| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................. xix
2018 NIGERIA DEMOGRAPHIC AND HEALTH SURVEY STEERING COMMITTEE .............. xxi
CONTRIBUTORS TO THE REPORT ................................................................................................ xxiii
READING AND UNDERSTANDING TABLES FROM THE 2018 NIGERIA DHS ........................ xxv
ACRONYMS AND ABBREVIATIONS ............................................................................................. xxxiii
SUSTAINABLE DEVELOPMENT GOAL INDICATORS ............................................................. xxxvii
MAP OF NIGERIA ............................................................................................................................ xxxviii
1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................. 1
1.1 Survey Objectives ................................................................................................................ 1
1.2 Sample Design ..................................................................................................................... 1
1.3 Questionnaires ..................................................................................................................... 3
1.4 Anthropometry, Anaemia Testing, Malaria Testing, and Sickle Cell Anaemia Testing ..... 4
1.5 Pretest .................................................................................................................................. 6
1.6 Training of Field Staff ......................................................................................................... 6
1.7 Fieldwork ............................................................................................................................. 7
1.8 Data Processing ................................................................................................................... 8
1.9 Response Rates .................................................................................................................... 8
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION .............................. 11
2.1 Drinking Water Sources and Treatment ............................................................................ 11
2.2 Sanitation ........................................................................................................................... 13
2.3 Exposure to Smoke inside the Home ................................................................................. 15
2.4 Household Wealth ............................................................................................................. 15
2.5 Handwashing ..................................................................................................................... 16
2.6 Household Population and Composition ........................................................................... 16
2.7 Children’s Living Arrangements and Parental Survival .................................................... 17
2.8 Birth Registration .............................................................................................................. 17
2.9 Education ........................................................................................................................... 18
2.9.1 Educational Attainment ....................................................................................... 18
2.9.2 School Attendance ............................................................................................... 19
3 CHARACTERISTICS OF RESPONDENTS ............................................................................. 43
3.1 Basic Characteristics of Survey Respondents .................................................................... 43
3.2 Education and Literacy ...................................................................................................... 44
3.3 Mass Media Exposure ....................................................................................................... 45
3.4 Internet Usage .................................................................................................................... 46
3.5 Employment ...................................................................................................................... 46
3.6 Occupation ......................................................................................................................... 47
3.7 Health Insurance Coverage ................................................................................................ 48
3.8 Tobacco Use ...................................................................................................................... 49
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 79
4.1 Marital Status ..................................................................................................................... 79
4.2 Polygyny ............................................................................................................................ 80
4.3 Age at First Marriage ......................................................................................................... 81
4.4 Age at First Sexual Intercourse ......................................................................................... 81
4.5 Recent Sexual Activity ...................................................................................................... 82
5 FERTILITY ................................................................................................................................... 97
5.1 Current Fertility ................................................................................................................. 97
5.2 Children Ever Born and Living ......................................................................................... 99
5.3 Birth Intervals .................................................................................................................... 99
5.4 Insusceptibility to Pregnancy ........................................................................................... 100
5.5 Age at First Birth ............................................................................................................. 101
5.6 Teenage Childbearing ...................................................................................................... 102
6 FERTILITY PREFERENCES ................................................................................................... 117
6.1 Desire for Another Child ................................................................................................. 117
6.2 Ideal Family Size ............................................................................................................. 118
6.3 Fertility Planning Status .................................................................................................. 119
6.4 Wanted Fertility Rates ..................................................................................................... 120
7 FAMILY PLANNING ................................................................................................................ 129
7.1 Contraceptive Knowledge and Use ................................................................................. 130
7.2 Source of Modern Contraceptive Methods ...................................................................... 132
7.3 Informed Choice .............................................................................................................. 132
7.4 Discontinuation of Contraceptives .................................................................................. 133
7.5 Demand for Family Planning .......................................................................................... 133
7.6 Contact of Nonusers with Family Planning Providers ..................................................... 136
8 INFANT AND CHILD MORTALITY ...................................................................................... 163
8.1 Infant and Child Mortality ............................................................................................... 164
8.2 Biodemographic Risk Factors ......................................................................................... 165
