Abstract

The 2022 Philippines National Demographic and Health Survey (NDHS) was implemented by the Philippine Statistics Authority (PSA). Data collection took place from May 2 to June 22, 2022.

The primary objective of the 2022 NDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the NDHS collected information on fertility, fertility preferences, family planning practices, childhood mortality, maternal and child health, nutrition, knowledge and attitudes regarding HIV/AIDS, violence against women, child discipline, early childhood development, and other health issues.

The information collected through the NDHS is intended to assist policymakers and program managers in designing and evaluating programs and strategies for improving the health of the country’s population. The 2022 NDHS also provides indicators anchored to the attainment of the Sustainable Development Goals (SDGs) and the new Philippine Development Plan for 2023 to 2028.

Geographic coverage

National coverage

Analysis unit

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

Universe

The survey covered all de jure household members (usual residents), all women aged 15-49, and all children aged 0-4 resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling scheme provides data representative of the country as a whole, for urban and rural areas separately, and for each of the country’s administrative regions. The sample selection methodology for the 2022 NDHS was based on a two-stage stratified sample design using the Master Sample Frame (MSF) designed and compiled by the PSA. The MSF was constructed based on the listing of households from the 2010 Census of Population and Housing and updated based on the listing of households from the 2015 Census of Population. The first stage involved a systematic selection of 1,247 primary sampling units (PSUs) distributed by province or HUC. A PSU can be a barangay, a portion of a large barangay, or two or more adjacent small barangays.

In the second stage, an equal take of either 22 or 29 sample housing units were selected from each sampled PSU using systematic random sampling. In situations where a housing unit contained one to three households, all households were interviewed. In the rare situation where a housing unit contained more than three households, no more than three households were interviewed. The survey interviewers were instructed to interview only the preselected housing units. No replacements and no changes of the preselected housing units were allowed in the implementing stage in order to prevent bias. Survey weights were calculated, added to the data file, and applied so that weighted results are representative estimates of indicators at the regional and national levels.

All women age 15–49 who were either usual residents of the selected households or visitors who stayed in the households the night before the survey were eligible to be interviewed. Among women eligible for an individual interview, one woman per household was selected for a module on women’s safety.

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

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Two questionnaires were used for the 2022 NDHS: the Household Questionnaire and the Woman’s Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to the Philippines. Input was solicited from various stakeholders representing government agencies, academe, and international agencies. The survey protocol was reviewed by the ICF Institutional Review Board.

After all questionnaires were finalized in English, they were translated into six major languages: Tagalog, Cebuano, Ilocano, Bikol, Hiligaynon, and Waray. The Household and Woman’s Questionnaires were programmed into tablet computers to allow for computer-assisted personal interviewing (CAPI) for data collection purposes, with the capability to choose any of the languages for each questionnaire.

Cleaning operations

Processing the 2022 NDHS data began almost as soon as fieldwork started, and data security procedures were in place in accordance with confidentiality of information as provided by Philippine laws. As data collection was completed in each PSU or cluster, all electronic data files were transferred securely via SyncCloud to a server maintained by the PSA Central Office in Quezon City. These data files were registered and checked for inconsistencies, incompleteness, and outliers. The field teams were alerted to any inconsistencies and errors while still in the area of assignment. Timely generation of field check tables allowed for effective monitoring of fieldwork, including tracking questionnaire completion rates. Only the field teams, project managers, and NDHS supervisors in the provincial, regional, and central offices were given access to the CAPI system and the SyncCloud server.

A team of secondary editors in the PSA Central Office carried out secondary editing, which involved resolving inconsistencies and recoding “other” responses; the former was conducted during data collection, and the latter was conducted following the completion of the fieldwork. Data editing was performed using the CSPro software package. The secondary editing of the data was completed in August 2022. The final cleaning of the data set was carried out by data processing specialists from The DHS Program in September 2022.

Response rate

A total of 35,470 households were selected for the 2022 NDHS sample, of which 30,621 were found to be occupied. Of the occupied households, 30,372 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 28,379 women age 15–49 were identified as eligible for individual interviews. Interviews were completed with 27,821 women, yielding a response rate of 98%.

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 in 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 2022 Philippines National Demographic and Health Survey (2022 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 2022 NDHS is only one of many samples that could have been selected from the same population, using the same design and identical 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.

A 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% 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 2022 NDHS sample was the result of a multistage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS using programs developed by ICF. These programs use the Taylor linearization method to estimate variances 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 report.

Data appraisal

Data Quality Tables

• Household age distribution
• Age distribution of eligible and interviewed women
• Age displacement at age 14/15
• Age displacement at age 49/50
• Pregnancy outcomes by years preceding the survey
• Completeness of reporting
• Observation of handwashing facility
• School attendance by single year of age
• Vaccination cards photographed
• Population pyramid
• Five-year mortality rates

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

Abstract

The 2017 Philippines National Demographic and Health Survey (NDHS 2017) is a nationwide survey with a nationally representative sample of approximately 30,832 housing units. The primary objective of the survey is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the NDHS 2017 collected information on marriage, fertility levels, fertility preferences, awareness and use of family planning methods, breastfeeding, maternal and child health, child mortality, awareness and behavior regarding HIV/AIDS, women’s empowerment, domestic violence, and other health-related issues such as smoking.

The information collected through the NDHS 2017 is intended to assist policymakers and program managers in the Department of Health (DOH) and other organizations in designing and evaluating programs and strategies for improving the health of the country’s population.

Geographic coverage

National coverage

Analysis unit

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

Universe

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

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling scheme provides data representative of the country as a whole, for urban and rural areas separately, and for each of the country’s administrative regions. The sample selection methodology for the NDHS 2017 is based on a two-stage stratified sample design using the Master Sample Frame (MSF), designed and compiled by the PSA. The MSF is constructed based on the results of the 2010 Census of Population and Housing and updated based on the 2015 Census of Population. The first stage involved a systematic selection of 1,250 primary sampling units (PSUs) distributed by province or HUC. A PSU can be a barangay, a portion of a large barangay, or two or more adjacent small barangays.

In the second stage, an equal take of either 20 or 26 sample housing units were selected from each sampled PSU using systematic random sampling. In situations where a housing unit contained one to three households, all households were interviewed. In the rare situation where a housing unit contained more than three households, no more than three households were interviewed. The survey interviewers were instructed to interview only the pre-selected housing units. No replacements and no changes of the preselected housing units were allowed in the implementing stage in order to prevent bias. Survey weights were calculated, added to the data file, and applied so that weighted results are representative estimates of indicators at the regional and national levels.

All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the households the night before the survey were eligible to be interviewed. Among women eligible for an individual interview, one woman per household was selected for a module on domestic violence.

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

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used for the NDHS 2017: the Household Questionnaire and the Woman’s Questionnaire. Both 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 the Philippines. Input was solicited from various stakeholders representing government agencies, universities, and international agencies.

Cleaning operations

The processing of the NDHS 2017 data began almost as soon as fieldwork started. As data collection was completed in each PSU, all electronic data files were transferred via an Internet file streaming system (IFSS) to the PSA central office in Quezon City. These data files were registered and checked for inconsistencies, incompleteness, and outliers. The field teams were alerted to any inconsistencies and errors while still in the PSU. Secondary editing involved resolving inconsistencies and the coding of openended questions; the former was carried out in the central office by a senior data processor, while the latter was taken on by regional coordinators and central office staff during a 5-day workshop following the completion of the fieldwork. Data editing was carried out using the CSPro software package. The concurrent processing of the data offered a distinct advantage, because it maximized the likelihood of the data being error-free and accurate. Timely generation of field check tables allowed for more effective monitoring. The secondary editing of the data was completed by November 2017. The final cleaning of the data set was carried out by data processing specialists from The DHS Program by the end of December 2017.

Response rate

A total of 31,791 households were selected for the sample, of which 27,855 were occupied. Of the occupied households, 27,496 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 25,690 women age 15-49 were identified for individual interviews; interviews were completed with 25,074 women, yielding a response rate of 98%.

