| Author(s) |
Kenya National Bureau of Statistics, Nairobi, Kenya Ministry of Health, Nairobi, Kenya National AIDS Control Council, Nairobi, Kenya Kenya Medical Research Institute, Nairobi, Kenya National Council for Population and Development, Nairobi, Kenya The DHS |
| Date |
2015-12-01 |
| Country |
Kenya |
| Language |
English |
| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................ xvii
MILLENNIUM DEVELOPMENT GOAL INDICATORS ................................................................... xix
SUMMARY OF FINDINGS ..................................................................................................................... xxi
MAP OF KENYA .................................................................................................................................... xxvi
1 INTRODUCTION ........................................................................................................................... 1
1.1 History, Geography, and Economy ..................................................................................... 1
1.1.1 History ................................................................................................................... 1
1.1.2 Geography .............................................................................................................. 1
1.1.3 Economy ................................................................................................................ 1
1.2 Population ............................................................................................................................ 1
1.3 Population and Health Policy Frameworks ......................................................................... 2
1.3.1 Population Policy Framework ................................................................................ 2
1.3.2 Health Priorities and Programmes ......................................................................... 3
1.4 Objectives of the Survey ...................................................................................................... 3
1.5 Survey Organisation ............................................................................................................ 4
1.6 Sample Design ..................................................................................................................... 5
1.7 Questionnaires ..................................................................................................................... 5
1.8 Training ............................................................................................................................... 7
1.8.1 Training of Trainers ............................................................................................... 7
1.8.2 Pretest Activities .................................................................................................... 7
1.8.3 Main Training of Field Staff .................................................................................. 7
1.9 Fieldwork ............................................................................................................................. 8
1.10 Data Processing ................................................................................................................... 8
1.11 Response Rates .................................................................................................................... 9
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION .............................. 11
2.1 Household Characteristics ................................................................................................. 11
2.1.1 Water and Sanitation ............................................................................................ 12
2.1.2 Housing Characteristics ....................................................................................... 14
2.1.3 Household Possessions ........................................................................................ 16
2.2 Household Wealth ............................................................................................................. 17
2.3 Food Security ..................................................................................................................... 18
2.4 Hand Washing ................................................................................................................... 19
2.5 Household Population by Age and Sex ............................................................................. 20
2.6 Household Composition .................................................................................................... 21
2.7 Birth Registration .............................................................................................................. 22
2.8 Children’s Living Arrangements, Orphanhood, and School Attendance .......................... 23
2.9 Education of the Household Population ............................................................................ 25
2.9.1 Educational Attainment ....................................................................................... 25
2.9.2 School Attendance Ratios .................................................................................... 27
3 CHARACTERISTICS OF RESPONDENTS ............................................................................. 31
3.1 Characteristics of Survey Respondents ............................................................................. 31
3.2 Educational Attainment by Background Characteristics ................................................... 34
3.3 Literacy .............................................................................................................................. 39
3.4 Access to Mass Media ....................................................................................................... 44
3.5 Employment ...................................................................................................................... 49
3.5.1 Employment Status .............................................................................................. 49
3.5.2 Occupation ........................................................................................................... 51
3.5.3 Earnings, Employers, and Continuity of Employment ........................................ 53
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 55
4.1 Current Marital Status ....................................................................................................... 55
4.2 Polygyny ............................................................................................................................ 56
4.3 Age at First Marriage ......................................................................................................... 58
4.4 Age at First Sexual Intercourse ......................................................................................... 60
4.5 Recent Sexual Activity ...................................................................................................... 62
5 FERTILITY ................................................................................................................................... 65