8.3 Perinatal Mortality ........................................................................................................... 166
8.4 High-risk Fertility Behaviour .......................................................................................... 167
9 MATERNAL HEALTH CARE ................................................................................................. 173
9.1 Antenatal Care Coverage and Content ............................................................................ 174
9.1.1 Skilled Providers ................................................................................................ 174
9.1.2 Timing and Number of ANC Visits ................................................................... 174
9.2 Components of ANC Visits ............................................................................................. 175
9.3 Protection against Neonatal Tetanus ............................................................................... 175
9.4 Delivery Services ............................................................................................................. 176
9.4.1 Institutional Deliveries ....................................................................................... 176
9.4.2 Skilled Assistance during Delivery .................................................................... 177
9.4.3 Delivery by Caesarean ....................................................................................... 178
9.4.4 Referral to Place of Delivery ............................................................................. 179
9.4.5 Reasons for Referral and Time Taken ............................................................... 180
9.4.6 Means of Transportation to Health Facility ....................................................... 180
9.4.7 Thermal Care for Newborns .............................................................................. 180
9.4.8 Cord Care ........................................................................................................... 180
9.5 Postnatal Care .................................................................................................................. 181
9.5.1 Postnatal Health Check for Mothers .................................................................. 181
9.5.2 Postnatal Health Check for Newborns ............................................................... 182
9.6 Problems in Accessing Health Care ................................................................................ 182
9.7 Fistula .............................................................................................................................. 183
10 CHILD HEALTH ........................................................................................................................ 223
10.1 Birth Weight .................................................................................................................... 223
10.2 Vaccination of Children................................................................................................... 224
10.3 Symptoms of Acute Respiratory Infection ...................................................................... 227
10.4 Fever ................................................................................................................................ 228
10.5 Diarrhoeal Disease ........................................................................................................... 228
10.5.1 Prevalence of Diarrhoea and Treatment-seeking Behaviour .............................. 228
10.5.2 Feeding Practices ............................................................................................... 229
10.5.3 Oral Rehydration Therapy and Other Treatments .............................................. 229
10.5.4 Knowledge of ORS Packets ............................................................................... 230
10.6 Treatment of Childhood Illness ....................................................................................... 231
10.7 Disposal of Children’s Stools .......................................................................................... 231
11 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 255
11.1 Nutritional Status of Children .......................................................................................... 255
11.1.1 Anthropometry Training and Data Collection ................................................... 257
11.1.2 Levels of Child Malnutrition ............................................................................. 257
11.2 Infant and Young Child Feeding Practices ...................................................................... 259
11.2.1 Early Initiation of Breastfeeding ........................................................................ 259
11.2.2 Exclusive Breastfeeding and Continued Breastfeeding ..................................... 260
11.2.3 Median Duration of Breastfeeding ..................................................................... 260
11.2.4 Bottle Feeding .................................................................................................... 261
11.2.5 Introduction of Complementary Foods .............................................................. 261
11.2.6 Minimum Dietary Diversity, Minimum Meal Frequency, and Minimum Acceptable Diet .... 262
11.3 Anaemia Prevalence in Children ..................................................................................... 263
11.4 Prevalence of Sickle Cell Trait and Disease in Children ................................................. 265
11.5 Presence of Iodised Salt in Households ........................................................................... 265
11.6 Micronutrient Intake and Supplementation among Children........................................... 266
11.7 Women’s Nutritional Status ............................................................................................ 266
11.8 Anaemia Prevalence in Women ...................................................................................... 268
11.9 Micronutrient Supplementation and Deworming during Pregnancy ............................... 268
11.10 Minimum Dietary Diversity for Women ......................................................................... 269
12 MALARIA ................................................................................................................................... 297
12.1 Ownership of Insecticide-treated Nets ............................................................................. 298
12.2 Household Access to and Use of ITNs ............................................................................ 300
12.3 Use of ITNs by Children and Pregnant Women .............................................................. 301
12.4 Reasons for Not Using the Net the Night Preceding the Interview ................................. 302
12.5 Malaria in Pregnancy ....................................................................................................... 302
12.6 Case Management of Malaria in Children ....................................................................... 303
12.7 Prevalence of Low Haemoglobin in Children ................................................................. 304
12.8 Prevalence of Malaria in Children ................................................................................... 305
12.9 Beliefs about the Effectiveness of Malaria Behaviours and Products and about Malaria Consequences .... 307
13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ....................... 343
13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods .................................... 344
13.2 Knowledge about Mother-to-Child Transmission ........................................................... 346
13.3 Discriminatory Attitudes towards People Living with HIV ............................................ 347
13.4 Multiple Sexual Partners ................................................................................................. 347
13.5 Paid Sex ........................................................................................................................... 348