The household response rate is slightly lower in urban areas than in rural areas (98% and 99%, respectively); however, there is no difference by urban-rural residence in response rates among women (98% for each).

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and 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 Philippines National Demographic and Health Survey (NDHS) 2017 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 NDHS 2017 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 among 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% 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 NDHS 2017 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 SAS, using programs developed by ICF. These programs use the Taylor linearization method to estimate variances 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 - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months

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

Contains data from the DHS data portal. There is also a dataset containing Mozambique - Subnational Demographic and Health Data on HDX.

The DHS Program Application Programming Interface (API) provides software developers access to aggregated indicator data from The Demographic and Health Surveys (DHS) Program. The API can be used to create various applications to help analyze, visualize, explore and disseminate data on population, health, HIV, and nutrition from more than 90 countries.

The 2001 Nepal Demographic and Health Survey (NDHS) is a nationally representative survey of 8,726 women age 15-49 and 2,261 men age 15-59. This Survey is the sixth in a series of national-level population and health surveys conducted in Nepal. It is the second nationally representative comprehensive survey conducted as part of the global Demographic and Health Survey (DHS) program, the first being the 1996 Nepal Family Health Survey (NFHS). The 2001 NDHS is the first in the history of demographic and health surveys conducted in Nepal that included a male sample. The 2001 NDHS was carried out under the aegis of the Family Health Division of the Department of Health Services, Ministry of Health, and was implemented by New ERA, a local research organization, which also conducted the 1996 NFHS. ORC Macro provided technical support through its MEASURE DHS+ project. The survey was funded by the United States Agency for International Development (USAID) through its mission in Nepal. The principal objective of the 2001 NDHS is to provide current and reliable data on fertility and family planning, infant and child mortality, children's and women's nutritional status, the utilization of maternal and child health services, and knowledge of HIV/AIDS. This information is essential for informed policy decisions, planning, monitoring, and evaluation of programs on health in general and reproductive health in particular at both the national and regional levels. A long-term objective of the survey is to strengthen the technical capacity of the Family Health Division of the Ministry of Health to plan, conduct, process, and analyze data from complex national population and health surveys. The 2001 NDHS data is comparable to data collected in the 1996 NFHS and similar to survey data conducted in other developing countries. This allows for temporal and spatial comparisons of demographic health information. The 2001 NDHS also adds to the vast and growing international database on demographic and health variables. The inclusion of data on men adds to the richness of this data.

Abstract

The 2008 National Demographic and Health Survey (2008 NDHS) is a nationally representative survey of 13,594 women age 15-49 from 12,469 households successfully interviewed, covering 794 enumeration areas (clusters) throughout the Philippines. This survey is the ninth in a series of demographic and health surveys conducted to assess the demographic and health situation in the country. The survey obtained detailed information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, and knowledge and attitudes regarding HIV/AIDS and tuberculosis. Also, for the first time, the Philippines NDHS gathered information on violence against women.

The 2008 NDHS was conducted by the Philippine National Statistics Office (NSO). Technical assistance was provided by ICF Macro through the MEASURE DHS program. Funding for the survey was mainly provided by the Government of the Philippines. Financial support for some preparatory and processing phases of the survey was provided by the U.S. Agency for International Development (USAID).

Like previous Demographic and Health Surveys (DHS) conducted in the Philippines, the 2008 National Demographic and Health Survey (NDHS) was primarily designed to provide information on population, family planning, and health to be used in evaluating and designing policies, programs, and strategies for improving health and family planning services in the country. The 2008 NDHS also included questions on domestic violence. Specifically, the 2008 NDHS had the following objectives:

• Collect data at the national level that will allow the estimation of demographic rates, particularly, fertility rates by urban-rural residence and region, and under-five mortality rates at the national level.
• Analyze the direct and indirect factors which determine the levels and patterns of fertility.
• Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region.
• Collect data on family health: immunizations, prenatal and postnatal checkups, assistance at delivery, breastfeeding, and prevalence and treatment of diarrhea, fever, and acute respiratory infections among children under five years.
• Collect data on environmental health, utilization of health facilities, prevalence of common noncommunicable and infectious diseases, and membership in health insurance plans.
• Collect data on awareness of tuberculosis.
• Determine women's knowledge about HIV/AIDS and access to HIV testing.
• Determine the extent of violence against women.

MAIN RESULTS

FERTILITY

Fertility Levels and Trends. There has been a steady decline in fertility in the Philippines in the past 36 years. From 6.0 children per woman in 1970, the total fertility rate (TFR) in the Philippines declined to 3.3 children per woman in 2006. The current fertility level in the country is relatively high compared with other countries in Southeast Asia, such as Thailand, Singapore and Indonesia, where the TFR is below 2 children per woman.

Fertility Differentials. Fertility varies substantially across subgroups of women. Urban women have, on average, 2.8 children compared with 3.8 children per woman in rural areas. The level of fertility has a negative relationship with education; the fertility rate of women who have attended college (2.3 children per woman) is about half that of women who have been to elementary school (4.5 children per woman). Fertility also decreases with household wealth: women in wealthier households have fewer children than those in poorer households.

FAMILY PLANNING

Knowledge of Contraception. Knowledge of family planning is universal in the Philippines- almost all women know at least one method of fam-ily planning. At least 90 percent of currently married women have heard of the pill, male condoms, injectables, and female sterilization, while 87 percent know about the IUD and 68 percent know about male sterilization. On average, currently married women know eight methods of family planning.

Unmet Need for Family Planning. Unmet need for family planning is defined as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. The 2008 NDHS data show that the total unmet need for family planning in the Philippines is 22 percent, of which 13 percent is limiting and 9 percent is for spacing. The level of unmet need has increased from 17 percent in 2003.

Overall, the total demand for family planning in the Philippines is 73 percent, of which 69 percent has been satisfied. If all of need were satisfied, a contraceptive prevalence rate of about 73 percent could, theoretically, be expected. Comparison with the 2003 NDHS indicates that the percentage of demand satisfied has declined from 75 percent.

MATERNAL HEALTH

Antenatal Care. Nine in ten Filipino mothers received some antenatal care (ANC) from a medical professional, either a nurse or midwife (52 percent) or a doctor (39 percent). Most women have at least four antenatal care visits. More than half (54 percent) of women had an antenatal care visit during the first trimester of pregnancy, as recommended. While more than 90 percent of women who received antenatal care had their blood pressure monitored and weight measured, only 54 percent had their urine sample taken and 47 percent had their blood sample taken. About seven in ten women were informed of pregnancy complications. Three in four births in the Philippines are protected against neonatal tetanus.

Delivery and Postnatal Care. Only 44 percent of births in the Philippines occur in health facilities-27 percent in a public facility and 18 percent in a private facility. More than half (56 percent) of births are still delivered at home. Sixty-two percent of births are assisted by a health professional-35 percent by a doctor and 27 percent by a midwife or nurse. Thirty-six percent are assisted by a traditional birth attendant or hilot. About 10 percent of births are delivered by C-section.

The Department of Health (DOH) recommends that mothers receive a postpartum check within 48 hours of delivery. A majority of women (77 percent) had a postnatal checkup within two days of delivery; 14 percent had a postnatal checkup 3 to 41 days after delivery.

CHILD HEALTH

Childhood Mortality. Childhood mortality continues to decline in the Philippines. Currently, about one in every 30 children in the Philippines dies before his or her fifth birthday. The infant mortality rate for the five years before the survey (roughly 2004-2008) is 25 deaths per 1,000 live births and the under-five mortality rate is 34 deaths per 1,000 live births. This is lower than the rates of 29 and 40 reported in 2003, respectively. The neonatal mortality rate, representing death in the first month of life, is 16 deaths per 1,000 live births. Under-five mortality decreases as household wealth increases; children from the poorest families are three times more likely to die before the age of five as those from the wealthiest families.

