In order to assess the possible effects of lifestyle on fertility and pregnancy outcome, the PALS (Pregnancy and Lifestyle study) collected extensive data on a broad range of parameters termed 'lifestyle' from couples who were planning a natural (non-assisted) pregnancy in the coming months. There was no intervention. Participants were recruited over a six year period from 1988 to 1993 in response to extensive promotion in the local media. Male and female partners were interviewed independently and all interviews were conducted prospectively before the couple attempted to conceive. The result of each month of 'trying' was recorded and pregnancies were confirmed by urine tests and by ultrasound. The length of gestation of each pregnancy was recorded and pregnancies at term were classified with respect to weight. Multiple pregnancies and/or babies with congenital abnormalities have been excluded from the dataset. The data is stored as an xls file and each variable has a codename. For each of 582 couples there are 355 variables, the codes for which are described in a separate metadata file. The questionnaire based data includes information about households, occupation, chemical exposures at work and home, diet, smoking, alcohol use, hobbies, exercise and health. Recorded observations include monthly pregnancy tests and pregnancy outcomes.

The 1997 the Kyrgyz Republic Demographic and Health Survey (KRDHS) is a nationally representative survey of 3,848 women age 15-49. Fieldwork was conducted from August to November 1997. The KRDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Research Institute of Obstetrics and Pediatrics implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The purpose of the KRDHS was to provide data to the MOH on factors which determine the health status of women and children such as fertility, contraception, induced abortion, maternal care, infant mortality, nutritional status, and anemia. Some statistics presented in this report are currently available to the MOH from other sources. For example, the MOH collects and regularly publishes information on fertility, contraception, induced abortion and infant mortality. However, the survey presents information on these indices in a manner which is not currently available, i.e., by population subgroups such as those defined by age, marital duration, education, and ethnicity. Additionally, the survey provides statistics on some issues not previously available in the Kyrgyz Republic: for example, breastfeeding practices and anemia status of women and children. When considered together, existing MOH data and the KRDHS data provide a more complete picture of the health conditions in the Kyrgyz Republic than was previously available. A secondary objective of the survey was to enhance the capabilities of institutions in the Kyrgyz Republic to collect, process, and analyze population and health data. MAIN FINDINGS FERTILITY Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of the Kyrgyz Republic of 3.4 children per woman. Fertility levels differ for different population groups. The TFR for women living in urban areas (2.3 children per woman) is substantially lower than for women living in rural areas (3.9). The TFR for Kyrgyz women (3.6 children per woman) is higher than for women of Russian ethnicity (1.5) but lower than Uzbek women (4.2). Among the regions of the Kyrgyz Republic, the TFR is lowest in Bishkek City (1.7 children per woman), and the highest in the East Region (4.3), and intermediate in the North and South Regions (3.1 and3.9, respectively). Time Trends. The KRDHS data show that fertility has declined in the Kyrgyz Republic in recent years. The decline in fertility from 5-9 to 0-4 years prior to the survey increases with age, from an 8 percent decline among 20-24 year olds to a 38 percent decline among 35-39 year olds. The declining trend in fertility can be seen by comparing the completed family size of women near the end of their childbearing years with the current TFR. Completed family size among women 40-49 is 4.6 children which is more than one child greater than the current TFR (3.4). Birth Intervals. Overall, 30 percent of births in the Kyrgyz Republic take place within 24 months of the previous birth. The median birth interval is 31.9 months. Age at Onset of Childbearing. The median age at which women in the Kyrgyz Republic begin childbearing has been holding steady over the past two decades at approximately 21.6 years. Most women have their first birth while in their early twenties, although about 20 percent of women give birth before age 20. Nearly half of married women in the Kyrgyz Republic (45 percent) do not want to have more children. Additional one-quarter of women (26 percent) want to delay their next birth by at least two years. These are the women who are potentially in need of some method of family planning. FAMILY PLANNING Ever Use. Among currently married women, 83 percent report having used a method of contraception at some time. The women most likely to have ever used a method of contraception are those age 30-44 (among both currently married and all women). Current Use. Overall, among currently married women, 60 percent report that they are currently using a contraceptive method. About half (49 