered to be in her child-bearing years. The fertility rate of a country provides an insight into its economic state, as well as the level of health and education of its population. Developing countries usually have a higher fertility rate due to lack of access to birth control and contraception, and to women usually foregoing a higher education, or even any education at all, in favor of taking care of housework. Many families in poorer countries also need their children to help provide for the family by starting to work early and/or as caretakers for their parents in old age. In developed countries, fertility rates and birth rates are usually much lower, as birth control is easier to obtain and women often choose a career before becoming a mother. Additionally, if the number of women of child-bearing age declines, so does the fertility rate of a country. As can be seen above, countries like Hong Kong are a good example for women leaving the patriarchal structures and focusing on their own career instead of becoming a mother at a young age, causing a decline of the country’s fertility rate. A look at the fertility rate per woman worldwide by income group also shows that women with a low income tend to have more children than those with a high income. The United States are neither among the countries with the lowest, nor among those with the highest fertility rate, by the way. At 2.08 children per woman, the fertility rate in the US has been continuously slightly below the global average of about 2.4 children per woman over the last decade.

In 2023, there were five countries, where the average woman of childbearing age can expect to have over six children throughout their lifetime. In fact, of the 20 countries in the world with the highest fertility rates, Afghanistan and Yemen are the only countries not found in Sub-Saharan Africa. High fertility rates in Africa With a fertility rate of 6.13 and 6.12 children per woman, Somalia and Chad were the countries with the highest fertility rate in the world. Population growth in Chad is among the highest in the world. Lack of healthcare access, as well as food instability, political instability, and climate change, are all exacerbating conditions that keep Chad's infant mortality rates high, which is generally the driver behind high fertility rates. This situation is common across much of the continent, and, although there has been considerable progress in recent decades, development in Sub-Saharan Africa is not moving as quickly as it did in other regions. Demographic transition While these countries have the highest fertility rates in the world, their rates are all on a generally downward trajectory due to a phenomenon known as the demographic transition. The third stage (of five) of this transition sees birth rates drop in response to decreased infant and child mortality, as families no longer feel the need to compensate for lost children. Eventually, fertility rates fall below replacement level (approximately 2.1 children per woman), which eventually leads to natural population decline once life expectancy plateaus. In some of the most developed countries today, low fertility rates are creating severe econoic and societal challenges as workforces are shrinking while aging populations are placin a greater burden on both public and personal resources.

In 2024, Monaco was the European country estimated to have the highest fertility rate. The country had a fertility rate of 2.1 children per woman. Other small countries such as Gibraltar or Montenegro also came towards the top of the list for 2024, while the large country with the highest fertility rate was France, with 1.64 children per woman. On the other hand, Ukraine had the lowest fertility rate, averaging around one child per woman.

Today, globally, women of childbearing age have an average of approximately 2.2 children over the course of their lifetime. In pre-industrial times, most women could expect to have somewhere between five and ten live births throughout their lifetime; however, the demographic transition then sees fertility rates fall significantly. Looking ahead, it is believed that the global fertility rate will fall below replacement level in the 2050s, which will eventually lead to population decline when life expectancy plateaus. Recent decades Between the 1950s and 1970s, the global fertility rate was roughly five children per woman - this was partly due to the post-WWII baby boom in many countries, on top of already-high rates in less-developed countries. The drop around 1960 can be attributed to China's "Great Leap Forward", where famine and disease in the world's most populous country saw the global fertility rate drop by roughly 0.5 children per woman. Between the 1970s and today, fertility rates fell consistently, although the rate of decline noticeably slowed as the baby boomer generation then began having their own children. Replacement level fertility Replacement level fertility, i.e. the number of children born per woman that a population needs for long-term stability, is approximately 2.1 children per woman. Populations may continue to grow naturally despite below-replacement level fertility, due to reduced mortality and increased life expectancy, however, these will plateau with time and then population decline will occur. It is believed that the global fertility rate will drop below replacement level in the mid-2050s, although improvements in healthcare and living standards will see population growth continue into the 2080s when the global population will then start falling.