There is a strong association between under-five mortality and mother's education. It ranges from 47 deaths per 1,000 live births among children of women with elementary education to 18 deaths per 1,000 live births among children of women who attended college. As in the 2003 NDHS, the highest level of under-five mortality is observed in ARMM (94 deaths per 1,000 live births), while the lowest is observed in NCR (24 deaths per 1,000 live births).

NUTRITION

Breastfeeding Practices. Eighty-eight percent of children born in the Philippines are breastfed. There has been no change in this practice since 1993. In addition, the median durations of any breastfeeding and of exclusive breastfeeding have remained at 14 months and less than one month, respectively. Although it is recommended that infants should not be given anything other than breast milk until six months of age, only one-third of Filipino children under six months are exclusively breastfed. Complementary foods should be introduced when a child is six months old to reduce the risk of malnutrition. More than half of children ages 6-9 months are eating complementary foods in addition to being breastfed.

The Infant and Young Child Feeding (IYCF) guidelines contain specific recommendations for the number of times that young children in various age groups should be fed each day as well as the number of food groups from which they should be fed. NDHS data indicate that just over half of children age 6-23 months (55 percent) were fed according to the IYCF guidelines.

HIV/AIDS

Awareness of HIV/AIDS. While over 94 percent of women have heard of AIDS, only 53 percent know the two major methods for preventing transmission of HIV (using condoms and limiting sex to one uninfected partner). Only 45 percent of young women age 15-49 know these two methods for preventing HIV transmission. Knowledge of prevention methods is higher in urban areas than in rural areas and increases dramatically with education and wealth. For example, only 16 percent of women with no education know that using condoms limits the risk of HIV infection compared with 69 percent of those who have attended college.

TUBERCULOSIS

Knowledge of TB. While awareness of tuberculosis (TB) is high, knowledge of its causes and symptoms is less common. Only 1 in 4 women know that TB is caused by microbes, germs or bacteria. Instead, respondents tend to say that TB is caused by smoking or drinking alcohol, or that it is inherited. Symptoms associated with TB are better recognized. Over half of the respondents cited coughing, while 39 percent mentioned weight loss, 35 percent

Contains data from the DHS data portal. There is also a dataset containing Eswatini - Subnational Demographic and Health Data on HDX.

The DHS Program Application Programming Interface (API) provides software developers access to aggregated indicator data from The Demographic and Health Surveys (DHS) Program. The API can be used to create various applications to help analyze, visualize, explore and disseminate data on population, health, HIV, and nutrition from more than 90 countries.

The 2003 National Demographic and Health Survey (NDHS) is a nationally representative survey of 13,945 women age 15-49 and 5,009 men age 15-54. The main purpose of the 2003 NDHS is to provide policymakers and program managers with detailed information on fertility, family planning, childhood and adult mortality, maternal and child health, and knowledge and attitudes related to HIV/AIDS and other sexually transmitted infections. The 2003 NDHS also collects high quality data on family health: immunizations, prevalence and treatment of diarrhea and other diseases among children under five, antenatal visits, assistance at delivery and breastfeeding. The 2003 NDHS is the third national sample survey undertaken in Philippines under the auspices of the worldwide Demographic and Health Surveys program. The 2003 Philippines National Demographic and Health Survey (NDHS) is designed to provide upto-date information on population, family planning, and health to assist policymakers and program managers in evaluating and designing strategies for improving health and family planning services in the country. In particular, the 2003 NDHS has the following objectives: Collect data at the national level, which will allow the calculation of demographic rates and, particularly, fertility and under-five mortality rates. Analyze the direct and indirect factors that determine the level and trends of fertility. Indicators related to fertility will serve to inform plans for social and economic development. Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region. Collect data on knowledge and attitudes of women and men about sexually transmitted infections and HIV/AIDS and evaluate patterns of recent behavior regarding condom use. Collect high-quality data on family health, including immunizations, prevalence and treatment of diarrhea and other diseases among children under five, antenatal visits, assistance at delivery, and breastfeeding.

The 2011 Nepal Demographic and Health Survey is the fourth nationally representative comprehensive survey conducted as part of the worldwide Demographic and Health Surveys (DHS) project in the country. The survey was implemented by New ERA under the aegis of the Population Division, Ministry of Health and Population. Technical support for this survey was provided by ICF International with financial support from the United States Agency for International Development (USAID) through its mission in Nepal. The primary objective of the 2011 NDHS is to provide up-to-date and reliable data on different issues related to population and health, which provides guidance in planning, implementing, monitoring, and evaluating health programs in Nepal. The long term objective of the survey is to strengthen the technical capacity of the local institutions to plan, conduct, process and analyze data from complex national population and health surveys. The survey includes topics on fertility levels and determinants, family planning, fertility preferences, childhood mortality, children and women’s nutritional status, the utilization of maternal and child health services, knowledge of HIV/AIDS and STIs, women’s empowerment and for the first time, information on women facing different types of domestic violence. The survey also reports on the anemia status of women age 15-49 and children age 6-59 months. In addition to providing national estimates, the survey report also provides disaggregated data at the level of various domains such as ecological region, development regions and for urban and rural areas. This being the fourth survey of its kind, there is considerable trend information on reproductive and health care over the past 15 years. Moreover, the 2011 NDHS is comparable to similar surveys conducted in other countries and therefore, affords an international comparison. The 2011 NDHS also adds to the vast and growing international database on demographic and health-related variables. The 2011 NDHS collected demographic and health information from a nationally representative sample of 10,826 households, which yielded completed interviews with 12,674 women age 15-49 in all selected households and with 4, 121 men age 15-49 in every second household. This survey is the concerted effort of various individuals and institutions.

Abstract

The 2013 NDHS is designed to provide information on fertility, family planning, and health in the country for use by the government in monitoring the progress of its programs on population, family planning and health.

In particular, the 2013 NDHS has the following specific objectives: • Collect data which will allow the estimation of demographic rates, particularly fertility rates and under-five mortality rates by urban-rural residence and region. • Analyze the direct and indirect factors which determine the level and patterns of fertility. • Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region. • Collect data on health, immunizations, prenatal and postnatal check-ups, assistance at delivery, breastfeeding, and prevalence and treatment of diarrhea, fever and acute respiratory infections among children below five years old. • Collect data on environmental health, utilization of health facilities, health care financing, prevalence of common non-communicable and infectious diseases, and membership in the National Health Insurance Program (PhilHealth). • Collect data on awareness of cancer, heart disease, diabetes, dengue fever and tuberculosis. • Determine the knowledge of women about AIDS, and the extent of misconception on HIV transmission and access to HIV testing. • Determine the extent of violence against women.

Geographic coverage

National coverage

Analysis unit

• Household
• Individuals/ persons
• Woman age 15 to 49

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample selection methodology for the 2013 NDHS is based on a stratified two-stage sample design, using the 2010 Census of Population and Housing (CPH) as a frame. The first stage involved a systematic selection of 800 sample enumeration areas (EAs) distributed by stratum (region, urban/rural). In the second stage, 20 sample housing units were selected from each sample EA, using systematic random sampling.

All households in the sampled housing units were interviewed. An EA is defined as an area with discern able boundaries consisting of contiguous households. The sample was designed to provide data representative of the country and its 17 administrative regions.

Further details on the sample design and implementation are given in Appendix A of the final report.

Mode of data collection

Face-to-face [f2f]

Research instrument

The 2013 NDHS used three questionnaires: Household Questionnaire, Individual Woman’s Questionnaire, and Women’s Safety Module. The development of these questionnaires resulted from the solicited comments and suggestions during the deliberation in the consultative meetings and separate meetings conducted with the various agencies/organizations namely: PSA-NSO, POPCOM, DOH, FNRI, ICF International, NEDA, PCW, PhilHealth, PIDS, PLCPD, UNFPA, USAID, UPPI, UPSE, and WHO. The three questionnaires were translated from English into six major languages - Tagalog, Cebuano, Ilocano, Bicol, Hiligaynon, and Waray.

