Ethiopia - Demographic and Health Survey - 2001

Publication date: 2001

Ethiopia 2000Demographic andHealth SurveyDem ographic and H ealth Survey E thio pia 2000 World Summit for Children Indicators: Ethiopia 2000 __________________________________________________________________________________________________ Value__________________________________________________________________________________________________ BASIC INDICATORS__________________________________________________________________________________________________ Childhood mortality Infant mortality rate 97.0 per 1,000 Under-five mortality rate 166.2 per 1,000 Maternal mortality Maternal mortality ratio 871 per 100,000 Childhood undernutrition Percent stunted (of children under 5 years) 51.5 Percent wasted (of children under 5 years) 10.5 Percent underweight (of children under 5 years) 47.2 Clean water supply Percent of households within 15 minutes of safe water supply1 10.1 Sanitary excreta disposal Percent of households with flush toilets 0.3 Basic education Percent of women 15-49 with completed primary education 10.7 Percent of men 15-49 with completed primary education 20.5 Percent of girls 6-12 attending school 23.5 Percent of boys 6-12 attending school 28.0 Percent of women 15-49 who are literate 18.5 Children in especially Percent of children who are orphans (both parents dead) 0.8 difficult situations Percent of children who do not live with their natural mother 15.2 Percent of children who live in single adult households 7.6 __________________________________________________________________________________________________ SUPPORTING INDICATORS__________________________________________________________________________________________________ Birth spacing Percent of births within 24 months of a previous birth2 19.7 Safe motherhood Percent of births with medical prenatal care3 26.7 Percent of births with prenatal care in first trimester3 6.2 Percent of births with medical assistance at delivery4 5.6 Percent of births in a medical facility4 5.0 Percent of births at high risk4 63.4 Family planning Contraceptive prevalence rate (any method, married women) 8.1 Percent of currently married women with an unmet demand for family planning 35.8 Percent of currently married women with an unmet need for family planning to avoid a high-risk birth 29.1 Maternal nutrition Percent of women age 15-49 with low BMI 30.1 Low birth weight Percent of births at low birth weight5 12.4 Breastfeeding Percent of children under 4 months who are exclusively breastfed 62.3 Iodized salt intake Percent of households that use iodized salt6 28.4 Vaccinations Percent of children whose mothers received at least one dose of tetanus toxoid vaccinations3 26.2 Percent of children 12-23 months with measles vaccination 26.6 Percent of children 12-23 months fully vaccinated 14.3 Diarrhea control Percent of children with diarrhea in preceding 2 weeks who received ORS or RHF 18.6 Acute respiratory infection Percent of children with acute respiratory infection in preceding 2 weeks who were taken to a health facility or provider 15.8 __________________________________________________________________________________________________ 1 Includes piped water and water from covered well and spring 2 First births are excluded 3 Refers to last births in the five years preceding the survey 4 Refers to all births in the five years preceding the survey 5 Standardized by mother’s assessment of child’s size at birth 6 25 ppm or more Ethiopia Demographic and Health Survey 2000 Central Statistical Authority Addis Ababa, Ethiopia ORC Macro Calverton, Maryland, USA May 2001 The 2000 Ethiopia DHS was implemented by the Central Statistical Authority under the aegis of the Ministry of Health. ORC Macro provided technical assistance through its MEASURE DHS+ program. The survey was funded principally by the Essential Services for Health in Ethiopia (ESHE) project through a bilateral agreement between the U.S. Agency for International Development (USAID) and the Federal Democratic Republic of Ethiopia. Funding was also provided by the United Nations Population Fund (UNFPA). Additional information about the Ethiopia DHS may be obtained from the Central Statistical Authority, P.O. Box 1143, Addis Ababa, Ethiopia (telephone: 115131; fax 563885). Information about the MEASURE DHS+ project may be obtained from ORC Macro, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705 (telephone: 301-572-0200; fax: 301-572-0999; e-mail: reports@macroint.com; internet: www.measuredhs.com Suggested citation: Central Statistical Authority [Ethiopia] and ORC Macro. 2001. Ethiopia Demographic and Health Survey 2000. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Authority and ORC Macro. Contents * iii CONTENTS Page Tables and Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Summary of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii CHAPTER 1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 History, Geography, and Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.3 Health and Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.4 Objectives and Organization of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS . . . . . . . . 5 2.1 Demographic Characteristics of Households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.2 Household Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2.3 Household Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.4 Housing Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2.5 Household Possessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2.6 Bednets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.7 Health Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 CHAPTER 3 RESPONDENT’S CHARACTERISTICS AND STATUS . . . . . . . . . . . . . . . . . . . 17 3.1 Background Characteristics of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 3.2 Educational Attainment by Background Characteristics . . . . . . . . . . . . . . . . . . . . . 19 3.3 Literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.4 Exposure to Mass Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.5 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 3.6 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 3.7 Employer and Form of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 3.8 Decision on Use of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 3.9 Women’s Attitude toward Wife Beating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 3.10 Female Circumcision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 CHAPTER 4 FERTILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 4.1 Current Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 4.2 Fertility Differentials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Page iv * Contents 4.3 Trends in Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 4.4 Children Ever Born and Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 4.5 Birth Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 4.6 Age at First Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 4.7 Teenage Pregnancy and Motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 CHAPTER 5 FERTILITY REGULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5.1 Knowledge of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5.2 Ever Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 5.3 Current Use of Contraceptive Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 5.4 Knowledge of Fertile Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 5.5 Trends in Contraceptive Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 5.6 Use of Social Marketing Brands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 5.7 Decision on Use of Contraceptives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 5.8 Number of Children at First Use of Family Planning . . . . . . . . . . . . . . . . . . . . . . . . 60 5.9 Source of Family Planning Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 5.10 Intention to Use Family Planning among Nonusers . . . . . . . . . . . . . . . . . . . . . . . . . 63 5.11 Reasons for Nonuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 5.12 Preferred Methods of Contraception for Future Use . . . . . . . . . . . . . . . . . . . . . . . . 64 5.13 Exposure to Family Planning Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 5.14 Exposure to Family Planning Messages through the Print Media . . . . . . . . . . . . . . . 67 5.15 Contact of Nonusers with Family Planning Providers . . . . . . . . . . . . . . . . . . . . . . . 68 5.16 Discussion of Family Planning between Spouses . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 5.17 Attitudes toward Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY . . . . . . . . . . . . . . . . . 73 6.1 Marital Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 6.2 Polygyny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 6.3 Age at First Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 6.4 Age at First Sexual Intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 6.5 Recent Sexual Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 6.6 Postpartum Amenorrhea, Abstinence, and Insusceptibility . . . . . . . . . . . . . . . . . . . 83 6.7 Termination of Exposure to Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 CHAPTER 7 FERTILITY PREFERENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 7.1 Desire for More Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 7.2 Need for Family Planning Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 7.3 Ideal Family Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 7.4 Fertility Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Page Contents * v CHAPTER 8 INFANT AND CHILD MORTALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 8.1 Assessment of Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 8.2 Levels and Trends in Infant and Child Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 8.3 Socioeconomic Differentials in Childhood Mortality . . . . . . . . . . . . . . . . . . . . . . . 100 8.4 Demographic Differentials in Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 8.5 Perinatal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 8.6 High-Risk Fertility Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 CHAPTER 9 ADULT AND MATERNAL MORTALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 9.1 Data Quality Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 9.2 Adult Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 9.3 Maternal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 CHAPTER 10 MATERNAL AND CHILD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 10.1 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 10.2 Antenatal Care Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 10.3 Tetanus Toxoid Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 10.4 Antimalarial Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 10.5 Eating Taboos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 10.6 Delivery Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 10.7 Assistance at Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 10.8 Delivery Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 10.9 Postnatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 10.10 Exposure to Sunlight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 10.11 Perceived Problems in Accessing Women’s Health Care . . . . . . . . . . . . . . . . . . . . 125 10.12 Vaccination Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 10.13 Trends in Vaccination Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 10.14 Acute Respiratory Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 10.15 Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 10.16 Stool Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 10.17 Prevalence of Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 10.18 Knowledge of ORS Packets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 10.19 Diarrhea Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 10.20 Feeding Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 10.21 Women’s Status and Children’s Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 CHAPTER 11 INFANT FEEDING AND CHILDHOOD AND MATERNAL NUTRITION . . . 141 11.1 Initiation of Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 11.2 Breastfeeding Status by Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 11.3 Duration and Frequency of Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 vi * Contents Page 11.4 Types of Supplemental Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 11.5 Frequency of Food Supplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 11.6 Iodine Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 11.7 Micronutrient Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 11.8 Early Termination of Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 11.9 Nutritional Status of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 11.10 Nutritional Status of Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 CHAPTER 12 HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS . . . . . . . . 159 12.1 AIDS Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 12.2 Knowledge of HIV/AIDS Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 12.3 Knowledge of HIV/AIDS-related Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 12.4 Social Aspects of HIV/AIDS Prevention and Mitigation . . . . . . . . . . . . . . . . . . . . . 167 12.5 Knowledge of Signs and Symptoms of Sexually Transmitted Infections . . . . . . . . 169 12.6 Prevalence and Treatment of STIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 12.7 Sexual Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 12.8 Knowledge of Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 12.9 Use of Condoms by Cohabiting and Noncohabiting Partners . . . . . . . . . . . . . . . . . 176 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 APPENDIX A SAMPLE DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 APPENDIX B ESTIMATES OF SAMPLING ERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 APPENDIX C DATA QUALITY TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 APPENDIX D SURVEY PERSONNEL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 APPENDIX E QUESTIONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Tables and Figures * vii TABLES AND FIGURES Page CHAPTER 1 INTRODUCTION Table 1.1 Basic demographic indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Table 1.2 Results of the household and individual interviews . . . . . . . . . . . . . . . . . . . . . . . . . . 4 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS Table 2.1 Household population by age, sex, and residence . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Table 2.2 Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Table 2.3 Children’s living arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Table 2.4 Educational attainment of household population . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Table 2.5 School attendance ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Table 2.6 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Table 2.7 Household durable goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Table 2.8 Possession of bednets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Table 2.9 Use of health facility services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Table 2.10 Types of health facilities utilized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Table 2.11 Utilization and source of drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Figure 2.1 Population pyramid of Ethiopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Figure 2.2 Age-specific attendance rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 CHAPTER 3 RESPONDENT’S CHARACTERISTICS AND STATUS Table 3.1 Background characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Table 3.2 Differential characteristics between spouses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Table 3.3 Educational attainment by background characteristics . . . . . . . . . . . . . . . . . . . . . . 