Malawi 2015-16

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HIV/AIDS-RELATED KNOWLEDGE, 13 ATTITUDES, AND BEHAVIOUR Key Findings • Knowledge about HIV transmission and prevention: Forty-two percent of women and 48% of men have comprehensive knowledge about the modes of HIV transmission and prevention; this is only a slight increase from 2010. • Knowledge of mother-to-child transmission of HIV: Seventy-six percent of women and 72% of men know that HIV can be transmitted during pregnancy, 81% of women and 82% of men know that HIV can be transmitted during labour, and 87% of women and 88% of men know that HIV can be transmitted during breastfeeding. • Discriminatory attitudes: Nine percent of women and 6% of men thought that children living with HIV should not be able to attend school with children who are HIV negative; 16% of women and 12% of men would not buy fresh vegetables from a shopkeeper who has HIV. • Sexual partners: One percent of women reported having more than one sexual partner in the past 12 months; however, only 27% reported using a condom during the last sexual intercourse. Thirteen percent of men reported having more than one sexual partner in the past 12 months. Of those, 30% reported using a condom during the last sexual intercourse. • Coverage of HIV tests: The vast majority of women (95%) and men (96%) know where to obtain an HIV test, but women are more likely than men to have ever been tested for HIV (83% versus 70%). However, in 12 months before the survey, about the same proportion of women and men had been tested for HIV (44% of women versus 42% of men). T he Joint United Nations Programme on HIV/AIDS in its 2015 HIV and AIDS estimates stated that there were 980,000 adults and children living with HIV in Malawi 1 . The Malawi government has been at the forefront of developing and implementing innovative public health strategies that address the HIV/AIDS epidemic. Beyond designing and being the first to implement Option B+, Malawi is also the first country to include Test-and-Start and the 90-90-90 objectives for epidemic control within its National Strategic Plan. Malawi initiated Test-and-Start in mid-2016, and has consistently adopted aggressive strategies in its HIV programming that has moved the country closer to epidemic control. The 1 Figures are based on 2015 UNAIDS estimates. HIV/AIDS-related Knowledge, Attitudes, and Behaviour • 201
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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
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CHARACTERISTICS OF RESPONDENTS 3 Ke
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• Women and men living in urban a
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Women and men are most commonly emp
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Table 3.1 Background characteristic
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Table 3.3.1 Literacy: Women Percent
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Table 3.5.1 Internet usage: Women P
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Table 3.6.1 Employment status: Wome
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Table 3.7.1 Occupation: Women Perce
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Table 3.8 Type of employment: Women
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Table 3.10.1 Tobacco smoking: Women
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Table 3.11 Average number of cigare
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Table 3.13.2 Knowledge and attitude
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Figure 4.1 Marital status Percent d
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marriage. The median age at first i
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Table 4.1 Current marital status Pe
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Table 4.3 Age at first marriage Per
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Table 4.5 Age at first sexual inter
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Table 4.7.1 Recent sexual activity:
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FERTILITY 5 Key Findings Total
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5.3 BIRTH INTERVALS Median birth in
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5.5 AGE AT FIRST BIRTH Median age a
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LIST OF TABLES For more information
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Table 5.3.1 Trends in age-specific
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Table 5.6 Postpartum amenorrhea, ab
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Table 5.10 Median age at first birt
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Trends: The percentage of currently
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Trends: Since 1992, the proportion
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Table 6.1 Fertility preferences by
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Table 6.3 Ideal number of children
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Table 6.5 Fertility planning status
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Overall, the contraceptive prevalen
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Nearly 8 in 10 (79%) of all modern
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Seventy-eight percent of currently
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the survey (Table 7.16). Ten percen
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Table 7.3 Current use of contracept
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Table 7.7 Informed choice Among cur
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Table 7.12.1 Need and demand for fa
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Table 7.13 Decision-making about fa
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Table 7.16 Contact of nonusers with
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• Any method of measuring childho
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Table 8.3 Early childhood mortality
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Table 8.5 High-risk fertility behav
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9.1 ANTENATAL CARE COVERAGE AND CON
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Trends: Since 1992, the rates of C-
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9.7 PROBLEMS IN ACCESSING HEALTH CA
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Table 9.3 Components of antenatal c
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Table 9.5 Place of delivery Percent
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Table 9.7 Caesarean section Percent
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Table 9.10 Type of provider of firs
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Table 9.12 Type of provider of firs
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Table 9.14 Pregnancy outcomes Perce
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Table 9.16 Problems in accessing he
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childhood death. In the 2015-16 MDH
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• Vaccination coverage generally
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of giving the same or more food to
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Table 10.1 Child’s size and weigh
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Page 186 and 187: Table 10.5 Prevalence and treatment
Page 188 and 189: Table 10.7 Prevalence and treatment
Page 190 and 191: Table 10.9 Oral rehydration therapy
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Page 196 and 197: 11.2 INFANT AND YOUNG CHILD FEEDING
Page 198 and 199: have shown that plant-based complem
Page 200 and 201: 11.3 ANAEMIA PREVALENCE IN CHILDREN
Page 202 and 203: Information on BMI is presented in
Page 204 and 205: Table 11.1 Nutritional status of ch
Page 206 and 207: Table 11.3 Breastfeeding status acc
Page 208 and 209: Table 11.5 Foods and liquids consum
Page 210 and 211: Table 11.7 Prevalence of anaemia in
Page 212 and 213: Table 11.9 Micronutrient intake amo
Page 214 and 215: Table 11.11 Nutritional status of w
Page 216 and 217: Table 11.13 Micronutrient intake am
Page 218 and 219: The ownership and use of both treat
Page 220 and 221: 12.3 HOUSEHOLD ACCESS AND USE OF IT
Page 222 and 223: SP during routine ANC visits. Follo
Page 224 and 225: Trends: The percentage of children
Page 226 and 227: Table 12.3 Indoor residual spraying
Page 228 and 229: Table 12.7 Use of existing ITNs Per
Page 230 and 231: Table 12.11 Prevalence, diagnosis,
Page 232 and 233: Table 12.13 Type of antimalarial dr
Page 236 and 237: 2015 Spectrum model estimated that
Page 238 and 239: Trends: The percentage of women who
Page 240 and 241: Eighteen percent of men have ever p
Page 242 and 243: Trends: The percentage of men circu
Page 244 and 245: 13.9.2 First Sex Young people who i
Page 246 and 247: 13.9.5 Coverage of HIV Testing Serv
Page 248 and 249: Table 13.2 Comprehensive knowledge
Page 250 and 251: Table 13.5.1 Multiple sexual partne
Page 252 and 253: Table 13.6 Payment for sexual inter
Page 254 and 255: Table 13.7.2 Coverage of prior HIV
Page 256 and 257: Table 13.9 Male circumcision Percen
Page 258 and 259: Table 13.11 Comprehensive knowledge
Page 260 and 261: Table 13.14.1 Multiple sexual partn
Page 262 and 263: Table 13.15 Recent HIV tests among
Page 264 and 265: Trends: Participation in HIV testin
Page 266 and 267: • HIV prevalence is highest in th
Page 268 and 269: LIST OF TABLES For more information
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Page 272 and 273: Table 14.4 HIV prevalence according
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Page 282 and 283: • 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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