Demographic and Health Survey 2006-07 Pakistan pdf

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PakistanDemographic and Health Survey2006-07 Pakistan Demographic and Health Survey 2006-07 National Institute of Population Studies Islamabad, Pakistan Macro International Inc. Calverton, Maryland USA June 2008 NIPS This report summarizes the findings of the 2006-07 Pakistan Demographic and Health Survey (PDHS) carried out by the National Institute of Population Studies. The Government of Pakistan provided financial assistance in terms of in-kind contribution of government staff time, office space, and logistical support. Macro International provided financial and technical assistance for the survey through the MEASURE DHS programme, which is funded by the U.S. Agency for International Development (USAID) and is designed to assist developing countries to collect data on fertility, family planning, and maternal and child health. Additional support for the PDHS was received from the United Nations Population Fund (UNFPA)/Pakistan and from UNICEF/Pakistan. The opinions expressed in this report are those of the authors and do not necessarily reflect the views of the donor organisations. Additional information about the survey may be obtained from the National Institute of Population Studies (NIPS), Block 12-A, Capital Inn Building, G-8 Markaz, P.O. Box 2197, Islamabad, Pakistan (Telephone: 92-51-926-0102 or 926-0380; Fax: 92-51-926-0071; Internet:: www.nips.org.pk) Information about the DHS programme may be obtained from MEASURE DHS, Macro International Inc., 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, U.S.A. (Telephone: 1-301-572-0200; Fax: 1-301-572-0999; E-mail: reports@macrointernational.com; Internet: measuredhs.com). Suggested citation: National Institute of Population Studies (NIPS) [Pakistan], and Macro International Inc. 2008. Pakistan Demographic and Health Survey 2006-07. Islamabad, Pakistan: National Institute of Population Studies and Macro International Inc. CONTENTS Page TABLES AND FIGURES ix FOREWORD xv ACKNOWLEDGMENTS xvii SUMMARY OF FINDINGS xix MAP OF PAKISTAN xxvi CHAPTER 1 INTRODUCTION Shahid Munir and Khalid Mehmood 1.1 Geography, Climate, and History 1 1.2 Economy and Population 2 1.3 Organization and Implementation of the 2006-07 PDHS 3 1.3.1 Objectives of the Survey 3 1.3.2 Institutional Framework 4 1.3.3 Sample Design 4 1.3.4 Questionnaires 5 1.3.5 Training of Field Staff 7 1.3.6 Field Supervision and Monitoring 7 1.3.7 Fieldwork and Data Processing 8 1.3.8 Field Problems 8 1.4 Response Rates 9 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS Aysha Sheraz and Zafar Zahir 2.1 Household Population by Age and Sex 11 2.2 Household Composition 14 2.3 Education of the Household Population 16 2.3.1 Educational Attainment of Household Population 16 2.3.2 School Attendance Ratios 18 2.4 Housing Characteristics 21 2.5 Household Possessions 24 2.6 Socioeconomic Status Index 25 2.7 Availability of Services in Rural Areas 26 2.8 Registration with the National Database and Registration Authority 27 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS Zahir Hussain and Zafar Iqbal Qamar 3.1 Characteristics of Survey Respondents 29 3.2 Educational Attainment and Literacy 30 3.3 Employment 33 3.3.1 Employment Status 33 Contents | iii 3.3.2 Occupation 36 3.3.3 Type of Earnings 37 3.3.4 Employment before and after Marriage 37 3.4 Knowledge and Attitudes Concerning Tuberculosis 39 CHAPTER 4 FERTILITY Syed Mubashir Ali and Ali Anwar Buriro 4.1 Current Fertility 41 4.2 Fertility Trends 44 4.3 Children Ever Born and Children Surviving 46 4.4 Birth Intervals 48 4.5 Age at First Birth 49 4.6 Teenage Fertility 51 CHAPTER 5 FAMILY PLANNING Iqbal Ahmad and Mumtaz Eskar 5.1 Knowledge of Contraceptive Methods 53 5.2 Ever Use of Family Planning Methods 55 5.3 Current Use of Contraceptive Methods 56 5.4 Differentials in Contraceptive Use by Background Characteristics 58 5.5 Use of Social Marketing Contraceptive Brands 60 5.6 Timing of Sterilization 61 5.7 Source of Contraception 62 5.8 Cost of Contraceptive Methods 63 5.9 Informed Choice 64 5.10 Future Use of Contraception 65 5.11 Reasons for Not Intending to Use 65 5.12 Exposure to Family Planning