The Poverty Mapping Project: Global Subnational Infant Mortality Rates data set consists of estimates of infant mortality rates for the year 2000. The infant mortality rate for a region or country is defined as the number of children who die before their first birthday for every 1,000 live births. The data products include a shapefile (vector data) of rates, grids (raster data) of rates (per 10,000 live births in order to preserve precision in integer format), births (the rate denominator) and deaths (the rate numerator), and a tabular data set of the same and associated data. Over 10,000 national and subnational Units are represented in the tabular and grid data sets, while the shapefile uses approximately 1,000 Units in order to protect the intellectual property of source data sets for Brazil, China, and Mexico. This data set is produced by the Columbia University Center for International Earth Science Information Network (CIESIN).

The leading cause of death in low-income countries worldwide in 2021 was lower respiratory infections, followed by stroke and ischemic heart disease. The death rate from lower respiratory infections that year was 59.4 deaths per 100,000 people. While the death rate from stroke was around 51.6 per 100,000 people. Many low-income countries suffer from health issues not seen in high-income countries, including infectious diseases, malnutrition and neonatal deaths, to name a few. Low-income countries worldwide Low-income countries are defined as those with per gross national incomes (GNI) per capita of 1,045 U.S. dollars or less. A majority of the world’s low-income countries are located in sub-Saharan Africa and South East Asia. Some of the lowest-income countries as of 2023 include Burundi, Sierra Leone, and South Sudan. Low-income countries have different health problems that lead to worse health outcomes. For example, Chad, Lesotho, and Nigeria have some of the lowest life expectancies on the planet. Health issues in low-income countries Low-income countries also tend to have higher rates of HIV/AIDS and other infectious diseases as a consequence of poor health infrastructure and a lack of qualified health workers. Eswatini, Lesotho, and South Africa have some of the highest rates of new HIV infections worldwide. Likewise, tuberculosis, a treatable condition that affects the respiratory system, has high incident rates in lower income countries. Other health issues can be affected by the income of a country as well, including maternal and infant mortality. In 2023, Afghanistan had one of the highest rates of infant mortality rates in the world.

The Poverty Mapping Project: Global Subnational Infant Mortality Rates data set consists of estimates of infant mortality rates for the year 2000. The infant mortality rate for a region or country is defined as the number of children who die before their first birthday for every 1,000 live births. The data products include a shapefile (vector data) of rates, grids (raster data) of rates (per 10,000 live births in order to preserve precision in integer format), births (the rate denominator) and deaths (the rate numerator), and a tabular data set of the same and associated data. Over 10,000 national and subnational Units are represented in the tabular and grid data sets, while the shapefile uses approximately 1,000 Units in order to protect the intellectual property of source data sets for Brazil, China, and Mexico. This data set is produced by the Columbia University Center for International Earth Science Information Network (CIESIN).

Users can access data related to international women’s health as well as data on population and families, education, work, power and decision making, violence against women, poverty, and environment. Background World’s Women Reports are prepared by the Statistics Division of the United Nations Department for Economic and Social Affairs (UNDESA). Reports are produced in five year intervals and began in 1990. A major theme of the reports is comparing women’s situation globally to that of men in a variety of fields. Health data is available related to life expectancy, cause of death, chronic disease, HIV/AIDS, prenatal care, maternal morbidity, reproductive health, contraceptive use, induced abortion, mortality of children under 5, and immunization. User functionality Users can download full text or specific chapter versions of the reports in color and black and white. A limited number of graphs are available for download directly from the website. Topics include obesity and underweight children. Data Notes The report and data tables are available for download in PDF format. The next report is scheduled to be released in 2015. The most recent report was released in 2010.

In 2023, Sub-Saharan Africa accounted for more than half of the global deaths of children under the age of five. The region has the highest poverty rates worldwide. Nevertheless, global child mortality rates have fallen steadily since the millennium.

Graph and download economic data for Infant Mortality Rate for Heavily Indebted Poor Countries (SPDYNIMRTINHPC) from 1990 to 2023 about mortality, infant, and rate.

