| Author(s) |
National Institute of Population Studies, Islamabad, Pakistan The DHS Program, ICF, Rockville, Maryland, USA |
| Date |
2019-01-01 |
| Country |
Pakistan |
| Language |
English |
| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................ xvii
ACKNOWLEDGEMENTS ...................................................................................................................... xix
2017-18 PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY TECHNICAL ADVISORY
COMMITTEE .............................................................................................................................. xxi
CONTRIBUTORS TO THE REPORT ................................................................................................ xxiii
ACRONYMS AND ABBREVIATIONS ................................................................................................. xxv
READING AND UNDERSTANDING TABLES FROM THE 2017-18 PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY (PDHS) .... xxix
SUSTAINABLE DEVELOPMENT GOALS INDICATORS ........................................................... xxxvii
MAP OF PAKISTAN ......................................................................................................................... xxxviii
1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................. 1
1.1 Survey Objectives ................................................................................................................ 1
1.2 Sample Design ..................................................................................................................... 2
1.3 Questionnaires ..................................................................................................................... 3
1.4 Anthropometry .................................................................................................................... 4
1.5 Pretest .................................................................................................................................. 4
1.6 Training of Field Staff ......................................................................................................... 4
1.7 Fieldwork ............................................................................................................................. 5
1.8 Data Processing ................................................................................................................... 6
1.9 Response Rates .................................................................................................................... 6
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION ................................ 9
2.1 Drinking Water Sources and Treatment .............................................................................. 9
2.2 Sanitation ........................................................................................................................... 10
2.3 Exposure to Smoke inside the Home ................................................................................. 11
2.3.1 Other Housing Characteristics ............................................................................. 11
2.4 Household Wealth ............................................................................................................. 11
2.4.1 Household Durable Goods ................................................................................... 11
2.5 Hand washing .................................................................................................................... 12
2.6 Household Population and Composition ........................................................................... 12
2.7 Children’s Living Arrangements and Parental Survival .................................................... 13
2.8 Birth Registration .............................................................................................................. 14
2.8.1 Registration with NADRA ................................................................................... 15
2.9 Education ........................................................................................................................... 15
2.9.1 Educational Attainment ....................................................................................... 15
2.9.2 School Attendance ............................................................................................... 16
3 CHARACTERISTICS OF RESPONDENTS ............................................................................. 33
3.1 Basic Characteristics of Survey Respondents .................................................................... 33
3.2 Education and Literacy ...................................................................................................... 34
3.3 Mass Media Exposure ....................................................................................................... 35
3.4 Employment ...................................................................................................................... 36
3.5 Occupation ......................................................................................................................... 36
3.6 Health Insurance Coverage and Safety Net ....................................................................... 37
3.7 Tobacco Use ...................................................................................................................... 38
3.8 Knowledge Concerning Tuberculosis ................................................................................ 38
3.9 Knowledge Concerning Hepatitis ...................................................................................... 38
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 67
4.1 Marital Status ..................................................................................................................... 67
4.2 Polygyny ............................................................................................................................ 68
4.3 Age at First Marriage ......................................................................................................... 69
4.4 Consanguinity .................................................................................................................... 69
4.5 Age at First Sexual Intercourse ......................................................................................... 70
4.6 Recent Sexual Activity ...................................................................................................... 71
5 FERTILITY ................................................................................................................................... 83
5.1 Current Fertility ................................................................................................................. 84
5.2 Children Ever Born and Living ......................................................................................... 85
5.3 Birth Intervals .................................................................................................................... 86
5.4 Insusceptibility to Pregnancy ............................................................................................. 86
5.5 Age at First Birth ............................................................................................................... 88
5.6 Teenage Childbearing ........................................................................................................ 88
6 FERTILITY PREFERENCES ................................................................................................... 101
6.1 Desire for Another Child ................................................................................................. 101
6.2 Ideal Family Size ............................................................................................................. 103
6.3 Fertility Planning Status .................................................................................................. 104
6.4 Wanted Fertility Rates ..................................................................................................... 104
7 FAMILY PLANNING ................................................................................................................ 113
7.1 Contraceptive Knowledge and Use ................................................................................. 114
7.2 Source of Modern Contraceptive Methods ...................................................................... 116
