COVID-19 rate of death, or the known deaths divided by confirmed cases, was over ten percent in Yemen, the only country that has 1,000 or more cases. This according to a calculation that combines coronavirus stats on both deaths and registered cases for 221 different countries. Note that death rates are not the same as the chance of dying from an infection or the number of deaths based on an at-risk population. By April 26, 2022, the virus had infected over 510.2 million people worldwide, and led to a loss of 6.2 million. The source seemingly does not differentiate between "the Wuhan strain" (2019-nCOV) of COVID-19, "the Kent mutation" (B.1.1.7) that appeared in the UK in late 2020, the 2021 Delta variant (B.1.617.2) from India or the Omicron variant (B.1.1.529) from South Africa.

Where are these numbers coming from?

The numbers shown here were collected by Johns Hopkins University, a source that manually checks the data with domestic health authorities. For the majority of countries, this is from national authorities. In some cases, like China, the United States, Canada or Australia, city reports or other various state authorities were consulted. In this statistic, these separately reported numbers were put together. Note that Statista aims to also provide domestic source material for a more complete picture, and not to just look at one particular source. Examples are these statistics on the confirmed coronavirus cases in Russia or the COVID-19 cases in Italy, both of which are from domestic sources. For more information or other freely accessible content, please visit our dedicated Facts and Figures page.

A word on the flaws of numbers like this

People are right to ask whether these numbers are at all representative or not for several reasons. First, countries worldwide decide differently on who gets tested for the virus, meaning that comparing case numbers or death rates could to some extent be misleading. Germany, for example, started testing relatively early once the country’s first case was confirmed in Bavaria in January 2020, whereas Italy tests for the coronavirus postmortem. Second, not all people go to see (or can see, due to testing capacity) a doctor when they have mild symptoms. Countries like Norway and the Netherlands, for example, recommend people with non-severe symptoms to just stay at home. This means not all cases are known all the time, which could significantly alter the death rate as it is presented here. Third and finally, numbers like this change very frequently depending on how the pandemic spreads or the national healthcare capacity. It is therefore recommended to look at other (freely accessible) content that dives more into specifics, such as the coronavirus testing capacity in India or the number of hospital beds in the UK. Only with additional pieces of information can you get the full picture, something that this statistic in its current state simply cannot provide.

This dataset of U.S. mortality trends since 1900 highlights childhood mortality rates by age group for age at death. Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below). Age groups for childhood death rates are based on age at death. SOURCES CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm. National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

These indicators are designed to accompany the SHMI publication. Information on the main condition the patient is in hospital for (the primary diagnosis) is used to calculate the expected number of deaths used in the calculation of the SHMI. A high percentage of records with an invalid primary diagnosis may indicate a data quality problem. A high percentage of records with a primary diagnosis which is a symptom or sign may indicate problems with data quality or timely diagnosis of patients, but may also reflect the case-mix of patients or the service model of the trust (e.g. a high level of admissions to acute admissions wards for assessment and stabilisation). Contextual indicators on the percentage of provider spells with an invalid primary diagnosis and the percentage of provider spells with a primary diagnosis which is a symptom or sign are produced to support the interpretation of the SHMI. Notes: 1. There is a shortfall in the number of records for North Middlesex University Hospital NHS Trust (trust code RAP), Northumbria Healthcare NHS Foundation Trust (trust code RTF), The Rotherham NHS Foundation Trust (trust code RFR), and The Shrewsbury and Telford Hospital NHS Trust (trust code RXW). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 2. A number of trusts are now submitting Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset. The SHMI is calculated using APC data. Removal of SDEC activity from the APC data may impact a trust’s SHMI value and may increase it. More information about this is available in the Background Quality Report. 3. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of this page.

