2003-2004 madagascar demographic and health survey ddss/instat, orc macro key preliminary findings...
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2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Key Key Preliminary Preliminary FindingsFindings
2003-2004 Madagascar DHS 2003-2004 Madagascar DHS
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
IntroductionIntroductionThe 2003-2004 Madagascar DHS (MDHS) is the 3rd in a series (1992, 1997).The MDHS was conducted by the Direction de la Démographie et des Statistiques Sociales at INSTAT, in partnership with the Ministère de la Santé et du Planning Familial. ORC Macro provided technical support.The MDHS was funded by the World Bank, UNICEF, UNFPA and USAID/Madagascar.The 2003-2004 MDHS provides estimates on key indicators, including fertility, MCH, STIs and AIDS awareness. New features include the implementation of 4 biomarkers (tetanus, measles, syphilis and anemia).
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
2003-2004 MDHS Sample2003-2004 MDHS Sample
• Nationally representative survey of >8,400
households:
– Close to 8,000 women age 15-49
– Close to 2,700 men age 15-59
• Biological testing (“biomarkers”) was
implemented for a sub-sample of the population
for tetanus, measles, syphilis and anemia
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Training consisted of interviewing techniques, field procedures, questionnaire review, and mock interviews in classroom and field as well as an anthropometric measurement practice.
Fieldwork: 11/23/2003 to 03/28/2004.
11 teams went in the field, each comprised of 2 nurses (for 4 biomarkers).
Training and FieldworkTraining and Fieldwork
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Households SelectedHouseholds Selected Households Interviewed Response rate (%)
9,2959,2958,420 98%
Eligible WomenEligible Women Women Interviewed Response rate (%)
8,3378,3377,949 95%
Eligible MenEligible Men Men Interviewed Response rate (%)
2,6852,6852,432 91%
Response RatesResponse Rates
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
KEY FINDINGS
2003-2004 Madagascar Demographic and Health Survey
KEY FINDINGS
2003-2004 Madagascar Demographic and Health Survey
Photo courtesy of Freedom From Hunger
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
FERTILITYFERTILITY
Photo courtesy of Freedom From Hunger
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Trends in Total Fertility Rates*Trends in Total Fertility Rates*
6.1 6.0
5.2
1992 1997 2003-2004
*Per 1,000 women; refer to the 5-year period preceding the survey, except for 2003-2004 which is for 3 years
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
4,0 – 4,95,0 – 5,96,0 – 6,9ANTSI
MA
A/RIVOTOA
FI
TOL
5.2 births
National average: 5.2 births
Varies from 4.2 births in Antananarivo to 6.3 births in Toliara.
How does fertility* vary by province?How does fertility* vary by province?
*TFR for women age 15-49
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
2.9
4.4
4.9
5.0
5.2
5.5
5.6
5.7
5.9
5.9
6.2
6.3
6.9
7.5
South Africa 1998
Ghana 2003
Kenya 2003
Cameroon 2004*
MADAGASCAR 2003-04*
Mozambique 2003
Tanzania 1999
Nigeria 2003
Ethiopia 2000
Zambia 2001-02
Burkina Faso 2003
Malawi 2000
Uganda 2001
Niger 1998
Total Fertility Rate:A Cross-national Comparison
Total Fertility Rate:A Cross-national Comparison
*Based on preliminary findings
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
15 – 19%20 – 39%40 – 59%ANTSI
MA
A/RIVOTOA
FI
TOL
34%
Nationally, 34% of women age 15-19 are either already mothers (28%) or pregnant with their 1st child (6%)
Varies from 19% in Antananarivo to 56% in Mahajanga.
How does teenage pregnancy vary by province?How does teenage pregnancy vary by province?
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
16.8
18.5
16.9
18.6
17.4
19.1
Age at first sexual intercourse Age at first union
1992 1997 2003-2004
Years
Trends in Fertility DeterminantsTrends in Fertility Determinants
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
FAMILY PLANNINGFAMILY PLANNING
Photo courtesy of Photoshare
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
5
16
3
10
18
7
18
27
16
Madagascar Urban Rural
1992 1997 2003-2004
Percent
Trends in Use of Modern Methods Trends in Use of Modern Methods
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
10 – 14%15 – 19%20 – 29%ANTSI
MA
A/RIVOTOA
FI
TOL
18%
Nationally, 18% of women age 15-49 use a modern method of contraception.