percent) are using a modern method of contraception and another 11 percent are using a traditional method. The IUD is by far the most commonly used method; 38 percent of currently married women are using the IUD. Other modern methods of contraception account for only a small amount of use among currently married women: pills (2 percent), condoms (6 percent), and injectables and female sterilization (1 and 2 percent, respectively). Thus, the practice of family planning in the Kyrgyz Republic places high reliance on a single method, the IUD. Source of Methods. The vast majority of women obtain their contraceptives through the public sector (97 percent): 35 percent from a government hospital, and 36 percent from a women counseling center. The source of supply of the method depends on the method being used. For example, most women using IUDs obtain them at women counseling centers (42 percent) or hospitals (39 percent). Government pharmacies supply 46 percent of pill users and 75 percent of condom users. Pill users also obtain supplies from women counseling centers or (33 percent). Fertility Preferences. A majority of women in the Kyrgyz Republic (45 percent) indicated that they desire no more children. By age 25-29, 20 percent want no more children, and by age 30-34, nearly half (46 percent) want no more children. Thus, many women come to the preference to stop childbearing at relatively young ages-when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization. However, there is a deficiency of use of this method in the Kyrgyz Republic. In the interests of providing a broad range of safe and effective methods, information about and access to sterilization should be increased so that individual women can make informed decisions about using this method. INDUCED ABORTION Abortion Rates. From the KRDHS data, the total abortion rate (TAR)-the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rates-was calculated. For the Kyrgyz Republic, the TAR for the period from mid-1994 to mid-1997 is 1.6 abortions per woman. The TAR for the Kyrgyz Republic is lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakhstan (1.8), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively), but higher than for Uzbekistan (0.7). The TAR is higher in urban areas (2.1 abortions per woman) than in rural areas (1.3). The TAR in Bishkek City is 2.0 which is two times higher than in other regions of the Kyrgyz Republic. Additionally the TAR is substantially lower among ethnic Kyrgyz women (1.3) than among women of Uzbek and Russian ethnicities (1.9 and 2.2 percent, respectively). INFANT MORTALITY In the KRDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid-1992 to mid1997), infant mortality in the Kyrgyz Republic is estimated at 61 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 32 and 30 per 1,000. The MOH publishes infant mortality rates annually but the definition of a live birth used by the MOH differs from that used in the survey. As is the case in most of the republics of the former Soviet Union, a pregnancy that terminates at less than 28 weeks of gestation is considered premature and is classified as a late miscarriage even if signs of life are present at the time of delivery. Thus, some events classified as late miscarriages in the MOH system would be classified as live births and infant deaths according to the definitions used in the KRDHS. Infant mortality rates based on the MOH data for the years 1983 through 1996 show a persistent declining trend throughout the period, starting at about 40 per 1,000 in the early 1980s and declining to 26 per 1,000 in 1996. This time trend is similar to that displayed by the rates estimated from the KRDHS. Thus, the estimates from both the KRDHS and the Ministry document a substantial decline in infant mortality; 25 percent over the period from 1982-87 to 1992-97 according to the KRDHS and 28 percent over the period from 1983-87 to 1993-96 according to the MOH estimates. This is strong evidence of improvements in infant survivorship in recent years in the Kyrgyz Republic. It should be noted that the rates from the survey are much higher than the MOH rates. For example, the KRDHS estimate of 61 per 1,000 for the period 1992-97 is twice the MOH estimate of 29 per 1,000 for 1993-96. Certainly, one factor leading to this difference are the differences in the definitions of a live birth and infant death in the KRDHS survey and in the MOH protocols. A thorough assessment of the difference between the two estimates would need to take into consideration the sampling variability of the survey's estimate. However, given the magnitude of the difference, it is likely that it arises from a combination of definitional and methodological differences between the survey and MOH registration system. MATERNAL AND CHILD HEALTH The Kyrgyz Republic has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women counseling centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout the rural areas. Delivery. Virtually all births in the Kyrgyz Republic (96 percent) are delivered at health facilities: 95 percent in delivery hospitals and another 1 percent in either general hospitals

Number of live births and fetal deaths (stillbirths), by type of birth (single or multiple), 1991 to most recent year.

