Key Preliminary Findings

2003-2004 Madagascar Demographic and Health SurveyDDSS/INSTAT, ORC Macro

Key Key Preliminary Preliminary FindingsFindings

2003-2004 Madagascar DHS 2003-2004 Madagascar DHS


IntroductionIntroductionThe 2003-2004 Madagascar DHS (MDHS) is the 3rd in a series (1992, 1997).The MDHS was conducted by the Direction de la Démographie et des Statistiques Sociales at INSTAT, in partnership with the Ministère de la Santé et du Planning Familial. ORC Macro provided technical support.The MDHS was funded by the World Bank, UNICEF, UNFPA and USAID/Madagascar.The 2003-2004 MDHS provides estimates on key indicators, including fertility, MCH, STIs and AIDS awareness. New features include the implementation of 4 biomarkers (tetanus, measles, syphilis and anemia).


2003-2004 MDHS Sample2003-2004 MDHS Sample

• Nationally representative survey of >8,400

households:

– Close to 8,000 women age 15-49

– Close to 2,700 men age 15-59

• Biological testing (“biomarkers”) was

implemented for a sub-sample of the population

for tetanus, measles, syphilis and anemia


Training consisted of interviewing techniques, field procedures, questionnaire review, and mock interviews in classroom and field as well as an anthropometric measurement practice.

Fieldwork: 11/23/2003 to 03/28/2004.

11 teams went in the field, each comprised of 2 nurses (for 4 biomarkers).

Training and FieldworkTraining and Fieldwork


Households SelectedHouseholds Selected Households Interviewed Response rate (%)

9,2959,2958,420 98%

Eligible WomenEligible Women Women Interviewed Response rate (%)

8,3378,3377,949 95%

Eligible MenEligible Men Men Interviewed Response rate (%)

2,6852,6852,432 91%

Response RatesResponse Rates


KEY FINDINGS

2003-2004 Madagascar Demographic and Health Survey

KEY FINDINGS

2003-2004 Madagascar Demographic and Health Survey

Photo courtesy of Freedom From Hunger


FERTILITYFERTILITY



Trends in Total Fertility Rates*Trends in Total Fertility Rates*

6.1 6.0

5.2

1992 1997 2003-2004

*Per 1,000 women; refer to the 5-year period preceding the survey, except for 2003-2004 which is for 3 years


4,0 – 4,95,0 – 5,96,0 – 6,9ANTSI

MA

A/RIVOTOA

FI

TOL

5.2 births

National average: 5.2 births

Varies from 4.2 births in Antananarivo to 6.3 births in Toliara.

How does fertility* vary by province?How does fertility* vary by province?

*TFR for women age 15-49


2.9

4.4

4.9

5.0

5.2

5.5

5.6

5.7

5.9

5.9

6.2

6.3

6.9

7.5

South Africa 1998

Ghana 2003

Kenya 2003

Cameroon 2004*

MADAGASCAR 2003-04*

Mozambique 2003

Tanzania 1999

Nigeria 2003

Ethiopia 2000

Zambia 2001-02

Burkina Faso 2003

Malawi 2000

Uganda 2001

Niger 1998

Total Fertility Rate:A Cross-national Comparison

Total Fertility Rate:A Cross-national Comparison

*Based on preliminary findings


15 – 19%20 – 39%40 – 59%ANTSI

MA

A/RIVOTOA

FI

TOL

34%

Nationally, 34% of women age 15-19 are either already mothers (28%) or pregnant with their 1st child (6%)

Varies from 19% in Antananarivo to 56% in Mahajanga.

How does teenage pregnancy vary by province?How does teenage pregnancy vary by province?


16.8

18.5

16.9

18.6

17.4

19.1

Age at first sexual intercourse Age at first union

1992 1997 2003-2004

Years

Trends in Fertility DeterminantsTrends in Fertility Determinants


FAMILY PLANNINGFAMILY PLANNING

Photo courtesy of Photoshare


5

16

3

10

18

7

18

27

16

Madagascar Urban Rural

1992 1997 2003-2004

Percent

Trends in Use of Modern Methods Trends in Use of Modern Methods


10 – 14%15 – 19%20 – 29%ANTSI

MA

A/RIVOTOA

FI

TOL

18%

Nationally, 18% of women age 15-49 use a modern method of contraception.

