Abstract

The 2022 Nepal Demographic and Health Survey (NDHS) is the sixth survey of its kind implemented in the country as part of the worldwide Demographic and Health Surveys (DHS) Program. It was implemented by New ERA under the aegis of the Ministry of Health and Population (MoHP) of the Government of Nepal with the objective of providing reliable, accurate, and up-to-date data for the country.

The primary objective of the 2022 NDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the 2022 NDHS collected information on fertility, marriage, family planning, breastfeeding practices, nutrition, food insecurity, maternal and child health, childhood mortality, awareness and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs), women’s empowerment, domestic violence, fistula, mental health, accident and injury, disability, and other healthrelated issues such as smoking, knowledge of tuberculosis, and prevalence of hypertension.

The information collected through the 2022 NDHS is intended to assist policymakers and program managers in evaluating and designing programs and strategies for improving the health of Nepal’s population. The survey also provides indicators relevant to the Sustainable Development Goals (SDGs) for Nepal.

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), all women aged 15-49, men ageed 15-49, 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 2022 NDHS is an updated version of the frame from the 2011 Nepal Population and Housing Census (NPHC) provided by the National Statistical Office. The 2022 NDHS considered wards from the 2011 census as sub-wards, the smallest administrative unit for the survey. The census frame includes a complete list of Nepal’s 36,020 sub-wards. Each sub-ward has a residence type (urban or rural), and the measure of size is the number of households.

In September 2015, Nepal’s Constituent Assembly declared changes in the administrative units and reclassified urban and rural areas in the country. Nepal is divided into seven provinces: Koshi Province, Madhesh Province, Bagmati Province, Gandaki Province, Lumbini Province, Karnali Province, and Sudurpashchim Province. Provinces are divided into districts, districts into municipalities, and municipalities into wards. Nepal has 77 districts comprising a total of 753 (local-level) municipalities. Of the municipalities, 293 are urban and 460 are rural.

Originally, the 2011 NPHC included 58 urban municipalities. This number increased to 217 as of 2015. On March 10, 2017, structural changes were made in the classification system for urban (Nagarpalika) and rural (Gaonpalika) locations. Nepal currently has 293 Nagarpalika, with 65% of the population living in these urban areas. The 2022 NDHS used this updated urban-rural classification system. The survey sample is a stratified sample selected in two stages. Stratification was achieved by dividing each of the seven provinces into urban and rural areas that together formed the sampling stratum for that province. A total of 14 sampling strata were created in this way. Implicit stratification with proportional allocation was achieved at each of the lower administrative levels by sorting the sampling frame within each sampling stratum before sample selection, according to administrative units at the different levels, and by using a probability-proportional-to-size selection at the first stage of sampling. In the first stage of sampling, 476 primary sampling units (PSUs) were selected with probability proportional to PSU size and with independent selection in each sampling stratum within the sample allocation. Among the 476 PSUs, 248 were from urban areas and 228 from rural areas. A household listing operation was carried out in all of the selected PSUs before the main survey. The resulting list of households served as the sampling frame for the selection of sample households in the second stage. Thirty households were selected from each cluster, for a total sample size of 14,280 households. Of these households, 7,440 were in urban areas and 6,840 were in rural areas. Some of the selected sub-wards were found to be overly large during the household listing operation. Selected sub-wards with an estimated number of households greater than 300 were segmented. Only one segment was selected for the survey with probability proportional to segment size.

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

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Four questionnaires were used in the 2022 NDHS: 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 Nepal. In addition, a self-administered Fieldworker Questionnaire collected information about the survey’s fieldworkers.

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 Nepali, Maithili, and Bhojpuri. The Household, Woman’s, and Man’s Questionnaires were programmed into tablet computers to facilitate computer-assisted personal interviewing (CAPI) for data collection purposes, with the capability to choose any of the three languages for each questionnaire. The Biomarker Questionnaire was completed on paper during data collection and then entered in the CAPI system.

Cleaning operations

Data capture for the 2022 NDHS was carried out with Microsoft Surface Go 2 tablets running Windows 10.1. Software was prepared for the survey using CSPro. The processing of the 2022 NDHS data began shortly after the fieldwork started. When data collection was completed in each cluster, the electronic data files were transferred via the Internet File Streaming System (IFSS) to the New ERA central office in Kathmandu. The data files were registered and checked for inconsistencies, incompleteness, and outliers. Errors and inconsistencies were immediately communicated to the field teams for review so that problems would be mitigated going forward. Secondary editing, carried out in the central office at New ERA, involved resolving inconsistencies and coding the open-ended questions. The New ERA senior data processor coordinated the exercise at the central office. The NDHS core team members assisted with the secondary editing. The paper Biomarker Questionnaires were compared with the electronic data file to check for any inconsistencies in data entry. The pictures of vaccination cards that were captured during data collection were verified with the data entered. Data processing and editing were carried out using the CSPro software package. The concurrent data collection and processing 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 effective monitoring. The secondary editing of the data was completed by July 2022, and the final cleaning of the data set was completed by the end of August.

Response rate

A total of 14,243 households were selected for the sample, of which 13,833 were found to be occupied. Of the occupied households, 13,786 were successfully interviewed, yielding a response rate of more than 99%. In the interviewed households, 15,238 women age 15-49 were identified as eligible for individual interviews. Interviews were completed with 14,845 women, yielding a response rate of 97%. In the subsample of households selected for the men’s survey, 5,185 men age 15-49 were identified as eligible for individual interviews and 4,913 were successfully interviewed, yielding a response rate of 95%.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors result from mistakes made in implementing data collection and in data processing, such as failing to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and entering the data incorrectly. Although numerous efforts were made during the implementation of the 2022 Nepal 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 expected sample size. Each of these samples would yield results that differ somewhat from the results of the selected sample. Sampling errors are a measure of the variability among all possible samples. Although the exact degree of variability is unknown, 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, and so on), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the

Percentage of normal and abnormal birth weights among different groups in urban Nigeria: NDHS 2008–2018.

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 primary objective of the 2018 NDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the NDHS collected information on fertility, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and children, maternal and child health, adult and childhood mortality, women’s empowerment, domestic violence, female genital cutting, prevalence of malaria, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs), disability, and other health-related issues such as smoking.

The information collected through the 2018 NDHS is intended to assist policymakers and programme managers in evaluating and designing programmes and strategies for improving the health of the country’s population. The 2018 NDHS also provides indicators relevant to the Sustainable Development Goals (SDGs) for Nigeria.