Key figures on fertility, live and stillborn children and multiple births among inhabitants of The Netherlands.

Available selections: - Live born children by sex; - Live born children by age of the mother (31 December), in groups; - Live born children by birth order from the mother; - Live born children by marital status of the mother; - Live born children by country of birth of the mother and origin country of the mother; - Stillborn children by duration of pregnancy; - Births: single and multiple; - Average number of children per female; - Average number of children per male; - Average age of the mother at childbirth by birth order from the mother; - Average age of the father at childbirth by birth order from the mother; - Net replacement factor.

CBS is in transition towards a new classification of the population by origin. Greater emphasis is now placed on where a person was born, aside from where that person’s parents were born. The term ‘migration background’ is no longer used in this regard. The main categories western/non-western are being replaced by categories based on continents and a few countries that share a specific migration history with the Netherlands. The new classification is being implemented gradually in tables and publications on population by origin.

Data available from: 1950 Most of the data is available as of 1950 with the exception of the live born children by country of birth of the mother and origin country of the mother (from 2021, previous periods will be added at a later time), stillborn children by duration of pregnancy (24+) (from 1991), average number of children per male (from 1996) and the average age of the father at childbirth (from 1996).

Status of the figures: All data recorded in this publication are final data.

Changed on 15 augustus 2025: The 2023 figures on stillbirths and (multiple) births are final. Final figures of 2024 have been added.

When will new figures be published? In the third quarter of 2026 final figures of 2025 will be published in this publication.

Families with children and young persons by age, family type, mothers country of birth, the fathers country of birth, observations and year

The total fertility rate of the world has dropped from around 5 children per woman in 1950, to 2.2 children per woman in 2025, which means that women today are having fewer than half the number of children that women did 75 years ago. Replacement level fertility This change has come as a result of the global demographic transition, and is influenced by factors such as the significant reduction in infant and child mortality, reduced number of child marriages, increased educational and vocational opportunities for women, and the increased efficacy and availability of contraception. While this change has become synonymous with societal progress, it does have wide-reaching demographic impact - if the global average falls below replacement level (roughly 2.1 children per woman), as is expected to happen in the 2050s, then this will lead to long-term population decline on a global scale. Regional variations When broken down by continent, Africa is the only region with a fertility rate above the global average, and, alongside Oceania, it is the only region with a fertility rate above replacement level. Until the 1980s, the average woman in Africa could expect to have 6-7 children over the course of their lifetime, and there are still several countries in Africa where women can still expect to have 5 or more children in 2025. Historically, Europe has had the lowest fertility rates in the world over the past century, falling below replacement level in 1975. Europe's population has grown through a combination of migration and increasing life expectancy, however even high immigration rates could not prevent its population from going into decline in 2021.

Australia Average Number of Dependent Children in Household: Multiple Family data was reported at 1.200 Person in 2020. This records a decrease from the previous number of 1.400 Person for 2018. Australia Average Number of Dependent Children in Household: Multiple Family data is updated yearly, averaging 1.300 Person from Jun 2004 (Median) to 2020, with 9 observations. The data reached an all-time high of 1.500 Person in 2016 and a record low of 1.200 Person in 2020. Australia Average Number of Dependent Children in Household: Multiple Family data remains active status in CEIC and is reported by Australian Bureau of Statistics. The data is categorized under Global Database’s Australia – Table AU.H039: Survey of Income and Housing: Average Number of Dependent Children in Household: by Family Composition.

Pakistan Average Number per Household: Children data was reported at 2.770 Person in 2016. This records a decrease from the previous number of 2.800 Person for 2014. Pakistan Average Number per Household: Children data is updated yearly, averaging 2.880 Person from Jun 2002 (Median) to 2016, with 8 observations. The data reached an all-time high of 3.310 Person in 2002 and a record low of 2.770 Person in 2016. Pakistan Average Number per Household: Children data remains active status in CEIC and is reported by Pakistan Bureau of Statistics. The data is categorized under Global Database’s Pakistan – Table PK.H005: Household Integrated Economic Survey: Average Numbers per Household.

