Malawi 2015-16

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FERTILITY PREFERENCES 6 Key Findings Desire for another child: Ten percent of currently married women age 15-49 want to have another child soon and 33% want to wait at least 2 years before having another child. Limiting childbearing: Women are more likely than men to want no more children, no matter how many children they have. Overall, 49% of women and 43% of men age 15-49 do not want another child. Ideal family size: Both women and men report 3.7 children as their ideal family size. Unwanted births: Of all the births in the past 5 years and current pregnancies, 59% were wanted at the time of conception, 30% were mistimed, and 11% were not wanted. Wanted fertility: The total wanted fertility rate (3.4) is lower than the actual fertility rate (4.4). On average, women in <strong>Malawi</strong> are currently having one child more than they want. I nformation on fertility preferences can help family planning program planners assess the desire for children, the extent of mistimed and unwanted pregnancies, and the demand for contraception that spaces or limits births. This information may suggest the direction of fertility patterns in the future. This chapter presents information on whether and when married women and men want more children, ideal family size, whether the last birth was wanted at that time, and the theoretical fertility rate if all unwanted births were prevented. 6.1 DESIRE FOR ANOTHER CHILD Desire for another child Women and men were asked whether they wanted more children and, if so, how long they would prefer to wait before the next child. Women and men who are sterilised are assumed not to want any more children. Sample: Currently married women and men age 15-49 Four in ten currently married women age 15-49 want to have another child; 10% want to have another child soon and 33% want to wait at least 2 years before having another child (Table 6.1). Most other women want to limit childbearing: 38% want no more children and 11% are sterilised. Of currently married men age 15-49, 12% want to have another child soon, 40% want to wait at least 2 years before having another child, 41% want no more children, and 2% are sterilised. Fertility Preferences • 83
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Malawi Demographic and Health Surve
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The 2015-16 Malawi Demographic and
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4.3 Age at First Marriage .........
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13.9.1 Knowledge ..................
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TABLES AND FIGURES 1 INTRODUCTION A
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6 FERTILITY PREFERENCES ...........
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11 NUTRITION OF CHILDREN AND WOMEN
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Figure 14.1 HIV prevalence by age .
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Table A-3.8.1 Type of earnings: Wom
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Table A-16.9.1 Women’s participat
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FOREWORD T he 2016-16 Malawi Demogr
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LA LAM LLIN LPG MAD MDHS MICS PPHC
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Table 3.4.1 Exposure to mass media:
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Example 2: Prevalence and Treatment
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Example 3: Understanding Sampling W
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xxxii • Map of Malawi
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The information collected in the 20
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ecorded on the Biomarker Questionna
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1.5 PRETEST The pretest for the 201
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HOUSING CHARACTERISTICS AND 2 HOUSE
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About half of Malawian households (
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A total of 117,177 individuals stay
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Patterns by background characterist
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school. The attendance rate decline
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Table 2.3 Household sanitation faci
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Table 2.5 Wealth quintiles Percent
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Table 2.9 Household composition Per
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Table 2.11 Children’s living arra
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Table 2.12.2 Educational attainment
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Table 2.14.1 Child functioning and
Page 65 and 66: CHARACTERISTICS OF RESPONDENTS 3 Ke
Page 67 and 68: • Women and men living in urban a
Page 69 and 70: Women and men are most commonly emp
Page 71 and 72: Table 3.1 Background characteristic
Page 73 and 74: Table 3.3.1 Literacy: Women Percent
Page 75 and 76: Table 3.5.1 Internet usage: Women P
Page 77 and 78: Table 3.6.1 Employment status: Wome
Page 79 and 80: Table 3.7.1 Occupation: Women Perce
Page 81 and 82: Table 3.8 Type of employment: Women
Page 83 and 84: Table 3.10.1 Tobacco smoking: Women
Page 85 and 86: Table 3.11 Average number of cigare
Page 87: Table 3.13.2 Knowledge and attitude
Page 90 and 91: Figure 4.1 Marital status Percent d
Page 92 and 93: marriage. The median age at first i
Page 94 and 95: Table 4.1 Current marital status Pe
Page 96 and 97: Table 4.3 Age at first marriage Per
Page 98 and 99: Table 4.5 Age at first sexual inter
Page 100 and 101: Table 4.7.1 Recent sexual activity:
Page 103 and 104: FERTILITY 5 Key Findings Total
Page 105 and 106: 5.3 BIRTH INTERVALS Median birth in
Page 107 and 108: 5.5 AGE AT FIRST BIRTH Median age a
Page 109 and 110: LIST OF TABLES For more information
Page 111 and 112: Table 5.3.1 Trends in age-specific
Page 113 and 114: Table 5.6 Postpartum amenorrhea, ab
Page 115: Table 5.10 Median age at first birt
Page 119 and 120: Patterns by background characterist
Page 121 and 122: • The gap between wanted and actu
Page 123 and 124: Table 6.2.1 Desire to limit childbe
Page 125 and 126: Table 6.4 Mean ideal number of chil
Page 127 and 128: FAMILY PLANNING 7 Key Findings
Page 129 and 130: Patterns by background characterist
Page 131 and 132: 7.4 DISCONTINUATION OF CONTRACEPTIV
Page 133 and 134: • Unmet need for family planning
Page 135 and 136: Table 7.1 Knowledge of contraceptiv
Page 137 and 138: Table 7.5 Source of modern contrace
Page 139 and 140: Table 7.9 Reasons for discontinuati
Page 141 and 142: Table 7.12.2 Need and demand for fa
Page 143 and 144: Table 7.15 Exposure to family plann
Page 145 and 146: INFANT AND CHILD MORTALITY 8 Key Fi
