Abstract

The 2005 Ethiopia Demographic and Health Survey (2005 EDHS) is part of the worldwide MEASURE DHS project which is funded by the United States Agency for International Development (USAID).

The principal objective of the 2005 Ethiopia Demographic and Health Survey (DHS) is to provide current and reliable data on fertility and family planning behaviour, child mortality, adult and maternal mortality, children’s nutritional status, the utilization of maternal and child health services, knowledge of HIV/AIDS and prevalence of HIV/AIDS and anaemia.

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

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 Central Statistical Agency to plan, conduct, process, and analyse data from complex national population and health surveys. Moreover, the 2005 Ethiopia DHS provides national and regional estimates on population and health that are comparable to data collected in similar surveys in other developing countries. The first ever Demographic and Health Survey (DHS) in Ethiopia was conducted in the year 2000 as part of the worldwide DHS programme. Data from the 2005 Ethiopia DHS survey, the second such survey, add to the vast and growing international database on demographic and health variables.

Wherever possible, the 2005 EDHS data is compared with data from the 2000 EDHS. In addition, where applicable, the 2005 EDHS is compared with the 1990 NFFS, which also sampled women age 15-49. Husbands of currently married women were also covered in this survey. However, for security and other reasons, the NFFS excluded from its coverage Eritrea, Tigray, Asseb, and Ogaden autonomous regions. In addition, fieldwork could not be carried out for Northern Gondar, Southern Gondar, Northern Wello, and Southern Wello due to security reasons. Thus, any comparison between the EDHS and the NFFS has to be interpreted with caution.

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

The 2005 EDHS sample was designed to provide estimates for the health and demographic variables of interest for the following domains: Ethiopia as a whole; urban and rural areas of Ethiopia (each as a separate domain); and 11 geographic areas (9 regions and 2 city administrations), namely: Tigray; Affar; Amhara; Oromiya; Somali; Benishangul-Gumuz; Southern Nations, Nationalities and Peoples (SNNP); Gambela; Harari; Addis Ababa and Dire Dawa. In general, a DHS sample is stratified, clustered and selected in two stages. In the 2005 EDHS a representative sample of approximately 14,500 households from 540 clusters was selected. The sample was selected in two stages. In the first stage, 540 clusters (145 urban and 395 rural) were selected from the list of enumeration areas (EA) from the 1994 Population and Housing Census sample frame.

In the census frame, each of the 11 administrative areas is subdivided into zones and each zone into weredas. In addition to these administrative units, each wereda was subdivided into convenient areas called census EAs. Each EA was either totally urban or rural and the EAs were grouped by administrative wereda. Demarcated cartographic maps as well as census household and population data were also available for each census EA. The 1994 Census provided an adequate frame for drawing the sample for the 2005 EDHS. As in the 2000 EDHS, the 2005 EDHS sampled three of seven zones in the Somali Region (namely, Jijiga, Shinile and Liben). In the Affar Region the incomplete frame used in 2000 was improved adding a list of villages not previously included, to improve the region's representativeness in the survey. However, despite efforts to cover the settled population, there may be some bias in the representativeness of the regional estimates for both the Somali and Affar regions, primarily because the census frame excluded some areas in these regions that had a predominantly nomadic population.

The 540 EAs selected for the EDHS are not distributed by region proportionally to the census population. Thus, the sample for the 2005 EDHS must be weighted to produce national estimates. As part of the second stage, a complete household listing was carried out in each selected cluster. The listing operation lasted for three months from November 2004 to January 2005. Between 24 and 32 households from each cluster were then systematically selected for participation in the survey.

Because of the way the sample was designed, the number of cases in some regions appear small since they are weighted to make the regional distribution nationally representative. Throughout this report, numbers in the tables reflect weighted numbers. To ensure statistical reliability, percentages based on 25 to 49 unweighted cases are shown in parentheses and percentages based on fewer than 25 unweighted cases are suppressed.

Note: See detailed sample implementation table in APPENDIX A of the survey report.