Messages 66 5.13 Contact of Nonusers with Family Planning Providers 68 CHAPTER 6 OTHER DETERMINANTS OF FERTILITY Mehboob Sultan and Mubashir Baqai 6.1 Marital Status 69 6.2 Polygyny 70 6.3 Consanguinity 70 6.4 Age at First Marriage 72 6.5 Postpartum Amenorrhoea, Abstinence, and Insusceptibility 73 CHAPTER 7 FERTILITY PREFERENCES Syed Mubashir Ali and Faateh ud din Ahmad 7.1 Desire for More Children 77 7.2 Need for Family Planning 81 7.3 Ideal Number of Children 83 7.4 Wanted and Unwanted Fertility 86 iv Ň Contents CHAPTER 8 INFANT AND CHILD MORTALITY Zulfiqar A. Bhutta, Anne Cross, Farrukh Raza, and Zafar Zahir 8.1 Data Quality 89 8.2 Levels and Trends in Infant and Child Mortality 90 8.3 Socioeconomic Differentials in Infant and Child Mortality 91 8.4 Demographic Differentials in Infant and Child Mortality 92 8.5 Perinatal Mortality 93 8.6 High-risk Fertility Behaviour 95 8.7 Causes of Death of Children Under Five 96 8.7.1 Methodology 96 8.7.2 Results 97 8.8 Causes of Stillbirths 100 8.9 Implications of the Findings 100 CHAPTER 9 REPRODUCTIVE HEALTH Rabia Zafar and Anne Cross 9.1 Prenatal Care 101 9.1.1 Number and Timing of Prenatal Visits 103 9.1.2 Components of Prenatal Care 104 9.1.3 Reasons for Not Receiving Prenatal Checkups 106 9.1.4 Tetanus Toxoid Vaccinations 107 9.1.5 Complications during Pregnancy 108 9.2 Delivery Care 111 9.2.1 Preparedness for Delivery 111 9.2.2 Place of Delivery 112 9.2.3 Reasons for Not Delivering in a Facility 114 9.2.4 Use of Home Delivery Kits 115 9.2.5 Assistance during Delivery 116 9.3 Postnatal Care 118 9.3.1 Timing of First Postnatal Checkups 118 9.3.2 Complications during Delivery and the Postnatal Period 120 9.3.3 Fistula 121 CHAPTER 10 CHILD HEALTH Arshad Mahmood and Mehboob Sultan 10.1 Birth Weight 123 10.2 Child Immunization 124 10.2.1 Vaccination Coverage 125 10.2.2 Differentials in Vaccination Coverage 126 10.2.3 Trends in Vaccination Coverage 128 10.3 Childhood Diseases 129 10.3.1 Prevalence and Treatment of ARI 129 10.3.2 Prevalence and Treatment of Fever 131 10.3.3 Prevalence of Diarrhoea 133 10.3.4 Treatment of Diarrhoea 134 10.3.5 Feeding Practices during Diarrhoea 136 Contents | v CHAPTER 11 NUTRITION Syed Mubashir Ali and Mehboob Sultan 11.1 Breastfeeding and Supplementation 139 11.1.1 Initiation of Breastfeeding 139 11.1.2 Breastfeeding Patterns 141 11.1.3 Complementary Feeding 144 11.2 Micronutrient Intake 144 11.2.1 Micronutrient Intake among Children 145 11.2.2 Micronutrient Intake among Women 145 CHAPTER 12 MALARIA Mehboob Sultan and Syed Mubashir Ali 12.1 Household Ownership of Mosquito Nets 147 12.2 Use of Mosquito Nets and Other Repellents 148 12.3 Malaria Prevalence and Treatment during Pregnancy 151 12.4 Malaria Case Management among Children 151 CHAPTER 13 KNOWLEDGE OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Faateh ud din Ahmad and Adnan Ahmad Khan 13.1 Knowledge of AIDS 155 13.2 Knowledge of Ways to Avoid Contracting HIV/AIDS 157 13.3 Comprehensive Knowledge of HIV/AIDS Transmission 159 13.4 Knowledge of Mother-to-Child Transmission 160 13.5 Attitudes towards People Living with HIV/AIDS 162 13.6 Knowledge of Sexually Transmitted Infections 163 13.7 Safe Injection Practices 164 CHAPTER 14 ADULT AND MATERNAL MORTALITY Farid Midhet and Sadiqua N.Jafarey, Dr. Azra Ahsan, Aysha Sheraz 14.1 Introduction 167 14.2 Methods of Data Collection 169 14.2.1 Development and Validation of the VA Questionnaire 169 14.2.2 Implementation of VAs in Sample Households 170 14.2.3 Review of VA Questionnaires and Assignment of Causes of Death 171 14.3 Adult Mortality Rates 172 14.4 Response to the Verbal Autopsy 174 14.5 Causes of Death Among Women Age 12-49 175 14.6 Pregnancy-Related Mortality and Maternal Mortality 177 14.7 Discussion 180 REFERENCES 183 APPENDIX A ADDITIONAL TABLES 189 vi Ň Contents Contents | vii APPENDIX B SAMPLING IMPLEMENTATION 185 APPENDIX C ESTIMATES OF SAMPLING ERRORS 197 APPENDIX D DATA QUALITY TABLES 209 APPENDIX E PERSONS INVOLVED IN THE 2006-07 PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY 215 APPENDIX F QUESTIONNAIRES 221 [...]