Abstract

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

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

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

Geographic coverage

National coverage

Analysis unit

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

Universe

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

Kind of data

Sample survey data [ssd]

Sampling procedure

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

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

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

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

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

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

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

Cleaning operations

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

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

Response rate

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

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and in data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2022 Philippines National Demographic and Health Survey (2022 NDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2022 NDHS is only one of many samples that could have been selected from the same population, using the same design and identical size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

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

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2022 NDHS sample was the result of a multistage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS using programs developed by ICF. These programs use the Taylor linearization method to estimate variances for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

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

Data appraisal

Data Quality Tables

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

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

Abstract

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

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

Geographic coverage

National coverage

Analysis unit

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

Universe

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

Kind of data

Sample survey data [ssd]

Sampling procedure

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

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

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

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

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used for the NDHS 2017: the Household Questionnaire and the Woman’s Questionnaire. Both questionnaires, based on The DHS Program’s standard Demographic and Health Survey (DHS-7) questionnaires, were adapted to reflect the population and health issues relevant to the Philippines. Input was solicited from various stakeholders representing government agencies, universities, and international agencies.

Cleaning operations

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

Response rate

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

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

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the Philippines National Demographic and Health Survey (NDHS) 2017 to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the NDHS 2017 is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability among all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

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

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the NDHS 2017 sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS, using programs developed by ICF. These programs use the Taylor linearization method to estimate variances for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

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

Data appraisal

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

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

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

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

Abstract

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

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

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

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

MAIN RESULTS

FERTILITY

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

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

FAMILY PLANNING

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

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

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

MATERNAL HEALTH

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

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

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

CHILD HEALTH

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

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

NUTRITION

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

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

HIV/AIDS

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

TUBERCULOSIS

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

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

Data description, The Philippines Demographic and Health Survey.

The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program. Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries. The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country. MAIN RESULTS Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila. Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women. Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l. The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom. Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage. Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate, More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively). Information on various aspects of maternal and child health-antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home. Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy. Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases-polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis. During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids. Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months. Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19. The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution. Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility.

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

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

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

Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which

Abstract

The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program.

Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries.

The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country.

MAIN RESULTS

Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila.

Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women.

Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l.

The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom.

Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage.

Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate,

More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively).

Information on various aspects of maternal and child health---antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home.

Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy.

Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases---polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis.

During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids.

Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months.

Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19.

The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution.

Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility.

Geographic coverage

National. The main objective of the 1993 NDS sample is to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region.

Analysis unit

• Household
• Women age 15-49

Universe

The population covered by the 1993 Phillipines NDS is defined as the universe of all females age 15-49 years, who are members of the sample household or visitors present at the time of interview and had slept in the sample households the night prior to the time of interview, regardless of marital status.

Kind of data

Sample survey data

Sampling procedure

The main objective of the 1993 National Demographic Survey (NDS) sample is to provide estimates with an acceptable precision for sociodemographics characteristics, like fertility, family planning, health and mortality variables and to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region.

The sample is nationally representative with a total size of about 15,000 women aged 15 to 49. The Integrated Survey of Households (ISH) was used as a frame. The ISH was developed in 1980, and was comprised of samples of primary sampling units (PSUs) systematically selected and with a probability proportional to size in each of the 14 regions. The PSUs were reselected in 1991, using the 1990 Population Census data on

The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program. Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries. The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country. MAIN RESULTS Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila. Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women. Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l. The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom. Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage. Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate, More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively). Information on various aspects of maternal and child health-antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home. Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy. Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases-polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis. During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids. Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months. Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19. The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution. Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility.

The urban indicators data available here are analyzed, compiled and published by UN-Habitat’s Global Urban Observatory which supports governments, local authorities and civil society organizations to develop urban indicators, data and statistics. Urban statistics are collected through household surveys and censuses conducted by national statistics authorities. Global Urban Observatory team analyses and compiles urban indicators statistics from surveys and censuses. Additionally, Local urban observatories collect, compile and analyze urban data for national policy development. Population statistics are produced by the United Nations Department of Economic and Social Affairs, World Urbanization Prospects.

PH: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 220.000 Ratio in 2011. This records an increase from the previous number of 160.000 Ratio for 2006. PH: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 190.500 Ratio from Dec 1990 (Median) to 2011, with 6 observations. The data reached an all-time high of 517.000 Ratio in 1993 and a record low of 160.000 Ratio in 2006. PH: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Philippines – Table PH.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.; ; UNICEF, State of the World's Children, Childinfo, and Demographic and Health Surveys.; ;

Summary statistics on the facility-based deliveries by insurance coverage before and after matching, The Philippines.