Mode of data collection

Face-to-face [f2f]

Research instrument

In order to adapt the standard DHS core questionnaires to the specific socio-cultural settings and needs in Ethiopia, its contents were revised through a technical committee composed of senior and experienced demographers of PHCCO. After the draft questionnaires were prepared in English, copies of the household, women’s and men’s questionnaires were distributed to relevant institutions and individual researchers for comments. A one-day workshop was organized on November 22, 2004 at the Ghion Hotel in Addis Ababa to discuss the contents of the questionnaire. Over 50 participants attended the national workshop and their comments and suggestions collected. Based on these comments, further revisions were made on the contents of the questionnaires. Some additional questions were included at the request of MOH, the Fistula Hospital, and USAID. The questionnaires were finalized in English and translated into the three main local languages: Amharic, Oromiffa and Tigrigna. In addition, the DHS core interviewer’s manual for the Women’s and Men’s Questionnaires, the supervisor’s and editor’s manual, and the HIV and anaemia field manual were modified and translated into Amharic.

The Household Questionnaire was used to list all 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. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor and roof of the house, ownership of various durable goods, and ownership and use of mosquito nets. In addition, this questionnaire was used to record height and weight measurements of women age 15-49 and children under the age of five, households eligible for collection of blood samples, and the respondents’ consent to voluntarily give blood samples.

The Women’s Questionnaire was used to collect information from all women age 15-49 years and covered the following topics. - Household and respondent characteristics - Fertility levels and preferences - Knowledge and use of family planning - Childhood mortality - Maternity care - Childhood illness, treatment, and preventative actions - Anaemia levels among women and children - Breastfeeding practices - Nutritional status of women and young children - Malaria prevention and treatment - Marriage and sexual activity - Awareness and behaviour regarding AIDS and STIs - Harmful traditional practices - Maternal mortality

The Men’s Questionnaire was administered to all men age 15-59 years living in every second household in the sample. The Men’s Questionnaire collected similar information contained in the Women’s Questionnaire, but was shorter because it did not contain questions on reproductive

Abstract

The principal objective of the Ethiopia Demographic and Health Survey (DHS) is to provide current and reliable data on fertility and family planning behavior, child mortality, children’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 Central Statistical Authority to plan, conduct, process, and analyze data from complex national population and health surveys. Moreover, the 2000 Ethiopia DHS is the first survey of its kind in the country to provide national and regional estimates on population and health that are comparable to data collected in similar surveys in other developing countries. As part of the worldwide DHS project, the Ethiopia DHS data add to the vast and growing international database on demographic and health variables. The Ethiopia DHS collected demographic and health information from a nationally representative sample of women and men in the reproductive age groups 15-49 and 15-59, respectively.

The Ethiopia DHS was carried out under the aegis of the Ministry of Health and was implemented by the Central Statistical Authority. ORC Macro provided technical assistance through its MEASURE DHS+ project. The survey was principally funded by the Essential Services for Health in Ethiopia (ESHE) project through a bilateral agreement between the United States Agency for International Development (USAID) and the Federal Democratic Republic of Ethiopia. Funding was also provided by the United Nations Population Fund (UNFPA).

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

The Ethiopia DHS used the sampling frame provided by the list of census enumeration areas (EAs) with population and household information from the 1994 Population and Housing Census. A proportional sample allocation was discarded because this procedure yielded a distribution in which 80 percent of the sample came from three regions, 16 percent from four regions and 4 percent from five regions. To avoid such an uneven sample allocation among regions, it was decided that the sample should be allocated by region in proportion to the square root of the region's population size. Additional adjustments were made to ensure that the sample size for each region included at least 700 households, in order to yield estimates with reasonable statistical precision.

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

Mode of data collection

Face-to-face

Research instrument

The Ethiopia DHS used three questionnaires: the Household Questionnaire, the Women’s Questionnaire, and the Men’s Questionnaire, which were based on model survey instruments developed for the international MEASURE DHS+ project. 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 on-going health and family planning programs in Ethiopia were added. These questionnaires were developed in the English language and translated into the five principal languages in use in the country: Amarigna, Oromigna, Tigrigna, Somaligna, and Afarigna. 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 five local languages in November 1999.