5.1 Current Fertility ................................................................................................................. 65
5.2 Fertility Differentials ......................................................................................................... 66
5.3 Fertility Trends .................................................................................................................. 69
5.4 Children Ever Born and Living ......................................................................................... 70
5.5 Birth Intervals .................................................................................................................... 71
5.6 Postpartum Amenorrhoea, Abstinence, and Insusceptibility ............................................. 74
5.7 Menopause ......................................................................................................................... 75
5.8 Age at First Birth ............................................................................................................... 75
5.9 Teenage Pregnancy and Motherhood ................................................................................ 78
6 FERTILITY PREFERENCES ..................................................................................................... 81
6.1 Desire for More Children .................................................................................................. 81
6.2 Desire to Limit Childbearing by Background Characteristics ........................................... 82
6.3 Ideal Family Size ............................................................................................................... 84
6.4 Fertility Planning ............................................................................................................... 86
6.5 Wanted Fertility Rates ....................................................................................................... 87
7 FAMILY PLANNING .................................................................................................................. 89
7.1 Introduction ....................................................................................................................... 89
7.2 Knowledge of Contraceptive Methods .............................................................................. 89
7.3 Current Use of Contraception ............................................................................................ 93
7.4 Current Use of Contraception by Background Characteristics .......................................... 94
7.5 Trends in Current Use of Contraception ............................................................................ 95
7.6 Timing of Sterilisation ....................................................................................................... 97
7.7 Source of Contraception .................................................................................................... 97
7.8 Informed Choice ................................................................................................................ 98
7.9 Contraceptive Discontinuation Rates ................................................................................ 99
7.10 Reasons for Discontinuation of Contraceptive Use ......................................................... 100
7.11 Knowledge of Fertile Period ............................................................................................ 101
7.12 Need and Demand for Family Planning Services ............................................................ 101
7.13 Future Use of Contraception ............................................................................................ 104
7.14 Exposure to Family Planning Messages .......................................................................... 105
7.15 Contact of Nonusers with Family Planning Providers ..................................................... 106
7.16 Men’s Knowledge of and Attitudes towards Contraceptive Use ..................................... 107
8 INFANT AND CHILD MORTALITY ...................................................................................... 111
8.1 Data Quality ..................................................................................................................... 112
8.2 Levels and Trends in Infant and Child Mortality ............................................................ 113
8.3 Socioeconomic Differentials in Infant and Child Mortality ............................................ 115
8.4 Demographic Differentials in Infant and Child Mortality ............................................... 116
8.5 Perinatal Mortality ........................................................................................................... 117
8.6 High-Risk Fertility Behaviour ......................................................................................... 118
9 MATERNAL HEALTH ............................................................................................................. 121
9.1 Antenatal Care ................................................................................................................. 121
9.1.1 Number and Timing of Antenatal Visits ............................................................ 123
9.1.2 Components of Antenatal Care .......................................................................... 124
9.2 Tetanus Toxoid Vaccination ............................................................................................ 126
9.3 Place of Delivery ............................................................................................................. 127
9.4 Assistance during Delivery .............................................................................................. 129
9.5 Postnatal Care .................................................................................................................. 132
9.5.1 Timing of First Postnatal Checkup for the Mother ............................................ 132
9.5.2 Provider of First Postnatal Checkup for the Mother .......................................... 133
9.5.3 Timing of First Postnatal Checkup for the Newborn ......................................... 134
9.5.4 Provider of First Postnatal Checkup for the Newborn ....................................... 135
9.6 Problems in Accessing Health Care ................................................................................ 136
9.7 Fistula .............................................................................................................................. 137
10 CHILD HEALTH ........................................................................................................................ 139
10.1 Child’s Weight and Size at Birth ..................................................................................... 140
10.2 Vaccination Coverage...................................................................................................... 141
10.3 Acute Respiratory Infection ............................................................................................. 145
10.4 Fever ................................................................................................................................ 147