7.3 Informed Choice .............................................................................................................. 117
7.4 Discontinuation of Contraceptives .................................................................................. 117
7.5 Demand for Family Planning .......................................................................................... 118
7.5.1 Decision Making about Family Planning ........................................................... 120
7.5.2 Future Use of Contraception .............................................................................. 120
7.5.3 Exposure to Family Planning Messages in the Media ....................................... 120
7.6 Contact of Nonusers with Family Planning Providers ..................................................... 121
7.7 Postpartum Counselling on Family Planning .................................................................. 122
7.8 Men’s Attitude towards Contraceptive Use ..................................................................... 122
8 INFANT AND CHILD MORTALITY ...................................................................................... 145
8.1 Infant and Child Mortality ............................................................................................... 146
8.2 Biodemographic and Sociodemographic Risk Factors .................................................... 146
8.3 Perinatal Mortality ........................................................................................................... 148
8.4 High-Risk Fertility Behaviour ......................................................................................... 149
9 MATERNAL HEALTH CARE ................................................................................................. 155
9.1 Antenatal Care Coverage and Content ............................................................................ 156
9.1.1 Skilled Providers ................................................................................................ 156
9.1.2 Timing and Number of ANC Visits ................................................................... 157
9.2 Components of ANC Visits ............................................................................................. 157
9.3 Protection against Neonatal Tetanus ............................................................................... 158
9.4 Delivery Services ............................................................................................................. 158
9.4.1 Institutional Deliveries ....................................................................................... 158
9.4.2 Skilled Assistance during Delivery .................................................................... 160
9.4.3 Delivery by Caesarean Section .......................................................................... 161
9.5 Postnatal Care .................................................................................................................. 162
9.5.1 Postnatal Health Check for Mothers .................................................................. 162
9.5.2 Postnatal Health Check for Newborns ............................................................... 163
9.5.3 Newborn Care Practices ..................................................................................... 163
9.5.4 Pregnancy Outcomes ......................................................................................... 164
9.6 Problems in Accessing Health Care ................................................................................ 164
10 CHILD HEALTH ........................................................................................................................ 183
10.1 Birth Weight .................................................................................................................... 184
10.2 Vaccination of Children ................................................................................................... 184
10.3 Symptoms of Acute Respiratory Infection ...................................................................... 187
10.4 Fever ................................................................................................................................ 188
10.5 Diarrhoeal Disease ........................................................................................................... 189
10.5.1 Prevalence of Diarrhoea and Treatment-seeking Behaviour .............................. 189
10.5.2 Feeding Practices ............................................................................................... 190
10.5.3 Treatment of Diarrhoea ...................................................................................... 190
10.5.4 Knowledge of ORS Packets ............................................................................... 192
10.6 Treatment of Childhood Illness ....................................................................................... 192
10.7 Disposal of Children’s Stools .......................................................................................... 192
11 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 209
11.1 Nutritional Status of Children .......................................................................................... 209
11.1.1 Measurement of Nutritional Status among Young Children .............................. 210
11.1.2 Data Collection .................................................................................................. 211
11.1.3 Malnutrition Prevalence in Children .................................................................. 211
11.2 Infant and Young Child Feeding Practices ...................................................................... 212
11.2.1 Initiation of Breastfeeding ................................................................................. 213
11.2.2 Exclusive Breastfeeding ..................................................................................... 213
11.2.3 Reasons for Not Breastfeeding or Stopping Breastfeeding ................................ 215
11.2.4 Median Duration of Breastfeeding ..................................................................... 215
11.2.5 Complementary Feeding .................................................................................... 215
11.2.6 Minimum Acceptable Diet ................................................................................. 216
11.3 Micronutrient Intake and Supplementation among Children ........................................... 217
11.4 Nutritional Status of Women ........................................................................................... 218
11.5 Micronutrient Supplementation And Deworming During Pregnancy ............................. 219
12 MALARIA ................................................................................................................................... 233
12.1 Ownership of Insecticide-treated Nets ............................................................................. 234
12.2 Household Access to and Use of ITNs ............................................................................ 235
12.3 Use of ITNs by Children and Pregnant Women .............................................................. 236
12.4 Use of Antimalarial Drugs ............................................................................................... 236
13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ....................... 245
13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods .................................... 246
13.2 Knowledge about Mother-to-Child Transmission ........................................................... 247
13.3 Discriminatory Attitudes towards People Living with HIV ............................................ 248
13.4 Coverage of HIV Testing Services .................................................................................. 248
13.4.1 Awareness of HIV Testing Services and Experience with HIV Testing ........... 249
13.5 Self-reporting of Sexually Transmitted Infections .......................................................... 249
13.6 HIV/AIDS-related Knowledge and Behaviour among Young People ............................ 249
13.6.1 Knowledge ......................................................................................................... 249
13.6.2 First Sex ............................................................................................................. 250
