Malawi 2015-16

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• The maternal mortality ratio (MMR) during the 7-year period before the 2015-16 MDHS is estimated as 439 maternal deaths per 100,000 live births. For every 1,000 live births in Malawi during the 7 years before 2015-16, between 4 and 5 women died during pregnancy, childbirth, or within 42 days after childbirth. 15.4 TRENDS IN PREGNANCY-RELATED MORTALITY In accordance with the WHO definition 1 , a maternal-related death is defined as the death of a woman while pregnant or during delivery, or in the 42 days after the delivery or within 42 days of termination of pregnancy, if the death is not due to accident or violence. However, the term maternal mortality used in previous MDHS corresponds to pregnancy-related mortality. The WHO defines a pregnancy-related death as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death (http://www.who.int/healthinfo/statistics/indmaternalmortality/en/). In keeping with this definition, the sibling survival module used in the DHS surveys measures only the timing of death and not the cause of death. Moreover, the data collected in previous MDHS surveys refer to deaths within 2 months after a birth rather than 42 days after a birth. Thus, current estimates of maternal mortality are not comparable to estimates from previous MDHS surveys in which only pregnancy-related mortality could be estimated. To assess the trends over time, pregnancy-related mortality was calculated for the 2015-16 MDHS in the same way that it was calculated in previous MDHS surveys. The results in Figure 15.2 present estimates of pregnancy-related mortality ratio (PRMR) with confidence intervals for current and previous MDHS surveys. Estimates from MDHS surveys indicate that a steady decline in pregnancy-related mortality ratio in Malawi since 2000, from 1,123 deaths per 100,000 live births in the 7 years before the 2000 MDHS survey to 675 deaths per 100,000 live births in the 7 years before the 2010 MDHS survey, before reaching 497 deaths per 100,000 live births in the 7 years before the 2015-16 MDHS survey. LIST OF TABLES 1400 1200 1000 For more information on adult and maternal mortality, see the following tables: • Table 15.1 Completeness of information on siblings • Table 15.2 Adult mortality rates • Table 15.3 Adult mortality probabilities • Table 15.4 Maternal mortality Figure 15.2 Trends in pregnancy-related mortality ratio (PRMR) with confidence intervals 800 600 400 200 0 Pregnancy-related deaths per 100,000 live births in the 7-year period before the survey 615 1123 984 675 1992 2000 2004 2010 2015-16 497 1 http://www.who.int/healthinfo/statistics/indmaternalmortality/en/ 248 • Adult and Maternal Mortality
Table 15.1 Completeness of information on siblings Completeness of data on survival status of sisters and brothers reported by interviewed women, age of living siblings and age at death (AD) and years since death (YSD) of dead siblings (unweighted), Malawi DHS 2015-16 Sisters Brothers All siblings Number Percent Number Percent Number Percent All siblings 62,867 100.0 63,404 100.0 126,271 100.0 Living 52,541 83.6 52,496 82.8 105,037 83.2 Dead 10,241 16.3 10,830 17.1 21,071 16.7 Survival status unknown 85 0.1 78 0.1 163 0.1 Living siblings 52,541 100.0 52,496 100.0 105,037 100.0 Age reported 51,909 98.8 51,846 98.8 103,755 98.8 Age missing 632 1.2 650 1.2 1,282 1.2 Dead siblings 10,241 100.0 10,830 100.0 21,071 100.0 AD and YSD reported 9,232 90.1 9,706 89.6 18,938 89.9 Missing only AD 181 1.8 248 2.3 429 2.0 Missing only YSD 298 2.9 336 3.1 634 3.0 Missing AD and YSD 530 5.2 540 5.0 1,070 5.1 Table 15.2 Adult mortality rates Direct estimates of female and male mortality rates for the 7 years before the survey, by five-year age groups, Malawi DHS 2015-16 Age Deaths FEMALE Exposure years Mortality rates 1 15-19 92 54,045 1.70 20-24 194 58,958 3.29 25-29 233 53,284 4.38 30-34 244 43,301 5.62 35-39 195 29,705 6.56 40-44 166 17,669 9.41 45-49 100 10,312 9.66 Total 15-49 1,224 267,273 4.77 a MALE 15-19 115 51,598 2.22 20-24 175 57,829 3.02 25-29 196 53,191 3.69 30-34 261 44,958 5.80 35-39 252 31,783 7.93 40-44 246 18,172 13.55 45-49 122 9,482 12.88 Total 15-49 1,367 267,012 5.45 a 1 Expressed per 1,000 population. a Age-adjusted rate. Table 15.3 Adult mortality probabilities The probability of dying between the ages of 15 and 50 for women and men during the 7 years before the survey, Malawi DHS 2004-2015-16 Survey 2015-16 MDHS (time period: 2009-2016) 2010 MDHS (time period: 2003-2010) 2004 MDHS (time period: 1997-2004) 2000 MDHS (time period: 1993-2000) 1992 MDHS (time period: 1985-1992) Female 35q15 1 184 (CI: 167-201) 305 (CI: 285-325) 341 (CI: 319-364) 373 (CI: 349-397) 223 (CI: 189-257) Male 35q15 1 218 (CI: 200-236) 341 (CI: 319-364) 385 (CI: 354-415) 391 (CI: 368-414) 223 (CI: 182-264) 1 The probability of dying between exact ages 15 and 50, expressed per 1,000 persons at age 15. Adult and Maternal Mortality • 249
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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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which the baby’s weight to be dis
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11.2 INFANT AND YOUNG CHILD FEEDING
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have shown that plant-based complem
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11.3 ANAEMIA PREVALENCE IN CHILDREN
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Information on BMI is presented in
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Table 11.1 Nutritional status of ch
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Table 11.3 Breastfeeding status acc
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Table 11.5 Foods and liquids consum
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Table 11.7 Prevalence of anaemia in
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Table 11.9 Micronutrient intake amo
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Table 11.11 Nutritional status of w
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Table 11.13 Micronutrient intake am
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The ownership and use of both treat
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12.3 HOUSEHOLD ACCESS AND USE OF IT
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SP during routine ANC visits. Follo
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Trends: The percentage of children
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Table 12.3 Indoor residual spraying
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Table 12.7 Use of existing ITNs Per
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Table 12.11 Prevalence, diagnosis,
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Page 235 and 236: HIV/AIDS-RELATED KNOWLEDGE, 13 ATTI
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Page 263 and 264: HIV PREVALENCE 14 Key Findings HIV
Page 265 and 266: The HIV prevalence among women and
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Page 279 and 280: ADULT AND MATERNAL MORTALITY 15 Key
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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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