United States US: Fertility Rate: Total: Births per Woman data was reported at 1.800 Ratio in 2016. This records a decrease from the previous number of 1.843 Ratio for 2015. United States US: Fertility Rate: Total: Births per Woman data is updated yearly, averaging 2.002 Ratio from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 3.654 Ratio in 1960 and a record low of 1.738 Ratio in 1976. United States US: Fertility Rate: Total: Births per Woman data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with age-specific fertility rates of the specified year.; ; (1) United Nations Population Division. World Population Prospects: 2017 Revision. (2) Census reports and other statistical publications from national statistical offices, (3) Eurostat: Demographic Statistics, (4) United Nations Statistical Division. Population and Vital Statistics Reprot (various years), (5) U.S. Census Bureau: International Database, and (6) Secretariat of the Pacific Community: Statistics and Demography Programme.; Weighted average; Relevance to gender indicator: it can indicate the status of women within households and a woman’s decision about the number and spacing of children.

The Occupied Palestinian territories, namely the West Bank and Gaza Strip, had the highest average births per woman in the Middle East and North Africa (MENA) region, reaching almost 3.5 and 3.3 births per woman respectively in 2024. Bahrain and the UAE had the lowest birth rates per woman in the region. Birth rates and maternal health improvements in MENA Birth rates in the Middle East and North Africa have decreased considerably over the years. The crude birth rate in MENA dropped from around 25 per 1,000 population in 2000 to 20 in 2021. Considerable progress has been made regarding the health of women who are pregnant. The maternal mortality ratio in MENA decreased from 108 deaths per 100,000 live births in 2000, to 56 in 2020. Another trend is a slow but noticeable decline in the adolescent fertility rate in MENA over the last two decades, from around 44 in 2000 to about 34 births per 1,000 adolescent girls in 2022. Persistent female health issues A high female obesity rate is a prevalent health issues stemming from lifestyles in MENA. The obesity rate among adult females in MENA ranged from around 59 percent in Egypt to approximately 31.5 percent in Morocco as of 2022. Female genital mutilation is another societal problem in the region, though not an isolated one. The number of girls and women who have undergone female genital mutilation in Africa was around 144 million in 2024. In the Middle East, this number was much lower, at about six million.

