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. This collection contains two datasets. An open access de-identifiable dataset and a restricted identifiable set.

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

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.

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

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

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.

Abstract

Vadu Rural Health Program, KEM Hospital Research Centre Pune has a rich tradition in health care and development being in the forefront of needs-based, issue-driven research over almost 35 years. During the decades of 1980 and 1990 the research at Vadu focused on mother and child with epidemiological and social science research exploring low birth weight, child survival, maternal mortality, safe abortion and domestic violence. The research portfolio has ever since expanded to include adult health and aging, non-communicable and communicable diseases and to clinical trials in recent years. It started with establishment of Health and Demographic Surveillance System at Vadu (HDSS Vadu) in August, 2002 that seeks to establish a quasi-experimental design setting to allow evaluation of impact of health interventions as well as monitor secular trends in diseases, risk factors and health behavior of humans.

The term "demographic surveillance" means to keep close track of the population dynamics. Vadu HDSS deals with keeping track of health issues and demographic changes in Vadu rural health program (VRHP) area. It is one of the most promising projects of national relevance that aims at establishing a quasi-experimental intervention research setting with the following objectives: 1) To create a longitudinal data base for efficient service delivery, future research, and linking all past micro-studies in Vadu area 2) Monitoring trends in public health problems 3) Keeping track of population dynamics 4) Evaluating intervention services

This dataset contains the events of all individuals ever resident during the study period (1 Jan. 2009 to 31 Dec. 2015).

Geographic coverage

Vadu HDSS falls in two administrative blocks: (1) Shirur and (2) Haweli of Pune district in Maharashtra in western India. It covers an area of approximately 232 square kilometers.

Analysis unit

Individual

Universe

Vadu HDSS covers as many as 50,000 households having 140,000 population spread across 22 villages.

Kind of data

Event history data

Frequency of data collection

Two rounds per year

Sampling procedure

Vadu area including 22 villages in two administrative blocks is the study area. This area was selected as this is primarily coverage area of Vadu Rural Health Program which is in function since more than four decade. Every individual household is included in HDSS. There is no sampling strategy employed as 100% population coverage in the area is expected.

Mode of data collection

Proxy Respondent [proxy]

Research instrument

Language of communication is in Marath or Hindi. The form labels are multilingual - in English and Marathi, but the data entered through the forms are in English only.

The following forms were used: - Field Worker Checklist Form - The checklist provides a guideline to ensure that all the households are covered during the round and the events occurred in each household are captured. - Enumeration Form: To capture the population details at the start of the HDSS or any addition of villages afterwards. - Pregnancy Form: To capture pregnancy details of women in the age group 15 to 49. - Birth Form: To capture the details of the birth events.
- Inmigration Form: To capture inward population movement from outside the HDSS area and also for movement within the HDSS area. - Outmigration Form: To capture outward population movement from inside the HDSS area and also for movement within the HDSS area. - Death Form: To capture death events.

Cleaning operations

Entered data undergo a data cleaning process. During the cleaning process all error data are either corrected in consultaiton with the data QC team or the respective forms are sent back to the field for re collection of correct data. Data editors have the access to the raw dataset for making necessary editing after corrected data are bought from the field.

For all individuals whose enumeration (ENU), Inmigration (IMG) or Birth (BTH) have occurred before the left censoring date (2009-01-01) and have not outmigrated (OMG) or not died (DTH) before the left censoring date (2009-01-01) are included in the dataset as Enumeration (ENU) with EventDate as the left censored date (2009-01-01). But the actual date of observation of the event (ENU, BTH, IMG) is retained in the dataset as observation date for these left censored ENU events. The individual is dropped from the dataset if their end event (OMG or DTH) is prior to the left censoring date (2009-01-01)

Response rate

On an average the response rate is 99.99% in all rounds over the years.

Sampling error estimates

Not Applicable

Data appraisal

Data is cleaned to an acceptable level against the standard data rules using Pentaho Data Integration Comminity Edition (PDI CE) tool. After the cleaning process, quality metrics were as follows:

CentreId MetricTable QMetric Illegal Legal Total Metric RunDate IN021 MicroDataCleaned Starts 1 301112 301113 0. 2017-05-31 20:06
IN021 MicroDataCleaned Transitions 0 667010 667010 0. 2017-05-31 20:07
IN021 MicroDataCleaned Ends 301113 2017-05-31 20:07
IN021 MicroDataCleaned SexValues 29 666981 667010 0. 2017-05-31 20:07
IN021 MicroDataCleaned DoBValues 575 666435 667010 0. 2017-05-31 20:07

Note: Except lower under five mortality in 2012 and lower adult mortality among females in 2013, all other estimates are fairly within expected range. Data underwent additional review in terms of electronic data capture, data cleaning and management to look for reasons for lower under five mortality rates in 2013 and lower female adult mortality in 2013. The additional review returned marginally higher rates and this supplements the validity of collected data. Further field related review of 2012 and 2013 data are underway and any revisions to published data/figures will be shared at a later stage.