Page 147 and 148: • Under-5 mortality declines with
Page 149 and 150: Table 8.1 Early childhood mortality
Page 151 and 152: Table 8.4 Perinatal mortality Numbe
Page 153 and 154: MATERNAL HEALTH CARE 9 Key Findings
Page 155 and 156: 9.2 COMPONENTS OF ANC VISITS Pregna
Page 157 and 158: 9.4.2 Skilled Assistance during Del
Page 159 and 160: • Mothers with more than a second
Page 161 and 162: Table 9.1 Antenatal care Percent di
Page 163 and 164: Table 9.4 Tetanus toxoid injections
Page 165 and 166: Table 9.6 Assistance during deliver
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Table 9.9 Timing of first postnatal
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Table 9.11 Timing of first postnata
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Table 9.13 Content of postnatal car
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Table 9.15 Prevalence of obstetric
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CHILD HEALTH 10 Key Findings • Va
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vaccine (81%). Although more childr
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10.5 DIARRHOEAL DISEASE 10.5.1 Prev
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10.5.5 Treatment of Childhood Illne
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Table 10.2 Vaccinations by source o
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Table 10.4 Possession and observati
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Table 10.6 Prevalence and treatment
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Table 10.8 Feeding practices during
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Table 10.10 Knowledge of ORS packet
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NUTRITION OF CHILDREN AND WOMEN 11
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shift in the entire sample populati
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Table 11.3 and Figure 11.3 show bre
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Minimum acceptable diet Proportion
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11.5 MICRONUTRIENT INTAKE AND SUPPL
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Trends: Anaemia prevalence among wo
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Table 11.2 Initial breastfeeding Am
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Table 11.4 Median duration of breas
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Table 11.6 Minimum acceptable diet
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Table 11.8 Presence of iodised salt
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Table 11.10 Therapeutic and supplem
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Table 11.12 Prevalence of anaemia i
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MALARIA 12 Key Findings Ownership
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Trends: The percentage of household
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12.4 USE OF ITNS BY CHILDREN AND PR
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treatment for children with fever;
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Table 12.1 Household possession of
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Table 12.5 Access to an ITN Percent
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Table 12.9 Use of mosquito nets by
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Table 12.12 Source of advice or tre
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Table 12.14 Haemoglobin
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2015 Spectrum model estimated that
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Trends: The percentage of women who
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Eighteen percent of men have ever p
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Trends: The percentage of men circu
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13.9.2 First Sex Young people who i
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13.9.5 Coverage of HIV Testing Serv
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Table 13.2 Comprehensive knowledge
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Table 13.5.1 Multiple sexual partne
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Table 13.6 Payment for sexual inter
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Table 13.7.2 Coverage of prior HIV
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Table 13.9 Male circumcision Percen
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Table 13.11 Comprehensive knowledge
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Table 13.14.1 Multiple sexual partn
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Table 13.15 Recent HIV tests among
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Trends: Participation in HIV testin
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• HIV prevalence is highest in th
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LIST OF TABLES For more information
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Table 14.2 Coverage of HIV testing
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Table 14.4 HIV prevalence according
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Table 14.12 HIV prevalence among co
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and dead siblings reported by the r
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• The maternal mortality ratio (M
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Table 15.4 Maternal mortality Direc
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16.1 MARRIED WOMEN’S AND MEN’S
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16.4 WOMEN’S CONTROL OVER THEIR O
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Overall, use of bank accounts and o
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Sixteen percent of women and 13% of
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16.13 WOMEN’S EMPOWERMENT INDICAT
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Table 16.1 Employment and cash earn
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Table 16.2.2 Control over men’s c
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Table 16.5.1 Ownership of title or
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Table 16.6.1 Ownership of title or
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Table 16.8 Participation in decisio
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Table 16.10.1 Attitude toward wife
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Table 16.11 Attitudes toward negoti
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Table 16.14 Current use of contrace
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DOMESTIC VIOLENCE 17 Key Findings
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17.2 WOMEN’S EXPERIENCE OF PHYSIC
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• Women’s experience of sexual