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, parental survivorship, and education of each usual resident or visitor. This information was used to identify women and men who were eligible for the individual interview. Women age 15-49 in all selected households and all men age 15-59 in every fifth 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 number of rooms, the flooring material, the source of water, the type of toilet facilities, and the ownership of a variety of durable items. Information was also obtained on the use of impregnated bednets, and the salt used in each household was tested for its iodine content. All eligible women and all children born since Meskerem 1987 in the Ethiopian Calendar, which roughly corresponds to September 1994 in the Gregorian Calendar, were weighed and measured.

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, and attitudes about family planning, husband’s background characteristics and women’s work, knowledge of HIV/AIDS and other sexually transmitted infections (STIs).

The Men’s Questionnaire collected information on the male respondent’s background characteristics, reproduction, contraceptive knowledge and use, marriage, fertility preferences and attitudes about family planning, and knowledge of HIV/AIDS and STIs.

Response rate

A total of 14,642 households were selected for the Ethiopia DHS, of which 14,167 were found to be occupied. Household interviews were completed for 99 percent of the occupied households. A total of 15,716 eligible women from these households and 2,771 eligible men from every fifth household were identified for the individual interviews. The response rate for eligible women is slightly higher than for eligible men (98 percent compared with 94 percent, respectively). Interviews were successfully completed for 15,367 women and 2,607 men.

There is no difference by urban-rural residence in the overall response rate for eligible women; however, rural men are slightly more likely than urban men to have completed an interview (94 percent and 92 percent, respectively). The overall response rate among women by region is relatively high and ranges from 93 percent in the Affar Region to 99 percent in the Oromiya Region. The response rate among men ranges from 83 percent in the Affar Region to 98 percent in the Tigray and Benishangul-Gumuz regions.

Note: See summarized response rates by place of residence in Table A.1.1 and Table A.1.2 of the survey report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors, and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the Ethiopia DHS 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 Ethiopia DHS 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.

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

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the Ethiopia DHS sample is the result of a two-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the Ethiopia DHS is the ISSA Sampling Error Module (SAMPERR). This module used the Taylor linearisation method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

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

Data appraisal

Data Quality Tables - Household age

Abstract

The authors combine data from 84 Demographic and Health Surveys from 46 countries to analyze trends and socioeconomic differences in adult mortality, calculating mortality based on the sibling mortality reports collected from female respondents aged 15-49.

The analysis yields four main findings. First, adult mortality is different from child mortality: while under-5 mortality shows a definite improving trend over time, adult mortality does not, especially in Sub-Saharan Africa. The second main finding is the increase in adult mortality in Sub-Saharan African countries. The increase is dramatic among those most affected by the HIV/AIDS pandemic. Mortality rates in the highest HIV-prevalence countries of southern Africa exceed those in countries that experienced episodes of civil war. Third, even in Sub-Saharan countries where HIV-prevalence is not as high, mortality rates appear to be at best stagnating, and even increasing in several cases. Finally, the main socioeconomic dimension along which mortality appears to differ in the aggregate is gender. Adult mortality rates in Sub-Saharan Africa have risen substantially higher for men than for women?especially so in the high HIV-prevalence countries. On the whole, the data do not show large gaps by urban/rural residence or by school attainment.

This paper is a product of the Human Development and Public Services Team, Development Research Group. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy Research Working Papers are also posted on the Web at http://econ.worldbank.org.

Geographic coverage

We derive estimates of adult mortality from an analysis of Demographic and Health Survey (DHS) data from 46 countries, 33 of which are from Sub-Saharan Africa and 13 of which are from countries in other regions (Annex Table). Several of the countries have been surveyed more than once and we base our estimates on the total of 84 surveys that have been carried out (59 in Sub-Saharan Africa, 25 elsewhere).

