Demographic_and_Health_Survey-2011._Azerbaijan._Final_Report (1).pdf - MINISTRY OF HEALTH AZERBAIJAN REPUBLIC THE DEMOGRAPHIC AND HEALTH SURVEY

Demographic_and_Health_Survey-2011._Azerbaijan._Final_Report (1).pdf

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Unformatted text preview: MINISTRY OF HEALTH AZERBAIJAN REPUBLIC THE DEMOGRAPHIC AND HEALTH SURVEY, AZERBAIJAN, 2011 Final Report Baku-2013 The implementation of the Demographic and Health Survey in Azerbaijan in 2011 (DHS-2011) was assigned by the Action Plan (2008-2010) for the “State Program on Poverty Reduction and Sustainable Development in the Republic of Azerbaijan for 2008-2015” approved by the Presidential Decree №3043 dated of September 15, 2008. The Action Plan designated the Ministry of Health of the Republic of Azerbaijan responsible for the survey implementation. According to the Ministry of Health Decree №70 dated of September 8, 2010, the Public Health and Reforms Center was appointed as an institution to conduct the survey. The funding for the survey was provided by the Ministry of Health. The DHS-2011 is based on models and standards adapted from Measure DHS, a worldwide Demographic and Health Surveys program. Additional information about the survey can be obtained from the Public Health and Reforms Center of the Ministry of Health of the Republic of Azerbaijan, 96 Zardabi Street, Baku, AZ1122, Azerbaijan (Telephone: +994 12-431-6088, Fax: +994 12-430-5285; E-mail: [email protected]). Recommended citation: Public Health and Reforms Center (PHRC) [Azerbaijan] 2013. Demographic and Health Survey, Azerbaijan, 2011. Ministry of Health (MoH) [Azerbaijan], Baku, Azerbaijan. ISBN 978-9952-8256-5-7 CONTENTS TABLES AND FIGURES ........................................................................................................................ vii PREFACE ................................................................................................................................................ xiii ACKNOWLEDGEMENTS ......................................................................................................................xv SUMMARY OF FINDINGS ....................................................................................................................xvi MILLENNIUM DEVELOPMENT GOAL INDICATORS ................................................................xxv MAP OF AZERBAIJAN .......................................................................................................................xxvi CHAPTER 1 INTRODUCTION 1.1 1.2 1.3 1.4 1.5 Geography and population ...............................................................................................................1 Health care system............................................................................................................................3 1.2.1 Facilities, finance, and human resources .............................................................................3 1.2.2 Health care reforms .............................................................................................................5 1.2.3 Health services provision ....................................................................................................5 1.2.4 Maternal and child health care ............................................................................................6 1.2.5 Family planning services .....................................................................................................8 Systems for collecting demographic and health data .......................................................................9 Objectives and organization of the survey .....................................................................................10 1.4.1 Sample design and implementation ...................................................................................10 1.4.2 Questionnaires ...................................................................................................................12 1.4.3 Biomarkers ........................................................................................................................13 1.4.4 Training of field staff ........................................................................................................13 1.4.5 Fieldwork and data processing ..........................................................................................14 1.4.6 Data processing .................................................................................................................15 Response rate ..............................................................................................................................15 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2.1 2.2 2.3 Characteristics of the population ....................................................................................................17 2.1.1 Age-sex structure ...............................................................................................................17 2.1.2 Household composition .....................................................................................................19 2.1.3 Children’s living arrangements and orphanhood...............................................................20 2.1.4 Education ...........................................................................................................................21 Housing characteristics ...................................................................................................................24 2.2.1 Drinking water ...................................................................................................................26 2.2.2 Sanitation facility ..............................................................................................................27 2.2.3 Household possessions ......................................................................................................28 Wealth quintiles ..............................................................................................................................29 CHAPTER 3 BACKGROUND CHARACTERISTICS OF RESPONDENTS 3.1 3.2 3.3 3.4 3.5 3.6 Background characteristics of respondents ....................................................................................31 Educational level of respondents ....................................................................................................32 Exposure to mass media .................................................................................................................33 Employment ..............................................................................................................................34 Occupation ...................................................................................................................................37 Employment characteristics............................................................................................................38 iii Contents CHAPTER 4 MARRIAGE AND SEXUAL ACTIVITY 4.1 4.2 4.3 4.4 Marital status ..............................................................................................................................40 Age at first marriage .......................................................................................................................41 Age at first sexual intercourse ........................................................................................................42 The most recent sexual activity previous to interview ...................................................................43 CHAPTER 5 FERTILITY 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 Current fertility ..............................................................................................................................46 Fertility differentials by background characteristics ......................................................................48 Fertility trends ..............................................................................................................................49 Children ever born and living .........................................................................................................50 Birth intervals ..............................................................................................................................51 Age at first birth..............................................................................................................................53 Teenage pregnancy and motherhood ..............................................................................................55 Postpartum amenorrhea, abstinence, and insusceptibility ..............................................................56 Termination of exposure to pregnancy ...........................................................................................58 CHAPTER 6 FERTILITY PREFERENCES 6.1 6.2 6.3 Desire for more children .................................................................................................................59 Ideal number of children in a family ..............................................................................................63 Wanted and unwanted fertility .......................................................................................................65 CHAPTER 7 FAMILY PLANNING 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 Knowledge of contraceptive methods ............................................................................................68 Ever use of contraception ...............................................................................................................69 Current use of contraceptive methods ............................................................................................70 Differentials in contraceptive use ...................................................................................................71 Number of children at first use of contraception ............................................................................74 Knowledge of the fertile period ......................................................................................................74 Need for family planning methods .................................................................................................75 Source of contraception ..................................................................................................................77 Cost of contraception......................................................................................................................77 Informed choice ..............................................................................................................................78 Contraceptive discontinuation ........................................................................................................79 Future use of contraception ............................................................................................................80 Reasons for not intending to use ....................................................................................................80 Preferred method for future use ......................................................................................................81 Exposure to family planning messages ..........................................................................................82 Contact of nonusers with family planning providers............................................ ..........................83 CHAPTER 8 ABORTION 8.1 8.2 8.3 8.4 8.5 Pregnancies ending in induced abortion .........................................................................................84 Lifetime experience with induced abortion ....................................................................................86 Rates of induced abortion ...............................................................................................................87 8.3.1 Recent trends in the total abortion rates ............................................................................90 Use of contraceptive methods before abortion ..............................................................................90 8.4.1 Advice on family planning methods before or after the last abortion ...............................92 Induced abortions in the three years preceding the survey .............................................................93 8.5.1 Number of abortions ..........................................................................................................94 8.5.2 Reasons for abortion ..........................................................................................................94 8.5.3 Place of abortion ................................................................................................................95 8.5.4 Method of abortions ..........................................................................................................97 8.5.5 Use of anesthesia during abortion .....................................................................................98 iv Contents 8.5.6 Post-abortion complications and antibiotic treatment .......................................................99 CHAPTER 9 INFANT AND CHILD MORTALITY 9.1 9.2 9.3 9.4 9.5 9.6 Definitions and methodology .......................................................................................................102 Assessment of data quality ...........................................................................................................103 Levels and trends in infant and child mortality ............................................................................104 Differentials in childhood mortality .............................................................................................107 Perinatal mortality ........................................................................................................................108 High-risk fertility behavior ...........................................................................................................109 CHAPTER 10 REPRODUCTIVE HEATLH 10.1 10.2 10.3 10.4 Antenatal care ............................................................................................................................111 10.1.1 Antenatal care by trained provider ..................................................................................111 10.1.2 Number and timing of ANC visits...................................................................................114 10.1.3 Antenatal care content .....................................................................................................115 Assistance and medical care at delivery .......................................................................................118 10.2.1 Place of delivery ..............................................................................................................118 10.2.2 Attended deliveries ..........................................................................................................120 10.2.3 Caesarean section delivery ..............................................................................................121 Postnatal care ............................................................................................................................122 Women’s perception of access to health care ...............................................................................123 CHAPTER 11 CHILD HEALTH 11.1 11.2 11.3 11.4 Child’s weight and size at birth ....................................................................................................126 Vaccination coverage ...................................................................................................................127 Acute respiratory infection ...........................................................................................................130 Diarrhea........................................................................................................................ ................130 CHAPTER 12 NUTRITION 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 Nutritional status of children ........................................................................................................135 Breastfeeding and supplementation ..............................................................................................139 12.2.1 Initiation of breastfeeding................................................................................................139 12.2.2 Breastfeeding patterns by age ..........................................................................................141 12.2.3 Supplemental foods .........................................................................................................144 12.2.4 Appropriate infant and child feeding ...............................................................................145 Anemia in children .......................................................................................................................147 Iodization of household salt..........................................................................................................150 Micronutrient intake in children ...................................................................................................153 Nutritional status of women .........................................................................................................155 Anemia in women.........................................................................................................................158 Micronutrient intake in women ....................................................................................................160 CHAPTER 13 HIV/AIDS RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR 13.1 13.2 13.3 13.4 13.5 13.6 13.7 Knowledge of HIV/AIDS and of transmission and prevention methods............................ .........162 13.1.1 Awareness of AIDS .........................................................................................................162 13.1.2 Knowledge of ways to reduce HIV/AIDS transmission ..................................................163 13.1.3 Knowledge about transmission of HIV/AIDS .................................................................165 Stigma associated with AIDS and attitudes related to HIV/AIDS ...............................................168 Attitudes towards negotiating safer sex ........................................................................................170 Testing for HIV ............................................................................................................................171 Reports of recent sexually transmitted infections.........................................................................173 Injections ............................................................................................................................173 HIV/AIDS -related knowledge and behavior among youth .........................................................176 v Contents CHAPTER 14 ADULT HEALTH 14.1 14.2 14.3 Health insurance ...........................................................................................................................179 Tuberculosis .............................................................................................................................179 14.2.1 Knowledge of tuberculosis ..............................................................................................180 14.2.2 Knowledge that tuberculosis is curable and willingness to keep secret a family member’s tuberculosis status ...........................................................................................181 14.2.3 Knowledge and misconceptions about the ways tuberculosis spreads ............................181 Hypertension ............................................................................................................................183 CHAPTER 15 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEAL...
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