The main purpose of the Household Questionnaire was to identify female members of the sample household who were eligible for interview with the Individual Woman’s Questionnaire and the Women’s Safety Module.

The Individual Woman’s Questionnaire was used to collect information from all women aged 15-49 years.

The Women’s Safety Module was used to collect information on domestic violence in the country, its prevalence, severity and frequency from only one selected respondent from among all the eligible women who were identified from the Household Questionnaire.

Cleaning operations

All completed questionnaires and the control forms were returned to the PSA-NSO central office in Manila for data processing, which consisted of manual editing, data entry and verification, and editing of computer-identified errors. An ad-hoc group of thirteen regular employees from the DSSD, the Information Resources Department (IRD), and the Information Technology Operations Division (ITOD) of the NSO was created to work fulltime and oversee data processing operation in the NDHS Data Processing Center that was carried out at the NSO-CVEA Building in Quezon City, Philippines. This group was responsible for the different aspects of NDHS data processing. There were 19 data encoders hired to process the data who underwent training on September 12-13, 2013.

Data entry started on September 16, 2013. The computer package program called Census and Survey Processing System (CSPro) was used for data entry, editing, and verification. Mr. Alexander Izmukhambetov, a data processing specialist from ICF International, spent two weeks at NSO in September 2013 to finalize the data entry program. Data processing was completed on December 6, 2013.

Response rate

For the 2013 NDHS sample, 16,732 households were selected, of which 14,893 were occupied. Of these households, 14,804 were successfully interviewed, yielding a household response rate of 99.4 percent. The household response rates in urban and rural areas are almost identical.

Among the households interviewed, 16,437 women were identified as eligible respondents, and the interviews were completed for 16,155 women, yielding a response rate of 98.3 percent. On the other hand, for the women’s safety module, from a total of 11,373 eligible women, 10,963 were interviewed with privacy, translating to a 96.4 percent response rate. At the individual level, urban and rural response rates showed no difference. The principal reason for non-response among women was the failure to find individuals at home, despite interviewers’ repeated visits to the household.

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 2013 National Demographic and Health Survey (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 2013 NDHS is only one of many samples that could have been selected from the same population, using the same design and identical size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling error is a measure of the variability between the results of all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey data.

A 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 2013 NDHS sample is the result of a multistage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 2013 NDHS is a SAS program. This program used the Taylor linearization method for variance estimation for survey estimates that are means or proportions. The Jackknife repeated replications method is used for variance estimation of more complex statistics such as fertility and mortality rates.

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of weighted cases in the group or subgroup under consideration.

Further details on sampling errors calculation are given in Appendix B of the final report.

Data appraisal

Data quality tables were produced to review the quality of the data: - Household age distribution - Age distribution of eligible and interviewed women - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months

Note: The tables are presented in APPENDIX C of the final report.

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

Abstract

The principal objective of the 2006 Nepal Demographic and Health Survey (NDHS) is to provide current and reliable data on fertility and family planning behavior, child mortality, adult and maternal mortality, children’s nutritional status, the utilization of maternal and child health services, and knowledge of HIV/AIDS. For the first time, the 2006 NDHS conducted anemia testing at the household level for the country as a whole to provide information on the prevalence of anemia at the population level. The specific objectives of the survey are to:

• collect data at the national level which will allow the calculation of key demographic rates;
• analyze the direct and indirect factors which determine the level and trends of fertility;
• measure the level of contraceptive knowledge and practice among women and men by method, urban-rural residence and region,
• collect high-quality data on family health including immunization coverage among children, prevalence and treatment of diarrhea and other diseases among children under five, and maternity care indicators including antenatal visits, assistance at delivery, and postnatal care;
• collect data on infant and child mortality, and maternal and adult mortality;
• obtain data on child feeding practices including breastfeeding, and collect anthropometric measures to use in assessing the nutritional status of women and children;
• collect data on knowledge and attitudes of women and men about sexually transmitted infections and HIV/AIDS and evaluate patterns of recent behavior regarding condom use;
• conduct hemoglobin testing on women age 15-49 and children age 6-59 months in the households selected for the survey to provide information on the prevalence of anemia among women in the reproductive ages and young children.

This information is essential for informed policy decisions, planning, monitoring, and evaluation of programs on health in general and reproductive health in particular at both the national and regional levels. A long-term objective of the survey is to strengthen the technical capacity of government organizations to plan, conduct, process, and analyze data from complex national population and health surveys. Moreover, the 2006 NDHS provides national, regional and subregional estimates on population and health that are comparable to data collected in similar surveys in other developing countries. The first Demographic and Health Survey (DHS) in Nepal was the 1996 Nepal Family Health Survey (NFHS) conducted as part of the worldwide DHS program, and was followed five years later by the 2001 Nepal Demographic and Health Survey (NDHS). Data from the 2006 NDHS survey, the third such survey, allow for comparison of information gathered over a longer period of time and add to the vast and growing international database on demographic and health variables.

Wherever possible, the 2006 NDHS data are compared with data from the two earlier DHS surveys—the 2001 NDHS and the 1996 NFHS—which also sampled women age 15-49. Additionally, men age 15-59 were interviewed in the 2001 NDHS and the 2006 NDHS to provide comparable data for men over the last five years.

Geographic coverage

National

Analysis unit

• Household
• Children under five years
• Women age 15-49
• Men age 15-59

Kind of data

Sample survey data

Sampling procedure

The primary focus of the 2006 NDHS was to provide estimates of key population and health indicators, including fertility and mortality rates, for the country as a whole and for urban and rural areas separately. In addition, the sample was designed to provide estimates of most key indicators for the 13 domains obtained by cross-classifying the three ecological zones (mountain, hill and terai) with the five development regions (East, Central, West, Mid-west, and Far-west).

The 2006 NDHS used the sampling frame provided by the list of census enumeration areas with population and household information from the 2001 Population Census. Each of the 75 districts in Nepal is subdivided into Village Development Committees (VDCs), and each VDC into wards. The primary sampling unit (PSU) for the 2006 NDHS is a ward, subward, or group of wards in rural areas, and subwards in urban areas. In rural areas, the ward is small enough in size for a complete household listing, but in urban areas the ward is large. It was therefore necessary to subdivide each urban ward into subwards. Information on the subdivision of the urban wards was obtained from the updated Living Standards Measurement Survey. The sampling frame is representative of 96 percent of the noninstitutional population.

The sample for the survey is based on a two-stage, stratified, nationally representative sample of households. At the first stage of sampling, 260 PSUs (82 in urban areas and 178 in rural areas) were selected using systematic sampling with probability proportional to size. A complete household listing operation was then carried out in all the selected PSUs to provide a sampling frame for the second stage selection of households. At the second stage of sampling, systematic samples of about 30 households per PSU on average in urban areas and about 36 households per PSU on average in rural areas were selected in all the regions, in order to provide statistically reliable estimates of key demographic and health variables. However, since Nepal is predominantly rural, in order to obtain statistically reliable estimates for urban areas, it was necessary to oversample the urban areas. As such, the total sample is weighted and a final weighting procedure was applied to provide estimates for the different domains, and for the urban and rural areas of the country as a whole.

The survey was designed to obtain completed interviews of 8,600 women age 15-49. In addition, males age 15-59 in every second household were interviewed. To take nonresponse into account, a total of 9,036 households nationwide were selected.

Mode of data collection

Face-to-face

Research instrument

Three questionnaires were administered for the 2006 NDHS: the Household Questionnaire, the Women’s Questionnaire, and the Men’s Questionnaire. These questionnaires were adapted to reflect the population and health issues relevant to Nepal at a series of meetings with various stakeholders from government ministries and agencies, NGOs and international donors. The final draft of the questionnaires was discussed at a questionnaire design workshop organized by MOHP in September 2005 in Kathmandu. The survey questionnaires were then translated into the three main local languages—Nepali, Bhojpuri and Maithili and pretested from November 16 to December 13, 2005.