20 Table 3.4 Literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Table 3.5 Exposure to mass media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Table 3.6.1 Employment: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Table 3.6.2 Employment: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Table 3.7.1 Occupation: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Table 3.7.2 Occupation: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Table 3.8 Employer and form of earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 3.9 Decision on use of earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Table 3.10 Women's agreement with reasons for wife beating . . . . . . . . . . . . . . . . . . . . . . . . . 32 Table 3.11 Prevalence of female circumcision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Table 3.12 Daughters' circumcision experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Table 3.13 Age at circumcision for daughters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Table 3.14 Person who performed the circumcision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Table 3.15 Severity of circumcision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 viii * Tables and Figures Page Figure 3.1 Percent distribution of women age 15-49 by employment status . . . . . . . . . . . . . . 25 Figure 3.2 Percent distribution of employed women age 15-49 by type of earnings . . . . . . . . . 30 CHAPTER 4 FERTILITY Table 4.1 Current fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Table 4.2 Fertility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Table 4.3 Trends in fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Table 4.4 Trends in age-specific fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Table 4.5 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Table 4.6 Birth intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Table 4.7 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Table 4.8 Median age at first birth by background characteristics . . . . . . . . . . . . . . . . . . . . . . 45 Table 4.9 Teenage pregnancy and motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Figure 4.1 Age-specific fertility rates by urban-rural residence . . . . . . . . . . . . . . . . . . . . . . . . . 38 Figure 4.2 Total fertility rates by selected background characteristics . . . . . . . . . . . . . . . . . . . 40 CHAPTER 5 FERTILITY REGULATION Table 5.1 Knowledge of contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Table 5.2 Couples’ knowledge of contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Table 5.3 Knowledge of contraceptive methods by background characteristics . . . . . . . . . . . . 50 Table 5.4 Ever use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Table 5.5 Current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Table 5.6.1 Current use of contraception by background characteristics: women . . . . . . . . . . . 55 Table 5.6.2 Current use of contraception by background characteristics: men . . . . . . . . . . . . . 57 Table 5.7 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Table 5.8 Trends in current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Table 5.9 Pill brands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Table 5.10 Condom brands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Table 5.11 Decision on use of contraceptives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Table 5.12 Number of children at first use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Table 5.13 Source of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Table 5.14 Time taken to reach source of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Table 5.15 Future use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Table 5.16 Reason for not intending to use contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Table 5.17 Preferred method of contraception for future use . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Table 5.18.1 Exposure to family planning messages on radio and television: women . . . . . . . . . 65 Table 5.18.2 Exposure to family planning messages on radio and television: men . . . . . . . . . . . 66 Table 5.19 Exposure to family planning messages in print media . . . . . . . . . . . . . . . . . . . . . . . 67 Table 5.20 Contact of nonusers with family planning providers . . . . . . . . . . . . . . . . . . . . . . . . 68 Table 5.21 Discussion of family planning with husband . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Tables and Figures * ix Page Table 5.22 Women’s approval of family planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Table 5.23 Couple’s approval of family planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Table 5.24 Wife’s perception of husband’s attitude toward family planning . . . . . . . . . . . . . . . 72 Figure 5.1 Current use of contraception by sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Figure 5.2 Current use of contraceptives among currently married women age 15-49 . . . . . . . 56 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table 6.1 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Table 6.2 Number of co-wives and wives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Table 6.3 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Table 6.4 Median age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Table 6.5 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Table 6.6 Median age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Table 6.7 Recent sexual activity: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Table 6.8 Recent sexual activity: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Table 6.9 Postpartum amenorrhea, abstinence, and insusceptibility . . . . . . . . . . . . . . . . . . . . 83 Table 6.10 Median duration of postpartum insusceptibility by background characteristics . . . . 84 Table 6.11 Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Figure 6.1 Marital union by age and sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 CHAPTER 7 FERTILITY PREFERENCE Table 7.1 Fertility preferences by number of living children . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Table 7.2 Desire for more children among monogamous couples . . . . . . . . . . . . . . . . . . . . . . 87 Table 7.3 Fertility preferences by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Table 7.4 Desire to limit childbearing by background characteristics . . . . . . . . . . . . . . . . . . . 89 Table 7.5 Need for family planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Table 7.6 Ideal and actual number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Table 7.7 Mean ideal number of children by background characteristics . . . . . . . . . . . . . . . . 93 Table 7.8 Fertility planning status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Table 7.9 Wanted fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Figure 7.1 Fertility preferences of currently married women age 15-49 . . . . . . . . . . . . . . . . . . 86 Figure 7.2 Desire to limit childbearing among currently married women and men, by number of living children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 CHAPTER 8 INFANT AND CHILD MORTALITY Table 8.1 Early childhood mortality rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Table 8.2 Early childhood mortality by socioeconomic characteristics . . . . . . . . . . . . . . . . . 100 Table 8.3 Early childhood mortality by demographic characteristics . . . . . . . . . . . . . . . . . . 102 Page x * Tables and Figures Table 8.4 Perinatal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Table 8.5 High-risk fertility behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Figure 8.1 Under-five mortality by selected demographic characteristics . . . . . . . . . . . . . . . . 103 CHAPTER 9 ADULT AND MATERNAL MORTALITY Table 9.1 Adult mortality rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Table 9.2 Direct estimates of maternal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 CHAPTER 10 MATERNAL AND CHILD HEALTH Table 10.1 Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Table 10.2 Number of antenatal care visits and stage of pregnancy . . . . . . . . . . . . . . . . . . . 113 Table 10.3 Antenatal care content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Table 10.4 Tetanus toxoid injections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Table 10.5 Antimalarial medication and eating taboos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Table 10.6 Place of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Table 10.7 Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Table 10.8 Delivery characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Table 10.9 Postnatal care by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Table 10.10 Postnatal care providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Table 10.11 Exposure to sunlight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Table 10.12 Perceived problem in accessing women's health care by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Table 10.13 Vaccinations by source of information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Table 10.14 Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Table 10.15 Vaccinations in first year of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Table 10.16 Immunization campaigns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Table 10.17 Prevalence and treatment of acute respiratory infection . . . . . . . . . . . . . . . . . . . 132 Table 10.18 Prevalence of fever and sources of treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Table 10.19 Treatment of fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Table 10.20 Disposal of children's stool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Table 10.21 Prevalence of diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Table 10.22 Knowledge of ORS packets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Table 10.23 Diarrhea treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Table 10.24 Feeding practices during diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Table 10.25 Women's status and children's health care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Figure 10.1 Antenatal care, tetanus toxoid (TT) vaccinations, place of delivery, and delivery assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Figure 10.2 Vaccination coverage among children age 12-23 months . . . . . . . . . . . . . . . . . . 128 Tables and Figures * xi Page CHAPTER 11 INFANT FEEDING AND CHILDHOOD AND MATERNAL NUTRITION Table 11.1 Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Table 11.2 Breastfeeding status by child's age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Table 11.3 Median duration and frequency of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . 144 Table 11.4 Foods consumed by children in preceding 24 hours . . . . . . . . . . . . . . . . . . . . . . . 146 Table 11.5 Frequency of foods consumed by children in preceding 24 hours . . . . . . . . . . . . 147 Table 11.6 Frequency of foods consumed by children in preceding 7 days . . . . . . . . . . . . . . 148 Table 11.7 Iodized salt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Table 11.8 Micronutrient intake among children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Table 11.9 Micronutrient intake and night blindness among mothers . . . . . . . . . . . . . . . . . . 151 Table 11.10 Children who stopped breastfeeding early . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Table 11.11 Nutritional status of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Table 11.12 Nutritional status of women by background characteristics . . . . . . . . . . . . . . . . . 156 Figure 11.1 Weight-for-age among children under age 5 by selected characteristics . . . . . . . 155 Figure 11.2 Percentage of women age 15-49 with a low body mass index (BMI) by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 CHAPTER 12 HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Table 12.1 Knowledge of AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Table 12.2.1 Source of information on AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Table 12.2.2 Source of information on AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Table 12.3 Knowledge of ways to avoid HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Table 12.4.1 Knowledge of programmatically important ways to avoid HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Table 12.4.2 Knowledge of programmatically important ways to avoid HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Table 12.5 Knowledge of HIV/AIDS-related issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Table 12.6 Discussion of HIV/AIDS with partner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Table 12.7 Social aspects of HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Table 12.8 Testing for AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Table 12.9.1 Knowledge of signs and symptoms of STIs: women . . . . . . . . . . . . . . . . . . . . . . 170 Table 12.9.2 Knowledge of signs and symptoms of STIs: men . . . . . . . . . . . . . . . . . . . . . . . . . 171 Table 12.10 Self-reporting of sexually transmitted infection and STI syptoms . . . . . . . . . . . . 172 Table 12.11 Number of sexual partners of married women and men . . . . . . . . . . . . . . . . . . . 173 Table 12.12 Number of sexual partners of unmarried women and men . . . . . . . . . . . . . . . . . 174 Table 12.13 Knowledge of condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Table 12.14.1 Use of condoms: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 Table 12.14.2 Use of condoms: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 xii * Tables and Figures Page APPENDIX A SAMPLE DESIGN Table A.1.1 Sample implementation: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Table A.1.2 Sample implementation: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 APPENDIX B ESTIMATES OF SAMPLING ERRORS Table B.1 List of selected variables for sampling errors, . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Table B.2 Sampling Errors - National sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 Table B.3 Sampling Errors - Urban sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 Table B.4 Sampling Errors - Rural sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 APPENDIX C DATA QUALITY TABLES Table C.1 Household age distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Table C.2 Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . . . 198 Table C.3 Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 Table C.4 Births by calendar years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Table C.5 Reporting of age at death in days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 Table C.6 Reporting of age at death in months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Table C.7 Data on siblings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Table C.8 Indicators of data quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Table C.7 Sibship size and sex ratio of siblings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Foreword * xiii FOREWORD The 2000 Ethiopia Demographic and Health Survey (DHS) is the first of its kind to be conducted in the country. The survey was conducted by the Central Statistical Authority (CSA) under the aegis of the Ministry of Health and funded primarily by the United States Agency for International Development (USAID). Funding was also provided by the United Nations Population Fund (UNFPA). ORC Macro provided technical assistance under the MEASURE DHS+ program. The survey collected information on family planning knowledge and use, fertility, infant and child mortality, maternal and child health, and knowledge of HIV/AIDS. Preparatory work for the DHS was initiated in June 1999 and fieldwork was carried out between early February and mid-June 2000. The findings presented in this report will provide valuable information in the formulation of appropriate population and health policies and programs in the country. Key indicators relating to fertility, mortality and health are provided for the 9 regions and 2 administrative council areas of the country. In addition, data are also provided by urban and rural residence. Findings from the DHS indicate that there has been some decline in fertility over the last decade. Knowledge of family planning is relatively high in Ethiopia. Nevertheless, the use of contraception is very low, with current use markedly lower than ever use. The mass media are not important sources of information on family planning, indicating tremendous potential for improving information, education and communication in Ethiopia. The majority of Ethiopian women and men prefer to space or limit the number of children that they have, and have a potential need for family planning. If all currently married women who say they want to space or limit the number of children were to use family planning, there would be a more than five-fold increase in the contraceptive prevalence rate in Ethiopia. DHS data also show that child mortality has declined over the last decade. Nevertheless, there is much scope for improvement in maternal and child health. Most mothers received no antenatal care, and the majority of deliveries is non-institutional and receives no assistance from health professionals. It is encouraging to note, however, that knowledge of HIV/AIDS in Ethiopia is high. The Central Statistical Authority acknowledges the invaluable assistance of a number of institutions and individuals toward the successful completion of the Ethiopia DHS. The CSA is particularly thankful to USAID and UNFPA for funding the survey, to ORC Macro for providing technical assistance, and to UNICEF for providing weighing scales and salt-testing kits used in the survey. The CSA expresses its gratitude to the Ministry of Health and the National Office of Population for their support. We highly appreciate and commend the dedicated effort of all persons involved in the Ethiopia DHS and in the timely completion of the fieldwork and publication of this report. Abdulahi Hassen Ph.D. General Manager Central Statistical Authority May 2001 Acknowledgments * xv ACKNOWLEDGMENTS The following persons contributed to the preparation of this report: Dr. Abdulahi Hassen, Central Statistical Authority Mr. Amare Isaias, Central Statistical Authority Mr. Jelaluden Ahmed, Central Statistical Authority Mr. Behailu G/Medhin, Central Statistical Authority Mrs. Gezu Birhanu, Central Statistical Authority Mr. Gebeyehu Abelti, Central Statistical Authority Mrs. Alemtsehay Birru, Central Statistical Authority Mr. Girma Kassie, Central Statistical Authority Mr. Yehalashet Mekonen, Central Statistical Authority Mr. Biruk Altaye, Central Statistical Authority Mr. Kasahum Asress, Central Statistical Authority Mr. Ayele Menbere, Central Statistical Authority Ms. Jerico Fekade, Central Statistical Authority Dr. Pav Govindasamy, ORC Macro Dr. Alfredo Aliaga, ORC Macro Mr. Albert Themme, ORC Macro Ms. Annie Cross, ORC Macro Ms. Arlinda Zhuzhuni, ORC Macro Dr. Sidney Moore, ORC Macro Ms. Kaye Mitchell, ORC Macro Summary of Findings * xvii SUMMARY OF FINDINGS The 2000 Ethiopia Demographic and Health Survey (DHS) is a nationally representative survey of 15,367 women age 15-49 and 2,607 men age 15-59. The Ethiopia DHS is the first comprehensive nationally representative popula- tion and health survey conducted in Ethiopia and the first to be implemented as part of the world- wide Demographic and Health Surveys (DHS) project. The primary purpose of the Ethiopia DHS is to furnish policymakers and planners with detailed information on fertility, family planning, infant and child mortality, maternal and child health, and nutrition. In addition, the survey collected information on knowledge of HIV/AIDS and other sexually transmitted infections. FERTILITY Survey results indicate that fertility has declined in the last decade from 6.4 births per woman in 1990 to 5.9 births per woman in 2000, a decline of half a child. There are distinct differences by residence, with rural women having twice as many children as urban women. Fertility is high- est in the Oromiya Region (6.4 births per woman) and lowest in Addis Ababa (1.9 births per woman). Education has a marked effect on fertility, with uneducated mothers having twice as many children as women with at least some secondary education. Childbearing starts early. At current age-specific rates of childbearing, an Ethiopian woman will have had more than half of her lifetime births by age 30, and nearly three-fourths by age 35. Several factors could account for the decline in fertility in Ethiopia. Over the last 10 years, there has been a decline in the percentage of women currently in union from 72 percent in 1990 to 64 percent in 2000. This decline in nuptiality is observed for all age groups. The median age at marriage has also risen over the last two decades from around 16 years for women age 30-49 to 18 years for women age 20-24. There has also been a rise in the median age at first birth during the last 10 years. In addition, the percentage of women married by age 15 has declined from 35 percent among women age 35-39 to 14 percent among those currently age 15-19. The median age at first sexual intercourse for women is the same as the median age at marriage, while men become sexually active well before marriage. The median age at first sexual intercourse for men is 20.3 years, three years earlier than the median age at first marriage. In general, Ethiopian men marry more than seven years later than women. Overall, 14 percent of currently married women are married to men who are in a polygynous union. Older women, rural women, women residing in the Gambela, Affar, and SNNP regions, and uneducated women more likely to be in a polygynous union than other women. About one in eleven men is in a polygynous union. The interval between births is relatively long in Ethiopia. Fifty-seven percent of all births occur nearly three years after a previous birth. Post- partum insusceptibility is one of the major factors contributing to the long birth interval in Ethiopia. The median duration of amenorrhea is 19 months, postpartum abstinence is 2 months, and insusceptibility is 20 months. FAMILY PLANNING Knowledge of family planning is relatively high in Ethiopia, with 86 percent of currently married women and 92 percent of currently married men having heard of at least one method of contraception. The pill and injectables are the most widely known modern methods among both women and men. Use of contraception is very low, with a noticeable discrepancy between ever use and current use. Seventeen percent of currently married women and 25 percent of currently married men have used a family planning method at least once in xviii * Summary of Findings their lifetime. However, only 8 percent of women and 15 percent of men are currently using a method. Current use of modern methods is even lower, with 6 percent of women and 9 percent of men currently using a modern method. Much of the male-female difference in current use is due to the higher level of reported use of the pill and injectables by men. Men are also three times more likely than women to report use of traditional methods, especially periodic abstinence. More than three in four current users of modern methods (78 percent) obtain their method from the public sector, while 16 percent and 6 percent, respectively, obtain their method from the private medical sector or other private sources. The contraceptive prevalence rate in Ethiopia for all methods has increased over the last decade from 5 percent in 1990 to 8 percent in 2000. The use of modern contraceptive methods doubled over the 10-year period. Much of this increase can be attributed to increase in the use of inject- ables, from virtually nil in 1990 to 3 percent in 2000. The mass media is not an important source of information on family planning. Only 17 percent of women and 29 percent of men have heard a family planning message on the radio and/or television. Although the large majority of women who know of family planning approve of its use (69 percent), only 38 percent believe that their husband approves of its use. Nevertheless, nearly one in two married couples approves of the use of family planning. The desire for more children is the major reason given by currently married nonusers for not intending to use a method of contraception in the future. Forty-two percent of currently married women and 65 percent of currently married men reported this reason for non-use. The majority of Ethiopian women (68 percent) and men (68 percent) prefer to space or limit the number of children they have, and have a potential need for family planning. More than one in three currently married women has an unmet need for family planning (36 percent). The need for spacing (22 percent) is higher than the need for limiting (14 percent). If all currently married women who say they want to space or limit the number of children were to use family planning, the contraceptive prevalence rate in Ethiopia would increase from 8 percent to 44 percent. CHILD HEALTH At current mortality levels, one of every 6 Ethiopian children will die before the fifth birthday, with 58 percent of these deaths occurring during the first year of life. The DHS data show, however, that mortality has declined over the last 15 years. Under-five mortality is 21 percent lower now than it was five to nine years ago, with the pace of decline in infant mortality (25 percent) somewhat faster than the decline in child mortality (18 percent). Mortality is consistently lower in urban areas than in rural areas, with mortality lowest in Addis Ababa, the most urbanized area of the country. Nevertheless, even in Addis Ababa, one in nine children dies before the fifth birthday. The corresponding rates are about one in four in the Affar and Gambela regions. Maternal education is strongly correlated with child mortality. Neonatal mortality is 60 percent lower, infant mortality is 47 percent lower, and under-five mortality is 55 percent lower among mothers with some secondary education than among mothers with no education. Survival of infants and children is strongly influenced by access to maternal health care. Neonatal death is 33 percent lower when mothers have access to either antenatal or delivery care, and 92 percent lower when mothers have access to both antenatal and delivery care, than when neither service is used. With the exception of child mortality, male children in general experience higher mortality than female children. Mortality is higher among children born to very young mothers (less than 20 years) and older mothers (more than 40 years), first births and births of order seven and higher, and children born within two years of a previous birth. Summary of Findings * xix Twelve percent of children are fully vaccinated by 12 months of age, 41 percent have received the BCG vaccination, and 21 percent have been vaccinated against measles. Three in four children age 12-23 months received the first dose of polio vaccine by 12 months of age, one in two received the second dose, and about one in three received the third dose. While DPT and polio vaccines are often administered at the same time, polio coverage in Ethiopia is much higher than DPT coverage. This is primarily due to the success of the national immunization day campaign, during which polio vaccines are administered. While coverage for the first dose of DPT is relatively high (40 percent), there is a 55 percent decline in coverage between the first and third doses. The dropout between the first and third doses of polio is also marked—a 59 percent decline. There has been little change in the percentage of children fully vaccinated over the last four years; however, the percentage of children who received no vaccinations at all has declined from 31 percent among children age 48-59 months, to 25 percent among children age 12-23 months. One in four children under age five showed symptoms of acute respiratory infection (ARI), in the two weeks before the survey. Use of a health facility for the treatment of symptoms of ARI is low, with only 16 percent of children taken to a health facility or provider. Twenty-eight percent of children under five were reported to have had fever, a major manifestation of malaria, in the two weeks before the survey. Seventy-eight percent of these children received no treatment at all. Aspirin (8 percent) and antibiotics (6 percent) are the most commonly used treatments for fever. Few children with fever are treated with antimalarial medication. Nationally, 24 percent of all children under five had diarrhea at some time in the two weeks before the survey. Only 13 percent of these children were taken to a health provider. Forty- five percent of children with diarrhea were treated with some kind of oral rehydration therapy (ORT): 13 percent were treated with ORS (solution prepared from ORS packets); 9 percent were given recommended home fluids (RHF) prepared at home; 19 percent received either ORS or RHF; and 35 percent were given increased fluids. A large proportion of children with diarrhea (39 percent) did not receive any type of treatment at all. MATERNAL HEALTH Twenty-seven percent of mothers who had a live birth in the five years preceding the survey received antenatal care from health professionals; less than 1 percent of mothers received antenatal care from trained and untrained traditional birth attendants. No antenatal care was received by nearly three-quarters (73 percent) of mothers. Only one in ten women make four or more antenatal care visits during their entire pregnancy. The median number of antenatal care visits is 2.5, about five times less than the recommended number. Among mothers who received antenatal care one in four reported that they were informed about pregnancy complications during their antenatal care visits. Height and weight measurements were collected for 67 percent and 43 percent of mothers, respectively. Blood pressure measurement was included in the antenatal care for 69 percent of mothers, and urine and blood sampling was done for 21 and 25 percent of mothers, respectively. Seventeen percent of women who had a live birth in the five years preceding the survey received two or more doses of tetanus toxoid injections during pregnancy. Nine percent reported having received antimalarial medication. An overwhelming majority of births in the five years before the survey were delivered