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or sexual violence by their current
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17.7 INJURIES TO WOMEN DUE TO SPOUS
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help, the most common is the police
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Table 17.2 Experience of violence d
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Table 17.4 Experience of sexual vio
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Table 17.8 Marital control exercise
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Table 17.10 Spousal violence accord
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Table 17.12 Physical or sexual viol
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Table 17.15 Violence by women again
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Table 17.17 Help seeking to stop vi
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REFERENCES Centers for Disease Cont
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DISTRICT TABLES Appendix A CHAPTER
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Table A-2.4 Household access to ele
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Table A-2.10.1 Birth registration o
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Table A-2.12.1 Educational attainme
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CHAPTER 3 CHARACTERISTICS OF RESPON
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Table A-3.2.2 Educational attainmen
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Table A-3.3.2 Literacy: Men by dist
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Table A-3.4.2 Exposure to mass medi
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Table A-3.5.2 Internet usage: Men b
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Table A-3.6.2 Employment status: Me
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Table A-3.7.2 Occupation: Men by di
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Table A-3.8.2 Type of employer: Wom
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Table A-3.10.2 Tobacco smoking: Men
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Table A-3.13.2 Knowledge and attitu
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Table A-4.2.2 Number of men’s wiv
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Table A-4.6 Median age at first sex
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Table A-4.7.2 Recent sexual activit
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Table A-5.5 Birth intervals: Distri
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Table A-5.11 Teenage pregnancy and
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Table A-6.6 Wanted fertility rates:
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Table A-7.12.1 Need and demand for
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Table A-7.15 Exposure to family pla
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CHAPTER 8 INFANT AND CHILD MORTALIT
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Table A-9.3 Components of antenatal
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Table A-9.5 Place of delivery: Dist
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Table A-9.7 Caesarean section: Dist
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Table A-9.10 Type of provider of fi
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Table A-9.12 Type of provider of fi
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Table A-9.14 Pregnancy outcomes: Di
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Table A-9.16 Problems in accessing
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Table A-10.3 Vaccinations: District
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Table A-10.5 Prevalence of ARI: Dis
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Table A-10.7 Prevalence and treatme
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Table A-10.9 Oral rehydration thera
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Table A-10.11 Disposal of children
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Table A-11.1—Continued Height-for
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Table A-11.6 Minimum acceptable die
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Table A-11.8 Presence of iodized sa
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Table A-11.10 Therapeutic and suppl
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Table A-11.12 Prevalence of anaemia
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CHAPTER 12 MALARIA Table A-12.1 Hou
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Table A-12.3 Indoor residual sprayi
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Table A-12.7 Use of existing ITNs:
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Table A-12.9 Use of mosquito nets b
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Table A-12.11 Prevalence, diagnosis
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CHAPTER 13 HIV/AIDS-RELATED KNOWLED
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Table A-13.5.1 Multiple sexual part
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Table A-13.6 Payment for sexual int
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Table A-13.7.2 Coverage of prior HI
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Table A-13.9 Male circumcision: Dis
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Table A-13.11 Comprehensive knowled
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Table A-13.13 Premarital sexual int
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Table A-13.14.2 Multiple sexual par
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Table A-14.1—Continued DBS Tested
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CHAPTER 15 ADULT AND MATERNAL MORTA
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Table A-16.2.2 Control over men’s
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Table A-16.4.2 Ownership of assets;
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Table A-16.5.2 Ownership of title o
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Table A-16.6.2 Ownership of title o
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Table A-16.7.2 Ownership and use of
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Table A-16.9.2 Men’s participatio
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Table A-16.10.2 Attitude toward wif
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Table A-16.12 Ability to negotiate
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Table A-17.2 Experience of violence
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Table A-17.8 Marital control exerci
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Table A-17.12 Physical or sexual vi
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Table A-17.17 Help seeking to stop