The Household Questionnaire was used to list all the usual members and visitors in the selected households and to identify women and men who were eligible for the individual interview. Some basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of the household. For children under age 18, the survival status of the parents was determined. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership of mosquito nets. Additionally, the Household Questionnaire was used to record height, weight, and hemoglobin measurements of women age 15-49 and children age 6-59 months. The Women’s Questionnaire was used to collect information from all women age 15-49.

These women were asked questions on the following topics: - respondent’s characteristics such as education, residential history, media exposure, - pregnancy history, childhood mortality, - knowledge and use of family planning methods, - fertility preferences, - antenatal, delivery, and postnatal care, - breastfeeding and infant feeding practices, - immunization and childhood illnesses, - marriage and sexual activity, - woman’s work and husband’s background characteristics, - awareness and behavior regarding AIDS and other sexually transmitted infections (STIs), and - maternal mortality.

The Men’s Questionnaire was administered to all men age 15-59 living in every second household in the 2006 NDHS sample. The Men’s Questionnaire collected much of the same information found in the Women’s Questionnaire, but was shorter because it did not contain a detailed reproductive history or questions on maternal and child health or nutrition.

In addition, the Verbal Autopsy Module into the causes of under-five mortality was administered to all women age 15-49 (and anyone else who remembered the circumstances surrounding the reported death) who reported a death or stillbirth in the five years preceding the survey to children under five years of age.

Response rate

A total of 9,036 households were selected, of which 8,742 were found to be occupied during data collection. Of these existing households, 8,707 were successfully interviewed, giving a household response rate of nearly 100 percent.

In the selected households, 10,973 women were identified as eligible for the individual interview. Interviews were completed for 10,793 women, yielding a response rate of 98 percent. Of the 4,582 eligible men identified in the selected subsample of households, 4,397 were successfully interviewed, giving a 96 percent response rate. Response rates were higher in rural than urban areas, especially for eligible men.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors, and (2)

The 2003 National Demographic and Health Survey (NDHS) is a nationally representative survey of 13,945 women age 15-49 and 5,009 men age 15-54. The main purpose of the 2003 NDHS is to provide policymakers and program managers with detailed information on fertility, family planning, childhood and adult mortality, maternal and child health, and knowledge and attitudes related to HIV/AIDS and other sexually transmitted infections. The 2003 NDHS also collects high quality data on family health: immunizations, prevalence and treatment of diarrhea and other diseases among children under five, antenatal visits, assistance at delivery and breastfeeding. The 2003 NDHS is the third national sample survey undertaken in Philippines under the auspices of the worldwide Demographic and Health Surveys program. The 2003 Philippines National Demographic and Health Survey (NDHS) is designed to provide upto-date information on population, family planning, and health to assist policymakers and program managers in evaluating and designing strategies for improving health and family planning services in the country. In particular, the 2003 NDHS has the following objectives: Collect data at the national level, which will allow the calculation of demographic rates and, particularly, fertility and under-five mortality rates. Analyze the direct and indirect factors that determine the level and trends of fertility. Indicators related to fertility will serve to inform plans for social and economic development. Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region. Collect data on knowledge and attitudes of women and men about sexually transmitted infections and HIV/AIDS and evaluate patterns of recent behavior regarding condom use. Collect high-quality data on family health, including immunizations, prevalence and treatment of diarrhea and other diseases among children under five, antenatal visits, assistance at delivery, and breastfeeding. MAIN RESULTS Despite increased use of family planning, increased age at first birth, and the continued decline in fertility, the 2003 NDHS reveals continuing challenges. Twenty-four percent of births in the five years preceding the survey were wanted, but at a later time, and 20 percent were not wanted at all. While the proportion of mistimed births declined from 27 percent in 1998 to 24 percent in 2003, the proportion of unwanted births increased from 18 percent in 1998 to 20 percent in 2003. As use of family planning has increased over time, there has been greater reliance on modern contraceptive methods. The largest increase in use of modern methods involves supply methods-the pill, and injectables. Greater program emphasis needs to be placed on long-term methods such as the IUD and sterilization. In the maternal health sector, while selected health indicators have shown improvement, others show deterioration. The Department of Health recommends that all pregnant women have at least four antenatal care visits during each pregnancy, but only seven in ten women had the recommended number of antenatal care visits during the last pregnancy resulting in a live birth. In the area of child health, while coverage of childhood immunizations against the six major diseases increased from 65 percent in 1998 to 70 percent in 2003, the percentage of women who have been immunized against neonatal tetanus has stayed at about 37 percent. Although childhood mortality continues to decline, 54 percent of births in the Philippines have an elevated mortality risk that is avoidable. These include births in which the mother is too young (under age 18) or too old (age 35 or older), the birth interval is too short (less than two years), or the mother has had too many prior births (more than three). While 95 to 96 percent the 2003 NDHS respondents have heard of AIDS, knowledge of ways to reduce the transmission of HIV is limited, and misconceptions about AIDS transmission are high. There is need for better information on the modes of transmission and ways to prevent HIV/AIDS.

Abstract

The main objective of a demographic household survey (DHS) is to provide estimates of a number of basic demographic and health variables. This is done through interviews with a scientifically selected probability sample that is chosen from a well-defined population.

The 2007 Nauru Demographic and Health Survey (2007 NDHS) was one of four pilot demographic and health surveys conducted in the Pacific under an Asian Development Bank ADB/ Secretariat of the Pacific Community (SPC) Regional DHS Pilot Project. The primary objective of this survey was to provide up-to-date information for policy-makers, planners, researchers and programme managers, for use in planning, implementing, monitoring and evaluating population and health programmes within the country. The survey was intended to provide key estimates of Nauru's demographics and health situation. The findings of the 2007 NDHS are very important in measuring the achievements of family planning and other health programmes. To ensure better understanding and use of these data, the results of this survey should be widely disseminated at different planning levels. Different dissemination techniques will be used to reach different segments of society.

The primary purpose of the 2007 NDHS was to furnish policy-makers and planners with detailed information on fertility, family planning, infant and child mortality, maternal and child health, nutrition, and knowledge of HIV and AIDS and other sexually transmitted infections.

NOTE: The only dissemination used was wide distribution of the report. A planned data use workshop was not undertaken. Hence there is some misconceptions and lack of awareness on the results obtained from the survey. The report is provided on the NBOS website free for download.

Geographic coverage

National Coverage - Districts

Analysis unit

• Households
• Children (0-14yrs)
• Individual women of reproductive age (15-49 yrs)
• Individual men of reproductive age (15yrs+)
• Facilities providing reproductive and child health services

Universe

The survey covered all household members (usual residents), - All children (aged 0-14 years) resident in the household - All women of reproductive age (15-49 years) resident in all household - All males (15yrs and above) in every second household (approx. 50%) resident in selected household

Results: The 2007 Nauru Demographic Health Survey (2007 NDHS) is a nationally representative survey of 655 eligible women (aged 15-49) and 392 eligible men (aged 15 and above).

Kind of data

Sample survey data [ssd]

Sampling procedure

IDG NOTES: Locate sampling documentation with SPC (Graeme Brown) and internal files. Add in this sections. Or second option dilute appendix A Sampling and extract key issues.

ESTIMATES OF SAMPLING ERRORS - Refer to Appendix A of final NDHS2007 report or; - External Resources - 2007 DHS- Appendix A and B Sampling (to be created separatedly by IDG progress ongoing)

Sampling deviation

IDG NOTES: Locate sampling documentation with Macro and internal files. Add in this section. Or second option dilute appendix B Sampling and extract key issues.

