National Demographic and Health Survey 2008
Philippines, 2008
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PHL_2008_DHS_v01_M
National Demographic and Health Survey 2008
| Name | Country code |
|---|---|
| Philippines | PHL |
Demographic and Health Survey (standard) - DHS V
The 2008 National Demographic and Health Survey (NDHS) is the ninth DHS survey carried out every five years since 1968 in order to measure trends in demographic and family planning indicators in Philippines. But the 2008 NDHS is the fourth national sample survey undertaken in Philippines under the auspices of the worldwide Demographic and Health Surveys program.
The 2008 NDHS was conducted by the Philippine National Statistics Office (NSO). Technical assistance was provided by ICF Macro through the MEASURE DHS program. Funding for the survey was mainly provided by the Government of the Philippines. Financial support for some preparatory and processing phases of the survey was provided by the U.S. Agency for International Development (USAID).
Like previous Demographic and Health Surveys (DHS) conducted in the Philippines, the 2008 National Demographic and Health Survey (NDHS) was primarily designed to provide information on population, family planning, and health to be used in evaluating and designing policies, programs, and strategies for improving health and family planning services in the country. The 2008 NDHS also included questions on domestic violence. Specifically, the 2008 NDHS had the following objectives:
- Collect data at the national level that will allow the estimation of demographic rates, particularly, fertility rates by urban-rural residence and region, and under-five mortality rates at the national level.
- Analyze the direct and indirect factors which determine the levels and patterns of fertility.
- Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region.
- Collect data on family health: immunizations, prenatal and postnatal checkups, assistance at delivery, breastfeeding, and prevalence and treatment of diarrhea, fever, and acute respiratory infections among children under five years.
- Collect data on environmental health, utilization of health facilities, prevalence of common noncommunicable and infectious diseases, and membership in health insurance plans.
- Collect data on awareness of tuberculosis.
- Determine women's knowledge about HIV/AIDS and access to HIV testing.
- Determine the extent of violence against women.
MAIN RESULTS
FERTILITY
Fertility Levels and Trends. There has been a steady decline in fertility in the Philippines in the past 36 years. From 6.0 children per woman in 1970, the total fertility rate (TFR) in the Philippines declined to 3.3 children per woman in 2006. The current fertility level in the country is relatively high compared with other countries in Southeast Asia, such as Thailand, Singapore and Indonesia, where the TFR is below 2 children per woman.
Fertility Differentials. Fertility varies substantially across subgroups of women. Urban women have, on average, 2.8 children compared with 3.8 children per woman in rural areas. The level of fertility has a negative relationship with education; the fertility rate of women who have attended college (2.3 children per woman) is about half that of women who have been to elementary school (4.5 children per woman). Fertility also decreases with household wealth: women in wealthier households have fewer children than those in poorer households.
FAMILY PLANNING
Knowledge of Contraception. Knowledge of family planning is universal in the Philippines- almost all women know at least one method of fam-ily planning. At least 90 percent of currently married women have heard of the pill, male condoms, injectables, and female sterilization, while 87 percent know about the IUD and 68 percent know about male sterilization. On average, currently married women know eight methods of family planning.
Unmet Need for Family Planning. Unmet need for family planning is defined as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. The 2008 NDHS data show that the total unmet need for family planning in the Philippines is 22 percent, of which 13 percent is limiting and 9 percent is for spacing. The level of unmet need has increased from 17 percent in 2003.
Overall, the total demand for family planning in the Philippines is 73 percent, of which 69 percent has been satisfied. If all of need were satisfied, a contraceptive prevalence rate of about 73 percent could, theoretically, be expected. Comparison with the 2003 NDHS indicates that the percentage of demand satisfied has declined from 75 percent.