The number of deaths of children under the age of five. The data is sorted by both sex and total and includes a range of values from 1955 to 2019. A birth-week cohort method is used to calculate the absolute number of deaths among neonates, infants, and children under age 5. First, each annual birth cohort is divided into 52 equal birth-week cohorts. Then each birth-week cohort is exposed throughout the first five years of life to the appropriate calendar year- and age-specific mortality rates depending on cohort age. All deaths from birth-week cohorts occurring as a result of exposure to the mortality rate for a given calendar year are allocated to that year and are summed by age group at death to get the total number of deaths for a given year and age group. The annual estimate of the number of live births in each country comes from the World Population Prospects. This data is sourced from the UN Inter-Agency Group for Child Mortality Estimation. The UN IGME uses the same estimation method across all countries to arrive at a smooth trend curve of age-specific mortality rates. The estimates are based on high quality nationally representative data including statistics from civil registration systems, results from household surveys, and censuses. The child mortality estimates are produced in conjunction with national level agencies such as a country’s Ministry of Health, National Statistics Office, or other relevant agencies.

Years of life lost due to mortality from tuberculosis (ICD-10 A15-A19). Years of life lost (YLL) is a measure of premature mortality. Its primary purpose is to compare the relative importance of different causes of premature death within a particular population and it can therefore be used by health planners to define priorities for the prevention of such deaths. It can also be used to compare the premature mortality experience of different populations for a particular cause of death. The concept of years of life lost is to estimate the length of time a person would have lived had they not died prematurely. By inherently including the age at which the death occurs, rather than just the fact of its occurrence, the calculation is an attempt to better quantify the burden, or impact, on society from the specified cause of mortality. Legacy unique identifier: P00461

Objective: To examine if the rankings of state HIV age-standardized death rates (ASDRs) changed if different standard population (SP) was used.

Design: A cross-sectional population-based observational study. Setting 36 states in the United States.

Participants: People died from 2015 to 2019.

Main outcome measures: State HIV ASDR using 4 SPs, namely WHO2000, US2000, US2mor020, and Eur2011–2030.

Results: The rankings of 19 states did not change when ASDRs were calculated using US2000 and US2020. Of the 17 states whose rankings changed, the rankings of 9 states calculated using US2000 were higher than those calculated using US2020; in 8 states, the rankings were lower. The states with the greatest changes in rankings between US2000 and US2020 were Kentucky (12th and 9th, respectively) and Massachusetts (8th and 11th, respectively).

Conclusions: State ASDRs calculated using the current official SP (US2000) weigh middle-age HIV death rates more heavily than older-age HIV death rates, resulting in lower ASDRs among states with higher older-age HIV death rates.

Excess Winter Deaths (EWD) by age and conditions (underlying cause of death) expressed as average per year based on 7 years pooled data, 2004-2011. EWD trend expressed as average per year based on 3 years data.

The Excess Winter Mortality Index (EWM Index was calculated based on the 'ONS Method' which defines the winter period as December to March, and the non-winter period as August to November of that same year and April to July of the following year.

This winter period was selected as they are the months which over the last 50 years have displayed above average monthly mortality. However, if mortality starts to increase prior to this, for example in November, the number of deaths in the non-winter period will increase, which in turn will decrease the estimate of excess winter mortality.

The EWM Index will be partly dependent on the proportion of older people in the population as most excess winter deaths effect older people (there is no standardisation in this calculation by age or any other factor).

Excess winter mortality is calculated as winter deaths (deaths occurring in December to March) minus the average of non-winter deaths (April to July of the current year and August to November of the previous year). The Excess winter mortality index is calculated as excess winter deaths divided by the average non-winter deaths, expressed as a percentage.

Relevant link: http://www.wmpho.org.uk/excesswinterdeathsinEnglandatlas/

This data shows premature deaths (Age under 75) from Respiratory Disease, numbers and rates by gender, as 3-year range. Smoking is the major cause of chronic obstructive pulmonary disease (COPD), one of the major Respiratory diseases. COPD (which includes chronic bronchitis and emphysema) results in many hospital admissions. Respiratory diseases can also be caused by environmental factors (such as pollution, or housing conditions) and influenza. Respiratory disease mortality rates show a socio-economic gradient. Directly Age-Standardised Rates (DASR) are shown in the data, where numbers are sufficient, so that death rates can be directly compared between areas. The DASR calculation applies Age-specific rates to a Standard (European) population to cancel out possible effects on crude rates due to different age structures among populations, thus enabling direct comparisons of rates. A limitation on using mortalities as a proxy for prevalence of health conditions is that mortalities may give an incomplete view of health conditions in an area, as ill-health might not lead to premature death. Data source: Office for Health Improvement and Disparities (OHID) Public Health Outcomes Framework (PHOF) indicator 4.07i. This data is updated annually.