The 1996 Uzbekistan Demographic and Health Survey (UDHS) is a nationally representative survey of 4,415 women age 15-49. Fieldwork was conducted from June to October 1996. The UDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Institute of Obstetrics and Gynecology implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The 1996 UDHS was the first national-level population and health survey in Uzbekistan. It was implemented by the Research Institute of Obstetrics and Gynecology of the Ministry of Health of Uzbekistan. The 1996 UDHS was funded by the United States Agency for International development (USAID) and technical assistance was provided by Macro International Inc. (Calverton, Maryland USA) through its contract with USAID. OBJECTIVES AND ORGANIZATION OF THE SURVEY The purpose of the 1996 Uzbekistan Demographic and Health Survey (UDHS) was to provide an information base to the Ministry of Health for the planning of policies and programs regarding the health of women and their children. The UDHS collected data on women's reproductive histories, knowledge and use of contraception, breastfeeding practices, and the nutrition, vaccination coverage, and episodes of illness among children under the age of three. The survey also included, for all women of reproductive age and for children under the age of three, the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutritional status. A secondary objective of the survey was to enhance the capabilities of institutions in Uzbekistan to collect, process and analyze population and health data so as to facilitate the implementation of future surveys of this type. MAIN RESULTS Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of Uzbekistan of 3.3 children per woman. Fertility levels differ for different population groups. The TFR for women living in urbml areas (2.7 children per woman) is substantially lower than for women living in rural areas (3.7). The TFR for Uzbeki women (3.5 children per woman) is higher than for women of other ethnicities (2.5). Among the regions of Uzbekistan, the TFR is lowest in Tashkent City (2.3 children per woman). Family Planning. Knowledge. Knowledge of contraceptive methods is high among women in Uzbekistan. Knowledge of at least one method is 89 percent. High levels of knowledge are the norm for women of all ages, all regions of the country, all educational levels, and all ethnicities. However, knowledge of sterilization was low; only 27 percent of women reported knowing of this method. Fertility Preferences. A majority of women in Uzbekistan (51 percent) indicated that they desire no more children. Among women age 30 and above, the proportion that want no more children increases to 75 percent. Thus, many women come to the preference to stop childbearing at relatively young ages when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization, However, there is a deficiency of both knowledge and use of this method in Uzbekistan. In the interest of providing couples with a broad choice of safe and effective methods, information about this method and access to it should be made available so that informed choices about its suitability can be made by individual women and couples. Induced Aboration : Abortion Rates. From the UDHS data, the total abortion rate (TAR)the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rateswas calculated. For Uzbekistan, the TAR for the period from mid-1993 to mid-1996 is 0.7 abortions per woman. As expected, the TAR for Uzbekistan is substantially lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakstan (1.8), Romania (3.4 abortions per woman), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively). Infant mortality : In the UDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid- 1992 to mid- 1996), infant mortality in Uzbekistan is estimated at 49 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 23 and 26 per 1,000. Maternal and child health : Uzbekistan has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women's consulting centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout rural areas. Nutrition : Breastfeeding. Breastfeeding is almost universal in Uzbekistan; 96 percent of children born in the three years preceding the survey are breastfed. Overall, 19 percent of children are breastfed within an hour of delivery and 40 percent within 24 hours of delivery. The median duration of breastfeeding is lengthy (17 months). However, durations of exclusive breastfeeding, as recommended by WHO, are short (0.4 months). Prevalence of anemia : Testing of women and children for anemia was one of the major efforts of the 1996 UDHS. Anemia has been considered a major public health problem in Uzbekistan for decades. Nevertheless, this was the first anemia study in Uzbekistan done on a national basis. The study involved hemoglobin (Hb) testing for anemia using the Hemocue system. Women. Sixty percent of the women in Uzbekistan suffer from some degree of anemia. The great majority of these women have either mild (45 percent) or moderate anemia (14 percent). One percent have severe anemia.