13.6.3 Coverage of HIV Testing Services .................................................................... 250
13.7 Knowledge of Treatment of HIV ..................................................................................... 250
14 DISABILITY ............................................................................................................................... 263
14.1 Disability by Domain and Age ........................................................................................ 263
14.2 Disability among Adults by Other Background Characteristics ...................................... 264
15 WOMEN’S EMPOWERMENT ................................................................................................ 269
15.1 Married Women’s and Men’s Employment .................................................................... 270
15.2 Control over Women’s Earnings ..................................................................................... 270
15.3 Control over Men’s Earnings .......................................................................................... 271
15.4 Women’s Control over Their Own Earnings and Those of Their Husbands ................... 272
15.5 Women’s and Men’s Ownership of Assets ..................................................................... 272
15.6 Ownership of Title or Deed for House and Land ............................................................ 273
15.7 Ownership and Use of Bank Accounts and Mobile Phones ............................................ 273
15.8 Women’s Participation in Decision Making .................................................................... 274
15.9 Attitudes toward Wife Beating ........................................................................................ 275
15.10 Attitude towards Negotiating Safer Sexual Relations with Husband .............................. 276
15.11 Ability to Negotiate Sexual Relations with Husband ...................................................... 277
15.12 Women’s Empowerment Indicators ................................................................................ 278
15.13 Current Use of Contraception by Women’s Empowerment ............................................ 278
15.14 Ideal Number of Children and Unmet Need for Family Planning by Women’s Empowerment ...... 278
15.15 Reproductive Health Care by Women’s Empowerment .................................................. 279
15.16 Early Childhood Mortality and Women’s Empowerment ............................................... 279
15 DOMESTIC VIOLENCE ........................................................................................................... 303
16.1 Measurement of Violence ................................................................................................ 304
16.2 Women’s Experience of Physical Violence .................................................................... 304
16.2.1 Perpetrators of Physical Violence ...................................................................... 305
16.3 Experience of Sexual Violence ........................................................................................ 305
16.3.1 Prevalence of Sexual Violence .......................................................................... 306
16.3.2 Perpetrators of Sexual Violence ......................................................................... 306
16.4 Experience of Different Forms of Violence .................................................................... 306
16.5 Marital Control by Husband ............................................................................................ 306
16.6 Forms of Spousal Violence .............................................................................................. 307
16.6.1 Prevalence of Spousal Violence ......................................................................... 307
16.6.2 Onset of Spousal Violence ................................................................................. 310
16.7 Injuries to Women due to Spousal Violence ................................................................... 310
16.8 Response to Violence ...................................................................................................... 310
16.8.1 Help Seeking among Women Who Have Experienced Violence ...................... 310
16.8.2 Sources for Help ................................................................................................ 311
16.8.3 Reasons for Seeking Help .................................................................................. 311
16.8.4 Reasons for Not Seeking Help ........................................................................... 311
17 MIGRATION .............................................................................................................................. 327
17.1 In-migration and Immigration ......................................................................................... 328
17.1.1 Incidence of In-migration and Immigration ....................................................... 328
17.1.2 Duration of Continuous Residence .................................................................... 329
17.1.3 Most Recent Place of Residence Prior to Current Residence ............................ 329
17.1.4 Direction of In-migration ................................................................................... 329
17.1.5 Reasons for In-migration ................................................................................... 331
17.2 Out-migration .................................................................................................................. 332
17.2.1 Out-migration within Pakistan ........................................................................... 332
17.2.2 Direction of Movement among Out-migrants .................................................... 333
17.2.3 Reasons for Out-migration within Pakistan ....................................................... 334
17.3 Emigration ....................................................................................................................... 334
17.4 Remittances ..................................................................................................................... 335
REFERENCES ......................................................................................................................................... 345
APPENDIX A SAMPLE DESIGN ......................................................................................................... 347
A.1 Introduction ..................................................................................................................... 347
A.2 Sample Frame .................................................................................................................. 347
A.3 Sample Design and Implementation ................................................................................ 348
A.4 Sample Probabilities and Sampling Weights ................................................................... 352
APPENDIX B ESTIMATES OF SAMPLING ERRORS .................................................................... 355
APPENDIX C DATA QUALITY TABLES .......................................................................................... 381
APPENDIX D ACCESS TO SERVICES IN RURAL COMMUNITIES ........................................... 397
APPENDIX E PERSONS INVOLVED IN THE 2017-18 PDHS ......................................................... 401
APPENDIX F QUESTIONNAIRES ...................................................................................................... 405
Household ..................................................................................................................................... 407
Woman's ........................................................................................................................................ 429
Man's ......................................................................................................................................... 493
Biomarker ...................................................................................................................................... 515
Community .................................................................................................................................... 521
Fieldworker ................................................................................................................................... 531 |
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