Background: Under-five mortality remains concentrated in resource-poor countries. Post-discharge mortality is becoming increasingly recognized as a significant contributor to overall child mortality. With a substantial recent expansion of research and novel data synthesis methods, this study aims to update the current evidence base by providing a more nuanced understanding of the burden and associated risk factors of pediatric post-discharge mortality after acute illness. Methods: Eligible studies published between January 1, 2017 and January 31, 2023, were retrieved using MEDLINE, Embase, and CINAHL databases. Studies published before 2017 were identified in a previous review and added to the total pool of studies. Only studies from countries with low or low-middle Socio-Demographic Index with a post-discharge observation period greater than seven days were included. Risk of bias was assessed using a modified version of the Joanna Briggs Institute critical appraisal tool for prevalence studies. Studies were grouped by patient population, and 6-month post-discharge mortality rates were quantified by random-effects meta-analysis. Secondary outcomes included post-discharge mortality relative to in-hospital mortality, pooled risk factor estimates, and pooled post-discharge Kaplan–Meier survival curves. PROSPERO study registration: #CRD42022350975. Findings: Of 1963 articles screened, 42 eligible articles were identified and combined with 22 articles identified in the previous review, resulting in 64 total articles. These articles represented 46 unique patient cohorts and included a total of 105,560 children. For children admitted with a general acute illness, the pooled risk of mortality six months post-discharge was 4.4% (95% CI: 3.5%–5.4%, I2 = 94.2%, n = 11 studies, 34,457 children), and the pooled in-hospital mortality rate was 5.9% (95% CI: 4.2%–7.7%, I2 = 98.7%, n = 12 studies, 63,307 children). Among disease subgroups, severe malnutrition (12.2%, 95% CI: 6.2%–19.7%, I2 = 98.2%, n = 10 studies, 7760 children) and severe anemia (6.4%, 95% CI: 4.2%–9.1%, I2 = 93.3%, n = 9 studies, 7806 children) demonstrated the highest 6-month post-discharge mortality estimates. Diarrhea demonstrated the shortest median time to death (3.3 weeks) and anemia the longest (8.9 weeks). Most significant risk factors for post-discharge mortality included unplanned discharges, severe malnutrition, and HIV seropositivity. Interpretation: Pediatric post-discharge mortality rates remain high in resource-poor settings, especially among children admitted with malnutrition or anemia. Global health strategies must prioritize this health issue by dedicating resources to research and policy innovation. Data Processing Methods: Data were extracted using a standard data extraction form developed by the review authors. Kaplan–Meier survival curves, where provided, were extracted using a plot digitizer. The data extraction file, “PDMSR2024_DataExtraction_Dataset_SD” was generated as described above and analyzed as is. Co-ordinates were extracted from the survival curves in their original, published form, using a plot digitizer (https://automeris.io/WebPlotDigitizer/). The co-ordinates for each survival curve were then cleaned up to: 1. Re-scale the time points to weeks 2. Curves which reported % mortality were converted to % survival (1 – mortality) 3. First co-ordinate was set to (0, 1), i.e., survival is 100% at time-point 0 4. Include the numbers at risk (if reported), primary reference, and subgroup information Using these cleaned co-ordinates, individual-level patient data were extracted (see Guyot et al, 2012, doi.org/10.1186/1471-2288-12-9) and the survival curves re-constructed to obtain the survival and number at risk at specified time-points (0-52 weeks). Where possible, disease and age subgroups were combined to create all admissions curves by combining the individual-level patient data from multiple curves in the same study. Additional data from the survival curves were extracted to produce the “PDMSR2024_AdditionalDataSurvivalCurves6M_Dataset_SD” and “PDMSR2024_AdditionalDataSurvivalCurves12M_Dataset_SD” files by extracting the survival rate at 6 and 12 months. Previously unpublished hazards ratios were extracted from the dataset used in the Wiens et al (2015) study on post-discharge mortality (doi:10.1136/bmjopen-2015-009449) to produce the “PDMSR2024_Wiens2015HazardsRatios_Dataset_SD.xlsx” file. These original data are published on Dataverse at: doi.org/10.5683/SP2/VBPLRM Analyses were in R version 4.3.0 (R Foundation for Statistical Computing, Vienna, Austria), and RStudio version 2023.6.1 (RStudio, Boston, MA). Additional Files: Survival curves in their original, published form, as well as survival curve coordinates files can be made available by request. NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business...