To estimate county of residence of Filipinx healthcare workers who died of COVID-19, we retrieved data from the Kanlungan website during the month of December 2020.22 In deciding who to include on the website, the AF3IRM team that established the Kanlungan website set two standards in data collection. First, the team found at least one source explicitly stating that the fallen healthcare worker was of Philippine ancestry; this was mostly media articles or obituaries sharing the life stories of the deceased. In a few cases, the confirmation came directly from the deceased healthcare worker's family member who submitted a tribute. Second, the team required a minimum of two sources to identify and announce fallen healthcare workers. We retrieved 86 US tributes from Kanlungan, but only 81 of them had information on county of residence. In total, 45 US counties with at least one reported tribute to a Filipinx healthcare worker who died of COVID-19 were identified for analysis and will hereafter be referred to as “Kanlungan counties.” Mortality data by county, race, and ethnicity came from the National Center for Health Statistics (NCHS).24 Updated weekly, this dataset is based on vital statistics data for use in conducting public health surveillance in near real time to provide provisional mortality estimates based on data received and processed by a specified cutoff date, before data are finalized and publicly released.25 We used the data released on December 30, 2020, which included provisional COVID-19 death counts from February 1, 2020 to December 26, 2020—during the height of the pandemic and prior to COVID-19 vaccines being available—for counties with at least 100 total COVID-19 deaths. During this time period, 501 counties (15.9% of the total 3,142 counties in all 50 states and Washington DC)26 met this criterion. Data on COVID-19 deaths were available for six major racial/ethnic groups: Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Native Hawaiian or Other Pacific Islander, Non-Hispanic American Indian or Alaska Native, Non-Hispanic Asian (hereafter referred to as Asian American), and Hispanic. People with more than one race, and those with unknown race were included in the “Other” category. NCHS suppressed county-level data by race and ethnicity if death counts are less than 10. In total, 133 US counties reported COVID-19 mortality data for Asian Americans. These data were used to calculate the percentage of all COVID-19 decedents in the county who were Asian American. We used data from the 2018 American Community Survey (ACS) five-year estimates, downloaded from the Integrated Public Use Microdata Series (IPUMS) to create county-level population demographic variables.27 IPUMS is publicly available, and the database integrates samples using ACS data from 2000 to the present using a high degree of precision.27 We applied survey weights to calculate the following variables at the county-level: median age among Asian Americans, average income to poverty ratio among Asian Americans, the percentage of the county population that is Filipinx, and the percentage of healthcare workers in the county who are Filipinx. Healthcare workers encompassed all healthcare practitioners, technical occupations, and healthcare service occupations, including nurse practitioners, physicians, surgeons, dentists, physical therapists, home health aides, personal care aides, and other medical technicians and healthcare support workers. County-level data were available for 107 out of the 133 counties (80.5%) that had NCHS data on the distribution of COVID-19 deaths among Asian Americans, and 96 counties (72.2%) with Asian American healthcare workforce data. The ACS 2018 five-year estimates were also the source of county-level percentage of the Asian American population (alone or in combination) who are Filipinx.8 In addition, the ACS provided county-level population counts26 to calculate population density (people per 1,000 people per square mile), estimated by dividing the total population by the county area, then dividing by 1,000 people. The county area was calculated in ArcGIS 10.7.1 using the county boundary shapefile and projected to Albers equal area conic (for counties in the US contiguous states), Hawai’i Albers Equal Area Conic (for Hawai’i counties), and Alaska Albers Equal Area Conic (for Alaska counties).20

Philippines PH: Condom Use: Population Aged 15-24: Female: % of Females Aged 15-24 data was reported at 2.700 % in 2013. This records an increase from the previous number of 2.400 % for 2008. Philippines PH: Condom Use: Population Aged 15-24: Female: % of Females Aged 15-24 data is updated yearly, averaging 2.700 % from Dec 2003 (Median) to 2013, with 3 observations. The data reached an all-time high of 3.100 % in 2003 and a record low of 2.400 % in 2008. Philippines PH: Condom Use: Population Aged 15-24: Female: % of Females Aged 15-24 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Philippines – Table PH.World Bank.WDI: Health Statistics. Condom use, female is the percentage of the female population ages 15-24 who used a condom at last intercourse in the last 12 months.; ; Demographic and Health Surveys, and UNAIDS.; Weighted average;

This shows the percentage of mortality rate of children from day of birth to before reaching 1st birthday (0-11 months) at the regional level for the years 2008, 2013, and 2017. These data were derived from the result of National Demographic and Health Survey of the Philippine Statistics Authority.

In 2024, the total population of the Philippines was at approximately 114.17 million inhabitants. For the foreseeable future, the Filipino population is expected to increase slightly, despite a current overall downward trend in population growth. The dwindling Filipino population For now, the population figures in the Philippines still show a steady increase and the country is still one of the most densely populated countries in the Asia-Pacific region, however, all signs point to a decline in the number of inhabitants in the long run: Just like the population growth rate, the country’s fertility rate, for example, has also been decreasing for years now, while the death rate has been increasing simultaneously.   Poor healthcare to blame One of the reasons for the downward trend is the aging population; fewer babies are born each year, while life expectancy at birth has been steady over the years. Another reason is poor healthcare in the country: The Philippines have a high tuberculosis incidence rate, a highly infectious disease, and are among the countries with a high probability of death from noncommunicable diseases as well.