The 1998 Philippines National Demographic and Health Survey (NDHS). is a nationally-representative survey of 13,983 women age 15-49. The NDHS was designed to provide information on levels and trends of fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. It was implemented by the National Statistics Office in collaboration with the Department of Health (DOH). Macro International Inc. of Calverton, Maryland provided technical assistance to the project, while financial assistance was provided by the U.S. Agency for International Development (USAID) and the DOH. Fieldwork for the NDHS took place from early March to early May 1998. The primary objective of the NDHS is to Provide up-to-date information on fertility levels; determinants of fertility; fertility preferences; infant and childhood mortality levels; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policy makers and program managers in evaluating and designing programs and strategies for improving health and family planning services in the country. MAIN RESULTS Survey data generally confirm patterns observed in the 1993 National Demographic Survey (NDS), showing increasing contraceptive use and declining fertility. FERTILITY Fertility Decline. The NDHS data indicate that fertility continues to decline gradually but steadily. At current levels, women will give birth an average of 3.7 children per woman during their reproductive years, a decline from the level of 4.1 recorded in the 1993 NDS. A total fertility rate of 3.7, however, is still considerably higher than the rates prevailing in neighboring Southeast Asian countries. Fertility Differentials. Survey data show that the large differential between urban and rural fertility levels is widening even further. While the total fertility rate in urban areas declined by about 15 percent over the last five years (from 3.5 to 3.0), the rate among rural women barely declined at all (from 4.8 to 4.7). Consequently, rural women give birth to almost two children more than urban women. Significant differences in fertility levels by region still exist. For example, fertility is more than twice as high in Eastern Visayas and Bicol Regions (with total fertility rates well over 5 births per woman) than in Metro Manila (with a rate of 2.5 births per woman). Fertility levels are closely related to women's education. Women with no formal education give birth to an average of 5.0 children in their lifetime, compared to 2.9 for women with at least some college education. Women with either elementary or high school education have intermediate fertility rates. Family Size Norms. One reason that fertility has not fallen more rapidly is that women in the Philippines still want moderately large families. Only one-third of women say they would ideally like to have one or two children, while another third state a desire for three children. The remaining third say they would choose four or more children. Overall, the mean ideal family size among all women is 3.2 children, identical to the mean found in 1993. Unplanned Fertility. Another reason for the relatively high fertility level is that unplanned pregnancies are still common in the Philippines. Overall, 45 percent of births in the five years prior to the survey were reported to be unplanned; 27 percent were mistimed (wanted later) and 18 percent were unwanted. If unwanted births could be eliminated altogether, the total fertility rate in the Philippines would be 2.7 births per woman instead of the actual level of 3.7. Age at First Birth. Fertility rates would be even higher if Filipino women did not have a pattem of late childbearing. The median age at first birth is 23 years in the Philippines, considerably higher than in most other countries. Another factor that holds down the overall level of fertility is the fact that about 9 or 10 percent of women never give birth, higher than the level of 3-4 percent found in most developing countries. FAMILY PLANNING Increasing Use of Contraception. A major cause of declining fertility in the Philippines has been the gradual but fairly steady increase in contraceptive use over the last three decades. The contraceptive prevalence rate has tripled since 1968, from 15 to 47 percent of married women. Although contraceptive use has increased since the 1993 NDS (from 40 to 47 percent of married women), comparison with the series of nationally representative Family Planning Surveys indicates that there has been a levelling-off in family planning use in recent years. Method Mix. Use of traditional methods of family planning has always accounted for a relatively high proportion of overall use in the Philippines, and data from the 1998 NDHS show the proportion holding steady at about 40 percent. The dominant changes in the "method mix" since 1993 have been an increase in use of injectables and traditional methods such as calendar rhythm and withdrawal and a decline in the proportions using female sterilization. Despite the decline in the latter, female sterilization still is the most widely used method, followed by the pill. Differentials in Family Planning Use. Differentials in current use of family planning in the 16 administrative regions of the country are large, ranging from 16 percent of married women in ARMM to 55 percent of those in Southern Mindanao and Central Luzon. Contraceptive use varies considerably by education of women. Only 15 percent of married women with no formal education are using a method, compared to half of those with some secondary school. The urban-rural gap in contraceptive use is moderate (51 vs. 42 percent, respectively). Knowledge of Contraception. Knowledge of contraceptive methods and supply sources has been almost universal in the Philippines for some time and the NDHS results indicate that 99 percent of currently married women age 15-49 have heard of at least one method of family planning. More than 9 in 10 married women know the pill, IUD, condom, and female sterilization, while about 8 in 10 have heard of injectables, male sterilization, rhythm, and withdrawal. Knowledge of injectables has increased far more than any other method, from 54 percent of married women in 1993 to 89 percent in 1998. Unmet Need for Family Planning. Unmet need for family planning services has declined since I993. Data from the 1993 NDS show that 26 percent of currently married women were in need of services, compared with 20 percent in the 1998 NDHS. A little under half of the unmet need is comprised of women who want to space their next birth, while just over half is for women who do not want any more children (limiters). If all women who say they want to space or limit their children were to use methods, the contraceptive prevalence rate could be increased from 47 percent to 70 percent of married women. Currently, about three-quarters of this "total demand" for family planning is being met. Discontinuation Rates. One challenge for the family planning program is to reduce the high levels of contraceptive discontinuation. NDHS data indicate that about 40 percent of contraceptive users in the Philippines stop using within 12 months of starting, almost one-third of whom stop because of an unwanted pregnancy (i.e., contraceptive failure). Discontinuation rates vary by method. Not surprisingly, the rates for the condom (60 percent), withdrawal (46 percent), and the pill (44 percent) are considerably higher than for the 1UD (14 percent). However, discontinuation rates for injectables are relatively high, considering that one dose is usually effective for three months. Fifty-two percent of injection users discontinue within one year of starting, a rate that is higher than for the pill. MATERNAL AND CHILD HEALTH Childhood Mortality. Survey results show that although the infant mortality rate remains unchanged, overall mortality of children under five has declined somewhat in recent years. Under-five mortality declined from 54 deaths per 1,000 births in 1988-92 to 48 for the period 1993-97. The infant mortality rate remained stable at about 35 per 1,000 births. Childhood Vaccination Coverage. The 1998 NDHS results show that 73 percent of children 12- 23 months are fully vaccinated by the date of the interview, almost identical to the level of 72 percent recorded in the 1993 NDS. When the data are restricted to vaccines received before the child's first birthday, however, only 65 percent of children age 12-23 months can be considered to be fully vaccinated. Childhood Health. The NDHS provides some data on childhood illness and treatment. Approximately one in four children under age five had a fever and 13 percent had respiratory illness in the two weeks before the survey. Of these, 58 percent were taken to a health facility for treatment. Seven percent of children under five were reported to have had diarrhea in the two weeks preceeding the survey. The fact that four-fifths of children with diarrhea received some type of oral rehydration therapy (fluid made from an ORS packet, recommended homemade fluid, or increased fluids) is encouraging. Breastfeeding Practices. Almost all Filipino babies (88 percent) are breastfed for some time, with a median duration of breastfeeding of 13 months. Although breastfeeding has beneficial effects on both the child and the mother, NDHS data indicate that supplementation of breastfeeding with other liquids and foods occurs too early in the Philippines. For example, among newborns less than two months of age, 19 percent were already receiving supplemental foods or liquids other than water. Maternal Health Care. NDHS data point to several areas regarding maternal health care in which improvements could be made. Although most Filipino mothers (86 percent) receive prenatal care from a doctor, nurse, or midwife, tetanus toxoid coverage is far from universal and

