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Ethiopia
2011
Demographic and
Health Survey
Ethiopia 2011DemographicandHealth Survey
Ethiopia
Demographic and
Health Survey
2011
Central Statistical Agency
Addis Ababa, Ethiopia
ICF International
Calverton, Maryland, USA
March 2012
The 2011EthiopiaDemographicandHealthSurvey (2011 EDHS) is part of the worldwide
MEASURE DHS project which is funded by the United States Agency for International Development
(USAID). The survey was implemented by the Ethiopian Central Statistical Agency (CSA). The
funding for the EDHS was provided by the HIV/AIDS Prevention and Control Office (HAPCO),
USAID, the United Nations Population Fund (UNFPA), the United Kingdom for International
Development (DFID), the United Nations Children’s Fund (UNICEF) and the Centers for Disease
Control and Prevention (CDC). ICF International provided technical assistance through the
MEASURE DHS project. The opinions expressed herein are those of the authors and do not
necessarily reflect the views of USAID.
Additional information about the 2011 EDHS may be obtained from the Central Statistical Agency,
P.O. Box 1143, Addis Ababa, Ethiopia; Telephone: (251) 111 55 30 11/111 15 78 41,
Fax: (251) 111 55 03 34, E-mail: csa@ethionet.et.
Information about the MEASURE DHS project may be obtained from ICF International, 11785
Beltsville Drive, Suite 300, Calverton, MD 20705, USA; Telephone: 301-572-0200,
Fax: 301-572-0999, E-mail: info@measuredhs.com, Internet: http://www.measuredhs.com.
Suggested citation:
Central Statistical Agency [Ethiopia] and ICF International. 2012. EthiopiaDemographicandHealth
Survey 2011. Addis Ababa, Ethiopiaand Calverton, Maryland, USA: Central Statistical Agency and
ICF International.
Contents • iii
CONTENTS
TABLES AND FIGURES ix
FOREWORD xv
ACKNOWLEDGMENTS xvii
MILLENNIUM DEVELOPMENT GOAL INDICATORS xix
CHAPTER 1 INTRODUCTION
1.1 History, Geography, and Economy 1
1.2 Population 3
1.3 Population andHealth Policies 4
1.4 Objectives of the 2011 EDHS Survey 5
1.5 Organization of the Survey 6
1.6 Sample Design 7
1.7. Questionnaires 7
1.8 Listing, Pretest, Main Training, Fieldwork, and Data Processing 8
1.9 Anthropometry, Anaemia, and HIV Testing 10
1.10 Response Rates 11
CHAPTER 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION
2.1 Household Environment 13
2.1.1 Drinking Water 13
2.1.2 Household Sanitation Facilities 15
2.1.3 Housing Characteristics 16
2.1.4 Household Possessions 18
2.2 Wealth Index 19
2.3 Population by Age and Sex 20
2.4 Household Composition 21
2.5 Children’s Living Arrangements and Parental Survival 22
2.6 Education of the Household Population 25
2.6.1 School Attendance by Survivorship of Parents 25
2.6.2 Educational Attainment 26
2.6.3 School Attendance Ratios 28
2.7 Child Labour 31
CHAPTER 3 CHARACTERISTICS OF RESPONDENTS
3.1 Characteristics of Survey Respondents 35
3.2 Educational Attainment by Background Characteristics 37
3.3 Literacy 39
3.4 Exposure to Mass Media 41
3.5 Employment 44
3.6 Occupation 48
3.7 Type Of Women’s Employment 50
3.8 Health Iss
ues 51
3.8.1 Use of Tobacco 51
3.8.2 Alcohol Consumption 52
3.8.3 Chewing Chat 53
3.8.4 Knowledge and Attitudes concerning Tuberculosis 55
iv • Contents
CHAPTER 4 MARRIAGE AND SEXUAL ACTIVITY
4.1 Current Marital Status 59
4.2 Polygyny 60
4.3 Age at First Marriage 62
4.4 Age at First Sexual Intercourse 64
4.5 Recent Sexual Activity 66
CHAPTER 5 FERTILITY LEVELS, TRENDS, AND DIFFERENTIALS
5.1 Current Fertility 69
5.2 Fertility Differentials by Background Characteristics 71
5.3 Fertility Trends 72
5.4 Children Ever Born and Living 73
5.5 Birth Intervals 74