MATERNAL HEALTH
Antenatal Care. Nine in ten Filipino mothers received some antenatal care (ANC) from a medical professional, either a nurse or midwife (52 percent) or a doctor (39 percent). Most women have at least four antenatal care visits. More than half (54 percent) of women had an antenatal care visit during the first trimester of pregnancy, as recommended. While more than 90 percent of women who received antenatal care had their blood pressure monitored and weight measured, only 54 percent had their urine sample taken and 47 percent had their blood sample taken. About seven in ten women were informed of pregnancy complications. Three in four births in the Philippines are protected against neonatal tetanus.
Delivery and Postnatal Care. Only 44 percent of births in the Philippines occur in health facilities-27 percent in a public facility and 18 percent in a private facility. More than half (56 percent) of births are still delivered at home. Sixty-two percent of births are assisted by a health professional-35 percent by a doctor and 27 percent by a midwife or nurse. Thirty-six percent are assisted by a traditional birth attendant or hilot. About 10 percent of births are delivered by C-section.
The Department of Health (DOH) recommends that mothers receive a postpartum check within 48 hours of delivery. A majority of women (77 percent) had a postnatal checkup within two days of delivery; 14 percent had a postnatal checkup 3 to 41 days after delivery.
CHILD HEALTH
Childhood Mortality. Childhood mortality continues to decline in the Philippines. Currently, about one in every 30 children in the Philippines dies before his or her fifth birthday. The infant mortality rate for the five years before the survey (roughly 2004-2008) is 25 deaths per 1,000 live births and the under-five mortality rate is 34 deaths per 1,000 live births. This is lower than the rates of 29 and 40 reported in 2003, respectively. The neonatal mortality rate, representing death in the first month of life, is 16 deaths per 1,000 live births. Under-five mortality decreases as household wealth increases; children from the poorest families are three times more likely to die before the age of five as those from the wealthiest families.
There is a strong association between under-five mortality and mother's education. It ranges from 47 deaths per 1,000 live births among children of women with elementary education to 18 deaths per 1,000 live births among children of women who attended college. As in the 2003 NDHS, the highest level of under-five mortality is observed in ARMM (94 deaths per 1,000 live births), while the lowest is observed in NCR (24 deaths per 1,000 live births).
NUTRITION
Breastfeeding Practices. Eighty-eight percent of children born in the Philippines are breastfed. There has been no change in this practice since 1993. In addition, the median durations of any breastfeeding and of exclusive breastfeeding have remained at 14 months and less than one month, respectively. Although it is recommended that infants should not be given anything other than breast milk until six months of age, only one-third of Filipino children under six months are exclusively breastfed. Complementary foods should be introduced when a child is six months old to reduce the risk of malnutrition. More than half of children ages 6-9 months are eating complementary foods in addition to being breastfed.
The Infant and Young Child Feeding (IYCF) guidelines contain specific recommendations for the number of times that young children in various age groups should be fed each day as well as the number of food groups from which they should be fed. NDHS data indicate that just over half of children age 6-23 months (55 percent) were fed according to the IYCF guidelines.
HIV/AIDS
Awareness of HIV/AIDS. While over 94 percent of women have heard of AIDS, only 53 percent know the two major methods for preventing transmission of HIV (using condoms and limiting sex to one uninfected partner). Only 45 percent of young women age 15-49 know these two methods for preventing HIV transmission. Knowledge of prevention methods is higher in urban areas than in rural areas and increases dramatically with education and wealth. For example, only 16 percent of women with no education know that using condoms limits the risk of HIV infection compared with 69 percent of those who have attended college.
TUBERCULOSIS
Knowledge of TB. While awareness of tuberculosis (TB) is high, knowledge of its causes and symptoms is less common. Only 1 in 4 women know that TB is caused by microbes, germs or bacteria. Instead, respondents tend to say that TB is caused by smoking or drinking alcohol, or that it is inherited. Symptoms associated with TB are better recognized. Over half of the respondents cited coughing, while 39 percent mentioned weight loss, 35 percent mentioned blood in sputum, and 30 percent cited coughing with sputum.