Switzerland Total Fertility Rate: Children per Woman data was reported at 1.490 Person in 2021. This stayed constant from the previous number of 1.490 Person for 2020. Switzerland Total Fertility Rate: Children per Woman data is updated yearly, averaging 1.490 Person from Dec 1990 (Median) to 2021, with 32 observations. The data reached an all-time high of 1.580 Person in 1991 and a record low of 1.380 Person in 2003. Switzerland Total Fertility Rate: Children per Woman data remains active status in CEIC and is reported by Organisation for Economic Co-operation and Development. The data is categorized under Global Database’s Switzerland – Table CH.OECD.GGI: Social: Demography: OECD Member: Annual.

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 count and description of the families of the Basque Country is carried out using various statistical sources. On the one hand, family counts are carried out through the Population and Housing Census; on the other hand, the Demographic Survey (ED) operation, of an intercensal nature and of five-year periodicity, provides information on the formation of families, family size, preferences on the number and spacing of children, as well as numerous other characteristics, using the method of retrospective approach to demographic phenomena.

Abstract

The 1998 Philippines National Demographic and Health Survey (NDHS). is a nationally-representative survey of 13,983 women age 15-49. The NDHS was designed to provide information on levels and trends of fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. It was implemented by the National Statistics Office in collaboration with the Department of Health (DOH). Macro International Inc. of Calverton, Maryland provided technical assistance to the project, while financial assistance was provided by the U.S. Agency for International Development (USAID) and the DOH. Fieldwork for the NDHS took place from early March to early May 1998.

The primary objective of the NDHS is to Provide up-to-date information on fertility levels; determinants of fertility; fertility preferences; infant and childhood mortality levels; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policy makers and program managers in evaluating and designing programs and strategies for improving health and family planning services in the country.

MAIN RESULTS

Survey data generally confirm patterns observed in the 1993 National Demographic Survey (NDS), showing increasing contraceptive use and declining fertility.

FERTILITY

Fertility Decline. The NDHS data indicate that fertility continues to decline gradually but steadily. At current levels, women will give birth an average of 3.7 children per woman during their reproductive years, a decline from the level of 4.1 recorded in the 1993 NDS. A total fertility rate of 3.7, however, is still considerably higher than the rates prevailing in neighboring Southeast Asian countries.