10.5 Diarrhoeal Disease ........................................................................................................... 150
10.6 Knowledge of ORS Packets and Zinc Tablets ................................................................. 154
10.7 Disposal of Children’s Stools .......................................................................................... 155
11 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 157
11.1 Nutritional Status of Children .......................................................................................... 158
11.1.1 Measurement of Nutritional Status among Young Children .............................. 158
11.1.2 Data Collection .................................................................................................. 158
11.1.3 Measures of Child Nutritional Status ................................................................. 159
11.1.4 Trends in Children’s Nutritional Status ............................................................. 163
11.2 Breastfeeding and Complementary Feeding .................................................................... 163
11.2.1 Initiation of Breastfeeding ................................................................................. 163
11.2.2 Breastfeeding Status by Age .............................................................................. 165
11.2.3 Duration of Breastfeeding .................................................................................. 167
11.2.4 Types of Complementary Foods ........................................................................ 168
11.2.5 Infant and Young Child Feeding (IYCF) Practices ............................................ 169
11.3 Micronutrient Intake among Children ............................................................................. 172
11.4 Iodisation of Household Salt ........................................................................................... 176
11.5 Nutritional Status of Women ........................................................................................... 177
11.6 Micronutrient Intake among Mothers .............................................................................. 180
12 MALARIA ................................................................................................................................... 183
12.1 Introduction ..................................................................................................................... 183
12.2 Ownership of Mosquito Nets ........................................................................................... 185
12.3 Access to Insecticide-Treated Nets .................................................................................. 188
12.4 Use of Mosquito Nets ...................................................................................................... 189
12.4.1 Overall Use of Mosquito Nets ........................................................................... 189
12.4.2 Use of Mosquito Nets by Children Under Age 5 ............................................... 194
12.4.3 Use of Mosquito Nets by Pregnant Women ....................................................... 197
12.5 Preventive Malaria Treatment During Pregnancy ........................................................... 198
12.6 Fever among Children Under Age 5 ................................................................................ 201
12.6.1 Prevalence and Treatment of Fever among Children ......................................... 201
12.6.2 Type and Timing of Antimalarial drugs ............................................................ 204
13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ....................... 207
13.1 Introduction ..................................................................................................................... 207
13.2 HIV and AIDS Knowledge, Transmission and Prevention Methods .............................. 208
13.2.1 Awareness of HIV and AIDS............................................................................. 208
13.2.2 Knowledge of HIV Prevention Methods ........................................................... 210
13.2.3 Rejection of Misconceptions about HIV/AIDS ................................................. 213
13.2.4 Knowledge of Mother-to-Child Transmission of HIV ....................................... 218
13.3 Attitudes towards People Living with HIV and AIDS .................................................... 221
13.4 Attitudes towards Negotiating Safer Sexual Relationships ............................................. 224
13.5 Attitude towards Condom Education for Youth .............................................................. 225
13.6 High-Risk Sex ................................................................................................................. 227
13.6.1 Multiple Partners and Condom Use ................................................................... 227
13.6.2 Point Prevalence and Cumulative Prevalence of Concurrent Sexual Partners ... 229
13.6.3 Transactional Sex ............................................................................................... 231
13.7 Coverage of HIV Counselling and Testing ..................................................................... 234
13.7.1 General HIV Testing .......................................................................................... 234
13.7.2 HIV Counselling and Testing During Pregnancy .............................................. 239
13.8 Male Circumcision .......................................................................................................... 241
13.9 Self-Reporting of Sexually Transmitted Infections ......................................................... 242
13.10 Prevalence of Medical Injections..................................................................................... 244
13.11 HIV/AIDS Knowledge and Sexual Behaviour among Youth ......................................... 245
13.11.1 HIV/AIDS-Related Knowledge among Youth .................................................. 246
13.11.2 Trends in Age at First Sex ................................................................................. 247
13.11.3 Abstinence and Premarital Sex .......................................................................... 249
13.11.4 Multiple Sexual Partners among Youth ............................................................. 250
13.11.5 Cross-generational Sexual Partners ................................................................... 251
13.11.6 Voluntary HIV Counselling and Testing among Youth..................................... 252
14 NONCOMMUNICABLE DISEASES AND OTHER HEALTH ISSUES ............................. 255
14.1 Introduction ..................................................................................................................... 255
14.2 Knowledge of and Screening for Cancer ......................................................................... 255
14.2.1 Breast Cancer ..................................................................................................... 255
14.2.2 Cervical Cancer .................................................................................................. 256