ESTIMATES OF SAMPLING ERRORS - Refer to Appendix B of final NDHS2007 report or;

• External Resources
  • 2007 DHS- Appendix A and B Sampling (to be created separatedly by IDG progress ongoing)

Extract:

In the 2007 NDHS Report of the survey results, sampling errors for selected variables have been presented in a tabular format. The sampling error tables should include:

.. Variable name

R: Value of the estimate; SE: Sampling error of the estimate; N: Unweighted number of cases on which the estimate is based; WN: Weighted number of cases; DEFT: Design effect value that compensates for the loss of precision that results from using cluster rather than simple random sampling; SE/R: Relative standard error (i.e. ratio of the sampling error to the value estimate); R-2SE: Lower limit of the 95% confidence interval; R+2SE: Upper limit of the 95% confidence interval (never >1.000 for a proportion).

Mode of data collection

Face-to-face [f2f]

Research instrument

DHS questionnaire for women cover the following sections:

• Background characteristics (age, education, religion, etc)
• Reproductive history
• Knowledge and use of contraception methods
• Antenatal care, delivery care and postnatal care
• Breastfeeding and infant feeding
• Immunization, child health and nutrition
• Marriage and recent sexual activity
• Fertility preferences
• Knowledge about HIV/AIDS and other sexually transmitted infections
• Husbands background and women's work

The men's questionnaire covers the same except for sections 4, 5, 6 which are not applicable to men.

It was also recognized that some countries have a need for special information that is not contained in the core questionnaire. Separate questionnaire modules were developed on a series of topics. These topics are optional and include:

• maternal mortality
• pill-taking behaviour
• sterilization experience
• children's education
• women's status
• domestic violence
• health expenditures
• consanguinity

The Papua New Guinea (PNG) questionnaire was proposed for Nauru to adapt as in comparison to the existing DHS model, this is not as lengthy and time-consuming. The PNG questionnaire also dealt with high incidence of alcohol and tobacco in Nauru. Questions on HIV/AIDS and STI knowledge were included in the men's questionnaire where it was not included in the PNG questionnaire.

Response rate

IDG NOTES: Locate response rate documentation with SPC (Graeme Brown) and internal files. Add in this sections.

We utilized nationally representative sample survey data from round 4 (2015-16) and round 5 (2019-21) of the National Family Health Survey (NFHS). NFHS data from various rounds was accessed from the 7th phase of Demographic Health Surveys (DHS). The surveys were conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW) and the designated nodal agency- the International Institute for Population Science (IIPS). We considered household data sets from various rounds of NFHS.

Contains data from the DHS data portal. There is also a dataset containing South Africa - Subnational Demographic and Health Data on HDX.

The DHS Program Application Programming Interface (API) provides software developers access to aggregated indicator data from The Demographic and Health Surveys (DHS) Program. The API can be used to create various applications to help analyze, visualize, explore and disseminate data on population, health, HIV, and nutrition from more than 90 countries.

Abstract

The 2023-24 Lesotho Demographic and Health Survey (2023-24 LDHS) is designed to provide data for monitoring the population and health situation in Lesotho. The 2023-24 LDHS is the 4th Demographic and Health Survey conducted in Lesotho since 2004.

The primary objective of the 2023–24 LDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the LDHS collected information on fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, childhood and maternal mortality, maternal and child health, awareness and behaviour regarding HIV and AIDS and other sexually transmitted infections (STIs), other health issues (including tuberculosis) and chronic diseases, adult mortality (including maternal mortality), mental health and well-being, and gender-based violence. In addition, the 2023–24 LDHS provides estimates of anaemia prevalence among children age 6–59 months and adults as well as estimates of hypertension and diabetes among adults.

The information collected through the 2023–24 LDHS is intended to assist policymakers and programme managers in designing and evaluating programmes and strategies for improving the health of Lesotho’s population. The survey also provides indicators relevant to the Sustainable Development Goals (SDGs) for Lesotho.

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15-59

Universe

The survey covered all de jure household members (usual residents), all women aged 15-49, all men aged 15-59, and all children aged 0-4 resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling frame used for the 2023–24 LDHS is based on the 2016 Population and Housing Census (2016 PHC), provided by the Lesotho Bureau of Statistics (BoS). The frame file is a complete list of all census enumeration areas (EAs) within Lesotho. An EA is a geographic area, usually a city block in an urban area or a village in a rural area, consisting of approximately 100 households. In rural areas, it may consist of one or more villages. Each EA serves as a counting unit for the population census and has a satellite map delineating its boundaries, with identification information and a measure of size, which is the number of residential households enumerated in the 2016 PHC. Lesotho is administratively divided into 10 districts; each district is subdivided into constituencies and each constituency into community councils.

The 2023–24 LDHS sample of households was stratified and selected independently in two stages. Each district was stratified into urban, peri-urban, and rural areas; this yielded 29 sampling strata because there are no peri-urban areas in Butha-Buthe. In the first sampling stage, 400 EAs were selected with probability proportional to EA size and with independent selection in each sampling stratum. A household listing operation was carried out in all of the selected sample EAs, and the resulting lists of households served as the sampling frame for the selection of households in the next stage.

In the second stage of selection, a fixed number of 25 households per cluster (EA) were selected with an equal probability systematic selection from the newly created household listing. All women age 15–49 who were usual members of the selected households or who spent the night before the survey in the selected households were eligible for the Woman’s Questionnaire. In every other household, all men age 15–59 who were usual members of the selected households or who spent the night before the survey in the selected households were eligible for the Man’s Questionnaire. All households in the men’s subsample were eligible for the Biomarker Questionnaire.

Fifteen listing teams, each consisting of three listers/mappers and a supervisor, were deployed in the field to complete the listing operation. Training of the household listers/mappers took place from 28 to 30 June 2024. The household listing operation was carried out in all of the selected EAs from 5 to 26 July 2024. For each household, Global Positioning System (GPS) data were collected at the time of listing and during interviews.

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Four questionnaires were used for the 2023–24 LDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Lesotho and were translated into Sesotho. In addition, a self-administered Fieldworker Questionnaire collected information about the survey’s fieldworkers.

Cleaning operations

The survey data were collected using tablet computers running the Android operating system and Census and Survey Processing System (CSPro) software, jointly developed by the United States Census Bureau, ICF, and Serpro S.A. English and Sesotho questionnaires were used for collecting data via CAPI. The CAPI programmes accepted only valid responses, automatically performed checks on ranges of values, skipped to the appropriate question based on the responses given, and checked the consistency of the data collected. Answers to the survey questions were entered into the tablets by each interviewer. Supervisors downloaded interview data to their tablet, checked the data for completeness, and monitored fieldwork progress.

Each day, after completion of interviews, field supervisors submitted data to the central server. Data were sent to the central office via secure internet data transfer. The data processing managers monitored the quality of the data received and downloaded completed data files for completed clusters into the system. ICF provided the CSPro software for data processing and technical assistance in the preparation of the data capture, data management, and data editing programmes. Secondary editing was conducted simultaneously with data collection. All technical support for data processing and use of the tablets was provided by ICF.

Abstract

The 1994 Indonesia Demographic and Health Survey (IDHS) is a follow-on project to the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS) and to the 1991 IDHS. The 1994 IDHS was significantly expanded from prior surveys to include two new modules in the women's questionnaire, namely maternal mortality and awareness of AIDS. The survey also investigated the availability of family planning and health services, which provides an opportunity for linking women's fertility, family planning and child health care with the availability of services. The 1994 IDHS also included a household expenditure module, which provides a means of identifying the household's economic status.

The 1994 IDHS was specifically designed to meet the following objectives: - Provide data concerning fertility, family planning, maternal and child health, maternal mortality and awareness of AIDS that can be used by program managers, policymakers, and researchers to evaluate and improve existing programs; - Provide data about availability of family planning and health services, thereby offering an opportunity for linking women's fertility, family planning and child-care behavior with the availability of services; - Provide data on household expenditures, which can be used to identify the household's economic status; - Provide data that can be used to analyze trends over time by examining many of the same fertility, mortality and health issues that were addressed in the earlier surveys (1987 NICPS and 1991 IDHS); - Measure changes in fertility and contraceptive prevalence rates and at the same time study factors that affect the changes, such as marriage patterns, urban/rural residence, education, breastfeeding habits, and the availability of contraception; - Measure the development and achievements of programs related to health policy, particularly those concerning the maternal and child health development program implemented through public health clinics in Indonesia.