Fertility Differentials. Survey data show that the large differential between urban and rural fertility levels is widening even further. While the total fertility rate in urban areas declined by about 15 percent over the last five years (from 3.5 to 3.0), the rate among rural women barely declined at all (from 4.8 to 4.7). Consequently, rural women give birth to almost two children more than urban women.

Significant differences in fertility levels by region still exist. For example, fertility is more than twice as high in Eastern Visayas and Bicol Regions (with total fertility rates well over 5 births per woman) than in Metro Manila (with a rate of 2.5 births per woman).

Fertility levels are closely related to women's education. Women with no formal education give birth to an average of 5.0 children in their lifetime, compared to 2.9 for women with at least some college education. Women with either elementary or high school education have intermediate fertility rates.

Family Size Norms. One reason that fertility has not fallen more rapidly is that women in the Philippines still want moderately large families. Only one-third of women say they would ideally like to have one or two children, while another third state a desire for three children. The remaining third say they would choose four or more children. Overall, the mean ideal family size among all women is 3.2 children, identical to the mean found in 1993.

Unplanned Fertility. Another reason for the relatively high fertility level is that unplanned pregnancies are still common in the Philippines. Overall, 45 percent of births in the five years prior to the survey were reported to be unplanned; 27 percent were mistimed (wanted later) and 18 percent were unwanted. If unwanted births could be eliminated altogether, the total fertility rate in the Philippines would be 2.7 births per woman instead of the actual level of 3.7.

Age at First Birth. Fertility rates would be even higher if Filipino women did not have a pattem of late childbearing. The median age at first birth is 23 years in the Philippines, considerably higher than in most other countries. Another factor that holds down the overall level of fertility is the fact that about 9 or 10 percent of women never give birth, higher than the level of 3-4 percent found in most developing countries.

FAMILY PLANNING

Increasing Use of Contraception. A major cause of declining fertility in the Philippines has been the gradual but fairly steady increase in contraceptive use over the last three decades. The contraceptive prevalence rate has tripled since 1968, from 15 to 47 percent of married women. Although contraceptive use has increased since the 1993 NDS (from 40 to 47 percent of married women), comparison with the series of nationally representative Family Planning Surveys indicates that there has been a levelling-off in family planning use in recent years.

Method Mix. Use of traditional methods of family planning has always accounted for a relatively high proportion of overall use in the Philippines, and data from the 1998 NDHS show the proportion holding steady at about 40 percent. The dominant changes in the "method mix" since 1993 have been an increase in use of injectables and traditional methods such as calendar rhythm and withdrawal and a decline in the proportions using female sterilization. Despite the decline in the latter, female sterilization still is the most widely used method, followed by the pill.

Differentials in Family Planning Use. Differentials in current use of family planning in the 16 administrative regions of the country are large, ranging from 16 percent of married women in ARMM to 55 percent of those in Southern Mindanao and Central Luzon. Contraceptive use varies considerably by education of women. Only 15 percent of married women with no formal education are using a method, compared to half of those with some secondary school. The urban-rural gap in contraceptive use is moderate (51 vs. 42 percent, respectively).

Knowledge of Contraception. Knowledge of contraceptive methods and supply sources has been almost universal in the Philippines for some time and the NDHS results indicate that 99 percent of currently married women age 15-49 have heard of at least one method of family planning. More than 9 in 10 married women know the pill, IUD, condom, and female sterilization, while about 8 in 10 have heard of injectables, male sterilization, rhythm, and withdrawal. Knowledge of injectables has increased far more than any other method, from 54 percent of married women in 1993 to 89 percent in 1998.

Unmet Need for Family Planning. Unmet need for family planning services has declined since I993. Data from the 1993 NDS show that 26 percent of currently married women were in need of services, compared with 20 percent in the 1998 NDHS. A little under half of the unmet need is comprised of women who want to space their next birth, while just over half is for women who do not want any more children (limiters). If all women who say they want to space or limit their children were to use methods, the contraceptive prevalence rate could be increased from 47 percent to 70 percent of married women. Currently, about three-quarters of this "total demand" for family planning is being met.