The Ukraine Demographic and Health Survey (UDHS) is a nationally representative survey of 6,841 women age 15-49 and 3,178 men age 15-49. Survey fieldwork was conducted during the period July through November 2007. The UDHS was conducted by the Ukrainian Center for Social Reforms in close collaboration with the State Statistical Committee of Ukraine. The MEASURE DHS Project provided technical support for the survey. The U.S. Agency for International Development/Kyiv Regional Mission to Ukraine, Moldova, and Belarus provided funding. The survey is a nationally representative sample survey designed to provide information on population and health issues in Ukraine. The primary goal of the survey was to develop a single integrated set of demographic and health data for the population of the Ukraine. The UDHS was conducted from July to November 2007 by the Ukrainian Center for Social Reforms (UCSR) in close collaboration with the State Statistical Committee (SSC) of Ukraine, which provided organizational and methodological support. Macro International Inc. provided technical assistance for the survey through the MEASURE DHS project. USAID/Kyiv Regional Mission to Ukraine, Moldova and Belarus provided funding for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators. The 2007 UDHS collected national- and regional-level data on fertility and contraceptive use, maternal health, adult health and life style, infant and child mortality, tuberculosis, and HIV/AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well. The results of the 2007 UDHS are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of Ukrainians and health services for the people of Ukraine. The 2007 UDHS also contributes to the growing international database on demographic and health-related variables. MAIN RESULTS Fertility rates. A useful index of the level of fertility is the total fertility rate (TFR), which indicates the number of children a woman would have if she passed through the childbearing ages at the current age-specific fertility rates (ASFR). The TFR, estimated for the three-year period preceding the survey, is 1.2 children per woman. This is below replacement level. Contraception : Knowledge and ever use. Knowledge of contraception is widespread in Ukraine. Among married women, knowledge of at least one method is universal (99 percent). On average, married women reported knowledge of seven methods of contraception. Eighty-nine percent of married women have used a method of contraception at some time. Abortion rates. The use of abortion can be measured by the total abortion rate (TAR), which indicates the number of abortions a woman would have in her lifetime if she passed through her childbearing years at the current age-specific abortion rates. The UDHS estimate of the TAR indicates that a woman in Ukraine will have an average of 0.4 abortions during her lifetime. This rate is considerably lower than the comparable rate in the 1999 Ukraine Reproductive Health Survey (URHS) of 1.6. Despite this decline, among pregnancies ending in the three years preceding the survey, one in four pregnancies (25 percent) ended in an induced abortion. Antenatal care. Ukraine has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. Overall, the levels of antenatal care and delivery assistance are high. Virtually all mothers receive antenatal care from professional health providers (doctors, nurses, and midwives) with negligible differences between urban and rural areas. Seventy-five percent of pregnant women have six or more antenatal care visits; 27 percent have 15 or more ANC visits. The percentage is slightly higher in rural areas than in urban areas (78 percent compared with 73 percent). However, a smaller proportion of rural women than urban women have 15 or more antenatal care visits (23 percent and 29 percent, respectively). HIV/AIDS and other sexually transmitted infections : The currently low level of HIV infection in Ukraine provides a unique window of opportunity for early targeted interventions to prevent further spread of the disease. However, the increases in the cumulative incidence of HIV infection suggest that this window of opportunity is rapidly closing. Adult Health : The major causes of death in Ukraine are similar to those in industrialized countries (cardiovascular diseases, cancer, and accidents), but there is also a rising incidence of certain infectious diseases, such as multidrug-resistant tuberculosis. Women's status : Sixty-four percent of married women make decisions on their own about their own health care, 33 percent decide jointly with their husband/partner, and 1 percent say that their husband or someone else is the primary decisionmaker about the woman's own health care. Domestic Violence : Overall, 17 percent of women age 15-49 experienced some type of physical violence between age 15 and the time of the survey. Nine percent of all women experienced at least one episode of violence in the 12 months preceding the survey. One percent of the women said they had often been subjected to violent physical acts during the past year. Overall, the data indicate that husbands are the main perpetrators of physical violence against women. Human Trafficking : The UDHS collected information on respondents' awareness of human trafficking in Ukraine and, if applicable, knowledge about any household members who had been the victim of human trafficking during the three years preceding the survey. More than half (52 percent) of respondents to the household questionnaire reported that they had heard of a person experiencing this problem and 10 percent reported that they knew personally someone who had experienced human trafficking.