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), all women aged 15-49 years resident in the household, and all children aged 0-5 years resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling frame used for the 2018 NDHS is the Population and Housing Census of the Federal Republic of Nigeria (NPHC), which was conducted in 2006 by the National Population Commission. Administratively, Nigeria is divided into states. Each state is subdivided into local government areas (LGAs), and each LGA is divided into wards. In addition to these administrative units, during the 2006 NPHC each locality was subdivided into convenient areas called census enumeration areas (EAs). The primary sampling unit (PSU), referred to as a cluster for the 2018 NDHS, is defined on the basis of EAs from the 2006 EA census frame. Although the 2006 NPHC did not provide the number of households and population for each EA, population estimates were published for 774 LGAs. A combination of information from cartographic material demarcating each EA and the LGA population estimates from the census was used to identify the list of EAs, estimate the number of households, and distinguish EAs as urban or rural for the survey sample frame. Before sample selection, all localities were classified separately into urban and rural areas based on predetermined minimum sizes of urban areas (cut-off points); consistent with the official definition in 2017, any locality with more than a minimum population size of 20,000 was classified as urban.

The sample for the 2018 NDHS was a stratified sample selected in two stages. Stratification was achieved by separating each of the 36 states and the Federal Capital Territory into urban and rural areas. In total, 74 sampling strata were identified. Samples were selected independently in every stratum via a two-stage selection. Implicit stratifications were achieved at each of the lower administrative levels by sorting the sampling frame before sample selection according to administrative order and by using a probability proportional to size selection during the first sampling stage.

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

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Four questionnaires were used for the 2018 NDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The 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 Nigeria. Comments were solicited from various stakeholders representing government ministries and agencies, nongovernmental organisations, and international donors. In addition, information about the fieldworkers for the survey was collected through a self-administered Fieldworker Questionnaire.

Cleaning operations

The processing of the 2018 NDHS data began almost immediately after the fieldwork started. As data collection was completed in each cluster, all electronic data files were transferred via the IFSS to the NPC central office in Abuja. These data files were registered and checked for inconsistencies, incompleteness, and outliers. The field teams were alerted to any inconsistencies and errors. Secondary editing, carried out in the central office, involved resolving inconsistencies and coding the open-ended questions. The NPC data processor coordinated the exercise at the central office. The biomarker paper questionnaires were compared with electronic data files to check for any inconsistencies in data entry. Data entry and editing were carried out using the CSPro software package. The concurrent processing of the data offered a distinct advantage because it maximised the likelihood of the data being error-free and accurate. Timely generation of field check tables allowed for effective monitoring. The secondary editing of the data was completed in the second week of April 2019.

Response rate

A total of 41,668 households were selected for the sample, of which 40,666 were occupied. Of the occupied households, 40,427 were successfully interviewed, yielding a response rate of 99%. In the households interviewed, 42,121 women age 15-49 were identified for individual interviews; interviews were completed with 41,821 women, yielding a response rate of 99%. In the subsample of households selected for the male survey, 13,422 men age 15-59 were identified and 13,311 were successfully interviewed, yielding a response rate of 99%.

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 2018 Nigeria Demographic and Health Survey (NDHS) to minimise 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 2018 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 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 2018 NDHS sample is 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 linearisation 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.

Note: 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 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 - Standardisation exercise results from anthropometry training - Height and weight data completeness and quality for children - Height measurements from random subsample of measured children - Sibship size and sex ratio of siblings - Pregnancy-related mortality trends - Data collection period - Malaria prevalence according to rapid diagnostic test (RDT)

Note: See detailed data quality tables in APPENDIX C of the report.

Abstract

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

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

Geographic coverage

National coverage

Analysis unit

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

Universe

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

Kind of data

Sample survey data [ssd]

Sampling procedure

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

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

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

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

Mode of data collection

Face-to-face [f2f]

Research instrument

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

Cleaning operations

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

Response rate

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

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

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

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Non-sampling errors result from mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2016 Nepal DHS (NDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2016 NDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

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

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

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

Data appraisal

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

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

The 2006-07 Namibia Demographic and Health Survey (NDHS) is a nationally representative survey of 9,804 women age 15-49 and 3,915 men age 15-49. The 2006-07 NDHS is the third comprehensive survey conducted in Namibia as part of the Demographic and Health Surveys (DHS) programme. The data are intended to provide programme managers and policymakers with detailed information on levels and trends in fertility; nuptiality; sexual activity; fertility preferences; awareness and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality, adult and maternal mortality; maternal and child health; and awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections. The 2006-07 NDHS is the first NDHS survey to collect information on malaria prevention and treatment. The 2006-07 NDHS has been a large-scale research project. Twenty-eight field teams interviewed about 9,200 households, 9,800 women and 3,900 men age 15-49. The interviews were conducted between November 2006 and March 2007. The survey covered about 500 primary sampling units in all regions. The 2006-07 Namibia Demographic and Health Survey is designed to: Determine key demographic rates, particularly fertility, under-five mortality, and adult mortality rates; Investigate the direct and indirect factors that determine the level and trends of fertility; Measure the level of contraceptive knowledge and practice among women and men by method; Determine immunisation coverage and prevalence and treatment of diarrhoea and acute respiratory diseases among children under five; identify infant and young child feeding practices and assess the nutritional status of children age 6-59 months and women age 15-49 years; Assess knowledge and attitudes of women and men regarding sexually transmitted infections and HIV/AIDS, and evaluate patterns of recent behaviour regarding condom use; Identify behaviours that protect or predispose people to HIV infection and examine social, economic, and cultural determinants of HIV; Determine the proportion of households with orphans and vulnerable children (OVCs); and Determine the proportion of households with sick people taken care of at household level. The 2006-07 NDHS is part of the worldwide Demographic and Health Surveys (DHS) programme funded by the United States Agency for International Development (USAID). DHS surveys are designed to collect data on fertility, family planning, and maternal and child health; assist countries in conducting periodic surveys to monitor changes in population, health, and nutrition; and provide an international database that can be used by researchers investigating topics related to population, health, and nutrition. MAIN RESULTS Fertility : The survey results show that Namibia has experienced a decline in fertility of almost two births over the past 15 years, with the fertility rate falling from 5.4 births per woman in 19901992 to 3.6 births in 2005-07. Family planning : Knowledge of family planning in Namibia has been nearly universal since 1992. In the 2006-07 NDHS, 98 percent of all women reported knowing about a contraceptive method. Male condoms, injectables, and the pill are the most widely known methods. Child health : Data from the 2006-07 NDHS indicate that the under-five mortality rate in Namibia is 69 deaths per 1,000 live births (based on the five-year period preceding the survey). Maternal health : In Namibia, almost all women who had a live birth in the five years preceding the survey received antenatal care from health professionals (95 percent): 16 percent from a doctor and 79 percent from a nurse or midwife. Only 4 percent of mothers did not receive any antenatal care. Breastfeeding and nutrition : Breastfeeding is common in Namibia, with 94 percent of children breastfed at some point during childhood. The median breastfeeding duration in Namibia is 16.8 months. Malaria: One in four households interviewed in the survey has at least one mosquito net, and most of these households have a net that has been treated at some time with an insecticide (20 percent). HIV/AIDS and STIS : Knowledge of HIV and AIDS is universal in Namibia; 99 percent of women age 15-49 and 99 percent of men age 15-49 have heard of AIDS. Orphans and vulnerable children : One-quarter of Namibian children under age 18 in the households sampled for the 2006-07 NDHS live with both parents, while one in three does not live with either parent. Seventeen percent of children under age 18 are orphaned, that is, one or both parents is dead. Access to health facilities : Households interviewed in the 2006-07 NDHS were asked to name the nearest government health facility, the mode of transport they would use to visit the facility, and how long it takes to get to the facility using the transport of choice.