Modern use varies from 11% in Mahajanga to 27% in Antananarivo.
How does modern use vary by province?How does modern use vary by province?
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Use of Modern Contraception:A Cross-national Comparison
Use of Modern Contraception:A Cross-national Comparison
5
6
8
9
12
13
17
18
18
19
23
26
32
55
Niger 1998
Ethiopia 2000
Nigeria 2003
Burkina Faso 2003
Mozambique 2003
Cameroon 2004*
Tanzania 1999
MADAGASCAR 2003-04*
Uganda 2001
Ghana 2003
Zambia 2001-02
Malawi 2000
Kenya 2003
South Africa 1998
*Based on preliminary findings
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
FERTILITY PREFERENCESFERTILITY PREFERENCES
Photo courtesy of Freedom From Hunger
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
3.5 – 3.94.0 – 4.95.0 – 5.9ANTSI
MA
A/RIVOTOA
FI
TOL
4.7
Nationally, women would like to have an average of 4.7 births.
Desired fertility varies from 3.7 births in Antananarivo to 5.7 in Toliara.
How does desired fertility vary by province?How does desired fertility vary by province?
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
MATERNITY CAREMATERNITY CARE
Photo courtesy of Freedom From Hunger
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Medical assistance from a doctor or nurse/midwife at delivery varies from 38% in Toamasina and Toliara to 66% in Antananarivo.
How does medical assistance at delivery vary by province?
How does medical assistance at delivery vary by province?35 – 39%40 – 49%50 – 69%ANTSI
MA
A/RIVOTOA
FI
TOL
For the 5-year preceding the survey
51%
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Medical Assistance at Delivery: A Cross-national Comparison
Medical Assistance at Delivery: A Cross-national Comparison
84
62
57
56
51
48
47
44
43
42
39
36
36
6
South Africa 1998
Cameroon 2004*
Burkina Faso 2003
Malawi 2000
MADAGASCAR 2003-04*
Mozambique 2003
Ghana 2003
Niger 1998
Zambia 2001-02
Kenya 2003
Uganda 2001
Nigeria 2003
Tanzania 1999
Ethiopia 2000
*Based on preliminary findings
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
CHILD HEALTH AND NUTRITIONCHILD HEALTH AND NUTRITION
Photo courtesy of Freedom From Hunger
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Trends in Initial Breastfeeding (within 1 hour after birth)
Trends in Initial Breastfeeding (within 1 hour after birth)
6
34
62
1992 1997 2003-2004
Percent
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Trends in Exclusive Breastfeeding (children under 6 months)
Trends in Exclusive Breastfeeding (children under 6 months)
35
48
67
1992 1997 2003-2004
Percent
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
75
54 54 54
43
20
66
48 48 46
36
20
72
61 6359
53
21
BCG DPT3 Polio 3 Measles All vaccinations
None
1992 1997 2003-2004
Percent
*For children age 12-23 months, at any time before the survey
Trends in Vaccination Coverage Trends in Vaccination Coverage
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Full Immunization:A Cross-national Comparison
Full Immunization:A Cross-national Comparison
7070
69
68
63
63
57
53
48
44
37
18
1413
Zambia 2001-02
Malawi 2000
Ghana 2003
Tanzania 1999
South Africa 1998
Mozambique 2003
Kenya 2003
MADAGASCAR 2003-04*
Cameroon 2004*
Burkina Faso 2003
Uganda 2001
Niger 1998
Ethiopia 2000
Nigeria 2003
*Based on preliminary findings
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Prevalence of diarrhea: reduced by half since 1997 Among those with diarrhoea, 42% received either ORS or especially a homemade solution (twice what was recorded in 1997).
Prevalence of children with ARI: reduced by more than half since 1997 (from 24% to 11%).
Prevalence of children with fever: from 32% to 27% since 1997.Of all children with ARI and/or fever, 44% were taken to a health facility/provider.
Prevalence and Treatment for Diarrhoea, ARI and Fever
Prevalence and Treatment for Diarrhoea, ARI and Fever
2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro
Supplementation of Vitamin A varies from 70% in Mahajanga to 83% in Antananarivo.
In comparison, 4% of women said their children had received a Vitamin A supplement in 1997.
How does vitamin A supplementation vary by province?
How does vitamin A supplementation vary by province?
70 – 74%75 – 79%80 – 84%ANTSI
MA
A/RIVOTOA
FI
TOL
76%