WOMEN'S STATUS
Women's Status and Employment. Sixty percent of currently married women age 15-49 interviewed in the 2008 NDHS were employed in the year before the survey. Among those who are employed, most earn cash, while 6 percent are unpaid. Most women decide how their earnings are spent jointly with their husbands. Only four percent report that mainly their husband decides how their earnings are spent.
DOMESTIC VIOLENCE
Spousal Violence. Emotional and other forms of non-personal violence-such as insults, humiliation, and threats of harm-are the most common types of spousal violence: 23 percent of ever-married women report having experienced such violence by their husbands, with 15 percent reporting these types of violence occurred in the year prior to the survey.
Sample survey data
- Household
- Women age 15-49
- Men age 15-54
- Children under five years
Scope
The 2008 Philippines Demographic and Health Survey covers the following topics:
- Antenatal, delivery, and postnatal care
- Availability of family planning
- Awareness and behavior regarding AIDS and other sexually transmitted infections
- Awareness and behavior regarding tuberculosis
- Background characteristics (education, religion, etc.)
- Breastfeeding and infant feeding practices
- Child immunization and health
- Childhood mortality
- Experience of forced sex at sexual initiation
- Fertility preferences
- Full Pregnancy History
- Health
- Infant's and children's feeding practices
- Interspousal violence
- Knowledge and use of family planning methods
- Knowledge and use of contraception
- Marriage and sexual activity
- Marital control
- Maternal Mortality
- Nutrition of mothers and children
- Reproductive history
- Supplies and services
- Vaccinations and childhood illnesses
- Violence during pregnancy
Coverage
National. The NDHS sample was designed to represent each of the country's 17 administrative regions.
The population covered by the 1998 Phillipines NDS is defined as the universe of all females age 15-49 years, who are members of the sample household or visitors present at the time of interview and had slept in the sample households the night prior to the time of interview, regardless of marital status and all men age 15-54 living in the household.
Producers and sponsors
| Name |
|---|
| National Statistics Office (NSO) |
| Name | Role |
|---|---|
| ICF Macro | Technical assistance |
| Name | Role |
|---|---|
| Government of the Philippines | Funding |
| United States Agency for International Development | Financial support in the preparatory phase of the project |
| Name | Role |
|---|---|
| National Institutes of Health (NIH) | Technical working group on health and on violence against women |
| National Statistical Coordination Board (NSCB) | Technical working group on health and on violence against women |
| University of the Philippines Population Institute (UPPI) | Technical working group on health and on violence against women |
| University of the Philippines School of Economics | Technical working group on health and on violence against women |
| National Economic and Development Authority (NEDA) | Technical working group on health and on violence against women |
| Food and Nutrition Research Institute (FNRI) | Technical working group on health and on violence against women |
| Population Commission (POPCOM) | Technical working group on health and on violence against women |
| Philippine Legislators’ Committee on Population Development (PLCPD) | Technical working group on health and on violence against women |
| Philippine Health Insurance Corporation (Philhealth) | Technical working group on health and on violence against women |
| National Commission on the Role of Filipino Women (NCRFW) | Technical working group on health and on violence against women |
| Department of Social Welfare and Development (DSWD) | Technical working group on health and on violence against women |
Sampling
The 2008 NDHS used the 2003 master sample created by NSO for its household-based surveys. The 2008 NDHS used one of the four replicates of the master sample. The NDHS sample was designed to represent each of the country's 17 administrative regions. In each region, a stratified three-stage sample design was employed. At the first stage, primary sampling units (PSUs) were selected with probability proportional to the estimated number of households from the 2000 Census. PSUs consisted of one barangay or a group of contiguous barangays. At the second stage, enumeration areas (EAs) were selected within sampled PSUs with probability proportional to size. At the third stage, housing units were selected with equal probability within sampled EAs.
An EA is defined as an area with discernable boundaries within barangays and consisting of about 150 contiguous households. These EAs were identified during the 2000 Census.