La statistique de mortalité maternelle est établie à partir de la base de données des causes de décès. Dans celle-ci, une sélection des « décès maternels » est faite, en suivant une longue procédure (décrite en détail dans les Métadonnées) qui respecte la définition de l’OMS. D’après la dixième révision de la Classification internationale des maladies (CIM-10), le décès maternel se définit comme « le décès d’une femme survenu au cours de la grossesse ou dans un délai de 42 jours après sa terminaison, quelles qu’en soient la durée ou la localisation, pour une cause quelconque déterminée ou aggravée par la grossesse ou les soins qu’elle a motivés, mais ni accidentelle, ni fortuite ». « Les décès maternels se subdivisent en deux groupes. Les décès par cause obstétricale directe sont ceux qui résultent de complications obstétricales (grossesse, travail et suites de couches), d’interventions, d’omissions, d’un traitement incorrect ou d’un enchaînement d’événements résultant de l’un quelconque des facteurs ci-dessus. Les décès par cause obstétricale indirecte sont ceux qui résultent d’une maladie préexistante ou d’une affection apparue au cours de la grossesse sans qu’elle soit due à des causes obstétricales directes, mais qui a été aggravée par les effets physiologiques de la grossesse ». La CIM-10 définit également le décès maternel tardif comme étant « le décès d’une femme résultant de causes obstétricales directes ou indirectes survenu plus de 42 jours, mais moins d’un an, après la terminaison de la grossesse ». Le ratio de mortalité maternelle est le rapport entre le nombre de décès maternels, directs et indirects, observés en une année, et le nombre de naissances vivantes de la même année, exprimé pour 100.000 naissances vivantes. Les décès maternels tardifs ne sont pas pris en compte pour le calcul de ce ratio. Etant donné le petit nombre de cas identifiés en Belgique chaque année et la grande variabilité de cet effectif, le choix a été fait de calculer le ratio en cumulant les décès maternels et les naissances vivantes de 5 années successives, en centrant le ratio sur l’année médiane. Lors de l’identification de ces décès maternels, le Groupe de travail ad hoc, qui rassemble autour de l’office belge de statistique toutes les entités fédérées productrices de données, n’a pas écarté le risque d’une sous-évaluation de ces décès, sur la base du seul bulletin statistique qui sert de source principale. Il demande donc de poursuivre les efforts afin d’améliorer davantage le suivi des décès liés à la maternité et soutient l’initiative prise récemment par le Collège de médecins pour la mère et le nouveau-né d’examiner la possibilité de création d’un Registre de la mortalité maternelle. Métadonnées La statistique de mortalité maternelle

This data shows deaths (of people age 10 and over) from Suicide and Undetermined Injury, numbers and rates by gender, as 3-year moving-averages.

Suicide is a significant cause of premature deaths occurring generally at younger ages than other common causes of premature mortality. It may also be seen as an indicator of underlying rates of mental ill-health.

Directly Age-Standardised Rates (DASR) are shown in the data, where numbers are sufficient, so that death rates can be directly compared between areas. The DASR calculation applies Age-specific rates to a Standard (European) population to cancel out possible effects on crude rates due to different age structures among populations, thus enabling direct comparisons of rates.

The figures in this dataset include deaths recorded as suicide (people age 10 and over) and undetermined injury (age 15 and over) as those are mostly likely also to have been caused by self-harm. The population denominators for rates are age 10 and over.

Data source: Public Health England, Public Health Outcomes Framework (PHOF) indicator 4.10. This data is updated annually.

