Malawi 2015-16

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The 2015-16 Malawi Demographic and Health Survey (2015-16 MDHS) was implemented by the National Statistical Office from 19 October 2015 to 17 February 2016. The funding for the 2015-16 MDHS was provided by the government of Malawi, the United States Agency for International Development (USAID), the United Nations Children’s Fund (UNICEF), the Malawi National AIDS Commission (NAC), the United Nations Population Fund (UNFPA), UN WOMEN, Irish Aid, and the World Bank. ICF provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2015-16 MDHS may be obtained from the Demography and Social Statistics Division, National Statistical Office, Chimbiya Road, P.O. Box 333, Zomba, Malawi; Telephone +265-1-524-377; E-mail: enquiries@statistics.gov.mw; Internet: www.nsomalawi.mw. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; Telephone: +1-301-407-6500; Fax: +1-301-407-6501; E-mail: info@DHSprogram.com; Internet: www.DHSprogram.com. Cover art “Lake Scenery” ©2016 Steve Bakali. Used with permission. Recommended citation: National Statistical Office (NSO) [Malawi] and ICF. 2017. Malawi Demographic and Health Survey 2015-16. Zomba, Malawi, and Rockville, Maryland, USA. NSO and ICF.
CONTENTS TABLES AND FIGURES ........................................................................................................................... ix FOREWORD ............................................................................................................................................. xxi ACRONYMS AND ABBREVIATIONS ............................................................................................... xxiii READING AND UNDERSTANDING THE 2015-16 MALAWI DEMOGRAPHIC AND HEALTH SURVEY (MDHS) ..................................................................................................... xxv MAP OF MALAWI ................................................................................................................................ xxxii 1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................. 1 1.1 Survey Objectives ................................................................................................................ 1 1.2 Sample Design ..................................................................................................................... 2 1.3 Questionnaires ..................................................................................................................... 2 1.4 Anthropometry, Anaemia Testing, and HIV Testing .......................................................... 3 1.5 Pretest .................................................................................................................................. 6 1.6 Training of Field Staff ......................................................................................................... 6 1.7 Fieldwork ............................................................................................................................. 6 1.8 Data Processing ................................................................................................................... 7 1.9 Response Rates .................................................................................................................... 7 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION ................................ 9 2.1 Drinking Water Sources and Treatment .............................................................................. 9 2.2 Sanitation ........................................................................................................................... 10 2.3 Exposure to Smoke inside the Home and Other Housing Characteristics ......................... 11 2.3.1 Exposure to Smoke Inside the Home ................................................................... 11 2.3.2 Other Housing Characteristics ............................................................................. 11 2.4 Household Wealth and Durable Goods ............................................................................. 11 2.5 Hand Washing ................................................................................................................... 12 2.6 Household Population and Composition ........................................................................... 12 2.7 Birth Registration .............................................................................................................. 13 2.8 Children’s Living Arrangements and Parental Survival .................................................... 14 2.9 Education ........................................................................................................................... 14 2.9.1 Educational Attainment ....................................................................................... 14 2.9.2 School Attendance ............................................................................................... 15 2.9.3 Other Measures of School Attendance ................................................................. 16 2.10 Child Functioning and Disability....................................................................................... 17 3 CHARACTERISTICS OF RESPONDENTS ............................................................................ 31 3.1 Basic Characteristics of Survey Respondents .................................................................... 31 3.2 Education and Literacy ...................................................................................................... 32 3.3 Mass Media Exposure and Internet Usage ........................................................................ 33 3.4 Employment ...................................................................................................................... 34 3.5 Occupation ......................................................................................................................... 34 3.6 Health Insurance Coverage ................................................................................................ 35 3.7 Tobacco Use ...................................................................................................................... 35 3.8 Knowledge and Attitudes regarding Tuberculosis ............................................................. 36 4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 55 4.1 Marital Status ..................................................................................................................... 55 4.2 Polygyny ............................................................................................................................ 56 Contents • iii
Page 1: Malawi Demographic and Health Surve
Page 6 and 7: 4.3 Age at First Marriage .........
Page 8 and 9: 13.9.1 Knowledge ..................
Page 11 and 12: TABLES AND FIGURES 1 INTRODUCTION A
Page 13 and 14: 6 FERTILITY PREFERENCES ...........
Page 15 and 16: 11 NUTRITION OF CHILDREN AND WOMEN
Page 17 and 18: Figure 14.1 HIV prevalence by age .
Page 19 and 20: Table A-3.8.1 Type of earnings: Wom
Page 21 and 22: Table A-16.9.1 Women’s participat
Page 23: FOREWORD T he 2016-16 Malawi Demogr
Page 26 and 27: LA LAM LLIN LPG MAD MDHS MICS PPHC
Page 28 and 29: Table 3.4.1 Exposure to mass media:
Page 30 and 31: Example 2: Prevalence and Treatment
Page 32 and 33: Example 3: Understanding Sampling W
Page 34 and 35: xxxii • Map of Malawi
Page 36 and 37: The information collected in the 20
Page 38 and 39: ecorded on the Biomarker Questionna
Page 40 and 41: 1.5 PRETEST The pretest for the 201
Page 43 and 44: HOUSING CHARACTERISTICS AND 2 HOUSE
Page 45 and 46: About half of Malawian households (
Page 47 and 48: A total of 117,177 individuals stay
Page 49 and 50: Patterns by background characterist
Page 51 and 52: school. The attendance rate decline
Page 53 and 54: 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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Patterns by background characterist
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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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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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