Malawi 2015-16

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13.9.2 First Sex Young people who initiate sex at an early age are typically at higher risk of becoming pregnant or contracting an STI than young people who initiate sex at a later age. Consistent condom use can reduce such risks. Table 13.12 provides information on the percentage of young women and men who have had sexual intercourse before the ages of 15 and 18 among those who have had sexual intercourse. Overall, a slightly higher percentage of young men reported having sex before the age of 15 (19%) compared with young women (14%). The reverse is observed when assessing young people who have had sex before the age of 18. Among young women, 59% reported having sex before the age of 18 compared with 53% of young men (Table 13.12). Trends: Overall, the percentage of young people age 15-24 who have had sex by age 15 has decreased only slightly between 2000 and 2015-16 for both women (from 17% to 14%) and men (from 25% to 19%). The percentage of young people age 18-24 who have had sex by age 18 has decreased only slightly from 2000 to 2015-16, from 64% to 59% among young women and from 58% to 53% among young men. Generally, the percentage of young men who have had sex by the age of 15 tends to be slightly higher than their female counterparts and, in contrast, the percentage of young women who have had sex by the age of 18 tends to be higher than the percentage of the young men (Figure 13.10). Figure 13.10 Trends in age at first sexual intercourse among young people Percentage of women and men age 15-24 who had sexual intercourse before age 15 25 17 Women 15 14 14 1 Men 14 22 19 2000 2004 2010 2015-16 Percentage of women and men age 18-24 who had sexual intercourse before age 18 64 Women 58 Men 59 60 59 52 53 53 2000 2004 2010 2015-16 Patterns by background characteristics • Young women and young men in rural areas are more likely to have initiated sex by age 15 or 18 than their urban counterparts. • Among women age 15-24, the percentage of those who had sexual intercourse declines with increasing level of education, from 26% among women with no education to 3% among those with more than secondary education. Among men, however, the percentage of those who had sexual intercourse before the age of 15 is highest in men with primary education. Among women and men age 18-24, the percentage of those who had sexual intercourse before the age of 18 decreases with increasing level of education. • The highest percentage of respondents who have had their first sexual intercourse before age 15 is highest in the Southern region for both women and men (17% and 21%, respectively). The lowest percentage of women who have had their first sexual intercourse before age 15 is observed in the Central region (11%) whereas for men, the lowest percentage is in the Northern region (14%). Similar trends can be noted with the percentage of respondents who have had their first sexual intercourse before age 18. 210 • HIV/AIDS-related Knowledge, Attitudes, and Behaviour
13.9.3 Premarital Sex The 2015-16 MDHS also collected information on patterns of sexual activity among never-married women and men age 15-24 in Malawi. Fifty-nine percent of never-married women and 38% of never-married men age 15-24 have never had sexual intercourse (Table 13.13). The percentage of never-married women and men who have never had sexual intercourse decreases sharply with age; from 73% of women and 57% of men age 15-17, the percentage drops to 47% of women and 32% of men age 18-19 and then to 20% and 16% among women and men age 23-24, respectively. Among never-married women age 15-24, the percentage of those who have never had sexual intercourse is higher in rural areas than in urban areas (60% versus 53%). The reverse is observed among nevermarried men; the percentage of those who have never had sexual intercourse is higher in urban areas than in rural areas (41% versus 37%). Regional differences are substantial among never-married women age 15-24 (Figure 13.11). The percentage of women who have never had sexual intercourse varies from 71% among women in the Northern region to 62% in the Central region and then to 52% in Southern region. The highest percentage of never-married men age 15-24 who have never had sexual intercourse is observed in the Northern region (47%). However, there is little variation in the percentage of men who have never had sexual intercourse between the Central and Southern regions (38% and 36%, respectively). 13.9.4 Multiple Sexual Partners Figure 13.11 Premarital sex by region Percentage of never-married women and men age 15-24 who have never had sexual intercourse Young men age 15-24 are more likely than their female counterparts to have had more than one partner in the previous 12 months; 10% of men have had more than one partner in the last 12 months, compared with 1% of women (Tables 13.14.1 and 13.14.2). Condom use is more common among young men who had more than one partner in past 12 months than among their female counterparts; 52% of young men with more than one partner reported using a condom during last intercourse compared with 36% among women. Young men are also more likely than young women to have had intercourse with a non-marital, noncohabitating partner in the last 12 months (71% of men versus 24% of women). Condom use at last sex with a non-marital, non-cohabiting partner is 54% among young women and 76% among young men. Condom use at last sex with a non-marital, non-cohabitating partner is higher in urban areas than in rural areas; 65% of women and 83% of men in urban areas have had sex with a non-marital partner, noncohabitating partner in the last 12 months and used a condom during last sexual intercourse with such a partner, compared with 49% of women and 74% of men in rural areas. HIV/AIDS-related Knowledge, Attitudes, and Behaviour • 211
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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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Table 10.3 Vaccinations by backgrou
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Table 10.5 Prevalence and treatment
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Table 10.7 Prevalence and treatment
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Table 10.9 Oral rehydration therapy
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Table 10.11 Disposal of children’