The 2008 NDHS sample contains 794 enumeration areas (EAs). From each EA, an average of 17 housing units was selected using systematic sampling. All households in a sampled housing unit were interviewed, except when there were three or more households in the housing unit. For such a housing unit, three households were selected using simple random sampling. Over 13,500 households were selected for the 2008 NDHS. The sampled households per EA ranged from as low as 3 to as high as 32.
In the 2008 NDHS a total of 13,764 households were selected in the sample, of which 12,555 households were occupied. Of these households, 12,469 were successfully interviewed, yielding a household response rate of 99 percent.
In the interviewed households 13,833 women were identified for the individual interview. A total of 13,594 women were successfully interviewed, yielding a response rate of 98 percent. A total of 9,458 women were identified as eligible for the Women's Safety Module, of whom 9,316 were interviewed with privacy, yielding a response rate of 99 percent. Response rates in urban and rural areas were similar.
Survey instrument
Three questionnaires were used for the 2008 NDHS: a) the Household Questionnaire, b) the Women's Questionnaire and c) the Women's Safety Module. These questionnaires were based on the standard questionnaires developed by the MEASURE DHS program and modified-as recommended by the technical working groups and approved by the Steering Committee-to address relevant family planning and health issues in the Philippines. The three questionnaires were translated from English into six major dialects-Tagalog, Cebuano, Ilocano, Bicol, Hiligaynon, and Waray.
a) The Household Questionnaire was used to list all the usual members and visitors in the selected households, as well as some background information on each person listed such as age, sex, relationship to head of the household, health insurance coverage, and education. The main purpose of the Household Questionnaire was to identify women who were eligible for the individual interview. Information on characteristics of the household's dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor, roof, and walls of the house, and ownership of various durable goods was recorded in the Household Questionnaire. These items are indicators of the household's socioeconomic status. Finally, this questionnaire was used to gather information on prevalence of common noncommunicable and infectious diseases, health-seeking behavior, and utilization of health facilities by household members.
b) The Women's Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics:
- Background characteristics (e.g., education, media exposure)
- Reproductive history
- Knowledge and use of family planning methods
- Prenatal, delivery, and postnatal care and breastfeeding
- Child immunization and health and nutrition of mothers and children
- Marriage and sexual activity
- Fertility preferences
- Woman's work and husband's background characteristics
- Awareness and behavior regarding HIV/AIDS
- Other health issues
c) The Women's Safety Module was used to interview one respondent selected from all eligible women age 15 to 49 years who were identified from the Household Questionnaire. It collected information on the following topics:
- Women's experience of violence since age 15 and in the 12 months preceding the survey
- Violence during pregnancy
- Marital control
- Interspousal violence
- Experience of forced sex at sexual initiation
- Help-seeking behavior by women who have experienced violence
Three pretests were conducted in 2008 prior to finalizing the survey instruments. The first was conducted in March, the second in April, and the third in May. The pretests primarily aimed to test the questionnaires for clarity and correctness of the new questions; the suitability of the translations in the six dialects (Tagalog, Cebuano, Ilocano, Bicol, Hiligaynon, and Waray); the sustainability of respondents' participation in the survey; and the actual field operation procedures.
Data collection
| Start | End |
|---|---|
| 2008-08 | 2008-09 |
| Name |
|---|
| National Statistics Office (NSO) |
Training of the field staff was conducted at two levels. The first was Task Force training for the instructors and regional supervisors; this was followed by training for the interviewing teams. The Task Force training was conducted in Manila on July 7-18, 2008. There were 36 participants, including 17 regional supervisors and 19 central office staff. Selected staff from the Demographic and Social Statistics Division (DSSD) at the NSO and professors from the University of the Philippines served as trainers. A consultant from ICF Macro and staff from the Department of Health, the National Commission on the Role of Filipino Women, and the Department of Social Welfare and Development served as resource persons.