at home (95 percent). Only 6 percent of births were delivered with the assistance of a trained health professional, that is, a doctor, nurse or midwife, while 4 percent were delivered by a trained birth attendant (TBA). The majority of births (85 percent) were attended by either an untrained TBA (26 percent) or a relative, or some other person (58 percent). Six percent of all births were delivered without assistance. Postnatal care is extremely low in Ethiopia. Nine xx * Summary of Findings in 10 mothers who had a live birth in the five years preceding the survey received no postnatal care (90 percent). Of those who received post- natal care, half (5 percent) were women who delivered in a health facility. Only 8 percent of mothers received postnatal care within the crucial first two days of delivery, and 1 percent received care three to seven days after delivery. BREASTFEEDING AND NUTRITION Breastfeeding is nearly universal in Ethiopia, and the median duration of any breastfeeding is long (26 months). Exclusive breastfeeding, on the other hand, is relatively short, with a median duration of 3 months; nearly one in seven children under 4 months of age is given other milk, and 6 percent receive other liquids. The use of a bottle with a nipple is common (13 percent of children under 4 months) and bottle-feeding starts as early as 0-1 month. The level of malnutrition is significant with more than one in two Ethiopian children under five years of age stunted (short for their age), 11 percent wasted (thin for their age), and 47 percent underweight. In general, rural children and children of uneducated mothers are more likely to be stunted, wasted, or underweight than other children. Children in the Tigray, Amhara, and SNNP regions are more likely to be stunted, children in the Somali and Gambela regions are more likely to be wasted, and children in the SNNP, Amhara, and Affar regions are more likely to be underweight, than other children. Survey results also show that the level of chronic energy deficiency in Ethiopia is relatively high. Nearly one in three women falls below the cut-off of 18.5 for the body mass index, which utilizes both the height and weight to measure thinness. HIV/AIDS AND STIS Most women (85 percent) and men (96 percent) have heard of AIDS. The most important source of information on AIDS is community meetings, with 80 percent and 71 percent of women and men, respectively, having heard of AIDS at a community meeting. Men are much more likely than women to have heard about AIDS on the radio and television. Three times as many women as men said that they had not heard of AIDS or did not know if AIDS can be avoided, while 5 percent of women and 3 percent of men stated that there is no way to avoid getting AIDS. Twenty-nine percent of women and 6 percent of men do not know a specific way to avoid contracting the virus (HIV) that causes AIDS. Most respondents (53 percent of women and 70 percent of men) believe that having sex with only one partner is the single most effective way to avoid contracting HIV. Thirty-seven percent of women and 55 percent of men believe that a healthy-looking person can have the AIDS virus. Fifty-eight percent of women and 72 percent of men also recognize that the disease can be transmitted from a mother to her child during pregnancy, at delivery, or through breastfeeding. One in four women and one in two men who are currently married or living with a partner have discussed the prevention of HIV/AIDS with their spouse or partner. Nearly twice as many women as men who have heard of AIDS believed that a person who knows that she/he has the AIDS virus should be allowed to keep this information private. About one in two women and men (45 percent and 50 percent, respectively) are willing to care for relatives who are infected with the AIDS virus in their house. Overall, a very small percentage of men (2 percent) said that they have been tested for AIDS. Nearly two in three men who have not been tested for AIDS say they want to be tested. Thirty-seven percent of women and 19 percent of men did not know of any other STIs. One in four women and 14 percent of men did not know of any signs or symptoms of STIs in a man while 27 percent of women and 41 percent of men did not know of any signs or symptoms of STIs in a woman. About 3 percent of men mentioned that they had experienced an infection in the 12 months preceding the survey. One in three men sought advice or treatment from a government medical facility. Fifty-four percent of men with an STI or associated symptoms did not inform their partner and 58 percent took no action to protect their partner. Summary of Findings * xxi WOMEN’S STATUS The DHS data shed some light on the status of women in Ethiopia. Fourteen percent of currently married women are in a polygynous union, with older women more likely than younger women to have a husband with several wives. There has been little change in the level of polygyny over the last decade. While the majority of Ethiopians have little or no education, women are generally less educated than men. The male-female gap in education is more obvious at lower levels of education primarily because the proportion of males and females attending higher levels of education is so small. The net attendance ratio, which indicates participation in primary schooling among those age 7-12 years, and secondary schooling among those age 13-18 years, is also lower among females than males. Fifty-six percent of women were working at the time of the survey, 7 percent were not working but had worked during the 12 months prior to the survey, and 37 percent did not work in the preceding 12 months. Agriculture is the dominant sector of the economy, employing 58 percent of women in the 12 months preceding the survey. Nearly half of the working women (48 percent) are self-employed, 43 percent work for a family member, and 9 percent work for someone else. Thirty-five percent of working women receive cash only, 5 percent are paid in cash and in kind, 19 percent are paid in kind only, and 41 percent do not receive any form of payment. Three-fourths of women who work for cash reported that they alone are mainly responsible for making decisions on how their earnings is spent, 16 percent said they make these decisions jointly with their husband/partner, and 2 percent said their husband/partner alone decides. A sizable majority of women (85 percent) believe that a husband is justified in beating his wife for at least one reason. Two in three women believe that a husband is justified in beating his wife if she burns the food or neglects the children. A slightly smaller percentage agree that if a woman argues with her husband (61 percent), or goes out without telling him (56 percent), then he is justified in beating her. One in two women believe that a husband is justified in beating his wife if she refuses to have sex with him. The practice of female circumcision is widespread in Ethiopia, with 80 percent of all women having been circumcised. More than half of the women who had one or more living daughters reported that at least one of their daughters had been circumcised. One in four Ethiopian women who died in the seven years preceding the survey died from pregnancy or pregnancy-related causes. The maternal mortality ratio, which measures the obstetric risk associated with each live birth, is 871 deaths per 100,000 live births for the period 1994-2000. Introduction * 1 INTRODUCTION 1 1.1 HISTORY, GEOGRAPHY, AND ECONOMY Ethiopia is an ancient country with a rich diversity of peoples and cultures and a unique alphabet that has existed for more than 3,000 years. The country has always maintained its independence, even during the colonial era in Africa. Ethiopia was ruled by successive emperors and kings with a feudal system of government until 1974. In 1974, the military took over the reign of rule by force and administered the country until May 1991. Currently, a federal system of government exists, and political leaders are elected every five years. The government is made up of two tiers of parliament, the House of the Council of Peoples Representatives and the House of Federal States, with the regions, zones, weredas, and kebeles within them having elected council members. The administrative boundaries within the country have changed three times since the mid-1970s, and at present Ethiopia has nine regional states, Addis Ababa City Administration and Dire Dawa Administration Council. Ethiopia is situated in the Horn of Africa between 3 and 15 degrees north latitude and 33 and 48 degrees east longitude. It is a country with great geographical diversity; its topographic features range from the highest peak at Ras Dashen, which is 4,550 meters above sea level, down to the Affar Depression at 110 meters below sea level (CSA, 2000). The climatic condition of the country varies with the topography, with temperatures as high as 47 degrees Celsius in the Affar Depression and as low as 10 degrees Celsius in the highlands. The total area of the country is about 1.1 million square kilometers and Djibouti, Eritrea, Sudan, Kenya, and Somalia border it. Ethiopia is an agrarian country, and agriculture accounts for 54 percent of the gross domestic product (GDP), employs about 80 percent of the population, and accounts for about 90 percent of the exports (CSA, 2000). The country is one of the least developed in the world, with a per capita gross national product (GNP) in 1998 of US$100 (PRB, 2000). Coffee is the main export of the country. The Ethiopian currency is the Birr, and at present, 1 US dollar is equivalent to about 8 Birr. Between 1974 and 1991, the country operated a central command economy under the socialist banner of the Derg regime. However, since their overthrow, Ethiopia has moved toward a market-oriented economy. At present, the country has two government-owned commercial banks and six privately owned commercial banks, one government-owned insurance company and seven private insurance companies (NBE, 2000). There are also 15 microfinancing institutions established by private organizations. 1.2 POPULATION Table 1.1 provides a summary of the basic demographic indicators for Ethiopia from data collected in the two population and housing censuses carried out in 1984 and 1994. The population increased over the decade from 42.6 million in 1984 to 53.5 million in 1994. There was a slight decline in the population growth rate over the decade, from 3.1 percent in 1984 to 2.9 percent in 1994. Ethiopia is one of the least urbanized countries in the world, with less than 14 percent of the country urbanized in 1994. Female life expectancy is about two years higher than male life expectancy. Over the decade, life expectancy for both males and females did not improve. 2 * Introduction Table 1.1 Basic demographic indicators Demographic indicators from various sources, Ethiopia __________________________________________________ 1984 1994 Indicator Census1 Census2 __________________________________________________ Population (millions) 42.6 53.5 Intercensal growth rate (percent) 3.1 2.9 Density (per square km.) 34.0 48.6 Percent urban 11.4 13.7 Life expectancy Male 51.1 50.9 Female 53.4 53.5 __________________________________________________ 1 Including Eritrea; CSA, 1991 2 CSA, 1998 The majority of the population lives in the highland areas of the country. The main occupation of the settled population is farming, while in the lowland areas, the mostly pastoral population moves from place to place with their livestock in search of grass and water. Christianity and Islam are the main religions; 51 percent of the population are Orthodox Christians, 33 percent are Muslims, and 10 percent are Protestants. The rest follow a diversity of other faiths. The country is home to about 80 ethnic groups that vary in population size from more than 18 million to less than 100 (CSA, 1998). 1.3 HEALTH AND FAMILY PLANNING The health system in Ethiopia is underdeveloped, and transportation problems are severe. The majority of the population resides in the rural areas and has little access to any type of modern health institution. It is estimated that about 75 percent of the population suffers from some type of communicable disease and malnutrition, which are potentially preventable (TGE, 1995). There was no health policy up through the 1950s; however, in the early 1960s, a health policy initiated by the World Health Organization (WHO) was adopted. In the mid-1970s, during the Derg regime, an elaborate health policy with emphasis on disease prevention and control was formulated. This policy gave priority to rural areas and advocated community involvement (TGE, 1993a). At present, the government health policy takes into account population dynamics, food availability, acceptable living conditions, and other requisites essential for health improvements (TGE, 1993a). The present health policy arises from the fundamental principle that health constitutes physical, mental, and social well-being for the enjoyment of life and for optimal productivity. To realize this objective, the government has established the Health Sector Development Program, which incorporates a 20-year health development strategy, through a series of 5-year investment programs (MOH, 1999). This program calls for the democratization and decentralization of health services; development of preventive health care; capacity building within the health service system; equitable access to health services; self-reliance; promotion of intersectoral activities and participation of the private sector, including non-governmental organizations (NGOs); and cooperation and collaboration with all countries in general and neighboring countries in particular and between regional and international organizations (TGE, 1993a). Population policies had been accorded a low priority in Ethiopia prior to the early 1990s. After the end of the Derg regime, the Transitional Government adopted a national population policy in 1993 (TGE, 1993b). The primary objective of the population policy was to harmonize the rate of population growth with socioeconomic development to achieve a high level of welfare. The main long-term objective was to close the gap between high population growth and low economic productivity and to expedite socioeconomic development through holistic integrated programs. Other objectives included preserving the environment and reducing rural-urban migration and reducing morbidity and mortality, particularly infant and child mortality. More specifically, the population policy targeted a reduction in the total fertility rate from 7.7 children per woman in 1990 to 4.0 children per woman in 2015 and an increase in contraceptive prevalence from 4 percent in 1990 to 44 percent in 2015 (TGE, 1993b). Family planning and related services and information are disseminated to the population through community organizations and women’s and youth groups. Introduction * 3 1.4 OBJECTIVES AND ORGANIZATION OF THE SURVEY The principal objective of the Ethiopia Demographic and Health Survey (DHS) is to provide current and reliable data on fertility and family planning behavior, child mortality, children’s nutritional status, the utilization of maternal and child health services, and knowledge of HIV/AIDS. This information is essential for informed policy decisions, planning, monitoring, and evaluation of programs on health in general and reproductive health in particular at both the national and regional levels. A long-term objective of the survey is to strengthen the technical capacity