Background characteristics of mother and child with non-missing birth weight, NDHS 2016 (n = 3095).

Abstract

The 2013 NDHS is part of the worldwide Demographic and Health Surveys (DHS) programme funded by the United States Agency for International Development (USAID). DHS surveys are designed to collect data on fertility, family planning, and maternal and child health; assist countries in monitoring changes in population, health, and nutrition; and provide an international database that can be used by researchers investigating topics related to population, health, and nutrition.

The overall objective of the survey is to provide demographic, socioeconomic, and health data necessary for policymaking, planning, monitoring, and evaluation of national health and population programmes. In addition, the survey measured the prevalence of anaemia, HIV, high blood glucose, and high blood pressure among adult women and men; assessed the prevalence of anaemia among children age 6-59 months; and collected anthropometric measurements to assess the nutritional status of women, men, and children.

A long-term objective of the survey is to strengthen the technical capacity of local organizations to plan, conduct, and process and analyse data from complex national population and health surveys. At the global level, the 2013 NDHS data are comparable with those from a number of DHS surveys conducted in other developing countries. The 2013 NDHS adds to the vast and growing international database on demographic and health-related variables.

Geographic coverage

National coverage

Analysis unit

Households and individuals

Kind of data

Sample survey data [ssd]

Sampling procedure

Sample Design The primary focus of the 2013 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. In addition, the sample was designed to provide estimates of most key variables for the 13 administrative regions.

Each of the administrative regions is subdivided into a number of constituencies (with an overall total of 107 constituencies). Each constituency is further subdivided into lower level administrative units. An enumeration area (EA) is the smallest identifiable entity without administrative specification, numbered sequentially within each constituency. Each EA is classified as urban or rural. The sampling frame used for the 2013 NDHS was the preliminary frame of the 2011 Namibia Population and Housing Census (NSA, 2013a). The sampling frame was a complete list of all EAs covering the whole country. Each EA is a geographical area covering an adequate number of households to serve as a counting unit for the population census. In rural areas, an EA is a natural village, part of a large village, or a group of small villages; in urban areas, an EA is usually a city block. The 2011 population census also produced a digitised map for each of the EAs that served as the means of identifying these areas.

The sample for the 2013 NDHS was a stratified sample selected in two stages. In the first stage, 554 EAs-269 in urban areas and 285 in rural areas-were selected with a stratified probability proportional to size selection from the sampling frame. The size of an EA is defined according to the number of households residing in the EA, as recorded in the 2011 Population and Housing Census. Stratification was achieved by separating every region into urban and rural areas. Therefore, the 13 regions were stratified into 26 sampling strata (13 rural strata and 13 urban strata). Samples were selected independently in every stratum, with a predetermined number of EAs selected. A complete household listing and mapping operation was carried out in all selected clusters. In the second stage, a fixed number of 20 households were selected in every urban and rural cluster according to equal probability systematic sampling.

Due to the non-proportional allocation of the sample to the different regions and the possible differences in response rates, sampling weights are required for any analysis using the 2013 NDHS data to ensure the representativeness of the survey results at the national as well as the regional level. Since the 2013 NDHS sample was a two-stage stratified cluster sample, sampling probabilities were calculated separately for each sampling stage and for each cluster.

See Appendix A in the final report for details

Mode of data collection

Face-to-face [f2f]

Research instrument

Three questionnaires were administered in the 2013 NDHS: the Household Questionnaire, the Woman’s Questionnaire, and the Man’s Questionnaire. These questionnaires were adapted from the standard DHS6 core questionnaires to reflect the population and health issues relevant to Namibia at a series of meetings with various stakeholders from government ministries and agencies, nongovernmental organisations, and international donors. The final draft of each questionnaire was discussed at a questionnaire design workshop organised by the MoHSS from September 25-28, 2012, in Windhoek. The questionnaires were then translated from English into the six main local languages—Afrikaans, Rukwangali, Oshiwambo, Damara/Nama, Otjiherero, and Silozi—and back translated into English. The questionnaires were finalised after the pretest, which took place from February 11-25, 2013.

The Household Questionnaire was used to list all usual household members as well as visitors in the selected households. 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, parents’ survival status was determined. In addition, the Household Questionnaire included questions on knowledge of malaria and use of mosquito nets by household members, along with questions regarding health expenditures. The Household Questionnaire was used to identify women and men who were eligible for the individual interview and the interview on domestic violence. The 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, and ownership of various durable goods. The results of tests assessing iodine levels were recorded as well.

In half of the survey households (the same households selected for the male survey), the Household Questionnaire was also used to record information on anthropometry and biomarker data collected from eligible respondents, as follows: • All eligible women and men age 15-64 were measured, weighed, and tested for anaemia and HIV. • All eligible women and men age 35-64 had their blood pressure and blood glucose measured. • All children age 0 to 59 months were measured and weighed. • All children age 6 to 59 months were tested for anaemia.

The Woman’s Questionnaire was also used to collect information from women age 50-64 living in half of the selected survey households on background characteristics, marriage and sexual activity, women’s work and husbands’ background characteristics, awareness and behaviour regarding AIDS and other STIs, and other health issues.

The Man’s Questionnaire was administered to all men age 15-64 living in half of the selected survey households. The Man’s Questionnaire collected much of the same information as 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

CSPro—a Windows-based integrated census and survey processing system that combines and replaces the ISSA and IMPS packages—was used for entry, editing, and tabulation of the NDHS data. Prior to data entry, a practical training session was provided by ICF International to all data entry staff. A total of 28 data processing personnel, including 17 data entry operators, one questionnaire administrator, two office editors, three secondary editors, two network technicians, two data processing supervisors, and one coordinator, were recruited and trained on administration of questionnaires and coding, data entry and verification, correction of questionnaires and provision of feedback, and secondary editing. NDHS data processing was formally launched during the week of June 22, 2013, at the National Statistics Agency Data Processing Centre in Windhoek. The data entry and editing phase of the survey was completed in January 2014.