Abstract

The Armenia Demographic and Health Survey (ADHS) was a nationally representative sample survey designed to provide information on population and health issues in Armenia. The primary goal of the survey was to develop a single integrated set of demographic and health data, the first such data set pertaining to the population of the Republic of Armenia. In addition to integrating measures of reproductive, child, and adult health, another feature of the DHS survey is that the majority of data are presented at the marz level.

The ADHS was conducted by the National Statistical Service and the Ministry of Health of the Republic of Armenia during October through December 2000. ORC Macro provided technical support for the survey through the MEASURE DHS+ project. MEASURE DHS+ is a worldwide project, sponsored by the USAID, with a mandate to assist countries in obtaining information on key population and health indicators. USAID/Armenia provided funding for the survey. The United Nations Children’s Fund (UNICEF)/Armenia provided support through the donation of equipment.

The ADHS collected national- and regional-level data on fertility and contraceptive use, maternal and child health, adult health, and AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well. Data are presented by marz wherever sample size permits.

The ADHS results are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of and health services for the people of Armenia. The ADHS also contributes to the growing international database on demographic and health-related variables.

Geographic coverage

National

Analysis unit

• Household
• Children under five years
• Women age 15-49
• Men age 15-54

Kind of data

Sample survey data

Sampling procedure

The sample was designed to provide estimates of most survey indicators (including fertility, abortion, and contraceptive prevalence) for Yerevan and each of the other ten administrative regions (marzes). The design also called for estimates of infant and child mortality at the national level for Yerevan and other urban areas and rural areas.

The target sample size of 6,500 completed interviews with women age 15-49 was allocated as follows: 1,500 to Yerevan and 500 to each of the ten marzes. Within each marz, the sample was allocated between urban and rural areas in proportion to the population size. This gave a target sample of approximately 2,300 completed interviews for urban areas exclusive of Yerevan and 2,700 completed interviews for the rural sector. Interviews were completed with 6,430 women. Men age 15-54 were interviewed in every third household; this yielded 1,719 completed interviews.

A two-stage sample was used. In the first stage, 260 areas or primary sampling units (PSUs) were selected with probability proportional to population size (PPS) by systematic selection from a list of areas. The list of areas was the 1996 Data Base of Addresses and Households constructed by the National Statistical Service. Because most selected areas were too large to be directly listed, a separate segmentation operation was conducted prior to household listing. Large selected areas were divided into segments of which two segments were included in the sample. A complete listing of households was then carried out in selected segments as well as selected areas that were not segmented.

The listing of households served as the sampling frame for the selection of households in the second stage of sampling. Within each area, households were selected systematically so as to yield an average of 25 completed interviews with eligible women per area. All women 15-49 who stayed in the sampled households on the night before the interview were eligible for the survey. In each segment, a subsample of one-third of all households was selected for the men's component of the survey. In these households, all men 15-54 who stayed in the household on the previous night were eligible for the survey.

Note: See detailed description of sample design in APPENDIX A of the survey report.

Mode of data collection

Face-to-face [f2f]

Research instrument

Three questionnaires were used in the ADHS: a Household Questionnaire, a Women’s Questionnaire, and a Men’s Questionnaire. The questionnaires were based on the model survey instruments developed for the MEASURE DHS+ program. The model questionnaires were adapted for use during a series of expert meetings hosted by the Center of Perinatology, Obstetrics, and Gynecology. The questionnaires were developed in English and translated into Armenian and Russian. The questionnaires were pretested in July 2000.

The Household Questionnaire was used to list all usual members of and visitors to a household and to collect information on the physical characteristics of the dwelling unit. The first part of the household questionnaire collected information on the age, sex, residence, educational attainment, and relationship to the household head of each household member or visitor. This information provided basic demographic data for Armenian households. It also was used to identify the women and men who were eligible for the individual interview (i.e., women 15-49 and men 15-54). The second part of the Household Questionnaire consisted of questions on housing characteristics (e.g., the flooring material, the source of water, and the type of toilet facilities) and on ownership of a variety of consumer goods.