14.2.3 Prostate Cancer .................................................................................................. 257
14.3 Screening for Hypertension and Diabetes ....................................................................... 258
14.4 Knowledge and Attitudes Concerning Tuberculosis ....................................................... 259
14.5 Use of Tobacco ................................................................................................................ 261
14.6 Alcohol Consumption ...................................................................................................... 263
14.7 Physical Activity ............................................................................................................. 265
14.8 Unintentional Injury ........................................................................................................ 267
14.9 Health Insurance Coverage .............................................................................................. 269
15 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES ... 273
15.1 Employment and Form of Earnings ................................................................................. 273
15.2 Control over and Relative Magnitude of Women’s and Husbands’ Earnings ................. 274
15.2.1 Control over Wife’s Earnings ............................................................................ 275
15.2.2 Control over Husbands’ Earnings ...................................................................... 276
15.3 Control over Women’s Earnings and Relative Size of Husband’s and Wife’s Earnings ............ 277
15.4 Ownership of Assets ........................................................................................................ 277
15.5 Women’s Participation in Decision Making .................................................................... 279
15.6 Attitudes towards Wife Beating ...................................................................................... 283
15.7 Women’s Empowerment Indices ..................................................................................... 286
15.8 Current Use of Contraception by Women’s Status .......................................................... 286
15.9 Ideal Family Size and Unmet Need by Women’s Status ................................................. 287
15.10 Reproductive Health Care and Women’s Empowerment ................................................ 288
15.11 Differentials in Infant and Child Mortality by Women’s Status ...................................... 289
16 DOMESTIC VIOLENCE ........................................................................................................... 291
16.1 Measurement of Violence ................................................................................................ 291
16.1.1 Use of Valid Measures of Violence ................................................................... 291
16.1.2 Ethical Considerations in the 2014 KDHS ........................................................ 293
16.1.3 Subsample for the Violence Module .................................................................. 293
16.2 Experience of Physical Violence ..................................................................................... 293
16.3 Perpetrators of Physical Violence .................................................................................... 296
16.4 Experience of Sexual Violence ........................................................................................ 297
16.5 Perpetrators of Sexual Violence ...................................................................................... 300
16.6 Age at First Experience of Sexual Violence .................................................................... 301
16.7 Experience of Different Forms of Violence .................................................................... 302
16.8 Violence during Pregnancy ............................................................................................. 303
16.9 Marital Control by Spouse ............................................................................................... 303
16.10 Forms of Spousal Violence .............................................................................................. 306
16.11 Spousal Violence by Background Characteristics ........................................................... 309
16.12 Violence by Spousal Characteristics and Women’s Empowerment Indicators ............... 311
16.13 Recent Spousal Violence ................................................................................................ 314
16.14 Onset of Spousal Violence .............................................................................................. 315
16.15 Physical Consequences of Spousal Violence .................................................................. 316
16.16 Violence by Women and Men against Their Spouse ....................................................... 317
16.17 Violence against Spouses by Spousal Characteristics and Women’s Empowerment Indicators ........... 320
16.18 Help-seeking Behaviour by Women and Men Who Experience Violence ...................... 322
17 ADULT AND MATERNAL MORTALITY ............................................................................. 327
17.1 Data and Assessment of Quality ...................................................................................... 327
17.2 Estimates of Adult Mortality ........................................................................................... 328
17.3 Estimates of Maternal Mortality ...................................................................................... 329
18 FEMALE GENITAL CUTTING ............................................................................................... 331
18.1 Knowledge of Female Circumcision ............................................................................... 331
18.2 Prevalence of and Age at Circumcision ........................................................................... 333
18.3 Aspects of Circumcision among Circumcised Girls and Women ................................... 337
18.4 Religious and Community Attitudes towards FGC ......................................................... 339
18.5 Support for the Continuation of FGC .............................................................................. 342
REFERENCES ......................................................................................................................................... 345
APPENDIX A SAMPLE IMPLEMENTATION ................................................................................. 351
APPENDIX B ESTIMATES OF SAMPLING ERRORS ................................................................... 357
APPENDIX C DATA QUALITY .......................................................................................................... 385
APPENDIX D PERSONS INVOLVED IN THE 2014 KENYA DEMOGRAHIC AND
HEALTH SURVEY ....................................................................................................... 391
APPENDIX E QUESTIONNAIRES ..................................................................................................... 399 |
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