of the Central Statistical Authority to plan, conduct, process, and analyze data from complex national population and health surveys. Moreover, the 2000 Ethiopia DHS is the first survey of its kind in the country to provide national and regional estimates on population and health that are comparable to data collected in similar surveys in other developing countries. As part of the worldwide DHS project, the Ethiopia DHS data add to the vast and growing international database on demographic and health variables. The Ethiopia DHS collected demographic and health information from a nationally representative sample of women and men in the reproductive age groups 15-49 and 15-59, respectively. The Ethiopia DHS was carried out under the aegis of the Ministry of Health and was implemented by the Central Statistical Authority. ORC Macro provided technical assistance through its MEASURE DHS+ project. The survey was principally funded by the Essential Services for Health in Ethiopia (ESHE) project through a bilateral agreement between the United States Agency for International Development (USAID) and the Federal Democratic Republic of Ethiopia. Funding was also provided by the United Nations Population Fund (UNFPA). Using systematic sampling with probabilities proportional to size, 539 enumeration areas (EAs)—138 in urban areas and 401 in rural areas—were selected initially. A complete household listing operation was carried out in each selected EA, and a systematic sample of 27 households per EA was selected in all the regions in the second stage in order to provide statistically reliable estimates of key demographic and health variables. The Ethiopia DHS used three questionnaires: the Household Questionnaire, the Women’s Questionnaire, and the Men’s Questionnaire. These questionnaires were developed in the English language and translated into the five principal languages in use in the country—Amarigna, Oromigna, Tigrigna, Somaligna, and Afarigna. A four-week training course was held for interviewers, editors, and supervisors in general interviewing techniques, field procedures, and monitoring data quality. Data were collected by 38 teams, each comprised of four female interviewers, one male interviewer, one female editor, and a male team supervisor. The fieldwork was closely monitored for data quality through actual field visits and through field check tables. The survey was fielded between February and May 2000. Of the 14,642 households selected, interviews were completed for 14,072 households, 15,367 women age 15-49, and 2,607 men age 15-59 (see Table 1.2). Details of the fieldwork and sample design are presented in Appendix A. 4 * Introduction Table 1.2 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence, Ethiopia 2000 ___________________________________________________ Residence _______________ Result Urban Rural Total ___________________________________________________ Household interviews Households sampled Households occupied Households interviewed Household response rate Individual interviews: women Number of eligible women Number of eligible women interviewed Eligible woman response rate Household interviews Households sampled Households occupied Households interviewed Household response rate Individual interviews: men Number of eligible men Number of eligible men interviewed Eligible man response rate 3,793 10,849 14,642 3,666 10,501 14,167 3,629 10,443 14,072 99.0 99.4 99.3 4,636 11,080 15,716 4,543 10,824 15,367 98.0 97.7 97.8 691 1,999 2,690 671 1,954 2,625 668 1,944 2,612 99.6 99.5 99.5 737 2,034 2,771 680 1,927 2,607 92.3 94.7 94.1 Household Population and Characteristics * 5 2HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS This chapter provides a summary of the socioeconomic characteristics of households and respondents surveyed, including age, sex, place of residence, educational status, religion, ethnicity, household facilities, and household characteristics. Information collected on the characteristics of the households and respondents is important in understanding and interpreting the findings of the survey and also provides indicators of the representativeness of the survey. The information is also useful in understanding and identifying the major factors that determine or influence the basic demographic indicators of the population. Due to the way the sample was designed, the number of cases in some regions appear small since they are weighted to make the regional distribution nationally representative. Throughout this report, numbers in the tables reflect weighted numbers. To ensure statistical reliability, percentages based on 25 to 49 unweighted cases are shown within parentheses, and percentages based on fewer than 25 unweighted cases are suppressed. Wherever possible, the Ethiopia DHS data is compared with data from the 1990 National Family and Fertility Survey (NFFS) conducted by the Central Statistical Authority (CSA, 1993). The NFFS primarily targeted women age 15-49. Husbands of currently married women were also covered. Due to security and other reasons, the NFFS excluded from its coverage Eritrea, Tigray, Asseb, and Ogaden autonomous regions. In addition, fieldwork could not be carried out for Northern Gondar, Southern Gondar, Northern Wello, and Southern Wello due to security reasons. The Ethiopia DHS collected information from all usual residents of a selected household (the de jure population) and persons who had stayed in the selected household the night before the interview (the de facto population). Since the difference between these two populations is very small and to maintain comparability with other DHS reports, all tables in this report refer to the de facto population unless otherwise specified. A household was defined as a person or group of related and unrelated persons who live together in the same dwelling unit(s) or in connected premises, who acknowledge one adult member as head of the household, and who have common arrangements for cooking and eating their food. 2.1 DEMOGRAPHIC CHARACTERISTICS OF HOUSEHOLDS Age and sex are important demographic variables and are the primary basis of demographic classification in vital statistics, censuses, and surveys. They are also very important variables in the study of mortality, fertility, and nuptiality. The effect of variations in sex composition from one population group to another should be taken into account in comparative studies of mortality. In general, a cross- classification with sex is useful for the effective analysis of all forms of data obtained in surveys. The distribution of the household population in the Ethiopia DHS is shown in Table 2.1 by five- year age groups, according to urban-rural residence and sex. The total population counted in the survey was 66,830, with females slightly outnumbering males. The results indicate an overall sex ratio of 98 males per 100 females. The sex ratio is higher in rural areas (100 males per 100 females) than in urban areas (87 males per 100 females). The sex ratio observed in the Ethiopia DHS is consistent with that of the 1990 NFFS (CSA, 1993). 6 * Household Population and Characteristics Table 2.1 Household population by age, sex, and residence Percent distribution of the de facto household population by five-year age group, according to sex and residence, Ethiopia 2000____________________________________________________________________________________________________ Urban Rural Total_______________________ _______________________ _______________________ Age group Male Female Total Male Female Total Male Female Total____________________________________________________________________________________________________ 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80 + Total Number 12.3 11.7 11.9 18.0 17.4 17.7 17.2 16.5 16.9 12.3 10.9 11.5 16.6 15.2 15.9 16.1 14.5 15.3 14.2 13.0 13.6 14.2 12.8 13.5 14.2 12.9 13.5 15.2 16.1 15.7 10.8 10.4 10.6 11.4 11.2 11.3 9.8 10.9 10.4 6.9 8.2 7.6 7.3 8.6 8.0 8.0 9.8 9.0 6.7 7.3 7.0 6.9 7.7 7.3 5.9 5.9 5.9 4.1 5.4 4.8 4.4 5.5 4.9 5.7 5.6 5.7 4.6 5.0 4.8 4.8 5.1 4.9 4.6 3.7 4.1 3.6 4.2 3.9 3.8 4.1 4.0 3.3 3.1 3.2 3.4 3.9 3.6 3.4 3.8 3.6 1.8 1.9 1.8 2.6 2.3 2.5 2.5 2.2 2.4 2.0 2.1 2.1 2.5 2.7 2.6 2.4 2.6 2.5 1.6 1.9 1.8 1.7 1.9 1.8 1.7 1.9 1.8 1.0 1.4 1.3 1.5 1.4 1.5 1.4 1.4 1.4 0.8 0.9 0.8 1.2 1.0 1.1 1.1 1.0 1.0 0.5 0.5 0.5 0.7 0.5 0.6 0.6 0.5 0.6 0.9 0.6 0.7 0.7 0.5 0.6 0.7 0.5 0.6 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 4,483 5,129 9,612 28,565 28,653 57,219 33,048 33,782 66,830 ____________________________________________________________________________________________________ Note: Table is based on the de facto population; i.e., persons who stayed in the household the night before the interview. Figure 2.1 Population Pyramid of Ethiopia Ethiopia DHS 2000 80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Age 0246810 0 2 4 6 8 10 Male Female Percent The age structure of the household population observed in the survey is typical of a society with a youthful population. The sex and age distribution of the population is also shown in the population pyramid in Figure 2.1. Ethiopia has a pyramidal age structure due to the large number of children under 15 years of age. Children under 15 years of age account for 46 percent of the population, a feature of populations with high fertility levels (Table 2.1). Fifty-one percent of the population is in the age group 15-64 and almost 4 percent are over 65. Household Population and Characteristics * 7 Table 2.2 Household composition Percent distribution of households by sex of head of household and by household size, according to residence, Ethiopia 2000_________________________________________ Residence_____________ Characteristic Urban Rural Total_________________________________________ Sex of head of household Male Female Total Number of usual members 1 2 3 4 5 6 7 8 9+ Total Mean size 64.6 78.7 76.4 35.4 21.3 23.6 100.0 100.0 100.0 12.8 3.6 5.1 15.0 9.9 10.7 17.0 14.9 15.2 15.2 17.7 17.3 12.8 16.7 16.1 10.0 14.2 13.5 6.2 9.7 9.1 4.7 6.5 6.2 6.4 6.8 6.7 100.0 100.0 100.0 4.2 4.9 4.8 _______________________________________ Note: Table is based on de jure members; i.e., usual residents. 2.2 HOUSEHOLD COMPOSITION Table 2.2 shows the distribution of households in the survey by the sex of the head of the household and by the number of household members in urban and rural areas. Households in Ethiopia are predominantly male headed, a common feature of most African countries. Less than one-fourth of households are headed by females with the proportion of female-headed households higher in urban areas than in rural areas. The average household size observed in the survey is 4.8 persons, which is similar to the average household size observed in the 1994 Census (CSA, 1999). Rural households have 4.9 persons per household and are slightly larger than urban households (4.2 persons). Single-person households are more common in urban areas (13 percent) than in rural areas (4 percent). Only 7 percent of households have nine or more members. Detailed information on children’s living arrangements and orphanhood is presented in Table 2.3. In Ethiopia, 71 percent of children under 15 live with both parents, 14 percent live with only their mother, 4 percent live with only their father, and 10 percent live with neither parent. Nine percent of children live with their mother even though their father is alive, 2 percent of children live with their father even though their mother is alive, and 7 percent live with neither parent even though both of them are alive. Seven percent of children do not have a father alive and 4 percent do not have a mother alive. The percentage of children not living with their parents increases with age of the child. The proportion of children living with both parents varies little by sex. However, rural children are more likely to live with both parents than urban children. The highest proportion of children living with both parents is in Benishangul-Gumuz (75 percent), while the lowest proportion is in Addis Ababa (56 percent). 1 Secondary education refers to both junior secondary (grades 7-8) and senior secondary (grades 9-12). 8 * Household Population and Characteristics Table 2.3 Children’s living arrangements Percent distribution of de jure children under age 15 by survival status of parents and children's living arrangements, according to background characteristics, Ethiopia 2000______________________________________________________________________________________________________ Living Living with mother with father but not father but not mother Not living with either parent Missing Living ____________ _______________________________________ informa- with Only Only tion on Background both Father Father Mother Mother Both father mother Both father/ characteristic parents alive dead alive dead alive alive alive dead mother Total Number______________________________________________________________________________________________________ Age <2 2-4 5-9 10-14 Sex Male Female Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 86.7 10.8 0.8 0.2 0.3 0.6 0.2 0.0 0.1 0.4 100.0 6,600 78.0 10.1 2.8 1.4 0.9 5.0 0.6 0.3 0.2 0.7 100.0 6,468 69.3 8.8 5.4 2.7 2.2 7.8 1.0 1.3 0.9 0.6 100.0 8,528 59.2 7.1 8.8 3.2 4.2 10.7 1.7 2.7 1.6 0.7 100.0 9,167 70.9 8.5 5.2 2.5 2.3 6.7 1.1 1.3 0.8 0.7 100.0 15,778 70.5 9.2 5.2 1.9 2.1 7.3 1.0 1.4 0.9 0.5 100.0 14,984 56.8 14.4 7.8 3.2 2.4 9.8 1.2 1.5 1.9 1.1 100.0 3,559 72.5 8.1 4.9 2.1 2.2 6.6 1.0 1.3 0.7 0.6 100.0 27,204 62.0 21.1 6.7 0.7 1.2 4.3 1.2 0.7 0.8 1.2 100.0 2,058 63.3 9.4 8.3 2.9 6.3 3.4 2.3 1.7 2.4 0.1 100.0 317 70.9 8.5 5.2 3.4 1.7 6.5 1.1 1.3 0.8 0.6 100.0 8,291 72.9 7.7 4.7 1.8 2.6 6.6 0.9 1.2 0.8 0.8 100.0 11,730 73.3 5.5 5.5 0.7 4.2 5.2 0.6 2.0 1.8 1.2 100.0 433 74.9 7.4 6.6 1.4 2.7 3.5 1.1 1.2 0.9 0.2 100.0 313 70.9 7.4 5.1 2.0 2.3 8.9 1.0 1.6 0.7 0.2 100.0 6,741 59.1 15.8 7.5 2.5 1.6 7.1 2.0 2.1 2.0 0.5 100.0 67 64.2 11.9 9.5 1.7 1.0 6.5 1.2 1.2 1.4 1.3 100.0 65 56.0 11.3 7.7 3.0 1.7 13.0 2.2 2.3 1.6 1.2 100.0 641 69.4 9.6 5.8 2.5 1.4 5.9 1.9 1.4 1.0 1.1 100.0 107 70.7 8.8 5.2 2.2 2.2 7.0 1.0 1.3 0.8 0.6 100.0 30,763 ___________________________________________________________________________________________________________ Note: Orphans are children with both parents dead. 2.3 HOUSEHOLD EDUCATION Studies show that education is one of the major socioeconomic factors that influence a person’s behavior and attitude. In general, the higher the level of education of a woman, the more knowledgeable she is about the use of health facilities, family planning methods, and the health of her children. 