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

Indonesia is divided into 27 provinces. For the implementation of its family planning program, the National Family Planning Coordinating Board (BKKBN) has divided these provinces into three regions as follows:

• Java-Bali: DKI Jakarta, West Java, Central Java, DI Yogyakarta, East Java, and Bali
• Outer Java-Bali I: Dista Aceh, North Sumatra, West Sumatra, South Sumatra, Lampung, West Nusa Tenggara, West Kalimantan, South Kalimantan, North Sulawesi, and South Sulawesi
• Outer Java-Bali II: Riau, Jambi, Bengkulu, East Nusa Tenggara, East Timer, Central Kalimantan, East Kalimantan, Central Sulawesi, Southeast Sulawesi, Maluku, and Irian Jaya

The 1990 Population Census of Indonesia shows that Java-Bali accounts for 62 percent of the national population, Outer Java-Bali I accounts for 27 percent, and Outer Java-Bali II accounts for 11 percent. The sample for the 1994 IDHS was designed to produce reliable estimates of fertility, contraceptive prevalence and other important variables for each of the provinces and for urban and rural areas of the three regions.

In order to meet this objective, between 1,650 and 2,050 households were selected in each of the provinces in Java-Bali, 1,250 to 1,500 households in the ten provinces in Outer Java-Bali I, and 1,000 to 1,250 households in each of the provinces in Outer Java-Bali II, for a total of 35,500 households. With an average of 0.8 ever-married women 15-49 per household, the sample was expected to yield approximately 28,000 women eligible for the individual interview.

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

Mode of data collection

Face-to-face

Research instrument

The 1994 IDHS used four questionnaires--three at the household level and one at the community level. The three questionnaires administered at the household level are the household questionnaire, an individual questionnaire for women, and the household expenditure questionnaire. The household and individual questionnaires were based on the DHS Model "A" Questionnaire, which is designed for use in countries with high contraceptive prevalence. A deviation from the standard DHS practice is the exclusion of the anthropometric measurement of young children and their mothers. Topics covered in the 1994 IDHS that were not included in the 1991 IDHS are knowledge of AIDS and maternal mortality. Additions and modifications to the model questionnaire were made in order to provide detailed information specific to Indonesia. Except for the household expenditure module, the questionnaires were developed mainly in English and were translated into Babasa Indonesia. The household expenditure schedule was adapted from the core Susenas questionnaire model. Susenas is a national household survey carried out annually by BPS to collect data on various demographic and socioeconomic indicators of the population.

Cleaning operations

The first stage of data editing was carried out by the field editors who checked the completed questionnaires for thoroughness and accuracy. Field supervisors then further examined the questionnaires. In many instances, the teams sent the questionnaires to CBS through the regency/municipality statistics offices. In these cases, no checking was done by the PSO. At CBS, the questionnaires underwent another round of editing, primarily for completeness and coding of responses to open-ended questions.

The data were processed using 16 microcomputers and the DHS computer program, ISSA (Integrated System for Survey Analysis). Data entry and office editing were initiated immediately after fieldwork began. Simple range and skip errors were corrected at the data entry stage. Data processing was completed by November 1994, and the preliminary report of the survey was published in January 1995.

Response rate

A total of 35,510 households were selected for the survey, of which 34,060 were found. Of the encountered households, 33,738 (99.1 percent) were successfully interviewed. In these households, 28,800 eligible women were identified and complete interviews were obtained from 28,168 women, or 97.8 percent of all eligible women. Generally high response rates for both household and individual interviews were due mainly to the strict enforcement of the role to revisit the originally selected household if no one was at home initially. No substitution for the originally selected households was allowed. Interviewers were instructed to make at least three visits in an effort to contact the household or eligible woman.

Note: See summarized response rates by place of residence in Table 1.2 of the survey report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) non-sampling errors, and (2) sampling errors. Non-sampling 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 questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during implementation of the 1994 IDHS to minimize this type of error, non-sampling 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 1994 IDHS 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 1994 IDHS sample is the result of a two-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 1994 IDHS is the ISSA Sampling Error Module. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jacknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

Note: See detailed estimate of sampling error calculation in APPENDIX B of the survey report.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

Abstract

The 2013 Nigeria Demographic and Health Survey (NDHS) was designed to provide data to monitor the population and health situation in Nigeria with an explicit goal of providing reliable information about maternal and child health and family planning services. The primary objective of the 2013 NDHS was to provide up-to-date information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding HIV/AIDS, and domestic violence. This information is intended to assist policymakers and programme managers in evaluating and designing programmes and strategies for improving health and family planning services in the country.

Geographic coverage

National coverage

Analysis unit

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

Kind of data

Sample survey data [ssd]

Sampling procedure

Sample Design The sample for the 2013 NDHS was nationally representative and covered the entire population residing in non-institutional dwelling units in the country. The survey used as a sampling frame the list of enumeration areas (EAs) prepared for the 2006 Population Census of the Federal Republic of Nigeria, provided by the National Population Commission. The sample was designed to provide population and health indicator estimates at the national, zonal, and state levels. The sample design allowed for specific indicators to be calculated for each of the six zones, 36 states, and the Federal Capital Territory, Abuja.

Administratively, Nigeria is divided into states. Each state is subdivided into local government areas (LGAs), and each LGA is divided into localities. In addition to these administrative units, during the 2006 population census, each locality was subdivided into census enumeration areas. The primary sampling unit (PSU), referred to as a cluster in the 2013 NDHS, is defined on the basis of EAs from the 2006 EA census frame. The 2013 NDHS sample was selected using a stratified three-stage cluster design consisting of 904 clusters, 372 in urban areas and 532 in rural areas. A representative sample of 40,680 households was selected for the survey, with a minimum target of 943 completed interviews per state.

A complete listing of households and a mapping exercise were carried out for each cluster from December 2012 to January 2013, with the resulting lists of households serving as the sampling frame for the selection of households. All regular households were listed. The NPC listing enumerators were trained to use Global Positioning System (GPS) receivers to calculate the coordinates of the 2013 NDHS sample clusters.

A fixed sample take of 45 households were selected per cluster. All women age 15-49 who were either permanent residents of the households in the 2013 NDHS sample or visitors present in the households on the night before the survey were eligible to be interviewed. In a subsample of half of the households, all men age 15-49 who were either permanent residents of the households in the sample or visitors present in the households on the night before the survey were eligible to be interviewed. Also, a subsample of one eligible woman in each household was randomly selected to be asked additional questions regarding domestic violence.

For further details on sample size and design, see Appendix B of the final report.

Mode of data collection

Face-to-face [f2f]

Research instrument

Three questionnaires were used in the 2013 NDHS: the Household Questionnaire, the Woman’s Questionnaire, and the Man’s Questionnaire.

The Household Questionnaire was used to list all of the usual members of and visitors to the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, marital status, education, and relationship to the head of the household. Information on other characteristics of household members was collected as well, including current school attendance and survivorship of parents among those under age 18. If a child in the household had a parent who was sick for more than three consecutive months in the 12 months preceding the survey or a parent who had died, additional questions related to support for orphans and vulnerable children were asked. Furthermore, if an adult in the household was sick for more than three consecutive months in the 12 months preceding the survey or an adult in the household had died, questions were asked relating to support for sick people or people in households where a member had died.

The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as source of water; type of toilet facilities; materials used for the floor of the house; ownership of various durable goods; ownership of agricultural land; ownership of livestock, farm animals, or poultry; and ownership and use of mosquito nets and long-lasting insecticidal nets. The Household Questionnaire was further used to record height and weight measurements for children age 0-59 months and women age 15-49. In addition, data on the age and sex of household members in the Household Questionnaire were used to identify women and men who were eligible for individual interviews.