Discontinuation Rates. One challenge for the family planning program is to reduce the high levels of contraceptive discontinuation. NDHS data indicate that about 40 percent of contraceptive users in the Philippines stop using within 12 months of starting, almost one-third of whom stop because of an unwanted pregnancy (i.e., contraceptive failure). Discontinuation rates vary by method. Not surprisingly, the rates for the condom (60 percent), withdrawal (46 percent), and the pill (44 percent) are considerably higher than for the 1UD (14 percent). However, discontinuation rates for injectables are relatively high, considering that one dose is usually effective for three months. Fifty-two percent of injection users discontinue within one year of starting, a rate that is higher than for the pill.

MATERNAL AND CHILD HEALTH

Childhood Mortality. Survey results show that although the infant mortality rate remains unchanged, overall mortality of children under five has declined somewhat in recent years. Under-five mortality declined from 54 deaths per 1,000 births in 1988-92 to 48 for the period 1993-97. The infant mortality rate remained stable at about 35 per 1,000 births. Childhood Vaccination Coverage. The 1998 NDHS results show that 73 percent of children 12- 23 months are fully vaccinated by the date of the interview, almost identical to the level of 72 percent recorded in the 1993 NDS. When the data are restricted to vaccines received before the child's first birthday, however, only 65 percent of children age 12-23 months can be considered to be fully vaccinated.

Childhood Health. The NDHS provides some data on childhood illness and treatment. Approximately one in four children under age five had a fever and 13 percent had respiratory illness in the two weeks before the survey. Of these, 58 percent were taken to a health facility for treatment. Seven percent of children under five were reported to have had diarrhea in the two weeks preceeding the survey. The fact that four-fifths of children with diarrhea received some type of oral rehydration therapy (fluid made from an ORS packet, recommended homemade fluid, or increased fluids) is encouraging.

Breastfeeding Practices. Almost all Filipino babies (88 percent) are breastfed for some time, with a median duration of breastfeeding of 13 months. Although breastfeeding has beneficial effects on both the child and the mother, NDHS data indicate that supplementation of breastfeeding with other liquids and foods occurs too early in the Philippines. For example, among newborns less than two months of age, 19 percent were already receiving supplemental foods or liquids other than water.

Maternal Health Care. NDHS data point to several areas regarding maternal health care in which improvements could be made. Although most Filipino mothers (86 percent) receive prenatal

In 2011, the average number of children in French families was *** children. This number was a little bit higher in blended families which accounted for *** children on average. With a higher divorce rate and a decreasing birth rate, families in France are experiencing changes in recent years.

More and more blended families in France

The most common family type in France in 2015 was a couple with children. In 2016, France was still the country with the highest fertility rate in Europe. That year, France had a mean of over **** children being born alive to a woman during her lifetime. French citizens have more children than their European neighbors which does not necessarily mean that France is not impacted by the decline of births. However, with the rising number of divorces in the country, more children are now living in a new type of family. Stepfamilies are becoming more common and in a survey from 2015, ** percent of responding French declared that they were in favor of creating a stepparent status for stepfamilies.

The evolution of family structure

Family structure is evolving in France and in Europe. Getting married and then having children in that order are not the most common life path anymore. In 2018, there were more than 60 percent of children born out of wedlock in France. Also, the country saw an increasing number of single parent families. The democratization of parental leave, as well as LGBT parenting, are reshaping the structure and the views public opinion could have about what being a family is.

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.

The fertility rate of a country is the average number of children that women from that country will have throughout their reproductive years. In the United States in 1800, the average woman of childbearing age would have seven children over the course of their lifetime. As factors such as technology, hygiene, medicine and education improved, women were having fewer children than before, reaching just two children per woman in 1940. This changed quite dramatically in the aftermath of the Second World War, rising sharply to over 3.5 children per woman in 1960 (children born between 1946 and 1964 are nowadays known as the 'Baby Boomer' generation, and they make up roughly twenty percent of todays US population). Due to the end of the baby boom and increased access to contraception, fertility reached it's lowest point in the US in 1980, where it was just 1.77. It did however rise to over two children per woman between 1995 and 2010, although it is expected to drop again by 2020, to just 1.78.

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