Malawi 2015-16

Recommendations

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CHAPTER 9 MATERNAL HEALTH CARE Table A-9.1 Antenatal care: Districts Percent distribution of women age 15-49 who had a live birth in the 5 years before the survey by antenatal care (ANC) provider during pregnancy for the most recent birth and percentage receiving antenatal care from a skilled provider for the most recent birth, according to district, Malawi DHS 2015-16 District Skilled antenatal care provider Doctor/ clinical officer/ medical assistant Nurse/ midwife Patient attendant Unskilled antenatal care provider Health surveillance attendant Traditional birth attendant Other No ANC Total Percentag e receiving antenatal care from a skilled provider 1 Number of women Northern Chitipa 22.5 66.6 6.3 3.9 0.0 0.0 0.6 100.0 89.1 139 Karonga 16.9 80.2 0.2 2.4 0.0 0.0 0.2 100.0 97.1 272 Likoma 10.6 88.8 0.0 0.0 0.0 0.0 0.6 100.0 99.4 9 Mzimba 24.6 73.3 0.8 0.5 0.2 0.0 0.6 100.0 97.9 820 Nkhata Bay 13.9 79.2 2.0 3.0 0.0 0.0 1.9 100.0 93.1 178 Rumphi 16.4 79.4 0.8 1.1 0.0 0.0 2.3 100.0 95.8 163 Total 21.0 75.3 1.3 1.5 0.1 0.0 0.8 100.0 96.2 1,580 Central Dedza 28.7 68.2 0.2 1.4 0.2 0.0 1.4 100.0 96.9 577 Dowa 16.9 80.4 0.8 0.8 0.0 0.0 1.2 100.0 97.3 555 Kasungu 22.9 74.4 0.2 0.9 0.0 0.0 1.7 100.0 97.3 569 Lilongwe 28.7 68.9 0.5 1.0 0.0 0.0 0.9 100.0 97.6 2,037 Mchinji 40.1 55.8 0.7 2.7 0.0 0.0 0.8 100.0 95.9 446 Nkhotakota 13.8 82.6 0.8 1.2 0.9 0.0 0.7 100.0 96.4 298 Ntcheu 13.9 81.4 1.7 1.4 0.0 0.0 1.6 100.0 95.3 539 Ntchisi 12.8 85.8 0.3 0.0 0.0 0.0 1.0 100.0 98.7 269 Salima 17.9 79.6 1.0 0.6 0.0 0.0 0.8 100.0 97.5 421 Total 24.2 72.9 0.6 1.1 0.1 0.0 1.1 100.0 97.1 5,711 Southern Balaka 19.9 71.8 0.5 2.2 0.0 0.0 5.6 100.0 91.7 326 Blantyre 27.9 67.7 0.7 1.5 0.0 0.0 2.1 100.0 95.6 955 Chikhwawa 27.7 57.4 5.0 7.3 0.2 0.0 2.4 100.0 85.1 421 Chiradzulu 31.1 67.8 0.0 0.2 0.0 0.0 0.8 100.0 99.0 269 Machinga 35.4 61.4 0.2 1.2 0.0 0.4 1.5 100.0 96.7 550 Mangochi 10.6 76.9 6.1 1.0 0.0 0.0 5.4 100.0 87.6 961 Mulanje 33.9 60.7 1.9 0.6 0.2 0.0 2.7 100.0 94.6 579 Mwanza 37.6 59.7 0.3 0.0 0.0 0.0 2.4 100.0 97.4 95 Neno 22.8 74.8 0.4 1.4 0.0 0.0 0.6 100.0 97.5 147 Nsanje 19.9 72.7 0.6 3.1 0.0 0.0 3.7 100.0 92.6 231 Phalombe 25.6 69.3 0.4 4.1 0.0 0.0 0.6 100.0 94.9 393 Thyolo 10.0 76.9 0.9 7.1 0.2 0.0 4.9 100.0 86.9 542 Zomba 14.2 78.0 2.5 5.2 0.0 0.0 0.2 100.0 92.1 757 Total 22.5 69.8 2.1 2.8 0.0 0.0 2.7 100.0 92.3 6,224 Total 23.0 71.8 1.4 1.9 0.1 0.0 1.8 100.0 94.8 13,515 Note: If more than one source of ANC was mentioned, only the provider with the highest qualifications is considered in this tabulation. 1 Skilled provider includes doctor, clinical officer, medical assistant, nurse, and midwife 352 • Appendix A
Table A-9.3 Components of antenatal care: Districts Among women age 15-49 with a live birth in the 5 years before the survey, percentages who took iron tablets and drugs for intestinal parasites during the pregnancy of the most recent birth; and among women receiving antenatal care (ANC) for the most recent live birth in the 5 years before the survey, percentage receiving specific antenatal services, according to District, Malawi DHS 2015-16 District Among women with a live birth in the past 5 years, the percentage who during the pregnancy of their last birth: Took iron tablets or syrup Took intestinal parasite drugs Number of women with a live birth in the past 5 years Among women who received antenatal care for their most recent birth in the past 5 years, the percentage with selected services Blood pressure measured Urine sample taken Blood sample taken Height measured Weighed Fetal heartbeat checked