The Women’s Questionnaire obtained information on the following topics: - Background characteristics - Pregnancy history - Antenatal, delivery, and postnatal care - Knowledge and use of contraception - Attitudes toward contraception and abortion - Reproductive and adult health - Vaccinations, birth registration, and health of children under age five - Episodes of diarrhea and respiratory illness of children under age five - Breastfeeding and weaning practices - Height and weight of women and children under age five - Hemoglobin measurement of women and children under age five - Marriage and recent sexual activity - Fertility preferences - Knowledge of and attitude toward AIDS and other sexually transmitted infections.

The Men’s Questionnaire focused on the following topics: - Background characteristics - Health - Marriage and recent sexual activity - Attitudes toward and use of condoms - Knowledge of and attitude toward AIDS and other sexually transmitted infections.

Cleaning operations

After a team had completed interviewing in a cluster, questionnaires were returned promptly to the National Statistical Service in Yerevan for data processing. The office editing staff first checked that questionnaires for all selected households and eligible respondents had been received from the field staff. In addition, a few questions that had not been precoded (e.g., occupation) were coded at this time. Using the ISSA (Integrated System for Survey Analysis) software, a specially trained team of data processing staff entered the questionnaires and edited the resulting data set on microcomputers. The process of office editing and data processing was initiated soon after the beginning of fieldwork and was completed by the end of January 2001.

Response rate

A total of 6,524 households were selected for the sample, of which 6,150 were occupied at the time of fieldwork. The main reason for the difference is that some of the dwelling units that were occupied during the household listing operation were either vacant or the household was away for an extended period at the time of interviewing. Of the occupied households, 97 percent were successfully interviewed.

In these households, 6,685 women were identified as eligible for the individual interview (i.e., age 15-49). Interviews were completed with 96 percent of them. Of the 1,913 eligible men identified, 90 percent were successfully interviewed. The principal reason for non-response among eligible women and men was the failure to find them at home despite repeated visits to the household. The refusal rate was low.

The overall response rates, the product of the household and the individual response rates, were 94 percent for women and 87 percent for men.

Note: See summarized response rates by residence (urban/rural) in Table 1.1 of the survey report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors, and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2000 Armenia Demographic and Health Survey (ADHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the ADHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey

Abstract

The purpose of the RHS was to establish a complete statistical data set on fertility, infant mortality, family planning, maternal health related to antenatal care, pregnancy difficulties and delivery complications. Moreover, through this survey some data on child health, breastfeeding, women's and men's attitude towards family planning and AIDS were collected. This information is important firstly, for the evaluation of the current vital statistics on fertility and infant mortality; secondly, for understanding the factors that influence the reproductive health of women and the health and survival of infants and young children. The output of the survey can be used for policies and programs in relation to maternal and child health in Mongolia. In addition, the results of the survey may suggest some changes in the registration of infant deaths and in the reporting system, or in the use of statistical tools for the measuring of fertility and infant mortality levels in Mongolia.The survey findings are especially important now when the country is in the transition period, because it provides some information on awareness of people about family planning and AIDS. During the socialist period people did not have experiences of using family planning, and similarly, they did not know the danger of AIDS. Overall, the findings of RHS will become a useful source of information necessary for health care reform in Mongolia.

A further objective was to instill in the NSO the capacity to carry out large-scale, nationally representative and internationally comparable scientific surveys. It is expected that the survey will provide policy makers, health officials and researchers with data essential for informed policy-making, program execution, and further research.

The RHS has the following objectives: - Gather information on fertility, mortality and family planning at the national level; - Determine fertility, knowledge of contraceptives, and level of contraceptive use by region and rural-urban residence, age, educational level, and other background characteristics of women; - Gather information on specific health issues such as child health, breastfeeding practices, prenatal care, difficulties and complications during pregnancy, and abortion; - Disseminate Mongolian data on reproduction, health and family planning both within the country and internationally; - Provide policy makers and researchers with data essential for informed policy-making and further research.

Geographic coverage

The survey 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 , three husbands out of five married women and their children above 5 years old.