2.3.1 Educational Attainment of Household Population Information on the educational level of the male and female population age 6 and over is presented in Table 2.4. Survey results show that the majority of Ethiopians have little or no education, with females much less educated than males. Sixty-two percent of males and 77 percent of females have no education, and 27 percent of males and 17 percent of females have only some primary education. Less than 3 percent of males and 1 percent of females have completed primary education only, and 6 percent of males and 4 percent of females have attended, but not completed, secondary school.1 Only 3 percent of males and 1 percent of females have completed secondary school or higher. The male- female gap in education is more obvious at lower levels of education primarily because the proportion of males and females attending higher levels of education is so small. Household Population and Characteristics * 9 Table 2.4 Educational attainment of household population Percent distribution of the de facto male and female household populations age six and over by highest level of education attended, according to background characteristics, Ethiopia 2000_______________________________________________________________________________________________ Level of education____________________________________________________________ Com- No Com- Some pleted More Don't Background educa- Some pleted second- second- than know/ characteristic tion primary primary1 ary ary2 secondary missing Total Number_______________________________________________________________________________________________ MALE_______________________________________________________________________________________________ Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 80.6 19.0 0.0 0.0 0.0 0.0 0.4 100.0 4,333 50.0 47.0 1.4 1.4 0.0 0.0 0.2 100.0 4,694 43.9 37.2 5.4 12.6 0.7 0.0 0.2 100.0 3,771 46.5 30.3 4.7 13.1 4.7 0.5 0.1 100.0 2,427 48.1 26.8 6.6 10.6 4.6 3.0 0.3 100.0 2,284 49.6 25.0 4.7 11.7 5.4 3.0 0.5 100.0 1,440 57.8 21.5 3.8 9.9 3.6 2.9 0.4 100.0 1,572 67.4 15.9 3.7 5.8 3.9 3.1 0.2 100.0 1,249 77.4 15.0 1.4 4.0 0.8 0.9 0.5 100.0 1,118 86.2 9.6 1.0 1.2 1.0 0.8 0.0 100.0 834 87.9 9.5 0.8 0.8 0.4 0.5 0.2 100.0 798 89.2 8.0 0.4 1.1 0.3 0.8 0.3 100.0 572 95.5 3.3 0.2 0.4 0.2 0.1 0.3 100.0 1,289 24.3 30.9 6.4 24.3 9.2 4.8 0.2 100.0 3,808 67.7 26.2 2.2 2.9 0.4 0.2 0.3 100.0 22,579 65.4 24.1 3.0 5.2 0.7 1.4 0.2 100.0 1,540 78.0 13.0 1.6 4.0 2.1 0.7 0.6 100.0 305 74.4 18.9 1.6 3.4 0.7 0.6 0.3 100.0 7,057 60.1 29.3 2.8 5.5 1.3 0.5 0.4 100.0 10,013 83.0 10.2 2.0 2.8 0.8 0.6 0.7 100.0 397 55.2 33.0 3.2 5.8 1.0 1.6 0.1 100.0 278 52.7 34.6 3.7 6.8 1.3 0.7 0.1 100.0 5,713 36.0 40.3 5.9 12.2 2.3 3.0 0.3 100.0 64 37.3 30.3 4.8 17.5 7.2 2.3 0.6 100.0 62 14.5 27.2 6.0 26.7 17.9 7.5 0.2 100.0 853 38.5 24.3 6.0 16.9 10.8 3.3 0.2 100.0 104 61.5 26.9 2.8 6.0 1.7 0.9 0.3 100.0 26,386 _______________________________________________________________________________________________ FEMALE_______________________________________________________________________________________________ Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 82.4 17.2 0.0 0.0 0.0 0.0 0.4 100.0 4,075 59.9 37.0 1.9 1.0 0.0 0.0 0.2 100.0 4,350 61.6 23.6 2.4 11.8 0.7 0.0 0.0 100.0 3,793 69.6 16.0 1.7 8.8 3.3 0.6 0.0 100.0 2,903 70.8 14.0 2.5 7.5 3.9 1.2 0.1 100.0 2,600 79.3 12.5 1.4 3.7 2.0 1.0 0.0 100.0 1,863 86.2 8.0 0.7 1.9 2.0 0.8 0.3 100.0 1,718 93.4 4.0 0.5 1.0 0.5 0.6 0.0 100.0 1,396 96.2 2.6 0.1 0.7 0.2 0.1 0.0 100.0 1,269 97.2 1.7 0.0 0.4 0.3 0.2 0.2 100.0 748 98.5 1.3 0.0 0.1 0.0 0.0 0.0 100.0 871 99.1 0.3 0.1 0.0 0.0 0.0 0.4 100.0 655 99.6 0.2 0.0 0.0 0.0 0.0 0.2 100.0 1,127 39.8 28.8 4.4 19.3 6.2 1.5 0.0 100.0 4,452 83.9 14.1 0.6 0.9 0.1 0.1 0.2 100.0 22,918 76.8 18.0 1.5 2.6 0.6 0.3 0.1 100.0 1,830 85.0 9.2 1.4 3.2 0.6 0.3 0.3 100.0 291 80.1 15.5 0.9 2.6 0.6 0.2 0.1 100.0 7,068 78.6 15.6 0.9 3.8 0.6 0.3 0.2 100.0 10,234 89.3 7.7 0.4 1.3 0.3 0.1 0.8 100.0 344 76.5 19.3 1.5 1.8 0.4 0.2 0.3 100.0 289 77.3 17.6 1.2 2.9 0.8 0.1 0.1 100.0 6,008 62.0 28.5 2.2 5.5 0.8 0.8 0.3 100.0 65 57.2 21.4 2.6 12.5 5.7 0.5 0.1 100.0 69 30.6 26.5 5.8 21.5 12.0 3.6 0.0 100.0 1,046 53.4 21.1 3.7 14.3 6.2 1.1 0.1 100.0 126 76.7 16.5 1.2 3.9 1.1 0.3 0.2 100.0 27,370 ________________________________________________________________________________________________ Note: Totals include 6 men and 3 women for whom information on age is not available. 1 Completed grade 6 at the primary level 2 Students who are overage for a given level of schooling may have started school overage, may have repeated one or more grades in school, or may have dropped out of school and later returned. 10 * Household Population and Characteristics An investigation of the changes in educational attainment by successive age groups indicates the long-term trend of the country’s educational achievement. Survey results show that there has been a marked improvement in the educational attainment of women. For example, the proportion of women with no education has declined significantly from nearly 100 percent among women age 65 and over to 60 percent among women age 10-14. A similar trend is noticeable among men, with the proportion of men with no education declining from 96 percent among those age 65 and over to 50 percent among those age 10-14. As expected, educational attainment is much higher among the urban than among the rural population. For example, 76 percent of males and 60 percent of females in urban areas have some education, compared with only 32 percent of males and 16 percent of females in rural areas. Regarding regional variation, the proportion of men and women with no education is the highest in the Somali Region (83 percent and 89 percent, respectively) and the lowest in the capital city of Addis Ababa (15 percent and 31 percent, respectively). 2.3.2 School Attendance Ratios Data on net attendance ratios (NARs) and gross attendance ratios (GARs) by school level, sex, residence, and region are shown in Table 2.5. The NAR indicates participation in primary schooling for the population age 7-12 and secondary schooling for the population age 13-18. The GAR measures participation at each level of schooling among those of any age from 5 to 24. The GAR is nearly always higher than the NAR for the same level because the GAR includes participation by those who may be older or younger than the official age range for that level.2 An NAR of 100 percent would indicate that all those in the official age range for the level are attending at that level. The GAR can exceed 100 percent if there is significant overage or underage participation at a given level of schooling. Less than one-third of children who should be attending primary school are currently doing so at that level. At the same time, only 12 percent of secondary-school-age youths are in school at that level. The NAR is higher among males than among females at both the primary and secondary levels. Attendance ratios are much lower in rural areas than in urban areas and are the lowest in the Somali Region. The GAR is also higher among males than among females, at 70 and 49 at the primary-school level, respectively, and 20 and 15 at the secondary-school level, respectively, indicating higher attendance among males than among females. Although the overall GAR at the primary-school level is 60, there are significant levels of overage and/or underage participation in the urban areas among both males (116) and females (110) and in Addis Ababa (112). Household Population and Characteristics * 11 Table 2.5 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de jure household population by level of schooling and sex, according to background characteristics, Ethiopia 2000 ________________________________________________________________________________________ Net attendance ratio (NAR)1 Gross attendance ratio (GAR)2 Background ____________________________ ___________________________ characteristic Male Female Total Male Female Total ________________________________________________________________________________________ PRIMARY SCHOOL ________________________________________________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 75.4 72.6 74.0 115.6 109.9 112.6 27.4 20.9 24.3 63.7 40.0 52.2 28.5 35.0 31.6 59.7 60.4 60.0 22.4 19.9 21.2 36.1 28.9 32.6 30.3 32.8 31.5 53.0 49.0 51.1 30.8 24.3 27.6 75.8 47.1 61.7 11.8 14.0 12.9 24.0 23.1 23.6 41.1 27.5 34.0 86.5 54.9 70.0 36.6 19.5 28.0 82.2 43.1 62.6 67.8 47.6 58.0 135.6 94.5 115.6 66.4 58.7 62.7 108.9 81.7 95.8 80.9 73.1 76.7 115.8 108.2 111.7 57.8 46.8 52.0 92.5 72.9 82.2 32.8 27.5 30.2 69.5 48.9 59.5 ________________________________________________________________________________________ SECONDARY SCHOOL ________________________________________________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 56.2 44.9 50.2 80.3 62.4 70.7 4.2 1.6 3.0 8.0 2.8 5.6 18.8 12.4 15.8 29.3 18.8 24.4 8.9 7.5 8.1 11.8 9.7 10.7 11.3 7.9 9.7 14.7 11.7 13.3 10.9 8.9 9.9 16.9 11.3 14.3 6.3 1.9 4.2 9.2 1.9 5.8 10.5 5.8 8.1 16.3 7.6 11.9 8.3 7.6 8.0 18.8 12.3 15.7 24.3 13.7 19.4 39.5 20.7 31.0 36.4 22.6 29.9 51.1 38.8 45.3 57.3 47.3 51.5 79.4 68.5 73.1 38.0 28.4 32.8 56.1 44.0 49.6 12.5 10.4 11.5 19.6 14.9 17.3 ________________________________________________________________________________________ 1 The NAR for primary school is the percentage of the primary-school-age (7-12 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary-school-age (13-18 years) population that is attending secondary school. By definition the NAR cannot exceed 100%. 2 The GAR for primary school is the total number of primary school students, among those of any age, expressed as the percentage of the official primary-school-age population. The GAR for secondary school is the total number of secondary school students 5-24 years, expressed as the percentage of the official secondary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100%. 12 * Household Population and Characteristics Figure 2.2 Age-Specific Attendance Rates 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Age 0 10 20 30 40 50 60 Percent Male Female Ethiopia DHS 2000 (Percentage of the De Facto Household Population Age 5-24 Years Attending School, by Age and Sex) The age-specific attendance rates (ASARs) for the population age 5 and over by sex are shown in Figure 2.2. The ASAR indicates participation in schooling at any level, from primary to higher levels of education. Although the minimum age for schooling in Ethiopia is 7, there are some children enrolled prior to this age. Nevertheless, only 15 percent of children age 7 are attending school, indicating that a large majority of children in Ethiopia at that age have not entered the school system. There is little difference in the proportion of males and females attending school up to age 10, after which a significantly higher proportion of males than females attends school. 2.4 HOUSING CHARACTERISTICS The physical characteristics of households are important in assessing the general socioeconomic condition of the population. In the Ethiopia DHS respondents to the household questionnaire were asked about access to electricity, source of drinking water and time taken to the nearest source, type of toilet facility, main material of floors, and number of rooms used for sleeping. The results are presented in Table 2.6. Thirteen percent of households have electricity, but this varies widely by place of residence. Less than 1 percent of households in rural areas have access to electricity, compared with three-fourths of urban households. Eighteen percent of households have access to piped drinking water, 40 percent of households fetch water from open springs, 27 percent get their drinking water from rivers, and 8 percent of households have access to a protected well or spring. Urban households are much more likely than rural households to have access to a protected source of drinking water. For example, 81 percent of urban households have access to piped water, compared with only 5 percent of rural households. The proportion of households with access to piped water has increased from about 14 percent in 1994 (CSA, 1999) to 18 percent in 2000. Households that did not have drinking water within their own compound were also asked for the time taken to fetch water. Twenty-six percent of all households (53 percent Household Population and Characteristics * 13 Table 2.6 Housing characteristics Percent distribution of households by background charac- teristics, according to residence, Ethiopia 2000_____________________________________________________ Residence Background ______________ characteristic Urban Rural Total_____________________________________________________ Electricity Yes No Total Source of drinking water Piped into dwelling Piped into compound Piped outside compound Open well Open spring Covered well Covered spring River Pond/lake/dam Other Total Time to water source (in minutes) Percentage <15 minutes Median time to source Sanitation facility Own flush toilet Traditional pit toilet Vent. improved pit latrine No facility/bush Total Main floor material Earth/sand Dung Rudimentary floor Vinyl/tiles/brick/carpet Cement Other Total Persons per sleeping room 1-2 3-4 5-6 7+ Missing/Don't know Total Mean Total 76.2 0.4 12.7 23.8 99.6 87.3 100.0 100.0 100.0 0.6 0.0 0.1 28.2 0.0 4.6 52.0 5.3 12.9 1.7 3.6 3.3 5.1 47.2 40.4 2.1 3.0 2.8 3.2 5.2 4.9 6.9 31.4 27.4 0.1 4.3 3.6 0.2 0.0 0.1 100.0 100.0 100.0 52.7 21.2 26.3 9.8 29.3 29.2 1.9 0.0 0.3 66.3 7.9 17.4 1.9 0.0 0.3 29.9 92.0 81.9 100.0 100.0 100.0 39.9 56.2 53.5 26.1 41.5 39.0 2.0 0.4 0.6 12.4 1.6 3.3 18.5 0.4 3.3 1.1 0.0 0.2 100.0 100.0 100.0 43.8 21.8 25.4 36.8 37.9 37.7 14.4 25.4 23.6 5.0 14.8 13.2 0.0 0.1 0.1 100.0 100.0 100.0 3.2 4.3 4.1 2,280 11,792 14,072 urban and 21 percent rural) take less than 15 minutes to fetch drinking water. The median time taken to access drink-ing water is 29.2 minutes. On average, rural households take three times longer to access drinking water than urban households. The majority of Ethiopian households (82 percent) do not have a toilet facility. A small proportion (17 percent) uses a traditional pit toilet. Ventilated pit latrines and flush toilets account for less than 1 percent. In urban areas, 70 percent of households have access to at least one form of toilet—66 percent use a traditional pit toilet, 2 percent of households have a flush toilet, and another 2 percent use a ventilated pit latrine. However, even though urban house- holds have better toilet facilities, a significant proportion (30 percent) do not have any facility at all. Fifty-four percent of households have floors made of earth or sand and 39 percent have dung floors. Rural houses are more likely than urban houses to use earth, sand, or dung. In contrast, urban houses are more likely than rural houses to have floors with vinyl/tiles/ brick/carpet (12 percent) or cement (19 per- cent). Data on the number of persons per sleeping room were also collected to provide information on crowdedness. Thirty-eight per- cent of households have three or four persons per sleeping room, and 25 percent have only one or two persons per sleeping room. Rural households are relatively more crowded than urban households in Ethiopia. The mean num- ber of persons per sleeping room in rural areas is 4.3, compared with 3.2 in urban areas. The mean number of persons per sleeping room overall is 4.1. 