13.6 Male Circumcision .......................................................................................................... 348
13.7 Self-reporting of Sexually Transmitted Infections .......................................................... 349
13.8 HIV/AIDS-related Knowledge and Behaviour among Young People ............................ 349
13.8.1 Comprehensive Knowledge ............................................................................... 349
13.8.2 First Sex ............................................................................................................. 350
13.8.3 Premarital Sex .................................................................................................... 350
13.8.4 Multiple Sexual Partners .................................................................................... 350
14 ADULT AND MATERNAL MORTALITY ............................................................................. 371
14.1 Data ................................................................................................................................. 371
14.2 Direct Estimates of Adult Mortality ................................................................................ 372
14.3 Trends in Adult Mortality ................................................................................................ 373
14.4 Direct Estimates of Maternal Mortality ........................................................................... 373
14.5 Trends in Pregnancy-Related Mortality ........................................................................... 374
15 WOMEN’S EMPOWERMENT ................................................................................................ 379
15.1 Married Women’s and Men’s Employment .................................................................... 380
15.2 Control over Women’s Earnings ..................................................................................... 381
15.3 Control over Men’s Earnings .......................................................................................... 381
15.4 Women’s Control over Their Own Earnings and over Those of Their Husbands ........... 382
15.5 Women’s and Men’s Ownership of Assets ..................................................................... 382
15.6 Possession of Title or Deed for a House or Land ............................................................ 383
15.7 Ownership and Use of Bank Accounts and Mobile Phones ............................................ 383
15.8 Women’s Participation in Decision Making .................................................................... 383
15.9 Attitudes toward Wife Beating ........................................................................................ 385
15.10 Negotiating Sexual Relations .......................................................................................... 386
15.11 Women’s Empowerment and Demographic and Health Outcomes ............................... 386
16 DOMESTIC VIOLENCE ........................................................................................................... 427
16.1 Measurement of Violence ................................................................................................ 428
16.2 Women’s Experience of Physical Violence..................................................................... 429
16.2.1 Perpetrators of Physical Violence ...................................................................... 430
16.3 Experience of Sexual Violence ........................................................................................ 430
16.3.1 Prevalence of Sexual Violence .......................................................................... 430
16.3.2 Perpetrators of Sexual Violence ......................................................................... 430
16.4 Experience of Different Forms of Violence .................................................................... 430
16.5 Marital Control by Husband ............................................................................................ 431
16.6 Forms of Spousal Violence .............................................................................................. 431
16.6.1 Prevalence of Spousal Violence ......................................................................... 431
16.6.2 Onset of Spousal Violence ................................................................................. 434
16.7 Injuries to Women due to Spousal Violence ................................................................... 434
16.8 Violence Initiated by Women against Husbands ............................................................. 435
16.9 Help Seeking among Women Who Have Experienced Violence .................................... 435
17 DISABILITY ............................................................................................................................... 457
17.1 Disability by Domain and Age ........................................................................................ 457
17.2 Disability among Adults by Other Background Characteristics ...................................... 458
18 FEMALE GENITAL MUTILATION ....................................................................................... 465
18.1 Respondents’ Knowledge of Female Genital Mutilation................................................. 465
18.2 Prevalence of Female Genital Mutilation ........................................................................ 466
18.2.1 Prevalence and Type of Circumcision ............................................................... 466
18.2.2 Unclassified Types of Female Circumcision ..................................................... 467
18.2.3 Age at Circumcision .......................................................................................... 468
18.3 Circumcision of Daughters .............................................................................................. 468
18.4 Person Who Performed the Circumcision ....................................................................... 469
18.5 Attitudes towards Female Circumcision .......................................................................... 469
REFERENCES.......................................................................................................................................... 485
APPENDIX A SAMPLE DESIGN ......................................................................................................... 489
A.1 Introduction ..................................................................................................................... 489
A.2 Sample Frame .................................................................................................................. 489
A.3 Sample Design and Implementation ................................................................................ 491
A.4 Sample Probabilities and Sampling Weights ................................................................... 496
APPENDIX B ESTIMATES OF SAMPLING ERRORS .................................................................... 497
APPENDIX C DATA QUALITY TABLES .......................................................................................... 547
APPENDIX D PERSONS INVOLVED IN THE 2018 NIGERIA DEMOGRAPHIC AND HEALTH
SURVEY ...................................................................................................................................... 557
APPENDIX E QUESTIONNAIRES ...................................................................................................... 563
Household Questionnaire .............................................................................................................. 565
Woman’s Questionnaire ................................................................................................................ 583
Man’s Questionnaire ..................................................................................................................... 663
Biomarker Questionnaire .............................................................................................................. 689
Fieldworker Questionnaire ............................................................................................................ 705 |