Received information on what foods to eat Number of women with ANC for their most recent birth Northern Chitipa 93.3 43.8 139 89.6 31.6 96.1 77.7 98.2 97.3 88.5 138 Karonga 95.6 20.1 272 98.2 44.9 97.5 63.1 96.6 97.2 90.0 271 Likoma 96.3 47.5 9 97.1 86.1 99.4 66.3 99.7 99.0 95.2 9 Mzimba 93.9 58.2 820 94.2 34.7 95.2 44.3 97.7 96.2 84.6 815 Nkhata Bay 94.3 41.6 178 89.6 30.2 96.1 49.6 99.4 96.0 89.6 174 Rumphi 92.7 49.1 163 92.2 35.9 93.5 44.4 99.0 95.8 81.4 160 Total 94.1 47.5 1,580 93.8 36.1 95.6 51.2 97.9 96.4 86.2 1,567 Central Dedza 87.7 47.1 577 76.8 27.3 89.8 48.4 96.2 98.0 93.5 569 Dowa 89.5 59.2 555 80.1 39.0 94.2 40.5 98.9 94.3 90.1 548 Kasungu 86.6 45.8 569 74.9 27.0 87.2 44.0 94.0 91.8 86.6 559 Lilongwe 88.4 50.6 2,037 82.3 33.6 93.5 52.2 97.2 98.4 86.7 2,018 Mchinji 93.9 39.2 446 82.0 23.4 91.3 41.4 98.0 97.5 83.6 443 Nkhotakota 88.1 56.4 298 82.0 28.1 90.9 61.5 94.5 95.6 94.1 296 Ntcheu 91.8 58.7 539 89.9 35.2 91.5 63.4 99.0 98.1 94.0 531 Ntchisi 92.8 41.9 269 71.1 24.5 87.7 26.0 93.6 92.0 86.2 266 Salima 91.0 55.9 421 78.1 20.7 94.3 39.3 97.6 98.3 87.3 418 Total 89.4 50.8 5,711 80.7 30.5 91.9 48.4 96.9 96.8 88.6 5,648 Southern Balaka 88.0 63.2 326 87.8 25.6 93.8 58.5 98.7 97.4 95.9 308 Blantyre 91.1 47.4 955 82.0 33.8 88.5 54.5 94.1 93.8 89.2 935 Chikhwawa 87.9 48.7 421 78.1 38.2 90.9 51.9 98.1 96.4 92.9 411 Chiradzulu 94.7 62.5 269 95.8 47.7 96.6 73.2 99.2 99.0 95.9 267 Machinga 77.6 56.6 550 77.7 29.5 92.1 51.7 99.5 94.4 87.8 542 Mangochi 82.8 46.2 961 79.1 28.5 86.2 54.0 96.7 88.5 88.9 909 Mulanje 91.3 51.4 579 73.5 27.5 91.5 53.8 98.0 95.9 96.3 563 Mwanza 85.1 47.5 95 83.5 19.3 89.1 42.5 99.6 98.3 90.2 92 Neno 94.7 53.8 147 81.3 27.0 92.0 57.5 99.6 98.3 85.6 146 Nsanje 90.6 49.0 231 86.3 33.4 94.5 61.9 98.1 95.5 94.8 222 Phalombe 91.5 47.2 393 80.0 24.8 95.0 50.7 99.8 96.6 96.0 391 Thyolo 83.7 54.3 542 84.5 49.1 96.2 63.8 97.7 98.4 92.7 515 Zomba 94.2 68.6 757 93.5 35.2 98.3 54.3 98.6 99.3 97.6 756 Total 88.1 53.3 6,224 82.7 33.0 92.2 55.6 97.7 95.3 92.5 6,056 Total 89.4 51.6 13,515 83.1 32.3 92.5 52.0 97.4 96.1 90.1 13,270 Appendix A • 353
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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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Table 12.13 Type of antimalarial dr
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HIV/AIDS-RELATED KNOWLEDGE, 13 ATTI
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avoid getting HIV; 64% of women and
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Only 1% of all women reported havin
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Forty-two percent of women and 41%
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13.9.3 Premarital Sex The 2015-16 M
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Table 13.1 Knowledge of HIV prevent
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Table 13.4 Discriminatory attitudes
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Table 13.5.2 Multiple sexual partne
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Table 13.7.1 Coverage of prior HIV
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Table 13.8 Pregnant women counselle
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Table 13.10 Self-reported prevalenc
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Table 13.13 Premarital sexual inter
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Table 13.14.2 Multiple sexual partn
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HIV PREVALENCE 14 Key Findings HIV
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The HIV prevalence among women and