The Woman’s Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following main topics: • Background characteristics (age, religion, education, literacy, media exposure, etc.) • Reproductive history and childhood mortality • Knowledge, source, and use of family planning methods • Fertility preferences • Antenatal, delivery, and postnatal care • Breastfeeding and infant feeding practices • Child immunisation and childhood illnesses • Marriage and sexual activity • Women’s work and husbands’ background characteristics • Malaria prevention and treatment • Women’s decision making • Awareness of AIDS and other sexually transmitted infections • Maternal mortality • Domestic violence

The Man’s Questionnaire was administered to all men age 15-49 in every second household in the 2013 NDHS sample. The Man’s Questionnaire collected much of the same information found in the Woman’s Questionnaire but was shorter because it did not contain a detailed reproductive history or questions on maternal and child health or nutrition.

Cleaning operations

The processing of the 2013 NDHS data began simultaneously with the fieldwork. Completed questionnaires were edited in the field immediately by the field editors and checked by the supervisors before being dispatched to the data processing centre in Abuja. The questionnaires were then edited and entered by 26 data processing personnel specially trained for this task. Data were entered using the CSPro computer package, and all data were entered twice to allow 100 percent verification. The concurrent processing of the data offered a distinct advantage because of the assurance that the data were error free and authentic. Moreover, the double entry of data enabled easy comparisons and identification of errors and inconsistencies. Inconsistencies were resolved by tallying results with the paper questionnaire entries. Secondary editing of the data was completed in the last week of July 2013. The final cleaning of the data set was carried out by the ICF data processing specialist and completed in August.

Response rate

A total of 40,320 households were selected from 896 sample points, of which 38,904 were found to be occupied at the time of the fieldwork. Of the occupied households, 38,522 were successfully interviewed, yielding a household response rate of 99 percent. In view of the security challenges in the country, this response rate is highly encouraging and appears to be the result of a well-coordinated team effort.

In the interviewed households, a total of 39,902 women age 15-49 were identified as eligible for individual interviews, and 98 percent of them were successfully interviewed. Among men, 18,229 were identified as eligible for interviews, and 95 percent were successfully interviewed. As expected, response rates were slightly lower in urban areas than in rural areas.

Note: See summarized response rates by residence (urban/rural) in Table 1.2 of the survey report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling 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 2013 Nigeria DHS (NDHS) to minimize this type of error, non-sampling 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 2013 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

Abstract

The 2015-16 Armenia Demographic and Health Survey (2015-16 ADHS) is the fourth in a series of nationally representative sample surveys designed to provide information on population and health issues. It is conducted in Armenia under the worldwide Demographic and Health Surveys program. Specifically, the objective of the 2015-16 ADHS is to provide current and reliable information on fertility and abortion levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of young children, childhood mortality, maternal and child health, domestic violence against women, child discipline, awareness and behavior regarding AIDS and other sexually transmitted infections (STIs), and other health-related issues such as smoking, tuberculosis, and anemia. The survey obtained detailed information on these issues from women of reproductive age and, for certain topics, from men as well.

The 2015-16 ADHS results are intended to provide information needed to evaluate existing social programs and to design new strategies to improve the health of and health services for the people of Armenia. Data are presented by region (marz) wherever sample size permits. The information collected in the 2015-16 ADHS will provide updated estimates of basic demographic and health indicators covered in the 2000, 2005, and 2010 surveys.

The long-term objective of the survey includes strengthening the technical capacity of major government institutions, including the NSS. The 2015-16 ADHS also provides comparable data for longterm trend analysis because the 2000, 2005, 2010, and 2015-16 surveys were implemented by the same organization and used similar data collection procedures. It also adds to the international database of demographic and health–related information for research purposes.

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), children age 0-4 years, 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 sample was designed to produce representative estimates of key indicators at the national level, for Yerevan, and for total urban and total rural areas separately. Many indicators can also be estimated at the regional (marz) level.

The sampling frame used for the 2015-16 ADHS is the Armenia Population and Housing Census, which was conducted in Armenia in 2011 (APHC 2011). The sampling frame is a complete list of enumeration areas (EAs) covering the whole country, a total number of 11,571 EAs, provided by the National Statistical Service (NSS) of Armenia, the implementing agency for the 2015-16 ADHS. This EA frame was created from the census data base by summarizing the households down to EA level. A representative probability sample of 8,749 households was selected for the 2015-16 ADHS sample. The sample was selected in two stages. In the first stage, 313 clusters (192 in urban areas and 121 in rural areas) were selected from a list of EAs in the sampling frame. In the second stage, a complete listing of households was carried out in each selected cluster. Households were then systematically selected for participation in the survey. Appendix A provides additional information on the sample design of the 2015-16 Armenia DHS. Because of the approximately equal sample size in each marz, the sample is not self-weighting at the national level, and weighting factors have been calculated, added to the data file, and applied so that results are representative at the national level.

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

Mode of data collection

Face-to-face [f2f]

Research instrument

Five questionnaires were used for the 2015-16 ADHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, the Biomarker Questionnaire, and the Fieldworker Questionnaire. These questionnaires, based on The DHS Program’s standard Demographic and Health Survey questionnaires, were adapted to reflect the population and health issues relevant to Armenia. Input was solicited from various stakeholders representing government ministries and agencies, nongovernmental organizations, and international donors. After all questionnaires were finalized in English, they were translated into Armenian. They were pretested in September-October 2015.

Cleaning operations

The processing of the 2015-16 ADHS data began shortly after fieldwork commenced. All completed questionnaires were edited immediately by field editors while still in the field and checked by the supervisors before being dispatched to the data processing center at the NSS central office in Yerevan. These completed questionnaires were edited and entered by 15 data processing personnel specially trained for this task. All data were entered twice for 100 percent verification. Data were entered using the CSPro computer package. The concurrent processing of the data was an advantage because the senior ADHS technical staff were able to advise field teams of problems detected during the data entry. In particular, tables were generated to check various data quality parameters. Moreover, the double entry of data enabled easy comparison and identification of errors and inconsistencies. As a result, specific feedback was given to the teams to improve performance. The data entry and editing phase of the survey was completed in June 2016.

Response rate

A total of 8,749 households were selected in the sample, of which 8,205 were occupied at the time of the 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. The number of occupied households successfully interviewed was 7,893, yielding a household response rate of 96 percent. The household response rate in urban areas (96 percent) was nearly the same as in rural areas (97 percent).

In these households, a total of 6,251 eligible women were identified; interviews were completed with 6,116 of these women, yielding a response rate of 98 percent. In one-half of the households, a total of 2,856 eligible men were identified, and interviews were completed with 2,755 of these men, yielding a response rate of 97 percent. Among men, response rates are slightly lower in urban areas (96 percent) than in rural areas (97 percent), whereas rates for women are the same in urban and in rural areas (98 percent).

The 2015-16 ADHS achieved a slightly higher response rate for households than the 2010 ADHS (NSS 2012). The increase is only notable for urban households (96 percent in 2015-16 compared with 94 percent in 2010). Response rates in all other categories are very close to what they were in 2010.

Sampling error estimates

SAS computer software were used to calculate sampling errors for the 2015-16 ADHS. The programs used the Taylor linearization method of variance estimation for means or proportions and the Jackknife repeated replication method 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 - Nutritional status of children based on the NCHS/CDC/WHO International Reference Population - Vaccinations by background characteristics for children age 18-29 months

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

Contains data from the DHS data portal. There is also a dataset containing Haiti - Subnational Demographic and Health Data on HDX.

The DHS Program Application Programming Interface (API) provides software developers access to aggregated indicator data from The Demographic and Health Surveys (DHS) Program. The API can be used to create various applications to help analyze, visualize, explore and disseminate data on population, health, HIV, and nutrition from more than 90 countries.