The countries covered by DHS in Sub-Saharan Africa represent almost 90 percent of the region's population. Outside of Sub-Saharan Africa the DHS surveys we use cover a far smaller share of the population-even if this is restricted to countries whose GDP per capita never exceeds $10,000: overall about 14 percent of the population is covered by these countries, although this increases to 29 percent if China and India are excluded (countries for which we cannot calculate adult mortality using the DHS). It is therefore important to keep in mind that the sample of non-Sub-Saharan African countries we have cannot be thought of as "representative" of the rest of the world, or even the rest of the developing world.

Analysis unit

Country

Kind of data

Sample survey data [ssd]

Mode of data collection

Face-to-face [f2f]

Cleaning operations

In the course of carrying out this study, the authors created two databases of adult mortality estimates based on the original DHS datasets, both of which are publicly available for analysts who wish to carry out their own analysis of the data.

The naming conventions for the adult mortality-related are as follows. Variables are named:

GGG_MC_AAAA

GGG refers to the population subgroup. The values it can take, and the corresponding definitions are in the following table:

All - All Fem - Female Mal - Male Rur - Rural Urb - Urban Rurm - Rural/Male Urbm - Urban/Male Rurf - Rural/Female Urbf - Urban/Female Noed - No education Pri - Some or completed primary only Sec - At least some secondary education Noedm - No education/Male Prim - Some or completed primary only/Male Secm - At least some secondary education/Male Noedf - No education/Female Prif - Some or completed primary only/Female Secf - At least some secondary education/Female Rch - Rural as child Uch - Urban as child Rchm - Rural as child/Male Uchm - Urban as child/Male Rchf - Rural as child/Female Uchf - Urban as child/Female Edltp - Less than primary schooling Edpom - Primary or more schooling Edltpm - Less than primary schooling/Male Edpomm - Primary or more schooling/Male Edltpf - Less than primary schooling/Female Edpomf - Primary or more schooling/Female Edltpu - Less than primary schooling/Urban Edpomu - Primary or more schooling/Urban Edltpr - Less than primary schooling/Rural Edpomr - Primary or more schooling/Rural Edltpmu - Less than primary schooling/Male/Urban Edpommu - Primary or more schooling/Male/Urban Edltpmr - Less than primary schooling/Male/Rural Edpommr - Primary or more schooling/Male/Rural Edltpfu - Less than primary schooling/Female/Urban Edpomfu - Primary or more schooling/Female/Urban Edltpfr - Less than primary schooling/Female/Rural Edpomfr - Primary or more schooling/Female/Rural

M refers to whether the variable is the number of observations used to calculate the estimate (in which case M takes on the value "n") or whether it is a mortality estimate (in which case M takes on the value "m").

C refers to whether the variable is for the unadjusted mortality rate calculation (in which case C takes on the value "u") or whether it adjusts for the number of surviving female siblings (in which case C takes on the value "a").

AAAA refers to the age group that the mortality estimate is calculated for. It takes on the values: 1554 - Ages 15-54 1524 - Ages 15-24 2534 - Ages 25-34 3544 - Ages 35-44 4554 - Ages 45-54

Other variables that are in the databases are:

period - Period for which mortality rate is calculated (takes on the values 1975-79, 1980-84 … 2000-04) svycountry - Name of country for DHS countries ccode3 - Country code u5mr - Under-5 mortality (from World Development Indicators) cname - Country name gdppc - GDP per capita (constant 2000 US$) (from World Development Indicators) gdppcppp - GDP per capita PPP (constant 2005 intl $) (from World Development Indicators) pop - Population (from World Development Indicators) hivprev2001 - HIV prevalence in 2001 (from UNAIDS 2010) region - Region

Abstract

IPUMS-International is an effort to inventory, preserve, harmonize, and disseminate census microdata from around the world. The project has collected the world's largest archive of publicly available census samples. The data are coded and documented consistently across countries and over time to facillitate comparative research. IPUMS-International makes these data available to qualified researchers free of charge through a web dissemination system.