Response rate

A total of 11,004 households were selected for the sample, of which 10,165 were found to be occupied during data collection. Of the occupied households, 9,849 were successfully interviewed, yielding a household response rate of 97 percent.

In these households, 9,940 women age 15-49 were identified as eligible for the individual interview. Interviews were completed with 9,176 women, yielding a response rate of 92 percent. In addition, in half of these households, 842 women age 50-64 were successfully interviewed; in this group of women, the response rate was 91 percent.

Of the 5,271 eligible men identified in the selected subsample of households, 4,481 (85 percent) were successfully interviewed.

Response rates were higher in rural than in urban areas, with the rural-urban difference more marked among men than among women.

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

Abstract

The 2010 NEDS is similar to the 2004 Nigeria DHS EdData Survey (NDES) in that it was designed to provide information on education for children age 4–16, focusing on factors influencing household decisions about children’s schooling. The survey gathers information on adult educational attainment, children’s characteristics and rates of school attendance, absenteeism among primary school pupils and secondary school students, household expenditures on schooling and other contributions to schooling, and parents’/guardians’ perceptions of schooling, among other topics.The 2010 NEDS was linked to the 2008 Nigeria Demographic and Health Survey (NDHS) in order to collect additional education data on a subset of the households (those with children age 2–14) surveyed in the 2008 Nigeria DHS survey. The 2008 NDHS, for which data collection was carried out from June to October 2008, was the fourth DHS conducted in Nigeria (previous surveys were implemented in 1990, 1999, and 2003).

The goal of the 2010 NEDS was to follow up with a subset of approximately 30,000 households from the 2008 NDHS survey. However, the 2008 NDHS sample shows that of the 34,070 households interviewed, only 20,823 had eligible children age 2–14. To make statistically significant observations at the State level, 1,700 children per State and the Federal Capital Territory (FCT) were needed. It was estimated that an additional 7,300 households would be required to meet the total number of eligible children needed. To bring the sample size up to the required target, additional households were screened and added to the overall sample. However, these households did not have the NDHS questionnaire administered. Thus, the two surveys were statistically linked to create some data used to produce the results presented in this report, but for some households, data were imputed or not included.

Geographic coverage

National

Analysis unit

Households Individuals

Kind of data

Sample survey data [ssd]

Sampling procedure

The eligible households for the 2010 NEDS are the same as those households in the 2008 NDHS sample for which interviews were completed and in which there is at least one child age 2-14, inclusive. In the 2008 NDHS, 34,070 households were successfully interviewed, and the goal here was to perform a follow-up NEDS on a subset of approximately 30,000 households. However, records from the 2008 NDHS sample showed that only 20,823 had children age 4-16. Therefore, to bring the sample size up to the required number of children, additional households were screened from the NDHS clusters.

The first step was to use the NDHS data to determine eligibility based on the presence of a child age 2-14. Second, based on a series of precision and power calculations, RTI determined that the final sample size should yield approximately 790 households per State to allow statistical significance for reporting at the State level, resulting in a total completed sample size of 790 × 37 = 29,230. This calculation was driven by desired estimates of precision, analytic goals, and available resources. To achieve the target number of households with completed interviews, we increased the final number of desired interviews to accommodate expected attrition factors such as unlocatable addresses, eligibility issues, and non-response or refusal. Third, to reach the target sample size, we selected additional samples from households that had been listed by NDHS but had not been sampled and visited for interviews. The final number of households with completed interviews was 26,934 slightly lower than the original target, but sufficient to yield interview data for 71,567 children, well above the targeted number of 1,700 children per State.

Mode of data collection

Face-to-face [f2f]

Research instrument

The four questionnaires used in the 2004 Nigeria DHS EdData Survey (NDES)— 1. Household Questionnaire 2. Parent/Guardian Questionnaire 3. Eligible Child Questionnaire 4. Independent Child Questionnaire—formed the basis for the 2010 NEDS questionnaires. These are all available in Appendix D of the survey report available under External Resources.

More than 90 percent of the questionnaires remained the same; for cases where there was a clear justification or a need for a change in item formulation or a specific requirement for additional items, these were updated accordingly. A one day workshop was convened with the NEDS Implementation Team and the NDES Advisory Committee to review the instruments and identify any needed revisions, additions, or deletions. Efforts were made to collect data to ease integration of the 2010 NEDS data into the FMOE’s national education management information system. Instrument issues that were identified as being problematic in the 2004 NDES as well as items identified as potentially confusing or difficult were proposed for revision. Issues that USAID, DFID, FMOE, and other stakeholders identified as being essential but not included in the 2004 NDES questionnaires were proposed for incorporation into the 2010 NEDS instruments, with USAID serving as the final arbiter regarding questionnaire revisions and content.

General revisions accepted into the questionnaires included the following: - A separation of all questions related to secondary education into junior secondary and senior secondary to reflect the UBE policy - Administration of school-based questions for children identified as attending pre-school - Inclusion of questions on disabilities of children and parents - Additional questions on Islamic schooling - Revision to the literacy question administration to assess English literacy for children attending school - Some additional questions on delivery of UBE under the financial questions section

Upon completion of revisions to the English-language questionnaires, the instruments were translated and adapted by local translators into three languages—Hausa, Igbo, and Yoruba—and then back-translated into English to ensure accuracy of the translation. After the questionnaires were finalized, training materials used in the 2004 NDES and developed by Macro International, which included training guides, data collection manuals, and field observation materials, were reviewed. The materials were updated to reflect changes in the questionnaires. In addition, the procedures as described in the manuals and guides were carefully reviewed. Adjustments were made, where needed, based on experience on large-scale survey and lessons learned from the 2004 NDES and the 2008 NDHS, to ensure the highest quality data capture.

Cleaning operations

Data processing for the 2010 NEDS occurred concurrently with data collection. Completed questionnaires were retrieved by the field coordinators/trainers and delivered to NPC in standard envelops, labeled with the sample identification, team, and State name. The shipment also contained a written summary of any issues detected during the data collection process. The questionnaire administrators logged the receipt of the questionnaires, acknowledged the list of issues, and acted upon them if required. The editors performed an initial check on the questionnaires, performed any coding of open-ended questions (with possible assistance from the data entry operators), and left them available to be assigned to the data entry operators. The data entry operators entered the data into the system, with the support of the editors for erroneous or unclear data.

Experienced data entry personnel were recruited from those who have performed data entry activities for NPC on previous studies. The data entry teams composed a data entry coordinator, supervisor and operators. Data entry coordinators oversaw the entire data entry process from programming and training to final data cleaning, made assignments, tracked progress, and ensured the quality and timeliness of the data entry process. Data entry supervisors were on hand at all times to ensure that proper procedures were followed and to help editors resolve any uncovered inconsistencies. The supervisors controlled incoming questionnaires, assigned batches of questionnaires to the data entry operators, and managed their progress. Approximately 30 clerks were recruited and trained as data entry operators to enter all completed questionnaires and to perform the secondary entry for data verification. Editors worked with the data entry operators to review information flagged as “erroneous” or “dubious” in the data entry process and provided follow up and resolution for those anomalies.