Modern use varies from 11% in Mahajanga to 27% in Antananarivo.

How does modern use vary by province?How does modern use vary by province?


Use of Modern Contraception:A Cross-national Comparison

Use of Modern Contraception:A Cross-national Comparison

5

6

8

9

12

13

17

18

18

19

23

26

32

55

Niger 1998

Ethiopia 2000

Nigeria 2003

Burkina Faso 2003

Mozambique 2003

Cameroon 2004*

Tanzania 1999

MADAGASCAR 2003-04*

Uganda 2001

Ghana 2003

Zambia 2001-02

Malawi 2000

Kenya 2003

South Africa 1998



FERTILITY PREFERENCESFERTILITY PREFERENCES



3.5 – 3.94.0 – 4.95.0 – 5.9ANTSI

MA

A/RIVOTOA

FI

TOL

4.7

Nationally, women would like to have an average of 4.7 births.

Desired fertility varies from 3.7 births in Antananarivo to 5.7 in Toliara.

How does desired fertility vary by province?How does desired fertility vary by province?


MATERNITY CAREMATERNITY CARE



Medical assistance from a doctor or nurse/midwife at delivery varies from 38% in Toamasina and Toliara to 66% in Antananarivo.

How does medical assistance at delivery vary by province?

How does medical assistance at delivery vary by province?35 – 39%40 – 49%50 – 69%ANTSI

MA

A/RIVOTOA

FI

TOL

For the 5-year preceding the survey

51%


Medical Assistance at Delivery: A Cross-national Comparison

Medical Assistance at Delivery: A Cross-national Comparison

84

62

57

56

51

48

47

44

43

42

39

36

36

6

South Africa 1998

Cameroon 2004*

Burkina Faso 2003

Malawi 2000

MADAGASCAR 2003-04*

Mozambique 2003

Ghana 2003

Niger 1998

Zambia 2001-02

Kenya 2003

Uganda 2001

Nigeria 2003

Tanzania 1999

Ethiopia 2000



CHILD HEALTH AND NUTRITIONCHILD HEALTH AND NUTRITION



Trends in Initial Breastfeeding (within 1 hour after birth)

Trends in Initial Breastfeeding (within 1 hour after birth)

6

34

62

1992 1997 2003-2004

Percent


Trends in Exclusive Breastfeeding (children under 6 months)

Trends in Exclusive Breastfeeding (children under 6 months)

35

48

67

1992 1997 2003-2004

Percent


75

54 54 54

43

20

66

48 48 46

36

20

72

61 6359

53

21

BCG DPT3 Polio 3 Measles All vaccinations

None

1992 1997 2003-2004

Percent

*For children age 12-23 months, at any time before the survey

Trends in Vaccination Coverage Trends in Vaccination Coverage


Full Immunization:A Cross-national Comparison

Full Immunization:A Cross-national Comparison

7070

69

68

63

63

57

53

48

44

37

18

1413

Zambia 2001-02

Malawi 2000

Ghana 2003

Tanzania 1999

South Africa 1998

Mozambique 2003

Kenya 2003

MADAGASCAR 2003-04*

Cameroon 2004*

Burkina Faso 2003

Uganda 2001

Niger 1998

Ethiopia 2000

Nigeria 2003



Prevalence of diarrhea: reduced by half since 1997 Among those with diarrhoea, 42% received either ORS or especially a homemade solution (twice what was recorded in 1997).

Prevalence of children with ARI: reduced by more than half since 1997 (from 24% to 11%).

Prevalence of children with fever: from 32% to 27% since 1997.Of all children with ARI and/or fever, 44% were taken to a health facility/provider.

Prevalence and Treatment for Diarrhoea, ARI and Fever

Prevalence and Treatment for Diarrhoea, ARI and Fever


Supplementation of Vitamin A varies from 70% in Mahajanga to 83% in Antananarivo.

In comparison, 4% of women said their children had received a Vitamin A supplement in 1997.

How does vitamin A supplementation vary by province?

How does vitamin A supplementation vary by province?

70 – 74%75 – 79%80 – 84%ANTSI

MA

A/RIVOTOA

FI

TOL

76%

Documents

Key Preliminary Findings