The IPUMS project is a collaboration of the Minnesota Population Center, National Statistical Offices, and international data archives. Major funding is provided by the U.S. National Science Foundation and the Demographic and Behavioral Sciences Branch of the National Institute of Child Health and Human Development. Additional support is provided by the University of Minnesota Office of the Vice President for Research, the Minnesota Population Center, and Sun Microsystems.

Geographic coverage

National coverage

Analysis unit

Household

Universe

All housing units and households; all individuals who passed the night of the census date in the dwelling

Kind of data

Census/enumeration data [cen]

Sampling procedure

MICRODATA SOURCE: Central Statistical Agency

SAMPLE DESIGN: Systematic sample of every 10th household with a random start, drawn by the country. NOTE: The sample includes data from both the short and the long questionnaire. Only one-fifth of household received the long questionnaire, thus only 20% of the population have responses for most variables.

SAMPLE UNIT: household

SAMPLE FRACTION: 10%

SAMPLE SIZE (person records): 7,434,086

Mode of data collection

Face-to-face [f2f]

Research instrument

Two census questionnaires, a short form and a long form, collected information in five sections: 1) Area identification, 2) Type of residence and housing identification, 3) Details of persons in the household, 4) Deaths in the household during the last 12 month, and 5) Information on housing unit. The long questionnaire was administerd to 1 in 5 households in each enumeration area. The short questionnaire with a subset of the long questionnaire items corresponding to basic demographic and social characteristics (population size, sex, age, religion, mother tongue, ethnic group, disability and orphanage) was administered to the remaining (non-sample) households.

Background: For decades, health targeted aid in the form of development assistance for health has been an important source of financing health sectors in developing countries. Health sectors in Sub Saharan countries in general and Ethiopia in particular, are even more heavily reliant upon donors. Consequently, a more audible donors support to health sectors was seen during the last four decades, consistent with the donor's response to the global goal of Alma-Ata declaration of "health for all by the year 2000" through primary health care in 1978. Ever since, a massive surge of development assistance for health has followed the out gone of the 2015 United Nations Millennium Declaration Goals in which three out of the eight goals were directly related to health. In spite of the long history of health targeted aid, with an ever increasing volumes, there is an increasing controversy on the extent to which health targeted aid is producing the intended health outcomes in the recipient countries. Despite the vast empirical literatures considering the effect of foreign development aid on economic growth of the recipient countries, systematic evidence that health sector targeted aid improves health outcomes is relatively scarce. The main contribution of this study is, therefore, to present a comprehensive country level, and cross-country evidences on the effect of development assistance for health on health outcomes. Objectives: The overall objective of this study was to analyze the effect of development assistance for health on health outcomes in Ethiopia, and in Sub Saharan Africa. Methods: For the Ethiopian (country level) study, a dynamic time series data analytic approach was employed. A retrospective sample of 36-year observations from 1978 to 2013 was analyzed using an econometric technique - vector error correction model. Beside including time dependency between the variables of interest and allowing for stochastic trends, the model provides valuable information on the existence of long-run and short-run relationships among the variables under study. Furthermore, to estimate the co-integrating relations and the other parameters in the model, the standard procedure of Johansen's approach was used. While development assistance for health expenditure was used as an explanatory variable of interest, life expectancy at birth was used as a dependent variable for the fact that it has long been used with or without mortality measures as health status indicators in the literatures.In the Sub Saharan Africa (cross-country level) study, a dynamic panel data analytic approach was employed using fixed effect, random effect, and the first difference-generalized method of moments estimators in the period confined to the year 1995-2013 over the cross section of 43 SSA countries. While development assistance for health expenditure was used as an explanatory variable of interest here again, infant mortality rate was used for health status measure done for its advantage over other mortality measures in cross-country studies. Results: In Ethiopia, the immediate one and two prior year of development assistance for health was shown to have a significant positive effect on life expectancy at birth. Other things being equal, an increase of development assistance for health expenditure per capita by 1% leads to an improvement in life expectancy at birth by about 0.026 years (P=0.000) in the immediate year following the period, and 0.008 years following the immediate prior two years period (P= 0.025). Similarly, in Sub-Saharan Africa, development assistance for health was found to have a strong negative effect on the reduction of infant mortality rate. The estimates of the study result indicated that during the covered period of study, in the region, a 1% increase in development assistance for health expenditure, which is far less than 10 cents per capita at the mean level, saves the life of two infants per 1000 live births (P=0.000). Conclusion: Contrary to the views of health aid skeptics, this study indicates strong favorable effect of development assistance for health sector in improving health status of people in Sub Saharan Africa in general and the Ethiopia in particular. Recommendations: The policy implication of the current findings is that development assistance for health sector should continue as an interim necessity means. However, domestic health financing system should also be sought, as the targeted countries cannot rely upon external resources continuously for improving the health status of the population. At the same time, the current development assistance stakeholders assumption of targeting facility based primary health care provision should be augmented by a more strong parallel strategy of improving socioeconomic status of the population that promotes sustainable improvement of health status in the targeted countries.