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Table 14.1 Coverage of HIV testing
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Table 14.3 HIV prevalence according
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Table 14.5 HIV prevalence according
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Table 14.7 HIV prevalence among you
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Table 14.11 HIV prevalence by male
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ADULT AND MATERNAL MORTALITY 15 Key
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Trends: Table 15.3 shows the probab
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Table 15.1 Completeness of informat
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WOMEN’S EMPOWERMENT 16 Key Findin
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husbands while smaller proportions
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5% participate in neither decisions
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from 78% to 74%. The percentage of
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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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Page 342 and 343: Table A-2.3 Household sanitation fa
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Page 346 and 347: Table A-2.11 Children’s living ar
Page 348 and 349: Table A-2.12.2 Educational attainme
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Page 352 and 353: Table A-3.3.1 Literacy: Women by di
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Page 356 and 357: Table A-3.5.1 Internet usage: Women
Page 358 and 359: Table A-3.6.1 Employment status: Wo
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Page 362 and 363: Table A-3.8.1 Type of earnings: Wom
Page 364 and 365: Table A-3.8.3 Continuity of employm
Page 366 and 367: Table A-3.13.1 Knowledge and attitu
Page 368 and 369: CHAPTER 4 MARRIAGE AND SEXUAL ACTIV
Page 370 and 371: Table A-4.4 Median age at first mar
Page 372 and 373: Table A-4.7.1 Recent sexual activit
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Page 376 and 377: Table A-5.10 Median age at first bi
Page 378 and 379: CHAPTER 6 FERTILITY PREFERENCES Tab
Page 380 and 381: CHAPTER 7 FAMILY PLANNING Table A-7
Page 382 and 383: Table A-7.13 Decision-making about
Page 384 and 385: Table A-7.16 Contact of nonusers wi
Page 388 and 389: Table A-9.4 Tetanus toxoid injectio
Page 390 and 391: Table A-9.6 Assistance during deliv
Page 392 and 393: Table A-9.9 Timing of first postnat
Page 394 and 395: Table A-9.11 Timing of first postna
Page 396 and 397: Table A-9.13 Content of postnatal c
Page 398 and 399: Table A-9.15 Prevalence of obstetri
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Page 402 and 403: Table A-10.4 Possession and observa
Page 404 and 405: Table A-10.6 Prevalence and treatme
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Page 410 and 411: CHAPTER 11 NUTRITION OF CHILDREN AN
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Page 414 and 415: Table A-11.7 Prevalence of anaemia
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Page 418 and 419: Table A-11.11 Nutritional status of
Page 420 and 421: Table A-11.13 Micronutrient intake
Page 422 and 423: Table A-12.2 Source of mosquito net
Page 424 and 425: Table A-12.6 Use of mosquito nets b
Page 426 and 427: Table A-12.8 Use of mosquito nets b
Page 428 and 429: Table A-12.10 Use of Intermittent P
Page 430 and 431: Table A-12.14 Haemoglobin
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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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