5.6 Postpartum Amenorrhoea, Abstinence, and Insusceptibility 76
5.7 Menopause 77
5.8 Age at First Birth 78
5.9 Teenage Pregnancy and Motherhood 79
CHAPTER 6 FERTILITY PREFERENCES
6.1 Desire for More Children 81
6.2 Desire to Limit Childbearing by Background Characteristics 83
6.3 Ideal Number of Children 86
6.4 Mean Ideal Number of Children by Women’s Background Characteristics 88
6.5 Fertility Planning Status 89
6.6 Wanted Fertility Rates 90
CHAPTER 7 FAMILY PLANNING
7.1 Knowledge of Contraceptive Methods 93
7.2 Current Use of Contraceptive Methods 95
7.2.1 Current Use of Contraceptive Methods By Age 95
7.2.2 Trends in Contraceptive Use 97
7.3 Current Use of Contraception by Background Characteristics 97
7.4 Source of Modern Contraceptive Methods 99
7.5 Informed Choice 99
7.6 Knowledge of the Fertile Period 100
7.7 Need and Demand for Family Planning 101
7.8 Future Use of Contraception 102
7.9 Exposure to Family Planning Messages 102
7.10 Exposure to Specific Type of Family Planning Messages 105
7.11 Contact of Nonusers with F
amily Planning Providers 106
7.12 Contraceptive Discontinuation Rate 108
CHAPTER 8 INFANT AND CHILD MORTALITY
8.1 Data Quality 110
8.2 Levels and Trends in Infant and Child Mortality 111
8.2.1 Early Childhood Mortality Rates 111
8.2.2 Trends in Early Childhood Mortality 111
8.3 Early Childhood Mortality Rates by Socioeconomic Characteristics 112
8.4 Demographic Differentials in Infant and Child Mortality 114
8.5 Perinatal Mortality 115
8.6 High-Risk Fertility Behaviour 117
Contents • v
CHAPTER 9 MATERNAL HEALTH
9.1 Antenatal Care 119
9.1.1 Coverage of Antenatal Care 120
9.1.2 Number of ANC Visits, Timing of First Visit, and Source Where ANC
Was Received 121
9.1.3 Components of Antenatal Care 122
9.1.4 Informed of signs of pregnancy complications during pregnancy 124
9.2 Tetanus Toxoid Injections 124
9.3 Place of Delivery 126
9.4 Assistance during Delivery 127
9.5 Reasons for Not Delivering in a Health Facility 128
9.6 Postnatal Care 129
9.6 Problems in Accessing Health Care 131
CHAPTER 10 CHILD HEALTH
10.1 Child’s Size at Birth 135
10.2 Vaccination Coverage 138
10.2.1 Vaccinations Coverage by Background Characteristics 140
10.3 Trends in Vaccination Coverage 141
10.4 Acute Respiratory Infection 142
10.5 Fever 143
10.6 Diarrhoeal Disease 146
10.6.1 Prevalence of Diarrhoea 146
10.6.2 Treatment of Diarrhoea 148
10.6.3 Feeding Practices during Diarrhoea 150
10.7 Knowledge of ORS Packets 152
10.8 Stool Disposal 153
CHAPTER 11 NUTRITION OF CHILDREN AND ADULTS
11.1 Nutritional Status of Children 156
11.1.1 Measurement of Nutritional Status among Young Children 156
11.1.2 Data Collection 157
11.1.3 Measures of Children’s Nutritional Status 158
11.1.4 Trends
in Children’s Nutritional Status 161
11.2 Breastfeeding and Complementary Feeding 162
11.2.1 Initiation of Breastfeeding 162
11.2.2 Breastfeeding Status by Age 164
11.2.3 Duration of Breastfeeding 168
11.2.4 Types of Complementary Foods 169
11.2.5 Infant and Young Child Feeding (IYCF) Practices 171
11.3 Prevalence of Anaemia in Children 173
11.4 Micronutrient Intake among Children 175
11.5 Iodisation of Household Salt 179
11.6 Nutritional Status of Women and Men 180
11.7 Prevalence of Anaemia in Women 184
11.8 Prevalence of Anaemia in Men 186
11.9 Micronutrient Intake among Mothers 186
vi • Contents
CHAPTER 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR
12.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods 190
12.1.1 Awareness of HIV/AIDS 190
12.1.2 Rejection of Misconceptions about HIV/AIDS 192
12.2 Knowledge of Prevention of Mother-to-Child Transmission of HIV 195