The 2005 Ethiopia Demographic and Health Survey (2005 EDHS) is part of the worldwide MEASURE DHS project which is funded by the United States Agency for International Development (USAID). The principal objective of the 2005 Ethiopia Demographic and Health Survey (DHS) is to provide current and reliable data on fertility and family planning behaviour, child mortality, adult and maternal mortality, children’s nutritional status, the utilization of maternal and child health services, knowledge of HIV/AIDS and prevalence of HIV/AIDS and anaemia. The specific objectives are to: collect data at the national level which will allow the calculation of key demographic rates; analyze the direct and indirect factors which determine the level and trends of fertility; measure the level of contraceptive knowledge and practice of women and men by method, urban-rural residence, and region; collect high quality data on family health including immunization coverage among children, prevalence and treatment of diarrhoea and other diseases among children under five, and maternity care indicators including antenatal visits and assistance at delivery; collect data on infant and child mortality and maternal and adult mortality; obtain data on child feeding practices including breastfeeding and collect anthropometric measures to use in assessing the nutritional status of women and children; collect data on knowledge and attitudes of women and men about sexually transmitted diseases and HIV/AIDS and evaluate patterns of recent behaviour regarding condom use; conduct haemoglobin testing on women age 15-49 and children under age five years in a subsample of the households selected for the survey to provide information on the prevalence of anaemia among women in the reproductive ages and young children; collect samples for anonymous HIV testing from women and men in the reproductive ages to provide information on the prevalence of HIV among the adult population. 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 Central Statistical Agency to plan, conduct, process, and analyse data from complex national population and health surveys. Moreover, the 2005 Ethiopia DHS provides national and regional estimates on population and health that are comparable to data collected in similar surveys in other developing countries. The first ever Demographic and Health Survey (DHS) in Ethiopia was conducted in the year 2000 as part of the worldwide DHS programme. Data from the 2005 Ethiopia DHS survey, the second such survey, add to the vast and growing international database on demographic and health variables. Wherever possible, the 2005 EDHS data is compared with data from the 2000 EDHS. In addition, where applicable, the 2005 EDHS is compared with the 1990 NFFS, which also sampled women age 15-49. Husbands of currently married women were also covered in this survey. However, for security and other reasons, the NFFS excluded from its coverage Eritrea, Tigray, Asseb, and Ogaden autonomous regions. In addition, fieldwork could not be carried out for Northern Gondar, Southern Gondar, Northern Wello, and Southern Wello due to security reasons. Thus, any comparison between the EDHS and the NFFS has to be interpreted with caution.

Distribution of socio-demographic characteristics of adolescents in Addis Ababa city, Ethiopia.