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urban EAs are larger, with an avera
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women’s and men’s weights. The
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Table B.2 Enumeration areas and hou
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Table B.5 Sample implementation: Wo
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Table B.7 Coverage of HIV testing b
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Table B.9 Coverage of HIV testing b
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ESTIMATES OF SAMPLING ERRORS Append
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For the total sample, the value of
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Table C.3 Sampling errors: Urban sa
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Table C.5 Sampling errors: Northern
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Table C.7 Sampling errors: Southern
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Table C.9 Sampling errors: Karonga
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Table C.11 Sampling errors: Rumphi
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Table C.13 Sampling errors: Likoma
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Table C.15 Sampling errors: Nkhota
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Table C.17 Sampling errors: Dowa sa
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Table C.19 Sampling errors: Lilongw
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Table C.21 Sampling errors: Dedza s
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Table C.23 Sampling errors: Mangoch
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Table C.25 Sampling errors: Zomba s
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Table C.27 Sampling errors: Blantyr
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Table C.29 Sampling errors: Thyolo
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Table C.31 Sampling errors: Phalomb
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Table C.33 Sampling errors: Nsanje
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Table C.35 Sampling errors: Neno sa
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DATA QUALITY TABLES Appendix D Tabl
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Table D.3 Completeness of reporting
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Table D.6 Reporting of age at death
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Table D.8 Sibship size and sex rati
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Laboratory Technologists—Communit
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Field Editors Shaina Chaula Mtisung
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QUESTIONNAIRES Appendix F Appendix
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510 • Appendix F THIS PAGE IS INT
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HOUSEHOLD SCHEDULE IF AGE 15 OR OLD
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HOUSEHOLD SCHEDULE IF AGE 15 OR OLD
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SELECTION OF WOMAN FOR THE DOMESTIC
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HOUSEHOLD CHARACTERISTICS NO. QUEST
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HOUSEHOLD CHARACTERISTICS NO. QUEST
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NET #1 MOSQUITO NETS NET #2 NET #3
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ADDITIONAL HOUSEHOLD CHARACTERISTIC
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CHILD FUNCTIONING AND DISABILITY (A
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CHILD 1 CHILD 2 303 LINE NUMBER FRO
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CHILD 3 CHILD 4 303 LINE NUMBER FRO
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ELIGIBILITY AND CONSENT FOR THE MIC
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534 • Appendix F
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WEIGHT, HEIGHT AND HEMOGLOBIN MEASU
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WEIGHT, HEIGHT AND HEMOGLOBIN MEASU
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WEIGHT, HEIGHT, HEMOGLOBIN MEASUREM
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FIELDWORKER'S OBSERVATIONS TO BE FI
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INTRODUCTION AND CONSENT Hello. My
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SECTION 1. RESPONDENT'S BACKGROUND
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212 213 214 215 216 217 218 219 220
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SECTION 2. REPRODUCTION NO. QUESTIO
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SECTION 3. CONTRACEPTION NO. QUESTI
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SECTION 3. CONTRACEPTION 311 CHECK
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SECTION 4. PREGNANCY AND POSTNATAL
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SECTION 5A. CHILD IMMUNIZATION (LAS
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SECTION 5A. CHILD IMMUNIZATION (LAS
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SECTION 5B. CHILD IMMUNIZATION (NEX
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SECTION 5B. CHILD IMMUNIZATION (NEX
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SECTION 6. CHILD HEALTH AND NUTRITI
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SECTION 7. MARRIAGE AND SEXUAL ACTI
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SECTION 8. FERTILITY PREFERENCES NO
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SECTION 9. HUSBAND'S BACKGROUND AND
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SECTION 9. HUSBAND'S BACKGROUND AND
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SECTION 10. HIV/AIDS NO. QUESTIONS
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SECTION 11. OTHER HEALTH ISSUES NO.
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NO. 1201 SECTION 12. MATERNAL MORTA
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SECTION 13. DOMESTIC VIOLENCE MODUL
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INTERVIEWER'S OBSERVATIONS TO BE FI
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630 • Appendix F
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INTRODUCTION AND CONSENT Hello. My
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SECTION 1. RESPONDENT'S BACKGROUND
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SECTION 5. FERTILITY PREFERENCES NO
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SECTION 6. EMPLOYMENT AND GENDER RO
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NO. SECTION 7. HIV/AIDS QUESTIONS A
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SECTION 7. HIV/AIDS NO. QUESTIONS A
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656 • Appendix F
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NO. QUESTIONS AND FILTERS CODING CA
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