Peru was one of the countries most affected by the COVID-19 pandemic in terms of health and economic impacts and the erosion of the socialgains achieved in the previous decade. By July 2022, Peru had registered more than 6,000 deaths per million population because of COVID-19,placing the country among the countries with the highest COVID-related mortality rates per capita. The economy contracted by 11 percent in 2020, its biggest fall in 30 years and the largest in Latin America during that year. As a result, the national poverty rate increased to 30.1 percent, a level not seen since 2010, and extreme poverty reached 5.1percent in 2020, comparable with the rate in 2013. By the end of 2021, the economy had recovered, but poverty and extreme poverty remained at the levels of 2012 and 2015, respectively. The magnitude of the welfare loss during the crisis revealed the fragility of the social gains that had been achieved during the previous two decades.

According to the Global Hunger Index 2024, which was adopted by the International Food Policy Research Institute, Somalia was the most affected by hunger and malnutrition, with an index of 44.1. Yemen and Chad followed behind. The World Hunger Index combines three indicators: undernourishment, child underweight, and child mortality. Sub-Saharan Africa most affected The index is dominated by countries in Sub-Saharan Africa. In the region, more than one fifth of the population is undernourished . In terms of individuals, however, South Asia has the highest number of undernourished people. Globally, there are 735 million people that are considered undernourished or starving. A lack of food is increasing in over 20 countries worldwide. Undernourishment worldwide The term malnutrition includes both undernutrition and overnutrition. Undernutrition occurs when an individual cannot maintain normal bodily functions such as growth, recovering from disease, and both learning and physical work. Some conditions such as diarrhea, malaria, and HIV/AIDS can all have a negative impact on undernutrition. Rural and agricultural communities can be especially susceptible to hunger during certain seasons. The annual hunger gap occurs when a family’s food supply may run out before the next season’s harvest is available and can result in malnutrition. Nevertheless, the prevalence of people worldwide that are undernourished has decreased over the last decades, from 18.7 percent in 1990-92 to 9.2 percent in 2022, but it has slightly increased since the outbreak of COVID-19. According to the Global Hunger Index, the reduction of global hunger has stagnated over the past decade.

This map service, derived from World Bank data, shows various characteristics of the Health topic. The World Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable health care; protects people from falling into poverty or worsening poverty due to illness; and promotes investments in all sectors that form the foundation of healthy societies.Age Dependency Ratio: Age dependency ratio is the ratio of dependents--people younger than 15 or older than 64--to the working-age population--those ages 15-64. Data are shown as the proportion of dependents per 100 working-age population. Data from 1960 – 2012.Age Dependency Ratio Old: Age dependency ratio, old, is the ratio of older dependents--people older than 64--to the working-age population--those ages 15-64. Data are shown as the proportion of dependents per 100 working-age population. Data from 1960 – 2012.Birth/Death Rate: Crude birth/death rate indicates the number of births/deaths occurring during the year, per
1,000 population estimated at midyear. Subtracting the crude death rate from the crude birth rate provides the rate of natural increase, which is equal to the rate of population change in the absence of migration. Data spans from 1960 – 2008.Total Fertility: Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current age-specific fertility rates. Data shown is for 1960 - 2008.Population Growth: Annual population growth rate for year t is the exponential rate of growth of midyear population from year t-1 to t, expressed as a percentage.
Population is based on the de facto definition of population, which
counts all residents regardless of legal status or citizenship--except
for refugees not permanently settled in the country of asylum, who are
generally considered part of the population of the country of origin. Data spans from 1960 – 2009.Life Expectancy: Life expectancy at birth indicates the number of years a newborn infant
would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life. Data spans from 1960 – 2008.Population Female: Female population is the percentage of the population that is female. Population is based on the de facto definition of population. Data from 1960 – 2009.For more information, please visit: World Bank Open Data. _Other International User Community content that may interest you World Bank World Bank Age World Bank Health

In 2024, Myanmar had the highest crude death rate among the Southeast Asian countries, with *** deaths per thousand population. That year, Singapore had the lowest crude death rate, with *** deaths per thousand population.Factors that influence the death rateThe death rate, also called mortality rate, is generally influenced by various factors such as the social environment, diseases, health facilities and services as well as the food supply of the respective countries. Myanmar’s government spent five percent of its public budget on health in 2016. In 2020, health expenditure per capita in Myanmar amounted to around ** U.S. dollars. The Maldives had the lowest crude death rate in the Asia-Pacific region in 2024. There, health expenditure accounted for ***** percent of the country’s GDP. Furthermore, the share of undernourished people was at around ***** percent in Myanmar in 2020. Within Southeast Asia, Myanmar has also been one of the poorest countries. In 2020, the country’s GDP per capita was estimated at **** thousand U.S. dollars, the lowest across the Asia-Pacific region.