This data shows premature deaths (Age under 75) from all Cancers, numbers and rates by gender, as 3-year moving-averages.

Cancers are a major cause of premature deaths. Inequalities exist in cancer rates between the most deprived areas and the most affluent areas.

Directly Age-Standardised Rates (DASR) are shown in the data (where numbers are sufficient) so that death rates can be directly compared between areas. The DASR calculation applies Age-specific rates to a Standard (European) population to cancel out possible effects on crude rates due to different age structures among populations, thus enabling direct comparisons of rates.

A limitation on using mortalities as a proxy for prevalence of health conditions is that mortalities may give an incomplete view of health conditions in an area, as ill-health might not lead to premature death.

Data source: NHS Health and Social Care Information Centre (NHS-HSCIC) (Dataset unique identifier P00399). This data is updated annually.

This data shows premature deaths (Age under 75) from Circulatory Disease, numbers and rates by gender, as 3-year moving-averages.

Circulatory diseases include heart diseases and stroke, and others. Socio-economic and lifestyle factors are associated with circulatory disease deaths and inequalities in circulatory disease rates. Modifiable risk factors include smoking, excess weight, diet, and physical inactivity.

Directly Age-Standardised Rates (DASR) are shown in the data, where numbers are sufficient, so that death rates can be directly compared between areas. The DASR calculation applies Age-specific rates to a Standard (European) population to cancel out possible effects on crude rates due to different age structures among populations, thus enabling direct comparisons of rates.

A limitation on using mortalities as a proxy for prevalence of health conditions is that mortalities may give an incomplete view of health conditions in an area, as ill-health might not lead to premature death.

Data source: NHS Health and Social Care Information Centre (NHS-HSCIC) (Dataset unique identifier P00395). This data is updated annually.

Abstract

The 1995 Uganda Demographic and Health Survey (UDHS-II) is a nationally-representative survey of 7,070 women age 15-49 and 1,996 men age 15-54. The UDHS 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. Fieldwork for the UDHS took place from late-March to mid-August 1995. The survey was similar in scope and design to the 1988-89 UDHS. Survey data show that fertility levels may be declining, contraceptive use is increasing, and childhood mortality is declining; however, data also point to several remaining areas of challenge.

The 1995 UDHS was a follow-up to a similar survey conducted in 1988-89. In addition to including most of the same questions included in the 1988-89 UDHS, the 1995 UDHS added more detailed questions on AIDS and maternal mortality, as well as incorporating a survey of men. The general objectives of the 1995 UDHS are to: - provide national level data which will allow the calculation of demographic rates, particularly fertility and childhood mortality rates; - analyse the direct and indirect factors which determine the level and trends of fertility; - measure the level of contraceptive knowledge and practice (of both women and men) by method, by urban-rural residence, and by region; - collect reliable data on maternal and child health indicators; immunisation, prevalence, and treatment of diarrhoea and other diseases among children under age four; antenatal visits; assistance at delivery; and breastfeeding; - assess the nutritional status of children under age four and their mothers by means of anthropometric measurements (weight and height), and also child feeding practices; and - assess among women and men the prevailing level of specific knowledge and attitudes regarding AIDS and to evaluate patterns of recent behaviour regarding condom use.

MAIN RESULTS

• Fertility:

Fertility Trends. UDHS data indicate that fertility in Uganda may be starting to decline. The total fertility rate has declined from the level of 7.1 births per woman that prevailed over the last 2 decades to 6.9 births for the period 1992-94. The crude birth rate for the period 1992-94 was 48 live births per I000 population, slightly lower than the level of 52 observed from the 1991 Population and Housing Census. For the roughly 80 percent of the country that was covered in the 1988-89 UDHS, fertility has declined from 7.3 to 6.8 births per woman, a drop of 7 percent over a six and a half year period.