... then, other surveys focusing on fertility and family planning, reproductive health, and status of women were conducted The current demographic and health survey has special features, including maternal mortality and infant and child health, mortality, and morbidity, in addition to the conventional areas that most demographic and health surveys cover Before deliberating on the findings of the survey, a... national survey on demographic and health issues carried out by the National Institute of Population Studies (NIPS) and the second survey as part of the worldwide Demographic and Health Survey (DHS) project The primary purpose of the 2006-07 PDHS is to furnish policymakers and planners with detailed information on fertility, family planning, infant, child and adult mortality, maternal and child health, ... federal and provincial governments is English The vast majority of the population is Muslim (97 percent) Minorities include Christians, Hindus, Parsis, Marwaris, Mangowars, and Ahmadies 1.3 ORGANIZATION AND IMPLEMENTATION OF THE 2006-07 PDHS 1.3.1 Objectives of the Survey The 2006-07 Pakistan Demographic and Health Survey (PDHS) was undertaken to address the monitoring and evaluation needs of maternal and. .. mortality and their causes, maternal and child health, immunization and nutritional status of mothers and children, knowledge of HIV/AIDS, and malaria The 2006-07 PDHS also includes direct estimation of maternal mortality and its causes at the national level for the first time in Pakistan The survey provides all other estimates for national, provincial and urban-rural domains This being the fifth survey. .. Pakistan The sample is designed to provide reliable estimates for a variety of health and demographic variables for various domains of interest The survey provides estimates at national, urban and rural, and provincial levels (each as a separate domain) One of the main objectives of the 2006-07 Pakistan Demographic and Health Survey (PDHS) is to provide a reliable estimate of the maternal mortality ratio... FINDINGS The 2006-07 Pakistan Demographic and Health Survey (PDHS) is the largest householdbased survey ever conducted in Pakistan Teams visited 972 sample points across Pakistan and collected data from a nationally representative sample of over 95,000 households Such a large sample size was required to measure the maternal mortality ratio at the national level In fact, this is the first survey that... Himalaya and Karakoram mountain ranges to the Arabian Sea It is a land of snow-covered peaks, hot deserts and barren land, as well as a vast area of irrigated plains Pakistan is located between 24Û and 37Û N latitude and between 61Û and 75Û E longitudes It occupies a strategically important position On its east and southeast lies India, to the north and northwest is Afghanistan, to the west is Iran, and. .. the outstanding cause of death in the reproductive years, accounting for one-fifth of deaths to women of childbearing age in Pakistan Cancer, tuberculosis, and other infectious diseases are the next most important causes of death among women in reproductive ages xxiv Summary of Findings xxvi | Map of Pakistan 1 INTRODUCTION Shahid Munir and Khalid Mehmood Pakistan s first Demographic and Health Survey. .. 209 Age distribution of eligible and interviewed women 210 Completeness of reporting 210 Births by calendar years 211 Reporting of age at death in days 212 Reporting of age at death in months 213 xiv | Tables and Figures FOREWORD The 2006-07 Pakistan Demographic and Health Survey (PDHS) is the fifth in a series of demographic surveys conducted by the National... description of the salient features of Pakistan including its geography, climatic conditions, history, economy, and population size and growth—as well as details regarding the sample size and field operations, is given to enable readers to place the findings of the survey in proper sociodemographic and geographic perspective 1.1 GEOGRAPHY, CLIMATE, AND HISTORY Pakistan is the “Land of the Indus River,” which . Pakistan Demographic and Health Survey 2006-07 Pakistan Demographic and Health Survey 2006-07 National. Population Studies (NIPS) [Pakistan] , and Macro International Inc. 2008. Pakistan Demographic and Health Survey 2006-07. Islamabad, Pakistan: National Institute
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