The data entry program developed for the 2004 NDES was revised to reflect the revisions in the 2010 NEDS questionnaire. The electronic data entry and reporting system ensured internal consistency and inconsistency checks.

Response rate

A very high overall response rate of 97.9 percent was achieved with interviews completed in 26,934 households out of a total of 27,512 occupied households from the original sample of 28,624 households. The response rates did not vary significantly by urban–rural (98.5 percent versus 97.6 percent, respectively). The response rates for parent/guardians and children were even higher, and the rate for independent children was slightly lower than the overall sample rate, 97.4 percent. In all these cases, the urban/rural differences were negligible.

Sampling error estimates

Estimates derived 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

Association between the frequency of watching television and overweight and obesity among reproductive age women in Nepal, NDHS 2016.

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.

Abstract

The 1992 Namibia Demographic and Health Survey (NDHS) is a nationally representative survey conducted by the Ministry of Health and Social Services, assisted by the Central Statistical Office, with the aim of gathering reliable information on fertility, family planning, infant and child mortality, maternal mortality, maternal and child health and nutrition. Interviewers collected information on the reproductive histories of 5,421 women 15-49 years and on the health of 3,562 children under the age of five years.

The Namibia Demographic and Health Survey (NDHS) is a national sample survey of women of reproductive age designed to collect data on mortality and fertility, socioeconomic characteristics, marriage patterns, breastfeeding, use of contraception, immunisation of children, accessibility to health and family planning services, treatment of children during episodes of illness, and the nutritional status of women and children. More specifically, the objectives of NDHS are: - To collect data at the national level which will allow the calculation of demographic rates, particularly fertility rates and child mortality rates, and maternal mortality rates; To analyse the direct and indirect factors which determine levels and trends in fertility and childhood mortality, Indicators of fertility and mortality are important in planning for social and economic development; - To measure the level of contraceptive knowledge and practice by method, region, and urban/rural residence; - To collect reliable data on family health: immunisations, prevalence and treatment of diarrhoea and other diseases among children under five, antenatal visits, assistance at delivery and breastfeeding; - To measure the nutritional status of children under five and of their mothers using anthropometric measurements (principally height and weight).

MAIN RESULTS

According to the NDHS, fertility is high in Namibia; at current fertility levels, Namibian women will have an average of 5.4 children by the end of their reproductive years. This is lower than most countries in sub-Saharan Africa, but similar to results from DHS surveys in Botswana (4.9 children per woman) and Zimbabwe (5.4 children per woman). Fertility in the South and Central regions is considerably lower (4.1 children per woman) than in the Northeast (6.0) and Northwest regions (6.7).

About one in four women uses a contraceptive method: 29 percent of married women currently use a method (26 percent use a modem method), and 23 percent of all women are current users. The pill, injection and female sterilisation are the most popular methods among married couples: each is used by about 7 to 8 percent of currently married women. Knowledge of contraception is high, with almost 90 percent of all women age 15-49 knowing of any modem method.

Certain groups of women are much more likely to use contraception than others. For example, urban women are almost four times more likely to be using a modem contraceptive method (47 percent) than rural women (13 percent). Women in the South and Central regions, those with more education, and those living closer to family planning services are also more likely to be using contraception.

Levels of fertility and contraceptive use are not likely to change until there is a drop in desired family size and until the idea of reproductive choice is more widely accepted. At present, the average ideal family size (5.0 children) is only slightly lower than the total fertility rate (5.4 children). Thus, the vast majority of births are wanted.

On average, Namibian women have their first child when they are about 21 years of age. The median age at first marriage is, however, 25 years. This indicates that many women give birth before marriage. In fact, married women are a minority in Namibia: 51 percent of women 15-49 were not married, 27 percent were currently married, 15 percent were currently living with a man (informal union), and 7 percent were widowed, divorced or separated. Therefore, a large proportion of children in Namibia are born out of wedlock.

The NDHS also provides inlbrmation about maternal and child health. The data indicate that 1 in 12 children dies before the fifth birthday. However, infant and child mortality have been declining over the past decade. Infant mortality has fallen from 67 deaths per 1,000 live births for the period 1983-87 to 57 per 1,000 live births for the period 1988-92, a decline of about 15 percent. Mortality is higher in the Northeast region than elsewhere in Namibia.

The leading causes of death are diarrhoea, undemutrition, acute respiratory infection (pneumonia) and malaria: each of these conditions was associated with about one-fifth of under-five deaths. Among neonatal deaths low birth weight and birth problems were the leading causes of death. Neonatal tetanus and measles were not lbund to be major causes of death.

Maternal mortality was estimated from reports on the survival status of sisters of the respondent. Maternal mortality was 225 per 100,000 live births for the decade prior to the survey. NDHS data also show considerable excess male mortality at ages 15-49, which may in part be related to the war of independence during the 1980s.

Utilisation of maternal and child health services is high. Almost 90 percent of mothers received antenatal care, and two-thirds of children were bom in health facilities. Traditional birth attendants assisted only 6 percent of births in the five years preceding the survey. Child vaccination coverage has increased rapidly since independence. Ninety-five percent of children age 12-23 months have received at least one vaccination, while 76 percent have received a measles vaccination, and 70 percent three doses of DPT and polio vaccines.

Children with symptoms of possible acute respiratory infection (cough and rapid breathing) may have pneumonia and need to be seen by a health worker. Among children with such symptoms in the two weeks preceding the survey two-thirds were taken to a health facility. Only children of mothers who lived more than 30 km from a health facility were less likely to be taken to a facility.

About one in five children had diarrhoea in the two weeks prior to the survey. Diarrhoea prevalence was very high in the Northeast region, where almost half of children reportedly had diarrhoea. The dysentery epidemic contributed to this high figure: diarrhoea with blood was reported for 17 percent of children under five in the Northeast region. Among children with diarrhoea in the last two weeks 68 percent were taken to a health facility, and 64 percent received a solution prepared from ORS packets. NDHS data indicate that more emphasis needs to put on increasing fluids during diarrhoea, since only I 1 percent mothers of children with diarrhoea said they increased the amount of fluids given during the episode.

Nearly all babies are breastfed (95 percent), but only 52 percent are put on the breast immediately. Exclusive breastfeeding is practiced for a short period, but not for the recommended 4-6 months. Most babies are given water, formula, or other supplements within the first four months of life, which both jeopardises their nutritional status and increases the risk of infection. On average, children are breastfed for about 17 months, but large differences exist by region. In the South region children are breastfed lor less than a year, in the Northwest region for about one and a half years and in the Northeast region for almost two years.