Birth Intervals. The majority of Ugandan children (72 percent) are born after a "safe" birth interval (24 or more months apart), with 30 percent born at least 36 months after a prior birth. Nevertheless, 28 percent of non-first births occur less than 24 months after the preceding birth, with 10 percent occurring less than 18 months since the previous birth. The overall median birth interval is 29 months. Fertility Preferences. Survey data indicate that there is a strong desire for children and a preference for large families in Ugandan society. Among those with six or more children, 18 percent of married women want to have more children compared to 48 percent of married men. Both men and women desire large families.

• Family planning:

Knowledge of Contraceptive Methods. Knowledge of contraceptive methods is nearly universal with 92 percent of all women age 15-49 and 96 percent of all men age 15-54 knowing at least one method of family planning. Increasing Use of Contraception. The contraceptive prevalence rate in Uganda has tripled over a six-year period, rising from about 5 percent in approximately 80 percent of the country surveyed in 1988-89 to 15 percent in 1995.

Source of Contraception. Half of current users (47 percent) obtain their methods from public sources, while 42 percent use non-governmental medical sources, and other private sources account for the remaining 11 percent.

• Maternal and child health:

High Childhood Mortality. Although childhood mortality in Uganda is still quite high in absolute terms, there is evidence of a significant decline in recent years. Currently, the direct estimate of the infant mortality rate is 81 deaths per 1,000 births and under five mortality is 147 per 1,000 births, a considerable decline from the rates of 101 and 180, respectively, that were derived for the roughly 80 percent of the country that was covered by the 1988-89 UDHS.

Childhood Vaccination Coverage. One possible reason for the declining mortality is improvement in childhood vaccination coverage. The UDHS results show that 47 percent of children age 12-23 months are fully vaccinated, and only 14 percent have not received any vaccinations.

Childhood Nutritional Status. Overall, 38 percent of Ugandan children under age four are classified as stunted (low height-for-age) and 15 percent as severely stunted. About 5 percent of children under four in Uganda are wasted (low weight-for-height); 1 percent are severely wasted. Comparison with other data sources shows little change in these measures over time.

• AIDS:

Virtually all women and men in Uganda are aware of AIDS. About 60 percent of respondents say that limiting the number of sexual partners or having only one partner can prevent the spread of disease. However, knowledge of ways to avoid AIDS is related to respondents' education. Safe patterns of sexual behaviour are less commonly reported by respondents who have little or no education than those with more education. Results show that 65 percent of women and 84 percent of men believe that they have little or no chance of being infected.

Availability of Health Services. Roughly half of women in Uganda live within 5 km of a facility providing antenatal care, delivery care, and immunisation services. However, the data show that children whose mothers receive both antenatal and delivery care are more likely to live within 5 km of a facility providing maternal and child health (MCH) services (70 percent) than either those whose mothers received only one of these services (46 percent) or those whose mothers received neither antenatal nor delivery care (39 percent).

Geographic coverage

The 1995 Uganda Demographic and Health Survey (UDHS-II) is a nationally-representative survey. For the purpose of the 1995 UDHS, the following domains were utilised: Uganda as a whole; urban and rural areas separately; each of the four regions: Central, Eastern, Northern, and Western; areas in the USAID-funded DISH project to permit calculation of contraceptive prevalence rates.

Analysis unit

• Household
• Women age 15-49
• Men age 15-54
• Children under four

Universe

The population covered by the 1995 UDHS is defined as the universe of all women age 15-49 in Uganda. But because of insecurity, eight EAs could not be surveyed (six in Kitgum District, one in Apac District, and one in Moyo District). An additional two EAs (one in Arua and one in Moroto) could not be surveyed, but substitute EAs were selected in their place.

Kind of data

Sample survey data

Sampling procedure

A sample of 303 primary sampling units (PSU) consisting of enumeration areas (EAs) was selected from a sampling frame of the 1991 Population and Housing Census. For the purpose of the 1995 UDHS, the following domains were utilised: Uganda as a whole; urban and rural areas separately; each of the four regions: Central, Eastern, Northern, and Western; areas in the USAID-funded DISH project to permit calculation of contraceptive prevalence rates.