12.3 Attitudes towards People Living with HIV/AIDS 196
12.4 Attitudes towards Refusing to Have Sex and Negotiating Safer Sex 198
12.5 Adult Support for Education about Condoms for Children Age 12 14 200
12.6 Higher-Risk Sex 201
12.6.1 Multiple Partners and Condom Use 201
12.6.2 Transactional Sex 205
12.7 Coverage of HIV Testing 206
12.7.1 General HIV Testing 206
12.7.2 HIV Counseling and Testing During Pregnancy 208
12.8 Male Circumcision 210
12.9 Self-Reporting of Sexually Transmitted Infections 211
12.10 Prevalence of Medical Injections 213
12.11 HIV/AIDS Knowledge and Sexual Behaviour among Youth 215
12.11.1 HIV/AIDS-Related Knowledge among Young Adults 215
12.11.2 Age at First Sexual Intercourse 216
12.11.3 Abstinence and Premarital Sex 219
12.11.4 Multiple Partnerships among Young Adults 221
12.11.5 Age-mixing in Sexual Relationships 222
12.11.6 Recent HIV Testing Among Youth 223
12.12 Use of Alcohol or Chat during Sexual Intercourse 224
12.13 Sharing of HIV Test Results Among Couples 226
12.14 Participation in Community Conversation Programme 227
CHAPTER 13 HIV PREVALENCE
13.1 Coverage Rates for HIV Testing 231
13.2 HIV Prevalence 234
13.2.1 HIV Prevalence by Age and Sex 234
13.2.2 HIV Prevalence by Socioeconomic Characteristics 235
13.2.3 HIV Prevalence by Demographic Characteristics 236
13.2.4 HIV Prevalence by Sexual Risk Behaviour 237
13.3 HIV Prevalence among Youth 238
13.3.1 HIV Prevalence by Sexual Behaviour among Youth 239
13.4 HIV Prevalence by Other Characteristics 240
13.4.1 HIV Prevalence and STIs 240
13.4.2 Prior HIV Testing and Current HIV Status 241
13.4.3 HIV Prevalence by Male Circumcision 241
13.5 HIV Prevalence among Cohabiting Couples 243
Contents • vii
CHAPTER 14 WOMEN’S EMPOWERMENT ANDDEMOGRAPHICANDHEALTH OUTCOMES
14.1 Employment and Form of Earnings 246
14.2 Control Over and Relative Magnitude of Women’s and Husband’s Earnings 247
14.2.1 Control Over Wife’s Earnings 247
14.2.2 Control Over Husband’s Earnings 249
14.3 Control Over Married Women’s Earnings and Relative Size of
Husband’s and Wife’s Earnings 250
14.4 Ownership of Assets 252
14.5 Women’s Participation in Decision-Making 253
14.6 Attitude towards Wife Beating 256
14.7 Women’s Empowerment Indices 259
14.8 Current Use of Contraception by Women’s Status 260
14.9 Ideal Family Size and Unmet Need by Women’s Status 261
14.10 Women’s Status and Reproductive Health Care 262
14.11 Differentials in Infant and Child Mortality by Women’s Status 263
14.12 Men’s Participation in Household Chores 264
14.13 Law Against Domestic Violence 265
CHAPTER 15 ADULT AND MATERNAL MORTALITY
15.1 Assessment of Data Quality 267
15.2 Estimates of Adult Mortality 268
15.3 Estimates of Maternal Mortality 270
REFERENCES 273
APPENDIX A SAMPLE IMPLEMENTATION 275
APPENDIX B ESTIMATES OF SAMPLING ERRORS 287
APPENDIX C DATA QUALITY TABLES 307
APPENDIX D PERSONS INVOLVED IN THE 2011ETHIOPIADEMOGRAPHIC
AND HEALTHSURVEY 317
APPENDIX E QUESTIONNAIRES 327
[...]... 100 (CSA, 2010) Ethiopia has made an effort to generate reliable demographic data by conducting a number of surveys These include the 1981 Demographic Survey, the 1990 National Family and Fertility Survey (NFFS), the 1995 Fertility Survey of Urban Addis Ababa, and the 2000, 2005, and2011EthiopiaDemographic and Health Surveys (EDHS) The 1990 NFFS was the first nationally representative survey to yield... population andhealth that are comparable to data collected in similar surveys in other developing countries and to Ethiopia s two previous DHS surveys, conducted in 2000 and 2005 Data collected in the 2011 EDHS add to the large and growing