The 2014 Global Nutrition Report Dataset contains data for all the indicators that were used in Global Nutrition Report 2014: Actions and Accountability to Accelerate the World's Progress on Nutrition . The data are compiled from secondary sources including United Nations Children's Fund (UNICEF), World Health Organization (WHO), and the World Bank among many others. The dataset broadly contains information on adult and child nutrition, economic demography, nutrition intervention coverage, and policy legislation in the nutrition sector. The data visualization based on a subset of this dataset can be accessed here.

Explore World Bank Health, Nutrition and Population Statistics dataset featuring a wide range of indicators such as School enrollment, UHC service coverage index, Fertility rate, and more from countries like Bahrain, China, India, Kuwait, Oman, Qatar, and Saudi Arabia.

School enrollment, tertiary, UHC service coverage index, Wanted fertility rate, People with basic handwashing facilities, urban population, Rural population, AIDS estimated deaths, Domestic private health expenditure, Fertility rate, Domestic general government health expenditure, Age dependency ratio, Postnatal care coverage, People using safely managed drinking water services, Unemployment, Lifetime risk of maternal death, External health expenditure, Population growth, Completeness of birth registration, Urban poverty headcount ratio, Prevalence of undernourishment, People using at least basic sanitation services, Prevalence of current tobacco use, Urban poverty headcount ratio, Tuberculosis treatment success rate, Low-birthweight babies, Female headed households, Completeness of birth registration, Urban population growth, Antiretroviral therapy coverage, Labor force, and more.

Bahrain, China, India, Kuwait, Oman, Qatar, Saudi Arabia

Follow data.kapsarc.org for timely data to advance energy economics research.

El Salvador's Mortality rate due to unsafe water, sanitation, and poor hygiene is 2[Per 100,000 population] which is the 78th highest in the world ranking. Transition graphs on Mortality rate due to unsafe water, sanitation, and poor hygiene in El Salvador and comparison bar charts (USA vs. China vs. Japan vs. El Salvador), (Nicaragua vs. Kyrgyzstan vs. El Salvador) are used for easy understanding. Various data can be downloaded and output in csv format for use in EXCEL free of charge.

This map service, derived from World Bank data, shows various characteristics of the Health topic. The World Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable health care; protects people from falling into poverty or worsening poverty due to illness; and promotes investments in all sectors that form the foundation of healthy societies.Age Dependency Ratio: Age dependency ratio is the ratio of dependents--people younger than 15 or older than 64--to the working-age population--those ages 15-64. Data are shown as the proportion of dependents per 100 working-age population. Data from 1960 – 2012.Age Dependency Ratio Old: Age dependency ratio, old, is the ratio of older dependents--people older than 64--to the working-age population--those ages 15-64. Data are shown as the proportion of dependents per 100 working-age population. Data from 1960 – 2012.Birth/Death Rate: Crude birth/death rate indicates the number of births/deaths occurring during the year, per
1,000 population estimated at midyear. Subtracting the crude death rate from the crude birth rate provides the rate of natural increase, which is equal to the rate of population change in the absence of migration. Data spans from 1960 – 2008.Total Fertility: Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current age-specific fertility rates. Data shown is for 1960 - 2008.Population Growth: Annual population growth rate for year t is the exponential rate of growth of midyear population from year t-1 to t, expressed as a percentage.
Population is based on the de facto definition of population, which
counts all residents regardless of legal status or citizenship--except
for refugees not permanently settled in the country of asylum, who are
generally considered part of the population of the country of origin. Data spans from 1960 – 2009.Life Expectancy: Life expectancy at birth indicates the number of years a newborn infant
would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life. Data spans from 1960 – 2008.Population Female: Female population is the percentage of the population that is female. Population is based on the de facto definition of population. Data from 1960 – 2009.For more information, please visit: World Bank Open Data. _Other International User Community content that may interest you World Bank World Bank Age World Bank Health

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27–1·45) deaths (440000 [416000–518000; 33·3%] in females and 883000 [838000–967000; 66·7%] in males) globally, compared with less than 899000 (829000–948000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3–2·6) of total deaths globally in 2017 compared with 1·9% (1·8–2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2–22·3) per 100000 population in 1990 to 16·5 (15·8–18·1) per 100000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8–38·6] deaths per 100000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8–10·5] deaths per 100000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3–4·0] per 100000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4–133·4] per 100000 in 2017). There were 10·6 million (10·3–10·9) prevalent cases of decompensated cirrhosis and 112 million (107–119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Costeffective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH.