Districts in the DISH project area were grouped by proximity into the following five reporting domains: - Kasese and Mbarara Districts - Masaka and Rakai Districts - Luwero and Masindi Districts - Jinja and Kamuli Districts - Kampala District

The sample for the 1995 UDHS was selected in two stages. In the first stage, 303 EAs were selected with probability proportional to size. Then, within each selected EA, a complete household listing and mapping exercise was conducted in December 1994 forming the basis for the second-stage sampling. For the listing exercise, 11 listers from the Statistics Department were trained. Institutional populations (army barracks, hospitals, police camps, etc.) were not listed.

From these household lists, households to be included in the UDHS were selected with probability inversely proportional to size based on the household listing results. All women age 15-49 years in these households were eligible to be interviewed in the UDHS. In one-third of these selected households, all men age 15-54 years were eligible for individual interview as well. The overall target sample was 6,000 women and 2,000 men. Because of insecurity, eight EAs could not be surveyed (six in Kitgum District, one in Apac District, and one in Moyo District). An additional two EAs (one in Arua and one in Moroto) could not be surveyed, but substitute EAs were selected in their place.

Since one objective of the survey was to produce estimates of specific demographic and health indicators for the areas included in the DISH project, the sample design allowed for oversampling of households in these districts relative to their actual proportion in the population. Thus, the 1995 UDHS sample is not self-weighting at the national level; weights are required to estimate national-level indicators. Due to the weighting factor and rounding of estimates, figures may not add to totals. In addition, the percent total may not add to 100.0 due to rounding.

Mode of data collection

Face-to-face

Research instrument

Four questionnaires were used in the 1995 UDHS.

a) A Household Schedule was used to list the names and certain

In 2023, the average life expectancy of the world was 70 years for men and 75 years for women. The lowest life expectancies were found in Africa, while Oceania and Europe had the highest.

What is life expectancy?

Life expectancy is defined as a statistical measure of how long a person may live, based on demographic factors such as gender, current age, and most importantly the year of their birth. The most commonly used measure of life expectancy is life expectancy at birth or at age zero. The calculation is based on the assumption that mortality rates at each age were to remain constant in the future.

Life expectancy has changed drastically over time, especially during the past 200 years. In the early 20th century, the average life expectancy at birth in the developed world stood at 31 years. It has grown to an average of 70 and 75 years for males and females respectively, and is expected to keep on growing with advances in medical treatment and living standard continuing.

Highest and lowest life expectancy worldwide

Life expectancy still varies greatly between different regions and countries of the world. The biggest impact on life expectancy is the quality of public health, medical care, and diet. As of 2021, the countries with the highest life expectancy were Japan, Liechtenstein, Switzerland, and South Korea, all at 84 years. Most of the countries with the lowest life expectancy are mostly African countries. The ranking was led by the Chad, Nigeria, and Lesotho with 53 years.

Number of excess deaths by location, diagnosis, and method of calculation.

Abstract

The primary objective of the 2016 Nepal Demographic and Health Survey (NDHS) is to provide up-to-date estimates of basic demographic and health indicators. The NDHS provides a comprehensive overview of population, maternal, and child health issues in Nepal. Specifically, the 2016 NDHS: - Collected data that allowed calculation of key demographic indicators, particularly fertility and under-5 mortality rates, at the national level, for urban and rural areas, and for the country’s seven provinces - Collected data that allowed for calculation of adult and maternal mortality rates at the national level - Explored the direct and indirect factors that determine levels and trends of fertility and child mortality - Measured levels of contraceptive knowledge and practice - Collected data on key aspects of family health, including immunization coverage among children, prevalence and treatment of diarrhea and other diseases among children under age 5, maternity care indicators such as antenatal visits and assistance at delivery, and newborn care - Obtained data on child feeding practices, including breastfeeding - Collected anthropometric measures to assess the nutritional status of children under age 5 and women and men age 15-49 - Conducted hemoglobin testing on eligible children age 6-59 months and women age 15-49 to provide information on the prevalence of anemia in these groups - Collected data on knowledge and attitudes of women and men about sexually transmitted diseases and HIV/AIDS and evaluated potential exposure to the risk of HIV infection by exploring high-risk behaviors and condom use - Measured blood pressure among women and men age 15 and above - Obtained data on women’s experience of emotional, physical, and sexual violence