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Page 202 and 203: Information on BMI is presented in
Page 204 and 205: Table 11.1 Nutritional status of ch
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Page 212 and 213: Table 11.9 Micronutrient intake amo
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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
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Page 224 and 225: Trends: The percentage of children
Page 226 and 227: Table 12.3 Indoor residual spraying
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Page 230 and 231: Table 12.11 Prevalence, diagnosis,
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Page 237 and 238: avoid getting HIV; 64% of women and
Page 239 and 240: Only 1% of all women reported havin
Page 241 and 242: Patterns by background characterist
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Page 247 and 248: Table 13.1 Knowledge of HIV prevent
Page 249 and 250: Table 13.4 Discriminatory attitudes
Page 251 and 252: Table 13.5.2 Multiple sexual partne
Page 253 and 254: Table 13.7.1 Coverage of prior HIV
Page 255 and 256: Table 13.8 Pregnant women counselle
Page 257 and 258: Table 13.10 Self-reported prevalenc
Page 259 and 260: Table 13.13 Premarital sexual inter
Page 261 and 262: Table 13.14.2 Multiple sexual partn
Page 263 and 264: HIV PREVALENCE 14 Key Findings HIV
Page 265 and 266: The HIV prevalence among women and
Page 269 and 270: Table 14.1 Coverage of HIV testing
Page 271 and 272: Table 14.3 HIV prevalence according
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Page 275 and 276: Table 14.7 HIV prevalence among you
Page 277 and 278: Table 14.11 HIV prevalence by male
Page 279 and 280: ADULT AND MATERNAL MORTALITY 15 Key
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Page 285 and 286: WOMEN’S EMPOWERMENT 16 Key Findin
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16.16 REPRODUCTIVE HEALTH CARE BY W
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Table 16.2.1 Control over women’s
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Table 16.4.1 Ownership of assets: W
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Table 16.5.2 Ownership of title or
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Table 16.7.1 Ownership and use of b
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Table 16.9.2 Men’s participation
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Table 16.10.2 Attitude toward wife
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Table 16.12 Ability to negotiate se
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Table 16.16 Reproductive health car
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harassment.” Most recently, the M
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• The experience of physical viol
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• Women’s experience of at leas
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women to have ever experienced spou
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• Women in urban areas are about
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Table 17.1 Experience of physical v
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Table 17.3 Persons committing physi
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Table 17.5 Age at first experience
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Table 17.9 Forms of spousal violenc
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Table 17.11 Spousal violence accord
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Table 17.13 Experience of spousal v
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Table 17.16 Violence by women again
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Table 17.18 Sources for help to sto
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World Health Organization (WHO) and
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Table A-2.3 Household sanitation fa
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Table A-2.7 Hand washing: Districts
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Table A-2.11 Children’s living ar
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Table A-2.12.2 Educational attainme
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Table A-3.2.1 Educational attainmen
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Table A-3.3.1 Literacy: Women by di
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Table A-3.4.1 Exposure to mass medi
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Table A-3.5.1 Internet usage: Women
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Table A-3.6.1 Employment status: Wo
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Table A-3.7.1 Occupation: Women by
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Table A-3.8.1 Type of earnings: Wom
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Table A-3.8.3 Continuity of employm
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Table A-3.13.1 Knowledge and attitu
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CHAPTER 4 MARRIAGE AND SEXUAL ACTIV
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Table A-4.4 Median age at first mar
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Table A-4.7.1 Recent sexual activit
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CHAPTER 5 FERTILITY Table A-5.2 Fer
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Table A-5.10 Median age at first bi
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CHAPTER 6 FERTILITY PREFERENCES Tab
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CHAPTER 7 FAMILY PLANNING Table A-7
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Table A-7.13 Decision-making about
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Table A-7.16 Contact of nonusers wi
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CHAPTER 9 MATERNAL HEALTH CARE Tabl
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Table A-9.4 Tetanus toxoid injectio
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Table A-9.6 Assistance during deliv
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Table A-9.9 Timing of first postnat
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Table A-9.11 Timing of first postna
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Table A-9.13 Content of postnatal c
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Table A-9.15 Prevalence of obstetri
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CHAPTER 10 CHILD HEALTH Table A-10.