Objectives: Direct comparative work in morphology and growth on widely dispersed wild primate taxa is rarely accomplished, yet critical to understanding ecogeographic variation, plastic local varia- tion in response to human impacts, and variation in patterns of growth and sexual dimorphism. We investigated population variation in morphology and growth in response to geographic variables (i.e., latitude, altitude), climatic variables (i.e., temperature and rainfall), and human impacts in the vervet monkey (Chlorocebus spp.).

Methods: We trapped over 1,600 wild vervets from across Sub-Saharan Africa and the Caribbean, and compared measurements of body mass, body length, and relative thigh, leg, and foot length in four well-represented geographic samples: Ethiopia, Kenya, South Africa, and St. Kitts & Nevis.

Results: We found significant variation in body mass and length consistent with Bergmann’s Rule in adult females, and in adult males when excluding the St. Kitts & Nevis population, which was more sexually dimorphic. Contrary to Rensch’s Rule, although the South African population had the largest average body size, it was the least dimorphic. There was significant, although very small, variation in all limb segments in support for Allen’s Rule. Females in high human impact areas were heavier than those with moderate exposures, while those in low human impact areas were lighter; human impacts had no effect on males.

Conclusions: Vervet monkeys appear to have adapted to local climate as predicted by Bergmann’s and, less consistently, Allen’s Rule, while also responding in predicted ways to human impacts. To better understand deviations from predicted patterns will require further comparative work in vervets.

Methods The data derive from field collections made over many years using a common protocol: Ethiopia in 1973, Kenya in 1978-79; South Africa in 2002–2008, and several African countries and the Caribbean in 2009– 2011 in collaboration with the International Vervet Research Consortium (Jasinska et al., 2013). The International Vervet Research Consortium is a multidisciplinary research group that has, in addition to morphological variation, studied variation in patterns of growth and development (Schmitt et al., 2018), genetic/genomic (Jasinska, et al., 2013; Schmitt et al., 2018; Svardal et al., 2017; Turner et al. 2016a; Warren et al. 2015) and transcriptomic (Jasinska et al., 2017) variation, SIV immune response (Ma et al., 2013, 2014; Svardal et al., 2017), hor- monal variation (Fourie et al., 2015), C4 isotopes variation in hair (Loudon et al., 2014), gut parasite and disease variation (Gaetano et al., 2014; Senghore et al., 2016), genital morphology and appearance (Cramer et al., 2013; Rodriguez et al., 2015a,b), and other biological parameters within the genus Chlorocebus.

Vervet monkeys were trapped at locations across sub-Saharan Africa, including South Africa, Botswana, Zambia, Ethiopia, The Gambia, Ghana, and on the Caribbean islands of St. Kitts and Nevis (Figure 1). Trapping in Africa employed individual drop traps as described by Brett, Turner, Jolly, & Cauble (1982) and Grobler and Turner (2010), while trapping in St. Kitts and Nevis was done by local trappers using large group traps (Jasinska et al., 2013). Animals were anesthetized while in the trap and then removed to a processing area. Sex was determined by visual and manual inspection, while age classes were assigned from dental eruption sequences and based on previous observations (Table 2). All animals were weighed with either an electronic or hanging scale, and measured with a tape measure and sliding calipers. Parameters and protocols describing all measurements are available through the Bones and Behavior Working Group (2015; http://www.bonesandbehavior. org/). All animals were released to their social group after sampling and recovery from anesthesia. Observations during trapping allowed us to confirm the animals’ social group and local population affiliation.

For the present study, we chose metrics representative of skeletal size (body length, thigh length, leg length, and foot length) and body mass from a total of 1,613 vervets in four geographically and genomi- cally distinct populations: Ch. aethiops in Ethiopia, Ch. p. hilgerti in Kenya, Ch. p. pygerythrus in South Africa, and Ch. sabaeus on the Carib- bean islands of St. Kitts and Nevis (Table 3). The Caribbean populations are known to be descended from West African Ch. sabaeus brought to the Caribbean several hundred years ago (Warren et al., 2015). Of the whole sample, 288 females and 460 males were dentally immature. Sexual maturity is typically not reached in vervets until near the time of canine tooth eruption, here denoting the beginning of dental age 6 (Cramer et al., 2013; Rodriguez et al., 2015a); although somatic and skeletal growth often continues beyond the emergence of the third molar, which is here denoted as adult (Bolter & Zihlman, 2003). As is common, dental age and skeletal age are presumed to be similarly cor- related across the genus, meaning that comparable dental age implies comparable skeletal developmental age across populations (Seselj, 2013).