In 2021, COVID-19 caused about *** deaths per 100,000 population in high-income countries. This statistic displays the leading causes of death in high-income countries in 2021 by deaths per 100,000 population. Mortality from chronic diseases such as cancer and heart diseases are increasing around the world. Chronic deaths are especially prominent in Western countries, but have also recently began to increase in the developing world. Non-communicable disease burden This increase in chronic and degenerative non-communicable diseases globally stems from aging populations, modernization, and rapid urbanization. Though these are all signs of socioeconomic progress, the resulting shift in disease carries a heavy burden for societies. Health expenditure makes up around ** percent or more of the GDP in most high-income countries, and the global spending on medicines is expected to more than double from 2010 to 2027. Non-communicable disease risk factors and prevention In most OECD countries, over 30 percent of adults are overweight. Lack of exercise, poor nutrition, and generally unhealthy lifestyles can often lead to a cluster of symptoms including abnormal blood levels, high blood pressure, and excess body fat, which in turn pose an increased risk of heart disease, stroke, and diabetes. However, most non-communicable diseases are preventable, and their modifiable risk factors can be lowered through lifestyle and behavioral changes.

Abstract

The 2006-07 Sri Lanka Demographic and Health Survey (SLDHS) is the fourth in a series of DHS surveys to be held in Sri Lanka-the first three having been implemented in 1987, 1993, and 2000. Teams visited 2,106 sample points across Sri Lanka and collected data from a nationally representative sample of almost 20,000 households and over 14,700 women age 15-49.

A nationally representative sample of 21,600 housing units was selected for the survey and 19,872 households were enumerated to give district level estimates (excluding Northern Province). Detailed information was collected from all ever-married women aged 15-49 years and about their children below five years at the time of the survey. Within the households interviewed, a total of 15,068 eligible women were identified, of whom 14,692 were successfully interviewed.

The Department of Census and Statistics (DCS) carried out the 2006-07 SLDHS for the Health Sector Development Project (HSDP) of the Ministry of Healthcare and Nutrition, a project funded by the World Bank. The objective of the survey is to provide data needed to monitor and evaluate the impact of population, health, and nutrition programmes implemented by different government agencies. Additionally, it also aims to measure the impact of interventions made under the HSDP towards improving the quality and efficiency of health care services as a whole.

All 25 districts of Sri Lanka were included at the design stage. The final sample has only 20 districts, however, after dropping the 5 districts of the Northern Province (Jaffna, Kilinochchi, Mannar, Vavuniya, and Mullativu), due to the security situation there.

OBJECTIVES

The objective of this report is to publish the final findings of the 2006-07 SLDHS. This final report provides information mainly on background characteristics of respondents, fertility, reproductive health and maternal care, child health, nutrition, women's empowerment, and awareness of HIV/AIDS and prevention. It is expected that the content of this report will satisfy the urgent needs of users of this information.

MAIN RESULTS

FERTILITY Survey results indicate that there has been a slight upturn in the total fertility rate since the 2000 SLDHS. The total fertility rate for Sri Lanka is 2.3, meaning that, if current age-specific fertility rates were to remain unchanged in the future, a woman in Sri Lanka would have an average of 2.3 children by the end of her childbearing period. This is somewhat higher than the total fertility rate of 1.9 measured in the 2000 SLDHS.

Fertility is only slightly lower in urban areas than in rural areas (2.2 and 2.3 children per woman, respectively); however, it is higher in the estate areas (2.5 children per woman). Interpretation of variations in fertility by administrative districts is limited by the small samples in some districts. Nevertheless, results indicate that Galle and Puttalam districts have fertility rates of 2.1 or below, which is at what is known as “replacement level” fertility, i.e., the level that is necessary to maintain population size over time. Differences in fertility by level of women's education and a measure of relative wealth status are minimal.