Most babies are weighed at birth, but the actual birth weight could be recalled for only 44 percent of births. Using these data and data on reported size of the newborn, for all births in the last five years, it was estimated that the mean birth weight in Namibia is 3048 grams, and that 16 percent of babies were low birth weight (less than 2500 grams).

Stunting, an indication of chronic undemutrition, was observed for 28 percent of children under five. Stunting was more common in the Northeast region (42 percent) than elsewhere in Namibia. Almost 9 percent of children were wasted, which is an indication of acute undemutrition. Wasting is higher than expected for Namibia and may have been caused by the drought conditions during 1992.

Matemal height is an indicator of nutritional status over generations. Women in Namibia have an average height of 160 cm and there is little variation by region. The Body Mass Index (BM1), defined as weight divided by squared height, is a measure of current nutritional status and was lower among women in the Northwest and the Northeast regions than among women in the South and Central regions.

On average, women had a health facility available within 40 minutes travel time. Women in the Northwest region, however, had to travel more than one hour to reach the nearest health facility. At a distance of less than 10 km, 56 percent of women had access to antenatal services, 48 percent to maternity services, 72 percent to immunisation services, and 49 percent to family planning services. Within one hour of travel time, fifty-two percent of women had antenatal services, 48 percent delivery services, 64 percent immunisation services and 49 percent family planning services. Distance and travel time were greatest in the Northwest region.

Geographic coverage

The sample for the NDHS was designed to be nationally representative. The design involved a two- stage stratified sample which is self-weighting within each of the three health regions for which estimates of fertility and mortality were required--Northwest, Northeast, and the combined Central/South region. In order to have a sufficient number of cases for analysis, oversampling was necessary for the Northeast region, which has only 14.8 percent of the population. Therefore, the sample was not allocated proportionally across regions and is not completely

Description of study participants and crude associations between quantitative exposures and HIV testing.

Logistic regression analysis of determinants of hypertension among adults in Nepal stratified by sex, Nepal Demographic and Health Survey (NDHS), 2016 (N = 13,304).

Explore the historical Whois records related to ndhs.net (Domain). Get insights into ownership history and changes over time.

Explore the historical Whois records related to ndhs.online (Domain). Get insights into ownership history and changes over time.

Abstract

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.

Geographic coverage

The 2001 NDHS collected demographic and health information from a nationally representative sample of ever-married women and men in the reproductive age groups of 15-49 and 15-59, respectively. The primary focus of the 2001 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.

Analysis unit

• Household
• Women age 15-49
• Men age 15-59

Universe

The population covered by the 2008 DHS is defined as the universe of all women ever-married women and men in the reproductive age groups of 15-49 and 15-59

Kind of data

Sample survey data

Sampling procedure

The survey was designed to obtain completed interviews of 8,400 ever-married women age 15-49. In addition, all ever-married males age 15-59 in every third household were interviewed. To take nonresponse into account, a total of 8,700 households nationwide were selected. The sample size was allocated to each district by urban and rural areas and the numbers of PSUs were calculated based on an average sample "take" (the number of ultimate sampled units in a cluster) of 34 completed interviews per PSU.

SAMPLE DESIGN

The 2001 NDHS collected demographic and health information from a nationally representative sample of ever-married women and men in the reproductive age groups of 15-49 and 15-59, respectively. The primary focus of the 2001 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 variables for the 13 domains obtained by cross-classifying the three ecological zones (mountains, hills, and terai) with the five development regions (Eastern, Central, Western, Mid-western, and Far-western). Due to their small size, the mountain areas of the Western, Mid-western, and Far-western regions were combined.

SAMPLING FRAME

The 2001 NDHS used the sampling frame provided by the list of census enumeration areas (EAs) with population and household information from the 1991 Population Census. Administratively, Nepal is divided into 75 districts. Each district is subdivided into village development committees (VDCs), and each VDC is divided into wards. The primary sampling unit (PSU) for the 2001 NDHS is a ward or group of wards in rural areas and subwards in urban areas. In rural areas, the ward is small enough for a complete household listing, but in urban areas, the ward size 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 Living Standards Measurement Survey, a project funded by the World Bank.

SAMPLE SELECTION

The sample for the survey is based on a two-stage, stratified, nationally representative sample of households. At the first stage of sampling, 257 PSUs - 42 in urban areas and 215 in rural areas were selected using systematic sampling with probability proportional to size. During fieldwork, six PSUs in the Mid-western region were dropped from the sample due to security issues, reducing the total number of PSUs covered to 251 and reducing the number of rural PSUs to 209. This also reduced the expected number of completed interviews to 8,170 from 8,400.

A complete household listing operation was then carried out in all the selected EAs to provide a sampling frame for the second-stage selection of households. Sketch maps were constructed to identify the relative position of housing units in an EA to help interviewers locate selected households during fieldwork. Table A.1 shows the sample distribution of PSUs.

Global positioning system (GPS) units were used to calculate latitude and longitude coordinates for each selected ward (or subward) during the household listing stage. One latitude/longitude coordinate was taken for the center of each settlement or community within the ward. The altitude reading was also taken with the GPS units. The positional accuracy of the GPS readings is approximately 5 to 10 meters for latitude/longitude and approximately 30 meters for altitude. This geographic information allows the 2001 NDHS data to be integrated into a geographic information system (GIS) along with other spatial data collected in the same localities and adds to the depth of information available from the 2001 NDHS.

At the second stage of sampling, systematic samples of 34 households per PSU on average 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.

Mode of data collection

Face-to-face

Research instrument

The 2001 NDHS used three questionnaires: the Household Questionnaire, the Women's Questionnaire, and the Men's Questionnaire. The content and design of the questionnaires were based on the MEASURE DHS+ Model 'B' Questionnaire. The questionnaires were specifically geared toward obtaining the kind of information needed by health and family planning program managers and policymakers. The model questionnaires were then adapted to local conditions and a number of additional questions specific to ongoing health and family planning programs in Nepal were added. These questionnaires were developed in English and translated into the three principal languages in use in the country: Nepali (the national language), Bhojpuri, and Maithili. They were then independently translated back to English and appropriate changes were made in the translation of questions in which the back-translated version did not compare well with the original English version. A pretest of all three questionnaires was conducted in the three local languages in September 2000.

a) All usual members in a selected household and visitors who stayed there the previous night were enumerated using the Household Questionnaire. Specifically, the Household Questionnaire obtained information on the relationship to the head of the household, residence, sex, age, marital status, and education of each usual resident or visitor. This information was used to identify eligible women and men for the individual interview. Ever-married women age 15-49 in all selected households and ever-married men age 15-59 in every third selected household, whether usual residents or visitors, were deemed eligible and were interviewed. The Household Questionnaire also obtained information on some basic socioeconomic indicators such as the source of drinking water, the type of toilet facilities, the ownership of a variety of consumer durable items, and the flooring material. All eligible women and all children born since Baisakh 2052 in the Nepali calendar (which roughly corresponds to April 1995 in the Gregorian calendar) were weighed and measured.

b) The Women's Questionnaire collected information on female respondent's background characteristics; reproductive history; contraceptive knowledge and use; antenatal, delivery, and postnatal care; infant feeding practices; child immunization and health; marriage; fertility preferences; attitudes about family planning;

Abstract

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.