IntroductionAlthough the European Medicines Agency (EMA) encourage coronavirus disease 2019 (COVID-19) vaccination in pregnant women, the scientific evidence supporting the use of COVID-19 vaccines during pregnancy is still limited.AimWe aimed to investigate adverse events following immunization (AEFI) with COVID-19 vaccines during pregnancy.MethodsWe retrieved Individual Case Safety Reports (ICSRs) related to the use of COVID-19 vaccines during pregnancy from the EudraVigilance database for the year 2021. We analyzed AEFI related to the mother and fetus/newborn. The reporting odds ratio (ROR) was computed to compare the reporting probability of spontaneous abortion between COVID-19 vaccines.ResultsDuring the study period, among 1,315,315 ICSRs related to COVID-19 vaccines, we retrieved 3,252 (0.25%) reports related to the use in pregnancy. More than half (58.24%) of ICSRs were submitted by non-healthcare professionals. Although the majority (87.82%) of ICSRs concerned serious AEFI, their outcomes were mostly favorable. In this study, 85.0% of total ICSRs referred to pregnant women (n = 2,764), while 7.9% referred to fetuses/newborns (n = 258). We identified 16,569 AEFI. Moreover, 55.16% were AEFI not related to pregnancy (mostly headache, pyrexia, and fatigue), while 17.92% were pregnancy-, newborn-, or fetus-related AEFI. Among pregnancy-related AEFI, the most reported was spontaneous abortion. Messenger RNA (mRNA) vaccines had a lower reporting probability of spontaneous abortion than viral vector-based vaccines (ROR 0.80, 95% CI 0.69–0.93). Moderna and Oxford-AstraZeneca vaccines had a higher reporting probability of spontaneous abortion (ROR 1.2, 95% CI 1.05–1.38 and ROR 1.26, 95% CI 1.08–1.47, respectively), while a lower reporting probability was found for Pfizer-BioNTech vaccine compared with all other COVID-19 vaccines (ROR 0.73, 95% CI 0.64–0.84). In addition, 5.8% of ICSRs reported a fatal outcome.ConclusionsNo strong insight of unknown AEFI associated with COVID-19 vaccination in pregnant women was observed. Considering the high risk associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, our analysis suggests that the benefits of COVID-19 vaccines during pregnancy outweigh the possible risks. However, it is important to continue monitoring the safety profile of COVID-19 vaccines in this subpopulation.

ObjectiveSmall for gestational age (SGA) infants comprise up to 50% of all stillbirths and a minority are detected before birth. We aimed to develop and validate early pregnancy predictive models for SGA infants.Methods5628 participants from SCOPE, a prospective study of nulliparous pregnant women, were interviewed at 15±1 weeks’ gestation. Fetal anthropometry, uterine and umbilical Doppler studies were performed at 20±1 weeks’. The cohort was divided into training (n = 3735) and validation datasets (n = 1871). All-SGA (birthweight <10th customised centile), Normotensive-SGA (SGA with normotensive mother) and Hypertensive-SGA (SGA with mother who developed hypertension) were the primary outcomes. Multivariable analysis was performed using stepwise logistic regression firstly using clinical variables and then with clinical and ultrasound variables. Receiver operator curves were constructed and areas under the curve (AUC) calculated.Results633 infants (11.3%) in the whole cohort were SGA; 465 (8.3%) Normotensive-SGA and 165 (3.0%) Hypertensive-SGA. In the training dataset risk factors for All-SGA at 15±1 weeks’ included: family history of coronary heart disease, maternal birthweight <3000 g and 3000 g to 3499 g compared with ≥3500 g, >12 months to conceive, university student, cigarette smoking, proteinuria, daily vigorous exercise and diastolic blood pressure ≥80. Recreational walking ≥4 times weekly, rhesus negative blood group and increasing random glucose were protective. AUC for clinical risk factors was 0.63. Fetal abdominal or head circumference z scores <10th centile and increasing uterine artery Doppler resistance at 20±1 weeks’ were associated with increased risk. Addition of these parameters increased the AUC to 0.69. Clinical predictors of Normotensive and Hypertensive-SGA were sub-groups of All-SGA predictors and were quite different. The combined clinical and ultrasound AUC for Normotensive and Hypertensive-SGA were 0.69 and 0.82 respectively.ConclusionPredictors for SGA of relevance to clinical practice were identified. The identity and predictive potential differed in normotensive women and those who developed hypertension.