2.5 HOUSEHOLD POSSESSIONS Information on ownership of durable goods and other possessions is presented in Table 2.7. One- fifth of all households has a radio, about 2 percent have a television, and 1 percent have a telephone. In general, households in rural Ethiopia are less likely to possess consumer items like radios, televisions, telephones, electric mitads (lamps), or kerosene or pressure lamps. Twice as many urban households as rural households are also likely to own a bed or table. In contrast, most rural households own the home they live in and their crop land. Not surprisingly, livestock ownership is more concentrated in 14 * Household Population and Characteristics Table 2.7 Household durable goods Percentage of households possessing various durable consumer goods and means of transport, by residence, Ethiopia 2000 ____________________________________________________ Residence Durable ______________ consumer goods Urban Rural Total ____________________________________________________ Household possessions Radio Television Telephone Electric mitad1 Kerosene/pressure lamp Bed/table Own house Crop land Cattle/camels Horse/mule/donkey Sheep/goats Cash crop Means of transport Bicycle Motorcycle/scooter Car/truck Horse/mule Number of households 61.3 12.8 20.7 11.7 0.0 1.9 7.9 0.0 1.3 12.4 0.0 2.0 17.2 8.5 9.9 84.8 41.6 48.6 46.0 96.4 88.3 16.3 92.0 79.7 20.4 75.2 66.4 6.4 29.5 25.7 12.8 39.7 35.4 4.0 29.1 25.1 3.5 0.3 0.8 0.5 0.0 0.1 2.1 0.0 0.3 2.5 7.2 6.5 2,280 11,792 14,072 _____________________________________________________ 1 Mitad is lamp Table 2.8 Possession of bednets Percentage of households owning bednets, by background characteristics, Ethiopia 2000_________________________________________________________________ Among households Among all households with bednets,____________________ ___________________ Percentage Number Percentage Number Background with of impreg- of characteristic bednets households nated households_________________________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 3.1 2,280 13.5 72 0.6 11,792 21.6 77 3.1 993 (32.4) 30 30.5 163 2.5 50 0.7 3,930 * 26 0.3 5,078 * 13 6.2 171 (4.9) 11 1.9 151 * 3 0.2 2,985 * 6 11.7 38 (17.9) 4 1.2 38 * 0 0.7 461 * 3 2.0 66 * 1 1.1 14,072 17.7 148 _________________________________________________________________ Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. rural than in urban households. The survey also collected information on means of transport (for humans as well as for goods) available to households. Most house- holds in Ethiopia do not have a means of trans- port. The predominant mode of transport in rural areas is horses and/or mules, which are owned by 7 percent of rural households. 2.6 BEDNETS Information about the possession of bednets by the household was also collected. Table 2.8 presents the proportion of households owning bednets by urban-rural residence and region. Only 1 percent of households in Ethio- pia have bednets, with urban households slight- ly more likely than rural households to possess bednets (3 percent and 1 percent, respectively). Households in the Affar, Gambela, and Somali regions are more likely to have bednets (31 percent, 12 percent, and 6 percent, respec- tively) primarily because the prevalence of malaria is high in those regions. Only 18 per- cent of households with bednets use impreg- nated nets. 2.7 HEALTH FACILITIES The Ethiopia DHS col- lected information about the use of health services in the 12 months preceding the survey. Table 2.9 shows the type of ser- vice utilized by urban-rural resi- dence. Two in five households (44 percent) utilized some type of health service, with the most com- mon treatments sought for a sick child (31 percent) and for immu- nization (24 percent). A higher percentage of urban than rural households utilized any type of health service, with urban house- holds being three times more like- ly than rural households to have accessed information on the pre- vention of sexually transmitted infections (STIs) and breastfeed- Household Population and Characteristics * 15 Table 2.9 Use of health facility services Percentage of households that utilized health services at any time during the 12 months preceding the survey, by type of health service and residence, Ethiopia 2000______________________________________________________ Residence Type of _________________ health service Urban Rural Total______________________________________________________ Treatment for sick child 36.4 29.8 30.8 Immunization 29.5 23.2 24.2 Family planning 19.4 8.4 10.1 Prenatal, postnatal, and delivery care 12.0 5.7 6.7 Information on STI prevention 19.5 7.1 9.1 Information on breastfeeding and infant feeding 14.7 5.5 7.0 Any service 53.8 42.6 44.4 Number 2,280 11,792 14,072 Table 2.10 Types of health facilities utilized Percentage of households that utilized health services at any time during the 12 months preceding the survey, by type of facility visited and residence, Ethiopia 2000 ______________________________________________________ Residence ________________ Type of facility Urban Rural Total ______________________________________________________ Government facility Hospital 22.0 4.6 8.1 Health center 52.5 23.6 29.3 Health station/clinic 15.6 48.6 42.1 Health post 1.0 6.2 5.2 Community-based outlet 2.2 1.1 1.3 Other facility Non-governmental organization 7.1 5.8 6.1 Private hospital/doctor/clinic 15.2 14.7 14.8 Kebele (during campaign) 0.6 4.0 3.3 Other 2.4 1.4 1.6 Number 1,226 5,021 6,247 ing and infant feeding. Households were also asked about the type of health institutions visited (Table 2.10). The majority of households (42 per- cent) that utilized health services did so at government health stations or clinics, and 29 percent used government health centers. About one in two urban households went to government health centers, whereas one in two rural households visited government health stations or clinics. Fifteen percent of households utilizing care did so at private health facilities, with little difference between urban and rural households. The survey also included questions on whether any member of a household had bought drugs, that is, medicines, in the 12 months prior to the survey. Table 2.11 shows that nearly one in two households had used medicines in the past 12 months, with urban households and households in Addis Ababa more likely to have done so. Pharmacies or other medical facilities served as the main source of medicines, with 89 percent of households that used medicines in the 12 months prior to the survey obtaining their medicines from them. On the other hand, 15 percent of those who bought medicines had obtained them from nonmedical facilities. Urban households are slightly more likely to have obtained medicines from medical facilities, whereas rural households are three times more likely than urban households to have obtained medicines from nonmedical facilities. Most households in Addis Ababa obtain their medicines from pharmacies or medical facilities. Nonmedical facilities are visited most often by households in the Oromiya and Amhara regions. 16 * Household Population and Characteristics Table 2.11 Utilization and source of drugs Percentage of households that bought drugs in the 12 months preceding the survey, by source of drugs and background characteristics, Ethiopia 2000 __________________________________________________________________________________ Among househods that bought drugs, source of drugs used in the Households that bought 12 months preceding the survey drugs in the 12 months __________________________________ preceding the survey Pharmacy/ Number of ________________________ other Non- households Background Number of medical medical that bought characteristic Percentage households facility facility drugs __________________________________________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 60.0 2,280 96.9 5.2 1,369 46.2 11,792 86.6 16.8 5,443 49.7 993 98.5 2.5 494 51.4 163 96.6 5.6 84 34.7 3,930 86.3 16.4 1,363 54.3 5,078 86.2 18.7 2,758 40.4 171 98.3 3.6 69 55.7 151 92.0 10.5 84 53.3 2,985 88.6 13.1 1,591 52.3 38 97.1 3.0 20 52.7 38 93.1 11.0 20 63.4 461 98.3 1.7 292 55.6 66 96.6 4.0 37 48.4 14,072 88.6 14.5 6,812 Respondent’s Characteristics and Status * 17 3RESPONDENT’S CHARACTERISTICS AND STATUS The objective of this chapter is to provide a demographic and socioeconomic profile of the 2000 Ethiopia DHS sample. Information on the basic characteristics of women and men interviewed in the survey is essential for the interpretation of findings presented later in the report and can provide an approximate indication of the representativeness of the survey. 3.1 BACKGROUND CHARACTERISTICS OF RESPONDENTS The distribution of women age 15-49 and men age 15-59 by background characteristics including age, marital status, place of residence, region, educational level, and religion is shown in Table 3.1. Relatively high proportions of women are in the younger age groups, with three-fifths under age 30. The proportion of women and men declines with age. This is true for men as well, with the proportion of men declining after age 44. Despite the older average age of males interviewed, a larger percentage of male respondents (40 percent) reported never having been married, compared with female respondents (24 percent). The majority of respondents (more than 80 percent) live in the rural areas. Two in five respondents live in the Oromiya Region, one in four in the Amhara Region, and one in five in the Southern Nations, Nationalities, and Peoples (SNNP) Region. Men are more educated than women. Three in four women and one in two men have never been to school. Sixteen percent of women and 33 percent of men had attended only primary education, and 9 percent of women and 15 percent of men had at least some secondary education or higher. Due to small numbers, respondents with higher education are grouped together with those who had secondary education, and the education category is reclassified into "secondary and higher" in subsequent tables in this report. In terms of religious affiliation, one in two women and men are Orthodox, nearly one in three are Muslim, and 16 percent are Protestant. Thirty-five percent of women and 37 percent of men are Oromos, 32 percent of women and 30 percent of men are Amharas, 7 percent of women and 6 percent of men are Tigraway, and 5 percent of women and 4 percent of men are Guragies. The fact that the Ethiopia DHS interviewed both women and men in some selected households allows the unique opportunity to study couples’ attitudes and behaviors regarding fertility and family planning. The survey gathered data from 1,355 couples, and some basic characteristics of spouses are shown in Table 3.2. The wife is 5 to 9 years younger than her husband among more than 2 in 5 couples, while the wife is 0 to 4 years or 10 to14 years younger among 1 in 5 couples. Among 11 percent of the couples the wife is 15 or more years younger than her husband. The mean age difference between a husband and his wife is eight years. However, the mean age difference between a husband and his second wife (in cases where the husband is in a polygynous union) is nearly 14 years. In a majority of the cases (57 percent), neither the husband nor his wife are educated. Three percent of wives are more educated than their husbands, while one in four husbands are more educated than their wives. In 16 percent of the cases, both husband and wife are equally educated. 18 * Respondent’s Characteristics and Status Table 3.1 Background characteristics of respondents Percent distribution of women and men by background characteristics, Ethiopia 2000______________________________________________________________________________________ Number of women Number of men__________________ __________________ Background Weighted Un- Weighted Un- characteristic percent Weighted weighted percent Weighted weighted______________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Marital status Never married Married Living together Divorced/separated Widowed Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary Higher Religion Orthodox Catholic Protestant Muslim Other Ethnic group Affar Amhara Guragie Oromo Sidamo Somali Tigraway Welaita Other Total 24.1 3,710 3,584 23.0 600 571 18.6 2,860 2,844 15.6 408 419 16.8 2,585 2,716 13.2 343 367 12.0 1,841 1,902 10.6 276 278 11.2 1,716 1,762 11.7 304 301 9.1 1,392 1,324 7.0 182 217 8.2 1,264 1,235 7.9 207 183 NA NA NA 5.4 142 132 NA NA NA 5.6 146 139 24.0 3,688 3,979 39.9 1,040 1,056 62.8 9,653 9,203 55.7 1,452 1,405 0.9 136 177 0.3 8 28 8.7 1,344 1,351 3.6 93 90 3.6 546 657 0.5 14 28 18.2 2,791 4,543 14.5 379 680 81.8 12,576 10,824 85.5 2,228 1,927 6.3 969 1,306 5.2 136 183 1.2 178 858 1.3 34 154 24.9 3,820 1,909 24.1 630 321 38.6 5,937 2,578 40.4 1,054 474 1.1 175 844 1.4 36 168 1.0 160 992 1.2 31 196 21.4 3,285 2,028 21.7 566 356 0.3 40 876 0.3 7 153 0.3 41 908 0.3 7 148 4.5 684 2,015 3.6 95 292 0.5 79 1,053 0.5 12 162 75.2 11,551 10,586 52.1 1,358 1,270 15.8 2,425 2,530 33.0 860 770 8.5 1,304 2,092 12.8 333 483 0.6 87 159 2.1 56 84 50.5 7,763 7,280 49.7 1,296 1,198 1.1 175 133 0.4 11 19 15.8 2,432 2,099 15.7 410 332 29.0 4,456 5,371 30.9 806 968 3.5 540 484 3.1 85 90 0.8 117 585 1.0 27 105 31.8 4,886 4,431 30.1 785 692 5.4 836 862 4.3 111 140 34.6 5,315 4,161 37.0 965 759 3.9 592 355 3.7 97 62 1.2 182 785 1.7 45 154 6.7 1,032 1,483 5.5 143 209 2.2 340 230 1.9 50 39 13.5 2,067 2,475 14.7 383 447 100.0 15,367 15,367 100.0 2,607 2,607 ______________________________________________________________________________________ Note: Education refers to the highest level ever attended whether or not that level was completed. NA = Not applicable Respondent’s Characteristics and Status * 19 Table 3.2 Differential characteristics between spouses Percent distribution of couples by age difference between spouses and level of education, Ethiopia 2000 ______________________________________ Differential characteristics Percent ______________________________________ Age difference Wife older (2.0) Wife 0-4 years younger 22.0 Wife 5-9 years years younger 42.8 Wife 10-14 years younger 22.0 Wife 15+ years younger 11.4 Mean age difference 1st wife 8.2 2nd wife (13.8) All wives 8.3 Level of education Neither husband nor wife educated 56.7 Wife educated, husband not 2.9 Husband educated, wife not 24.8 Both husband and wife educated 15.6 Total 100.0 Number of couples 1,355 ______________________________________ Note: Figures in parentheses are based on 25- 49 unweighted cases. 3.2 EDUCATIONAL ATTAINMENT BY BACKGROUND CHARACTERISTICS Table 3.3 shows the educational level of female and male respondents by selected background characteristics. Three-fourths of women and more than half of men have no formal education. Among men and women who attended school, the majority (14 percent of all women and 29 percent of men) has not completed primary education. Twice as many men as women have completed secondary education or higher. The level of education varies greatly according to residence. Two-thirds of women and 84 percent of men who live in urban areas have been to school, while 41 percent of women and 61 percent of men have reached the secondary level of education. But for the more than 80 percent of Ethiopia’s population that lives in rural areas, educational attainment is substantially lower, with 84 percent of women and 58 percent of men having never attended school. Only 2 percent of women and 7 percent of men have attained secondary-level schooling in rural areas. Residents of the heavily urban areas of the country like Addis Ababa, Dire Dawa, and the Harari Region have higher levels of educational attainment, especially at the secondary level or higher. 