Geographic coverage

The primary focus of the 2011 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 variables for the 13 eco-development regions.

Analysis unit

Household, adult woman, adult man

Kind of data

Sample survey data

Sampling procedure

The primary focus of the 2011 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 variables for the 13 eco-development regions.

Sampling Frame

Nepal is divided into 75 districts, which are further divided into smaller VDCs and municipalities. The VDCs and municipalities, in turn, are further divided into wards. The larger wards in the urban areas are divided into subwards. An enumeration area (EA) is defined as a ward in rural areas and a subward in urban areas. Each EA is classified as urban or rural. As the upcoming population census was scheduled for June 2011, the 2011 NDHS used the list of EAs with population and household information developed by the Central Bureau of Statistics for the 2001 Population Census. The long gap between the 2001 census and the fielding of the 2011 NDHS necessitated an updating of the 2001 sampling frame to take into account not only population growth but also mass internal and external migration due to the 10-year political conflict in the country. To obtain an updated list, a partial updating of the 2001 census frame was carried out by conducting a quick count of dwelling units in EAs five times more than the sample required for each of the 13 domains. The results of the quick count survey served as the actual frame for the 2011 NDHS sample design.

Domains

The country is broadly divided into three horizontal ecological zones, namely mountain, hill, and terai. Vertically, the country is divided into five development regions. The cross section of these zones and regions results in 15 eco-development regions, which are referred to in the 2011 NDHS as subregions or domains. Due to the small population size in the mountain regions, the Western, Mid-western, and Far-western mountain regions are combined into one domain, yielding a total of 13 domains. In order to provide an adequate sample to calculate most of the key indicators at an acceptable level of precision, each domain had a minimum of about 600 households.

Stratification was achieved by separating each of the 13 domains into urban and rural areas. The 2011 NDHS used the same urban-rural stratification as in the 2001 census frame. In total, 25 sampling strata were created. There are no urban areas in the Western, Mid-western, and Far-western mountain regions. The numbers of wards and subwards in each of the 13 domains are not allocated proportional to their population due to the need to provide estimates with acceptable levels of statistical precision for each domain and for urban and rural domains of the country as a whole. The vast majority of the population in Nepal resides in the rural areas. In order to provide national urban estimates, urban areas of the country were oversampled.

Sample Selection

Samples were selected independently in each stratum through a two-stage selection process. In the first stage, EAs were selected using a probability-proportional-to-size strategy. In order to achieve the target sample size in each domain, the ratio of urban EAs to rural EAs in each domain was roughly 1 to 2, resulting in 95 urban and 194 rural EAs (a total of 289 EAs).

Complete household listing and mapping was carried out in all selected EAs (clusters). In the second stage, 35 households in each urban EA and 40 households in each rural EA were randomly selected. Due to the nonproportional allocation of the sample to the different domains and to oversampling of urban areas in each domain, sampling weights are required for any analysis using the 2011 NDHS data to ensure the actual representativeness of the sample at the national level as well as at the domain levels. Since the 2011 NDHS sample is a two-stage stratified cluster sample, sampling weights were calculated based on sampling probabilities separately for each sampling stage, taking into account nonproportionality in the allocation process for domains and urban-rural strata.

Mode of data collection

Face-to-face

Research instrument

Three questionnaires were administered in the 2011 NDHS: the Household Questionnaire, the Woman’s Questionnaire, and the Man’s Questionnaire. These questionnaires were adapted from the standard DHS6 core questionnaires to reflect the population and health issues relevant to Nepal at a series of meetings with various stakeholders from government ministries and agencies, nongovernmental organizations, EDPs, and international donors. The final draft of each questionnaire was discussed at a questionnaire design workshop organized by the MOHP, Population Division on 22 April 2010 in Kathmandu. These questionnaires were then translated from English into the three main local languages—Nepali, Maithali, and Bhojpuri—and back translated into English. Questionnaires were finalized after the pretest, which was held from 30 September to 4 November 2010, with a one-week break in October for the Dasain holiday.

The Household Questionnaire was used to list all of the usual members and visitors in the selected households. 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 was used to identify women and men who were eligible for the individual interview and women who were eligible for the interview focusing on domestic violence. 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 mosquito nets, and household food security. The results of salt testing for iodine content, height and weight measurements, and anemia testing were also recorded in the Household Questionnaire.

The Woman’s Questionnaire was used to collect information from women age 15-49. Women were asked questions on the following topics: - background characteristics (education, residential history, media exposure, etc.) - pregnancy history and childhood mortality - knowledge and use of family planning methods - fertility preferences - antenatal, delivery, and postnatal care - breastfeeding and infant feeding practices - vaccinations and childhood illnesses - marriage and sexual activity - work characteristics and husband’s background characteristics - awareness and behavior regarding AIDS and other sexually transmitted infections - domestic violence

The Man’s Questionnaire was administered to all men age 15-49 living in every second household in the 2011 NDHS. The Man’s Questionnaire collected much of the same information as the Woman’s Questionnaire but was shorter

Abstract

The 2008 Nigeria Demographic Health Survey (NDHS) is a nationally representative survey of 33,385 women age 15-49 and 15,486 men age 15-59. The 2008 NDHS is the fourth comprehensive survey conducted in Nigeria as part of the Demographic and Health Surveys (DHS) programme. The data are intended to furnish programme managers and policymakers with detailed information on levels and trends in fertility; nuptiality; sexual activity; fertility preferences; awareness and use of family planning methods; infants and young children feeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; maternal and child health; and awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections. Additionally, the 2008 NDHS collected information on malaria prevention and treatment, neglected tropical diseases, domestic violence, fistulae, and female genital cutting (FGC).

The 2008 Nigeria Demographic and Health Survey (2008 NDHS) was implemented by the National Population Commission from June to October 2008 on a nationally representative sample of more than 36,000 households. All women age 15-49 in these households and all men age 15-59 in a sub-sample of half of the households were individually interviewed.

While significantly expanded in content, the 2008 NDHS is a follow-up to the 1990, 1999, and 2003 NDHS surveys and provides updated estimates of basic demographic and health indicators covered in these earlier surveys. In addition, the 2008 NDHS includes the collection of information on violence against women. Although previous surveys collected data at the national and zonal levels, the 2008 NDHS is the first NDHS survey to collect data on basic demographic and health indicators at the state level.