international database of demographicandhealth indicators 1.5 ORGANIZATION OF THE SURVEY The 2011 EDHS was carried out under the aegis of the Ministry of Health (MOH) and. .. the third Demographic and HealthSurvey (DHS) conducted in Ethiopia, under the worldwide MEASURE DHS project, a USAID-funded project providing support and technical assistance in the implementation of population andhealth surveys in countries worldwide The three EDHS surveys have been conducted at five-year intervals since 2000, and the 2011 EDHS is the second survey presenting results on HIV and anemia... for sampling errors, Ethiopia2011 290 Sampling errors for national sample, Ethiopia2011 291 Sampling errors for urban sample, Ethiopia2011 292 Sampling errors for rural sample, Ethiopia2011 293 Sampling errors for Tigray region, Ethiopia2011 .294 Sampling errors for Affar region, Ethiopia2011 295 Sampling errors for Amhara region, Ethiopia2011 296 Sampling... principal objective of the 2011EthiopiaDemographic and HealthSurvey (EDHS) is to provide current and reliable data on fertility and family planning behaviour, child mortality, adult and maternal mortality, children’s nutritional status, use of maternal and child health services, knowledge of HIV/AIDS, and prevalence of HIV/AIDS and anaemia The specific objectives are these: • Collect data at the national... Oromiya region, Ethiopia2011 297 Sampling errors for Somali region, Ethiopia2011 298 Sampling errors for Benishangul-Gumuz region, Ethiopia2011 299 Sampling errors for SNNP region, Ethiopia2011 .300 Sampling errors for Gambela region, Ethiopia2011 .301 Sampling errors for Harari region, Ethiopia2011 .302 Sampling errors for Addis Ababa region, Ethiopia2011 303... Key Findings • The 2011EthiopiaDemographic and HealthSurvey (EDHS) is a nationally representative survey of 16,515 women age 15-49 and 14,110 men age 15-59 • The 2011 EDHS is the third comprehensive survey conducted in Ethiopia as part of the worldwide Demographic and Health Surveys project • The primary purpose of the EDHS is to furnish policymakers and planners with detailed information on fertility,... include: democratisation and decentralisation of the health care system; development of the preventive and curative components of health care; ensuring accessibility of health care for all segments of the population; and, promotion of private sector and NGO participation in the health sector The HSDP prioritizes maternal and newborn care, and child health, and aims to halt and reverse the spread of... planning, contraceptive use, and related topics In addition to the topics covered by the NFFS, the 2000, 2005, and2011 EDHS surveys collected information on maternal and child health, nutrition and breastfeeding practices, and HIV and other sexually transmitted diseases 1.3 POPULATION ANDHEALTH POLICIES National Population Policy Population policies had low priority in Ethiopia until the early 1990s... monitoring, and evaluation of programmes on health in general and reproductive health in particular at both the national and regional levels A long-term objective of the survey is to strengthen the technical capacity of the Central Statistical Agency to plan, conduct, process, and analyse data from complex national population andhealth surveys Moreover, the 2011 EDHS provides national and regional . Ethiopia
2011
Demographic and
Health Survey
Ethiopia 2011 Demographic and Health Survey
Ethiopia
Demographic and
Health Survey
2011
. Agency [Ethiopia] and ICF International. 2012. Ethiopia Demographic and Health
Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central