All measurements were developed by CJJ and TRT and other measurers (CAS and JDC) were trained directly by TRT. During training, repeated measures of the same individual were conducted in tandem with TRT until concordance was reached.

The location of each trapping site is reported in decimal degrees (Table 1), and for most sites measured using hand-held GPS units. For those trapping sites lacking GPS readings, a general latitude and longi- tude for the trapping area (e.g., game reserve, town) was used. Human impact at each trapping location was assessed according to conditions during the time of trapping using a previously published index devel- oped by Pampush (2010) to study variation in vervet body size, and subsequently used by Loudon et al. (2014) and Fourie et al. (2015) (Table 1). This index includes presence/absence measures of reliable access to (1) agricultural land, (2) human food, (3) rubbish or garbage dumps, and (4) whether animals are regularly provisioned, as well as a three-level scale of human activity within the presumed home range of the group (low, moderate, or high). In the index, point values are assigned to each value, with the lowest tier of human impact each receiving a 1, scaling up by 1 for each level. Added together, these val- ues comprise a human impact group ranging from low (lowest score in each category; index 5 5), to moderate (index 5 6–8), to high (index- 5 9–11). These measures take into account only the ecological impact of humans, and do not address local ecological variables (such as native plant productivity) that might also influence body size and growth. As a proxy for these measures, we collected several climatic variables for trapping sites from the WorldClim 2 database, which has a spatial reso- lution of about 1 km2 (Fick & Hijmans, 2017). Climatic variables consid- ered for inclusion in our models were (1) annual mean temperature (in degrees Celsius), (2) temperature seasonality (measured as the standard deviation of annual mean temperature multiplied by 100), (3) the mini- mum temperature of the coldest month (in degrees Celsius), (4) the mean temperature of the coldest quarter of the year, (5) annual precipi- tation (in mm), and (6) precipitation seasonality (measured as thecoefficient of variation of monthly precipitation). Climate data were accessed via the R package raster v. 2.6-7 (Hijmans & van Etten, 2012), and assigned to trapping sites based on latitude and longitude.

Socio-demographic characteristics of selected mothers in Ethiopia.

BackgroundStunting, short for age, affects the overall growth and development of the children. It occurs due to chronic under nutrition. Stunting vastly occurs in impoverished regions of the world, including Ethiopia.ObjectiveThis study aimed to investigate the prevalence and correlates of stunting among under-five children in Ethiopia using marginal models.MethodsData were taken from the 2016 Ethiopian Demographic Health Survey, which is a nationally representative survey of children in the 0–59 month age group. For marginal models, generalized estimating equations and alternating logistic regression models were used for the analysis.ResultsThe prevalence of stunting among the under-five children was 34.91% in the area. The proportion was slightly higher among male (36.01%) than female (33.76%) child. The Alternating Logistic Regression model analysis revealed that the child’s age, the mother’s education level, the mother’s body mass index, the place of residence, the wealth index, and the previous birth interval were found to be significant determinants of childhood stunting, and the result shows that children born with a lower previous birth interval (less than 24 months) were more likely to be stunted than those born within a higher birth interval. Children in rural Ethiopia were more likely to be stunted than children in urban Ethiopia.ConclusionThis study found that more than one third of children were stunted in the area. The study also determined that child’s age, the mother’s education, the mother’s body mass index, the place of residence, the wealth index, and birth interval influence stunting. Therefore, it is better enhancing the nutritional intervention programs.

Decomposition of the concentration index of wealth-related inequalities for iron-rich animal source foods consumption among children aged 6–23 months in Ethiopia evidence by 2019 EMDHS.