Kind of data

Sample survey data [ssd]

Sampling procedure

The survey was conducted using a two-stage sampling method, with equal probability of selection of households. The sample frame comprised the listings of households prepared annually in bags and horoos across the country. It was determined from experience of other countries that 25 households per cluster would provide an optimum representation in a country where no such survey has ever before been conducted. (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 6000 households, which is a 1,13 percent sample of all households in the country. This implied the selection of 240 clusters of households. Bags and horoos were the primary sampling units (PSUs). All 1684 PSUs were stratified implicitly by aimag and soum, and the selection of the 240 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. Each registered household in Mongolia had an equal and known probability of being selected in the RHS sample. 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. Interviewing teams were also instructed to interview 6 husbands of interviewed women in each PSU.

Distribution of the RHS Household Sampling by Aimag, Mongolia 1998

-- Aimag, Clusters, Number of Households 1) Arhangai, 1-12, 300 2) Bayan-Olgii, 13-20, 200 3) Bayanhongor, 21-30, 250 4) Bulgan, 31-37, 175 5) Gobi-Altai, 38-44, 175 6) Dornogobi, 45-49, 125 7) Dornod, 50-57, 200 8) Dundgobi, 58-63, 150 9) Zavhan, 64-73, 250 10) Selenge, 74-83, 250 11) Suhbaatar, 84-89, 150 12) Uvs, 90-99, 249 13) Tov, 100-110, 275 14) Ovorhangai, 111-124, 350 15) Omnogobi, 125-129, 125 16) Hovd, 130-137, 200 17) Hovsgol, 138-150, 325 18) Hentii, 151-158, 200 19) Darhan-Uul, 159-168, 250 20) Orhon, 169-174,149 21) Gobisumber, 175-176, 50 22) Ulaanbaatar, 177-240, 1607 Total number of households 6005

Mode of data collection

Face-to-face [f2f]

Research instrument

There were three questionnaires used in the RHS 1998.

The contents of the three questionnaires are outlined briefly below.
1. Household Questionnaire: The household questionnaire consists of questions on relationship to the household head, age, sex, educational level and marital status. The questions in the household questionnaire were asked concerning all members of the household, as well as visitors who spent the night before the survey in the household. The household questionnaire was developed in order to obtain general demographic information, information on household amenities and housing conditions, and as a tool for selecting women and husbands for individual interview.

1. Woman's Questionnaire: Background questions Reproduction Maternal health, pregnancy, breastfeeding, and child health Knowledge and use of contraceptive methods Marriage Fertility preferences and abortion Employment, and questions concerning the husband Knowledge about AIDS

3.Husband's Questionnaire: Background questions Reproduction Knowledge and use of contraceptive methods Knowledge about AIDS

All questionnaires are provided as external resources.

Cleaning operations

The computer data entry work was initiated on 20 October 1998 and terminated 1 February 1999. The editing of the computer files finished by the middle of February. The computer software package “Integrated System for Survey Analysis” (ISSA), created and distributed by Macro International, Inc. was used for data entry and data processing. From February 1999, output tables started to be produced, and this activity lasted for two months. Activities such as data entry, quality control and production of output tables were accomplished by the national staff under the supervision of the UN Technical Adviser and an adviser from the UNFPA Country Support Team in Bangkok. Similarly, the main report of RHS has been prepared through the cooperative work of national staff with the Technical Adviser. The tabulation plan follows closely the recommendations contained in Guidelines for the DHS-III Main Survey Report, published by Macro International.

Response rate

Results of the Household and Individual Interviews (Women and Husbands), Mongolia 1998

Number of Dwellings Sampled: Urban 2931, Rural 3074, and Total 6005 Number of Households Interviewed: Urban 2930, Rural 3073, and Total 6003 Household Response Rate: Urban 100.0, Rural 100.0, Total 100.0

Number of Eligible Women: Urban 3943, Rural 3610, and Total 7553 Number of Eligible Women Interviewed: Urban 3904, Rural 3557, and Total 7461 Eligible Women Response Rate: Urban 99.0, Rural 98.5, and Total 98.8

Number of Husbands Selected: Urban 794, Rural 766, and Total 1560 Number of Husbands Interviewed: Urban 793, Rural 764, and Total 1557 Husbands Response Rate: Urban 99.9, Rural 99.7, and Total 99.8

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 32.2%, and its standard error is 0.8%. 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 30.6% and 33.8%.

The relative standard errors for most estimates for the country as a whole

The adult population of the country 18 years old and older.