FAMILY PLANNING According to the survey findings, knowledge of any method of family planning is almost universal in Sri Lanka and there are almost no differences between ever-married and currently married women. Over 90 percent of currently married women have heard about pills, injectables, female sterilization, and the IUD. Eight out of ten respondents know about some traditional method of delaying or avoiding pregnancies.

Although the proportion of currently married women who have heard of at least one method of family planning has been high for some time, knowledge of some specific methods has increased recently. Since 1993, knowledge of implants has increased five-fold-from about 10 percent in 1993 to over 50 percent in 2006-07. Awareness about pill, IUD, injectables, implants, and withdrawal has also increased. On the other hand, awareness of male sterilization has dropped by 14 percentage points.

CHILD HEALTH The study of infant and child mortality is critical for assessment of population and health policies and programmes. Infant and child mortality rates are also regarded as indices reflecting the degree of poverty and deprivation of a population. Survey data show that for the most recent five-year period before the survey, the infant mortality rate is 15 deaths per 1,000 live births and under-five mortality is 21 deaths per 1,000 live births. Thus, one in every 48 Sri Lankan children dies before reaching age five. The neonatal mortality rate is 11 deaths per 1,000 live births and the postneonatal mortality rate is 5 deaths per 1,000 live births. The child mortality rate is 5 deaths per 1,000 children surviving to age one year.

REPRODUCTIVE HEALTH The survey shows that virtually all mothers (99 percent) in Sri Lanka receive antenatal care from a health professional (doctor specialist, doctor, or midwife). The proportion receiving care from a skilled provider is remarkably uniform across all categories for age, residence, district, woman's education, and household wealth quintile. Even in the estate sector, antenatal care usage is at the same high level. Although doctors are the most frequently seen provider (96 percent), women also go to public health midwives often for prenatal care (44 percent).

BREASTFEEDING AND NUTRITION Poor nutritional status is one of the most important health and welfare problems facing Sri Lanka today and particularly affects women and children. The survey data show that 17 percent of children under five are stunted or short for their age, while 15 percent of children under five are wasted or too thin for their height. Overall, 21 percent of children are underweight, which may reflect stunting, wasting, or both. As for women, at the national level, 16 percent of women are considered to be thin (with a body mass index < 18.5); however, only 6 percent of women are considered to be moderately or severely thin.

Poor breastfeeding and infant feeding practices can have adverse consequences for the health and nutritional status of children. Fortunately, breastfeeding in Sri Lanka is universal and generally of fairly long duration; 97 percent of newborns are breastfed within one day after delivery and 76 percent of infants under 6 months are exclusively breastfed, lower than the recommended 100 percent exclusive breastfeeding for children under 6 months. The median duration of any breastfeeding is 33 months in Sri Lanka and the median duration of exclusive breastfeeding is 5 months.

HIV/AIDS The HIV/AIDS pandemic is a serious health concern in the world today because of its high case fatality rate and the lack of a cure. Awareness of AIDS is almost universal among Sri Lankan adults, with 92 percent of ever-married women saying that they have heard about AIDS. Nevertheless, only 22 percent of ever-married women are classified as having “comprehensive knowledge” about AIDS, i.e., knowing that consistent use of condoms and having just one faithful partner can reduce the chance of getting infected, knowing that a healthy-looking person can be infected, and knowing that AIDS cannot be transmitted by sharing food or by mosquito bites. Such a low level of knowledge about AIDS implies that a concerted effort is needed to address misconceptions about HIV transmission. Programs might be focused in the estate sector and especially in Batticaloa, Ampara, and Nuwara Eliya districts where comprehensive knowledge is lowest.

Moreover, a composite indicator on stigma towards HIV-infected people shows that only 8 percent of ever-married women expressed accepting attitudes toward persons living with HIV/AIDS. Overall, only about one- half of ever-married women age 15-49 years know where to get an HIV test.

WOMEN'S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES The 2006-07 SLDHS collected data on women's empowerment, their participation in decisionmaking, and attitudes towards wife beating. Survey results show that more than 90 percent of currently married women, either alone or jointly with their husband, make decisions on how their income is used. However, husbands' control over women's earnings is higher among women with no education (15 percent) than among women with higher education (4 percent).

In Sri Lanka, the husband is usually the main source of household income; two-thirds of women earn less than their husband. Although the majority of women earn less than their husband, almost half have autonomy in decisions about how to spend their earnings.