The second-level training for the interviewers took place in 12 training centers from July 21 through August 5, 2008: Antipolo, Rizal; San Fernando Pampanga; Agoo, La Union; Lipa City, Batangas; Calapan City, Oriental Mindoro; Legazpi City; Iloilo City; Cebu City; Zamboanga City; Cagayan de Oro City; Davao City; and Cotabato City. Instructors for the training were members of the Task Force who had been trained in the first-level training.
Data collection was carried out from August 7 to September 27, 2008 by 57 interviewing teams. Each team consisted of a team supervisor, a field editor, and 3-6 female interviewers.
Data processing
Data processing was carried out at the NSO central office in Manila. It consisted of manual editing, data entry, verification, and editing of computer-identified errors. Forty-five hired data processors who underwent training October 6-17, 2008 processed the 2008 NDHS data.
An ad hoc group composed of eight employees from the Demographic and Social Statistics Division, the Information Resources Division, and the Information Technology Operations Division of the NSO was created. They worked full time at the NDHS Data Processing Center and were responsible for various aspects of the NDHS data processing.
Manual editing began October 7, 2008 and data entry began October 21, 2008. The computer software package called CSPro (Census and Survey Processing System) was used for data entry. The data entry program was developed in Manila at NSO with the assistance of data processing specialists from ICF Macro. Data processing was completed on December 22, 2008.
Data appraisal
Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2008 NDHS 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 2008 NDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 2008 NDHS is a Macro SAS procedure. This procedure used the Taylor linearization 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.
The Jackknife repeated-replication method derives estimates of complex rates from each of several replications of the parent sample, and calculates standard errors for these estimates using simple formulae. Each replication considers all but one cluster in the calculation of the estimates. Pseudo-independent replications are thus created. In the 2008 NDHS, there were 792 non-empty clusters. Hence, 792 replications were created.
In addition to the standard error, the procedure computes the design effect (DEFT) for each estimate, which is defined as the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error because of the use of a more complex and less statistically efficient design. The procedure also computes the relative error and confidence limits for the estimates.
Sampling errors for the 2008 NDHS are calculated for selected variables considered to be of primary interest. The results are presented in an appendix to the Final Report for the country as a whole, for urban and rural areas, and for each of the 17 geographical regions. For each variable, the type of statistic (mean, proportion, or rate) and the base population are given in Table B.1 of the Final Report. Tables B.2 to B.21 present the value of the statistic (R), its standard error (SE), the number of unweighted (N-UNWE) and weighted (N-WEIG) cases, the design effect (DEFT), the relative standard error (SE/R), and the 95 percent confidence limits (R±2SE), for each variable. The DEFT is considered undefined when the standard error considering simple random sample is zero (when the estimate is close to 0 or 1). In the case of the total fertility rate, the number of unweighted cases is not relevant, as there is no known unweighted value for woman-years of exposure to childbearing.
The confidence interval (e.g., as calculated for children ever born to women 40-49) can be interpreted as follows: the overall average from the national sample is 3.964 and its standard error is 0.060. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 3.964±2×0.060. There is a high probability (95 percent) that the true average number of children ever born to all women is between 3.845 and 4.083. For the total sample, the value of the DEFT, averaged over all variables, is 1.219. This means that, because of multi-stage clustering of the sample, the average standard error is increased by a factor of 1.219 over that in an equivalent simple random sample.
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 2008 Philippines National Demographic and Health Survey (NDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Data Access
| Name | Affiliation | URL | |
|---|---|---|---|
| MEASURE DHS | ICF International | www.measuredhs.com | archive@measuredhs.com |
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | URL | |
|---|---|---|
| General Inquiries | info@measuredhs.com | www.measuredhs.com |
| Data and Data Related Resources | archive@measuredhs.com | www.measuredhs.com |
| National Statistics Office | info@mail.census.gov.ph | http://www.census.gov.ph/ |
Metadata production
DDI_PHL_2008_DHS_v01_M
| Name | Role |
|---|---|
| World Bank, Development Economics Data Group | Generation of DDI documentation |
2012-05-02