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Table A-10.4 Possession and observa
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Table A-10.6 Prevalence and treatme
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Table A-10.8 Feeding practices duri
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Table A-10.10 Knowledge of ORS pack
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CHAPTER 11 NUTRITION OF CHILDREN AN
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Table A-11.2 Initial breastfeeding:
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Table A-11.7 Prevalence of anaemia
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Table A-11.9 Micronutrient intake a
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Table A-11.11 Nutritional status of
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Table A-11.13 Micronutrient intake
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Table A-12.2 Source of mosquito net
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Table A-12.6 Use of mosquito nets b
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Table A-12.8 Use of mosquito nets b
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Table A-12.10 Use of Intermittent P
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Table A-12.14 Haemoglobin
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Table A-13.4 Discriminatory attitud
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Table A-13.5.2 Multiple sexual part
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Table A-13.7.1 Coverage of prior HI
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Table A-13.8 Pregnant women counsel
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Table A-13.10 Self-reported prevale
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Table A-13.12 Age at first sexual i
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Table A-13.14.1 Multiple sexual par
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CHAPTER 14 HIV PREVALENCE Table A-1
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Table A-14.3 HIV prevalence: Distri
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CHAPTER 16 WOMEN’S EMPOWERMENT Ta
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Table A-16.4.1 Ownership of assets:
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Table A-16.5.1 Ownership of title o
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Table A-16.6.1 Ownership of title o
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Table A-16.7.1 Ownership and use of
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Table A-16.9.1 Women’s participat
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Table A-16.10.1 Attitude toward wif
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Table A-16.11 Attitudes toward nego
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CHAPTER 17 DOMESTIC VIOLENCE Table
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Table A-17.4 Experience of sexual v
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Table A-17.10 Spousal violence: Dis
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Table A-17.15 Violence by women aga
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SAMPLE DESIGN Appendix B B.1 INTROD
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two-stage stratified cluster sample
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Table B.1 Distribution of residenti
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Table B.4 Sample allocation of comp
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Table B.6 Sample implementation: Me
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Table B.8 Coverage of HIV testing b
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Table B.10 Coverage of HIV testing
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where h represents the stratum whic
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Table C.2 Sampling errors: Total sa
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Table C.4 Sampling errors: Rural sa
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Table C.6 Sampling errors: Central
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Table C.8 Sampling errors: Chitipa
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Table C.10 Sampling errors: Nkhatab
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Table C.12 Sampling errors: Mzimba
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Table C.14 Sampling errors: Kasungu
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Table C.16 Sampling errors: Ntchisi
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Table C.18 Sampling errors: Salima
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Table C.20 Sampling errors: Mchinji
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Table C.22 Sampling errors: Ntcheu
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Table C.24 Sampling errors: Maching
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Table C.26 Sampling errors: Chiradz
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Table C.28 Sampling errors: Mwanza
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Table C.30 Sampling errors: Mulanje
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Table C.32 Sampling errors: Chikwaw
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Table C.34 Sampling errors: Balaka
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Table C.36 Sampling errors for adul
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Table D.2.1 Age distribution of eli
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Table D.5 Reporting of age at death
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Table D.7 Nutritional status of chi
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SURVEY PERSONNEL Appendix E 2015-16
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Team Leaders Benson Mvula Grossveno
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Ireen Yohane Chisomo Mkwapatira Des
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2015-2016 MALAWI DEMOGRAPHIC AND HE
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INTRODUCTION AND CONSENT Hello. My
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HOUSEHOLD SCHEDULE IF AGE 0-17 YEAR
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HOUSEHOLD SCHEDULE IF AGE 0-17 YEAR
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HOUSEHOLD CHARACTERISTICS NO. QUEST
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HOUSEHOLD CHARACTERISTICS NO. QUEST
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MOSQUITO NETS NET #1 NET #2 NET #3
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ADDITIONAL HOUSEHOLD CHARACTERISTIC
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200 CHILD FUNCTIONING AND DISABILIT
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300 CHILD FUNCTIONING AND DISABILIT
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CHILD FUNCTIONING AND DISABILITY (A
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ELIGIBILITY AND CONSENT FOR THE MIC
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INTERVIEWER'S OBSERVATIONS TO BE FI
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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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HIV TESTING FOR MEN AGE 15-54 301 C
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SECTION 1. RESPONDENT'S BACKGROUND
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SECTION 2. REPRODUCTION NO. QUESTIO
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212 213 214 215 216 217 218 219 220
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SECTION 3. CONTRACEPTION 301 Now I
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SECTION 3. CONTRACEPTION NO. QUESTI
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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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NO. QUESTIONS AND FILTERS SECTION 1
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SECTION 10. HIV/AIDS NO. QUESTIONS
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SECTION 10. HIV/AIDS NO. QUESTIONS
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SECTION 11. OTHER HEALTH ISSUES NO.
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SECTION MM. MATERNAL MORTALITY MODU
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SECTION 13. DOMESTIC VIOLENCE MODUL
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INSTRUCTIONS: COL. 1 COL. 2 ONLY ON
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SECTION 1. RESPONDENT'S BACKGROUND
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SECTION 3. CONTRACEPTION 301 Now I
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SECTION 6. EMPLOYMENT AND GENDER RO
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SECTION 7. HIV/AIDS NO. QUESTIONS A
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SECTION 7. HIV/AIDS NO. QUESTIONS A
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INTERVIEWER'S OBSERVATIONS TO BE FI
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MALAWI GOVERNEMNT NATIONAL STATISTI
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Malawi 2015-16

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