The survey also collected information on who decides how the husband's cash earnings are spent. The majority of couples (60 percent) make joint decisions on how the husband's cash income is used. More than 1 in 5 women (23 percent) reported that they decide how their husband's earnings are used; another 16 percent of the women reported that their husband mainly decides how his earnings are spent.

Geographic coverage

A nationally representative sample of 21,600 housing units was selected for the survey and 19,872 households were enumerated to give district level estimates (excluding Northern Province).

Analysis unit

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

Universe

In principle, the sample was designed to cover private households in the areas sampled. The population residing in institutions and institutional households was excluded. For the detailed individual interview, the eligibility criteria wereall ever-married women aged 15-49 years who slept in the household the previous night and about their children below five years at the

Abstract

The 2008 Sierra Leone Demographic and Health Survey (SLDHS) is the first DHS survey to be held in Sierra Leone. Teams visited 353 sample points across Sierra Leone and collected data from a nationally representative sample of 7,374 women age 15-49 and 3,280 men age 15-59. The primary purpose of the 2008 SLDHS is to provide policy-makers and planners with detailed information on Demography and health.

This is the first Demographic and Health Survey conducted in Sierra Leone and was carried out by Statistics Sierra Leone (SSL) in collaboration with the Ministry of Health and Sanitation. The 2008 SLDHS was funded by the Sierra Leone government, UNFPA, UNDP, UNICEF, DFID, USAID, and The World Bank. WHO, WFP and UNHCR provided logistical support. ICF Macro, an ICF International Company, provided technical support for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators.

The purpose of the SLDHS is to collect national- and regional-level data on fertility and contraceptive use, marriage and sexual activity, fertility preferences, breastfeeding practices, nutritional status of women and young children, childhood and adult mortality, maternal and child health, female genital cutting, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections, adult health, and other issues. The survey obtained detailed information on these topics from women of reproductive age and, for certain topics, from men as well. The 2008 SLDHS was carried out from late April 2008 to late June 2008, using a nationally representative sample of 7,758 households.

The survey results are intended to assist policymakers and planners in assessing the current health and population programmes and in designing new strategies for improving reproductive health and health services in Sierra Leone.

MAIN RESULTS

FERTILITY

Survey results indicate that there has been little or no decline in the total fertility rate over the past two decades, from 5.7 children per woman in 1980-85 to 5.1 children per woman for the three years preceding the 2008 SLDHS (approximately 2004-07). Fertility is lower in urban areas than in rural areas (3.8 and 5.8 children per woman, respectively). Regional variations in fertility are marked, ranging from 3.4 births per woman in the Western Region (where the capital, Freetown, is located) to almost six births per woman in the Northern and Eastern regions. Women with no education give birth to almost twice as many children as women who have been to secondary school (5.8 births, compared with 3.1 births). Fertility is also closely associated with household wealth, ranging from 3.2 births among women in the highest wealth quintile to 6.3 births among women in the lowest wealth quintile, a difference of more than three births. Research has demonstrated that children born too close to a previous birth are at increased risk of dying. In Sierra Leone, only 18 percent of births occur within 24 months of a previous birth. The interval between births is relatively long; the median interval is 36 months.

FAMILY PLANNING

The vast majority of Sierra Leonean women and men know of at least one method of contraception. Contraceptive pills and injectables are known to about 60 percent of currently married women and 49 percent of married men. Male condoms are known to 58 percent of married women and 80 percent of men. A higher proportion of respondents reported knowing a modern method of family planning than a traditional method.

About one in five (21 percent) currently married women has used a contraceptive method at some time-19 percent have used a modern method and 6 percent have used a traditional method. However, only about one in twelve currently married women (8 percent) is currently using a contraceptive method. Modern methods account for almost all contraceptive use, with 7 percent of married women reporting use of a modern method, compared with only 1 percent using a traditional method. Injectables and the pill are the most widely used methods (3 and 2 percent of married women, respectively), followed by LAM and male condoms (less than 1 percent each).