The information collected through the 2016 NDHS is intended to assist policymakers and program managers in the Ministry of Health and other organizations in designing and evaluating programs and strategies for improving the health of the country’s population. The 2016 NDHS also provides data on indicators relevant to the Nepal Health Sector Strategy (NHSS) 2016-2021 and the Sustainable Development Goals (SDGs).

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15-49

Universe

The survey covered all de jure household members (usual residents), women age 15-49 years and men age 15-49 years resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling frame used for the 2016 NDHS is an updated version of the frame from the 2011 National Population and Housing Census (NPHC), conducted by the Central Bureau of Statistics (CBS).

The sampling frame contains information about ward location, type of residence (urban or rural), estimated number of residential households, and estimated population. In rural areas, the wards are small in size (average of 104 households) and serve as the primary sampling units (PSUs). In urban areas, the wards are large, with average of 800 households per ward. The CBS has a frame of enumeration areas (EAs) for each ward in the original 58 municipalities. However, for the 159 municipalities declared in 2014 and 2015, each municipality is composed of old wards, which are small in size and can serve as EAs.

The 2016 NDHS sample was stratified and selected in two stages in rural areas and three stages in urban areas. In rural areas, wards were selected as primary sampling units, and households were selected from the sample PSUs. In urban areas, wards were selected as PSUs, one EA was selected from each PSU, and then households were selected from the sample EAs.

For further details on sample design, see Appendix A of the final report.

Mode of data collection

Face-to-face [f2f]

Research instrument

Six questionnaires were administered in the 2016 NDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, the Biomarker Questionnaire, the Fieldworker Questionnaire, and the Verbal Autopsy Questionnaire (for neonatal deaths). The first five questionnaires, based on The DHS Program’s standard Demographic and Health Survey (DHS-7) questionnaires, were adapted to reflect the population and health issues relevant to Nepal. The Verbal Autopsy Questionnaire was based on the recent 2014 World Health Organization (WHO) verbal autopsy instruments (WHO 2015a).

Cleaning operations

The processing of the 2016 NDHS data began simultaneously with the fieldwork. As soon as data collection was completed in each cluster, all electronic data files were transferred via the IFSS to the New ERA central office in Kathmandu. These data files were registered and checked for inconsistencies, incompleteness, and outliers. The biomarker paper questionnaires were compared with the electronic data files to check for any inconsistencies in data entry. Data entry and editing were carried out using the CSPro software package. The secondary editing of the data was completed in the second week of February 2017. The final cleaning of the data set was carried out by The DHS Program data processing specialist and was completed by the end of February 2017.

Response rate

A total of 11,473 households were selected for the sample, of which 11,203 were occupied. Of the occupied households, 11,040 were successfully interviewed, yielding a response rate of 99%.

In the interviewed households, 13,089 women age 15-49 were identified for individual interviews; interviews were completed with 12,862 women, yielding a response rate of 98%. In the subsample of households selected for the male survey, 4,235 men age 15-49 were identified and 4,063 were successfully interviewed, yielding a response rate of 96%.

Response rates were lower in urban areas than in rural areas. The difference was slightly more prominent for men than for women, as men in urban areas were often away from their households for work.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Non-sampling errors result from mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding 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 2016 Nepal DHS (NDHS) 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 2016 NDHS 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 results.

Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2016 NDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in either ISSA or SAS, using programs developed by ICF. These programs use the Taylor linearization method of variance estimation for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

A more detailed description of estimates of sampling errors are presented in Appendix B of the survey final report.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Age distribution of eligible and interviewed men - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months - Sibling size and sex ratio of siblings - Pregnancy-related mortality trends

See details of the data quality tables in Appendix C of the survey final report.

Sensitivity analysis parameters.