The primary objectives of the 2008 NDHS project were to provide up-to-date information on fertility levels; nuptiality; sexual activity; fertility preferences; awareness and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; maternal and child health; and awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections.

MAIN FINDINGS

FERTILITY

The survey results show fertility in Nigeria has remained at a high level over the last 17 years from 5.9 births per woman in 1991 to 5.7 births in 2008. On average, rural women are having two children more than urban women (6.3 and 4.7 children, respectively). Fertility differentials by education and wealth are noticeable. Women who have no formal education and women in the lowest wealth quintile on average are having 7 children, while women with higher than a secondary education are having 3 children and women in the highest wealth quintile are having 4 children.

FAMILY PLANNING

In the 2008 NDHS, 72 percent of all women and 90 percent of all men know at least one contraceptive method. Male condoms, the pill, and injectables are the most widely known methods.

Twenty-nine percent of currently married women have used a family planning method at least once in their lifetime. Fifteen percent of currently married women are using any contraceptive method and 10 percent are using a modern method. The most commonly used methods among currently married women are injectables (3 percent), followed by male condoms and the pill (2 percent each).

Current use of contraception in Nigeria has increased from 6 percent in 1990 and 13 percent in 2003 to 15 percent in 2008. There has been a corresponding increase in the use of modern contraceptive methods, from 4 percent in 1990 and 8 percent in 2003 to 10 percent in 2008.

CHILD HEALTH

Data from the 2008 NDHS indicate that the infant mortality rate is 75 deaths per 1,000 live births, while the under-five mortality rate is 157 per 1,000 live births for the five-year period immediately preceding the survey. The neonatal mortality rate is 40 per 1,000 births. Thus, almost half of childhood deaths occurred during infancy, with one-quarter taking place during the first month of life.

Child mortality is consistently lower in urban areas than in rural areas. There is also variation in the mortality level across zones. The infant mortality and under-five mortality rates are highest in the North East, and lowest in the South West.

In Nigeria, children are considered fully vaccinated when they receive one dose of BCG vaccine, three doses of DPT vaccine, three doses of polio vaccine, and one dose of measles vaccine. Overall, 23 percent of children 12-23 months have received all vaccinations at the time of the survey. Fifty percent of children have received the BCG vaccination, and 41 percent have been vaccinated against measles. The coverage of the first dose of DPT vaccine and polio 1 is 52 and 68 percent, respectively). However, only 35 percent of children have received the third dose of DPT vaccine, and 39 percent have received the third dose of polio vaccine. A comparison of the 2008 NDHS results with those of the earlier surveys shows there has been an increase in the overall vaccination coverage in Nigeria from 13 percent in 2003 to the current rate of 23 percent. However, the percentage of children with no vaccinations has not improved for the same period, 27 percent in 2003 and 29 percent in 2008.

MATERNAL HEALTH

In Nigeria more than half of women who had a live birth in the five years preceding the survey received antenatal care from a health professional (58 percent); 23 percent from a doctor, 30 percent from a nurse or midwife, and 5 percent from an auxiliary nurse or midwife. Thirty-six percent of mothers did not receive any antenatal care.

Tetanus toxoid injections are given during pregnancy to prevent neonatal tetanus. Overall, 48 percent of last births in Nigeria were protected against neonatal tetanus.

More than one-third of births in the five years before the survey were delivered in a health facility (35 percent). Twenty percent of births occurred in public health facilities and 15 percent occurred in private health facilities. Almost two-thirds (62 percent) of births occurred at home. Nine percent of births were assisted by a doctor, 25 percent by a nurse or midwife, 5 percent by an auxiliary nurse or midwife, and 22 percent by a traditional birth attendant. Nineteen percent of births were assisted by a relative and 19 percent of births had no assistance at all. Two percent of births were delivered by a caesarean section.

Overall, 42 percent of mothers received a postnatal check-up for the most recent birth in the five years preceding the survey, with 38 percent having the check-up within the critical 48 hours after delivery.

Results from the 2008 NDHS show that the estimated maternal mortality ratio during the seven-year period prior to the survey is 545 maternal deaths per 100,000 live births.

BREASTFEEDING AND NUTRITION

Ninety-seven percent of Nigerian children under age five were breastfed at some point in their life. The median breastfeeding duration in Nigeria is long (18.1 months). On the other hand, the median duration for exclusive breastfeeding is only for half a month. A small proportion of babies (13 percent) are exclusively breastfed throughout the first six months of life. More than seven in ten (76 percent) children age 6-9 months receive complementary foods. Sixteen percent of babies less than six months of age are fed with a bottle with a nipple, and the proportion bottle-fed peaks at 17 percent among children in the age groups 2-3 months and 4-5 months.

Anthropometric measurements carried out at the time of the survey indicate that, overall, 41 percent of Nigerian children are stunted (short for their age), 14 percent are wasted (thin for their height), and 23 percent are underweight. The indices show that malnutrition in young children increases with age, starting with wasting, which peaks among children age 6-8 months, underweight peaks among children age 12-17 months, and stunting is highest among children age 18-23 months. Stunting affects half of children in this age group and almost one-third of children age 18-23 months are severely stunted.

Overall, 66 percent of women have a body mass index (BMI) in the normal range; 12 percent of women are classified as thin and 4 percent are severely thin. Twenty-two percent of women are classified as overweight or obese, with 6 percent in the latter category.

MALARIA

Seventeen percent of all households interviewed during the survey had at least one mosquito net, while 8 percent had more than one. Sixteen percent of households had at least one net that had been treated at some time (ever-treated) with an insecticide. Eight percent of households had at least one insecticide-treated net (ITN).

Mosquito net usage is low among young children and pregnant women, groups that are particularly vulnerable to the effects of malaria. Overall, 12 percent of children under five slept under a mosquito net the night before the survey. Twelve percent of children slept under an ever-treated net and 6 percent slept under an ITN. Among pregnant women, 12 percent slept under any mosquito net the night before the interview. Twelve percent slept under an ever-treated net and 5 percent slept under an ITN.

Among women who had their last birth in the two years before the survey, 18 percent took an anti-malarial drug during the pregnancy. Eleven percent of all pregnant women took at least one dose of a sulphadoxine-pyrimethamine (SP) drug such as Fansidar, Amalar, or Maloxine, while 7 percent reported taking two or more doses of an SP drug. Eight percent of the women who took an SP drug were given the drug during an antenatal care visit, a practice known as intermittent preventive treatment (IPT).

HIV/AIDS KNOWLEDGE AND BEHAVIOUR

The majority of

MSS, Midwives Service Scheme; NDHS, Nigeria Demographic and Health Survey.