CHILD HEALTH

Examination of levels of infant and child mortality is essential for assessing population and health policies and programmes. Infant and child mortality rates are also used as indices reflecting levels of poverty and deprivation in a population. The 2008 survey data show that over the past 15 years, infant and under-five mortality have decreased by 26 percent. Still, one in seven Sierra Leonean children dies before reaching age five. For the most recent five-year period before the survey (approximately calendar years 2003 to 2008), the infant mortality rate was 89 deaths per 1,000 live births and the under-five mortality rate was 140 deaths per 1,000 live births. The neonatal mortality rate was 36 deaths per 1,000 live births and the post-neonatal mortality rate was 53 deaths per 1,000 live births. The child mortality rate was 56 deaths per 1,000 children surviving to age one year. Mortality rates at all ages of childhood show a strong relationship with the length of the preceding birth interval. Under-five mortality is three times higher among children born less than two years after a preceding sibling (252 deaths per 1,000 births) than among children born four or more years after a previous child (deaths 81 per 1,000 births).

MATERNAL HEALTH

Almost nine in ten mothers (87 percent) in Sierra Leone receive antenatal care from a health professional (doctor, nurse, midwife, or MCH aid). Only 5 percent of mothers receive antenatal care from a traditional midwife or a community health worker; 7 percent of mothers do not receive any antenatal care.

In Sierra Leone, over half of mothers have four or more antenatal care (ANC) visits, about 20 percent have one to three ANC visits, and only 7 percent have no antenatal care at all. The survey shows that not all women in Sierra Leone receive antenatal care services early in pregnancy. Only 30 percent of mothers obtain antenatal care in the first three months of pregnancy, 41 percent make their first visit in the fourth or fifth month, and 17 percent in have their first visit in the sixth or seventh month. Only 1 percent of women have their first ANC visit in their eighth month of pregnancy or later.

BREASTFEEDING AND NUTRITION

Poor nutritional status is one of the most important health and welfare problems facing Sierra Leone today and particularly afflicts women and children. The data show that 36 percent of children under five are stunted (too short for their age) and 10 percent of children under five are wasted (too thin for their height). Overall, 21 percent of children are underweight, which may reflect stunting, wasting, or both. For women, at the national level 11 percent of women are considered to be thin (body mass index <18.5); however, only 4 percent of women are considered severely thin. At the other end of a spectrum, 20 percent of women age 15-49 are considered to be overweight (body mass index 25.025.9) and 9 percent are considered obese (body mass index =30.0).

HIV/AIDS

The HIV/AIDS pandemic is one of the most serious health concerns in the world today because of its high case-fatality rate and the lack of a cure. Awareness of AIDS is relatively high among Sierra Leonean adults age 15-49, with 69 percent of women and 83 percent of men saying that they have heard about AIDS. Nevertheless, only 14 percent of women and 25 percent of men are classified as having 'comprehensive knowledge' about AIDS, i.e., knowing that consistent use of condoms during sexual intercourse and having just one faithful, HIV-negative partner can reduce the chances of getting HIV/AIDS, knowing that a healthy-looking person can have HIV (the virus that causes AIDS), and knowing that HIV cannot be transmitted by sharing food/utensils with someone who has HIV/AIDS, or by mosquito bites.

Such a low level of knowledge about HIV/AIDS implies that a concerted effort is needed to address misconceptions about the transmission of HIV in Sierra Leone. Comprehensive knowledge is substantially lower among respondents with no education and those who live in the poorest households. Programmes could be targeted to populations in rural areas, and especially women in the Northern and Southern regions and men in the Eastern Region, where comprehensive knowledge is lowest. A composite indicator on stigma towards people who are HIV positive shows that only 5 percent of women and 15 percent of men age 15-49 expressed accepting attitudes towards persons living with HIV/AIDS.

FEMALE CIRCUMCISION

The 2008 SLDHS collected data on the practice of female circumcision (or female genital cutting) in Sierra Leone. Awareness of the practice is universally high. Almost all (99 percent) of Sierra Leonean women and 96 percent of men age 15-49 have heard of the practice. The prevalence of female circumcision is high (91 percent). Most women (82 percent) reported that the cutting involves the removal of flesh. The most radical procedure, infibulation-when vagina is sewn closed during the circumcision-is reported by only 3 percent of women. The survey results indicate that almost all of the women were circumcised by traditional practitioners (95 percent); only a small proportion of circumcisions were performed by a trained health professional (0.3 percent).

Among Sierra Leonean adults age 15-49 who have heard of female circumcision, more men than women oppose the practice (41 and 26 percent, respectively), which is similar to patterns in other West African countries.

Geographic coverage

The survey used a

Multiple linear regression model for OPD adjusted with a logit link function.