20 * Respondent’s Characteristics and Status Table 3.3 Educational attainment by background characteristics Percent distribution of women and men by highest level of schooling attended, by background characteristics, Ethiopia 2000 _____________________________________________________________________________________________________ Highest level of schooling attained _______________________________________________________________ Background No edu- Some Completed Some Completed More than characteristic cation primary primary1 secondary secondary secondary Total Number _____________________________________________________________________________________________________ WOMEN _____________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 61.0 23.9 2.4 11.9 0.7 0.0 100.0 3,710 70.5 15.9 1.5 8.5 3.3 0.5 100.0 2,860 70.1 14.5 2.6 7.8 3.8 1.2 100.0 2,585 79.2 12.6 1.4 3.7 2.1 1.0 100.0 1,841 86.5 8.0 1.0 1.8 1.9 0.7 100.0 1,716 93.3 3.9 0.5 1.2 0.6 0.6 100.0 1,392 96.4 2.6 0.2 0.5 0.2 0.1 100.0 1,264 35.8 18.9 4.6 28.7 9.8 2.3 100.0 2,791 83.9 13.1 1.0 1.7 0.2 0.2 100.0 12,576 77.8 13.1 2.3 5.0 1.2 0.6 100.0 969 84.7 6.5 2.5 4.9 1.0 0.5 100.0 178 83.5 9.5 1.2 4.5 0.9 0.4 100.0 3,820 75.8 15.1 1.2 6.4 1.0 0.4 100.0 5,937 88.5 7.0 1.0 2.7 0.6 0.2 100.0 175 76.4 16.9 2.4 3.1 0.8 0.3 100.0 160 73.8 18.0 1.7 5.0 1.4 0.1 100.0 3,285 60.2 25.4 3.5 8.7 1.3 0.9 100.0 40 53.4 13.2 2.9 20.0 9.5 0.9 100.0 41 25.0 16.8 5.9 29.0 18.4 5.0 100.0 684 46.0 15.5 4.6 22.3 10.1 1.6 100.0 79 75.2 14.1 1.6 6.6 1.9 0.6 100.0 15,367 _____________________________________________________________________________________________________ MEN _____________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 38.8 41.4 5.7 13.3 0.9 0.0 100.0 600 40.4 36.4 3.1 14.6 4.6 0.8 100.0 408 43.7 31.6 7.5 8.7 4.5 4.0 100.0 343 41.3 31.9 3.0 11.3 7.8 4.7 100.0 276 49.9 27.1 4.3 11.3 4.1 3.2 100.0 304 69.4 15.6 1.4 6.2 2.1 5.3 100.0 182 79.9 16.1 0.2 3.1 0.5 0.2 100.0 207 86.3 10.0 0.3 0.3 0.5 2.5 100.0 142 89.8 8.0 0.2 0.4 0.0 1.6 100.0 146 16.3 18.3 4.1 33.3 16.0 12.0 100.0 379 58.2 31.1 3.7 5.7 0.8 0.4 100.0 2,228 54.5 23.3 3.7 14.2 2.1 2.2 100.0 136 72.1 10.2 2.9 8.6 3.9 2.3 100.0 34 76.9 12.6 1.5 6.2 0.6 2.1 100.0 630 48.4 36.7 3.7 7.1 2.6 1.5 100.0 1,054 68.7 16.6 5.7 4.2 1.0 3.8 100.0 36 46.6 34.0 8.2 7.1 0.4 3.6 100.0 31 37.0 39.9 5.3 14.1 2.7 1.0 100.0 566 35.4 29.0 9.4 14.0 4.1 8.2 100.0 7 39.9 18.7 4.5 24.5 9.7 2.7 100.0 7 8.0 15.3 6.3 30.1 27.3 13.1 100.0 95 25.7 15.2 7.7 24.7 18.8 7.9 100.0 12 52.1 29.3 3.7 9.7 3.0 2.1 100.0 2,607 _____________________________________________________________________________________________________ 1 Completed grade 6 at the primary level 2 Completed grade 12 at the secondary level Respondent’s Characteristics and Status * 21 3.3 LITERACY In the Ethiopia DHS, literacy was determined by a respondent’s ability to read part or all of a sentence in any language that the respondent was familiar with. The questions assessing literacy were asked only of respondents who have not attended school or have attended primary school only. Literacy is widely acknowledged as benefiting both the individual and society and is associated with a number of positive outcomes for health and nutrition. Table 3.4 shows that only 19 percent of women and 40 percent of men are literate, while 6 percent of women and 13 percent of men are only partially literate. There is a much lower literacy level among rural women and men than among those living in the urban areas. Literacy levels vary widely among regions, from a high of 68 percent among women in Addis Ababa to a low of 9 percent of women in the Somali Region. Literacy among men ranges from a high of 87 percent in Addis Ababa to a low of 16 percent in the Somali Region. 3.4 EXPOSURE TO MASS MEDIA The Ethiopia DHS collected information on the exposure of respondents to both the broadcast and print media. This information is important because it provides an indication of the exposure of women to the mass media and is used to disseminate family planning, health, and other information. Access to mass media is generally low in Ethiopia. Table 3.5 shows that 86 percent of women and 73 percent of men have no exposure to the mass media. Generally men have a higher exposure to the mass media than women. Listening to the radio is the most common way of accessing the media. Nevertheless, only about one in ten women and one in four men listen to the radio at least once a week. Media exposure varies with the age of the respondent. Men and women in the older age groups tend to listen to the radio or read a newspaper less frequently than younger men and women. There are significant geographic differences in media exposure. Urban women and men have better access to all three media sources than their rural counterparts. Due to lower literacy levels, rural women are much less likely to report that they read a newspaper at least once a week. Despite the place of residence, the level of exposure of women and men to radio broadcasts is greater than all other media sources. Very likely due to the greater ownership of a television set, women and men residing in urban areas have a much greater exposure to television than rural women and men. Among the regions, women and men residing in Addis Ababa, Dire Dawa, and the Harari Region have a greater exposure to all three media, compared with other regions, since these areas are relatively more urban. Women and men residing in the Amhara Region are the least likely to be exposed to the media. As expected, media exposure is highly related with the educational level of the respondent. One in two women and 65 percent of men with secondary or higher levels of education listen to the radio at least once a week, whereas only 5 percent of uneducated women and 10 percent of uneducated men reported listening to the radio at least once a week. Regarding the printed media, only 3 percent of women and 6 percent of men with primary education reported reading a newspaper at least once a week, compared with 14 percent of women and 27 percent of men with secondary and higher education. 22 * Respondent’s Characteristics and Status Table 3.4 Literacy Percent distribution of women and men by level of schooling attended and by level of literacy, according to background characteristics, Ethiopia 2000_______________________________________________________________________________________________ No schooling or primary school______________________________________ Secondary No card school Can read Can read Cannot with Background or a whole part of read required Percent characteristic higher sentence a sentence at all language Total Number literate1_______________________________________________________________________________________________ WOMEN_______________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul- Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 12.6 14.5 5.5 66.4 1.0 100.0 3,710 27.1 12.2 8.7 5.5 73.3 0.3 100.0 2,860 20.9 12.8 11.7 7.2 68.0 0.3 100.0 2,585 24.5 6.7 8.5 9.0 75.7 0.0 100.0 1,841 15.3 4.5 7.4 5.5 82.5 0.0 100.0 1,716 11.9 2.3 3.8 4.7 89.2 0.0 100.0 1,392 6.1 0.8 2.4 2.5 94.3 0.0 100.0 1,264 3.2 40.8 17.0 7.5 34.4 0.3 100.0 2,791 57.7 2.0 7.8 5.5 84.3 0.4 100.0 12,576 9.8 6.8 10.3 5.6 77.4 0.0 100.0 969 17.0 6.4 6.4 3.8 83.0 0.4 100.0 178 12.7 5.8 10.2 5.8 78.0 0.2 100.0 3,820 16.0 7.8 7.5 6.4 78.1 0.1 100.0 5,937 15.3 3.5 5.8 2.9 87.8 0.0 100.0 175 9.2 4.3 12.7 5.4 77.5 0.2 100.0 160 17.0 6.5 10.8 5.0 76.6 1.1 100.0 3,285 17.4 10.9 8.8 10.1 65.8 4.3 100.0 40 19.8 30.4 8.0 6.3 55.1 0.2 100.0 41 38.4 52.3 15.7 8.1 23.7 0.2 100.0 684 68.0 34.0 15.8 2.4 47.4 0.1 100.0 79 49.8 9.1 9.5 5.9 75.2 0.3 100.0 15,367 18.5 _______________________________________________________________________________________________ MEN_______________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul- Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Total 14.2 25.9 10.3 49.4 0.2 100.0 600 40.1 20.0 24.3 14.4 41.3 0.0 100.0 408 44.3 17.2 31.4 15.7 35.1 0.5 100.0 343 48.6 23.8 27.9 8.1 40.3 0.0 100.0 276 51.6 18.7 33.2 13.1 34.7 0.3 100.0 304 51.9 13.5 21.2 11.8 53.4 0.0 100.0 182 34.8 3.8 10.4 21.6 63.3 0.0 100.0 207 14.2 3.4 19.2 12.3 65.1 0.0 100.0 142 22.6 2.0 10.6 14.8 71.2 1.4 100.0 146 12.7 61.3 18.3 8.1 11.8 0.0 100.0 379 79.5 7.0 25.7 13.9 53.0 0.3 100.0 2,228 32.8 18.5 29.1 12.5 40.0 0.0 100.0 136 47.5 14.8 9.1 8.8 65.2 2.2 100.0 34 23.9 8.9 24.3 15.7 51.1 0.0 100.0 630 33.2 11.1 21.4 14.4 53.0 0.2 100.0 1,054 32.5 9.0 7.0 26.5 57.2 0.1 100.0 36 16.0 11.2 30.2 14.4 42.6 1.5 100.0 31 41.4 17.7 33.3 8.9 39.3 0.5 100.0 566 51.0 26.3 36.4 6.5 30.2 0.0 100.0 7 62.7 36.9 17.4 9.4 36.3 0.0 100.0 7 54.3 70.5 16.9 6.2 6.5 0.0 100.0 95 87.3 51.5 20.3 3.2 23.5 1.5 100.0 12 71.8 14.9 24.7 13.1 47.0 0.2 100.0 2,607 39.6 _________________________________________________________________________________________________ Note: Total includes women and men with missing information on literacy, who are not shown separately.1 Includes respondents who attended at least secondary school or higher and respondents who can read a whole sentence. Respondent’s Characteristics and Status * 23 Table 3.5 Exposure to mass media Percentage of women and men who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by background characteristics, Ethiopia 2000___________________________________________________________________________________________ Reads a Watches Listens to newspaper television the radio at least at least at least All No Background once a once a once a three mass characteristic week week week media media Number___________________________________________________________________________________________ WOMEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 3.1 7.1 14.5 0.9 81.0 3,710 1.9 4.6 11.6 0.7 85.9 2,860 1.5 5.2 13.2 0.4 84.4 2,585 1.3 3.0 8.9 0.6 89.3 1,841 0.8 2.6 9.7 0.1 89.2 1,716 0.6 1.7 7.1 0.4 92.1 1,392 0.2 1.4 6.4 0.1 92.8 1,264 7.2 21.8 36.0 2.8 53.6 2,791 0.4 0.5 5.7 0.0 93.7 12,576 1.8 4.7 15.6 0.1 81.8 969 0.7 3.8 7.2 0.0 89.4 178 0.5 2.1 7.7 0.1 91.2 3,820 1.7 2.6 9.3 0.4 88.7 5,937 2.0 2.7 7.7 0.4 89.9 175 1.6 0.9 10.5 0.0 87.7 160 0.8 2.1 9.8 0.2 88.9 3,285 2.2 6.1 9.4 0.2 86.1 40 5.1 23.8 31.6 3.4 61.2 41 11.5 39.9 46.7 6.0 36.3 684 5.1 30.7 26.9 2.4 59.0 79 0.0 0.8 4.8 0.0 94.6 11,551 2.6 5.8 19.3 0.5 76.6 2,425 13.8 31.1 50.4 5.1 35.3 1,391 1.7 4.4 11.2 0.5 86.4 15,367 ___________________________________________________________________________________________ MEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 8.0 12.3 24.2 3.2 68.6 600 7.3 7.2 23.4 2.3 73.2 408 8.0 6.1 27.0 2.1 68.1 343 6.0 9.0 33.0 1.9 65.0 276 5.5 6.1 25.9 2.3 69.9 304 6.5 8.8 28.8 4.5 70.2 182 1.4 1.6 16.0 0.6 83.7 207 2.7 1.9 10.3 1.4 89.3 142 0.3 3.6 11.2 0.3 88.1 146 22.3 36.4 63.5 13.4 26.7 379 3.3 2.6 17.0 0.4 80.3 2,228 16.0 21.1 33.0 11.3 60.9 136 1.2 6.7 26.0 0.6 72.2 34 3.1 3.3 10.8 1.1 87.2 630 4.8 5.1 25.8 1.0 70.5 1,054 0.0 12.1 36.7 0.0 62.3 36 1.9 1.5 17.4 0.0 81.7 31 4.6 3.8 22.9 0.5 73.7 566 6.1 11.4 36.7 3.8 60.8 7 13.8 29.4 49.7 6.3 40.1 7 34.8 55.6 67.2 21.2 18.2 95 30.8 55.0 59.0 22.7 26.4 12 0.2 1.2 9.6 0.0 89.6 1,358 5.8 6.6 27.4 1.0 66.8 860 27.1 31.3 65.4 13.1 25.7 388 6.0 7.5 23.8 2.3 72.6 2,607 24 * Respondent’s Characteristics and Status Table 3.6.1 Employment: women Percent distribution of women by employment status and continuity of employment, according to background characteristics, Ethiopia 2000___________________________________________________________________________________________________ Employment in the 12 months pre- Not Continuity of employment ceding the survey employed among those who worked in the________________ in the 12 months preceding the survey Not 12 months ______________________________ Cur- cur- preced- Missing/ Background rently em- rently ing the All Season- Occasion- don't characteristic ployed employed survey Total Number year ally ally know Total Number____________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Current marital status Never married Currently married/ living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Afar Amhara Oromiya Somali Ben-Gumz SNNP Gambela Harari Addis Dire Dawa Education No education Primary Secondary and higher Total 49.5 6.7 43.8 100.0 3,710 48.7 20.8 30.4 0.1 100.0 2,085 55.8 7.2 37.0 100.0 2,860 47.3 26.8 25.0 0.9 100.0 1,801 59.8 6.6 33.4 100.0 2,585 53.4 24.1 21.7 0.8 100.0 1,718 56.8 7.7 35.2 100.0 1,841 51.9 24.0 22.9 1.3 100.0 1,188 59.1 5.6 35.3 100.0 1,716 55.8 24.1 19.4 0.8 100.0 1,110 62.6 7.2 30.2 100.0 1,392 52.4 22.1 25.3 0.2 100.0 971 61.2 6.6 32.2 100.0 1,264 54.0 22.5 22.4 1.1 100.0 857 50.1 6.0 43.9 100.0 3,688 48.9 17.0 33.9 0.2 100.0 2,069 56.1 7.2 36.7 100.0 9,789 50.0 27.1 22.3 0.7 100.0 6,194 71.0 6.6 22.4 100.0 1,890 60.1 17.8 20.6 1.5 100.0 1,467 51.9 6.4 41.7 100.0 5,191 51.0 19.3 29.4 0.4 100.0 3,024 58.4 7.5 34.0 100.0 3,882 50.8 25.5 22.8 0.9 100.0 2,562 59.7 6.9 33.4 100.0 3,032 52.3 24.8 21.8 1.1 100.0 2,018 58.6 6.6 34.7 100.0 3,262 51.3 26.0 22.1 0.6 100.0 2,126 50.5 5.9 43.3 100.0 2,791 68.0 8.2 22.3 1.5 100.0 1,576 57.8 7.0 35.2 100.0 12,576 48.1 26.5 24.9 0.5 100.0 8,154 72.1 7.8 20.1 100.0 969 78.5 13.7 7.4 0.4 100.0 775 57.6 2.8 39.5 100.0 178 69.6 14.0 15.5 0.8 100.0 107 69.0 7.0 24.0 100.0 3,820 54.6 29.1 16.0 0.2 100.0 2,903 49.6 6.9 43.5 100.0 5,937 45.8 23.2 29.6 1.4 100.0 3,351 31.6 6.9 61.5 100.0 175 75.9 8.7 12.6 2.8 100.0 67 67.8 11.6 20.6 100.0 160 55.3 31.3 13.4 0.1 100.0 127 53.3 6.5 40.2 100.0 3,285 38.0 23.5 38.1 0.4 100.0 1,964 42.8 5.6 51.4 100.0 40 33.4 14.7 51.1 0.8 100.0 19 54.3 4.3 41.3 100.0 41 69.0 14.9 15.6 0.6 100.0 24 44.2 5.8 49.8 100.0 684 74.4 7.5 18.1 0.1 100.0 342 58.4 5.2 36.5 100.0 79 75.5 18.4 6.2 0.0 100.0 50 58.6 7.0 34.4 100.0 11,551 50.6 25.3 23.5 0.7 100.0 7,572 52.8 7.2 40.0 100.0 2,425 48.7 20.1 30.5 0.7 100.0 1,454 45.8 4.8 49.4 100.0 1,391 64.4 12.3 22.5 0.9 100.0 704 56.5 6.8 36.6 100.0 15,367 51.3 23.5 24.5 0.7 100.0 9,730 _____________________________________________________________________________________________________ Note: Total for employment status in the 12 months preceding the survey includes women whose employment status was missing or not known, who are not shown separately. 3.5 EMPLOYMENT Respondents were asked a number of questions to elicit their employment status at the time of the survey and continuity of employment in the 12 months prior to the survey. Table 3.6.1 shows this information for women, according to different background characteristics. Fifty-seven percent of women were working at the time of the survey, 7 percent worked during the 12 months prior to the Respondent’s Characteristics and Status * 25 Ethiopia DHS 2000 Figure 3.1 Percent Distribution of Women Age 15-49 by Employment Status Currently employed 57% Did not work in last 12 months 37% Worked during last 12 months 7% Note: Percentages add to more than 100 due to rounding. survey, and 37 percent did not work at all (Figure 3.1). Fifty-one percent of women employed in the 12 months preceding the survey were employed all year, 24 percent were employed seasonally, and another 25 percent were employed occasionally. Women age 40-49 are the most active group, while women under 20 are relatively less active. Divorced, separated, and widowed women are more likely to be gainfully employed than other women. Women with children were also more likely to be working at the time of the survey than women with no children. A higher proportion of rural women than urban women are currently working (58 percent and 51 percent, respectively). However, rural women are more likely to have seasonal jobs than urban women; about 27 percent of women in rural areas work seasonally, compared with only 8 percent in urban areas. There exists a notable variation in the proportion of women currently working among the regions, ranging from 72 percent in the Tigray Region to 32 percent in the Somali Region. In a relatively less industrialized country such as Ethiopia, education is no guarantee for employment. Among the small proportion of women who attained secondary and higher levels of education, 49 percent were not working in the 12 months preceding the survey, compared with those who received no education at all (34 percent). Seasonal employment is more common among uneducated women (25 percent) than among those with secondary and higher education (12 percent). Table 3.6.2 shows employment information for men. Eighty-seven percent of men were working at the time of the survey, 5 percent worked in the 12 months prior to the survey, and 8 percent did not work at all. Men 25 years and older are more active than younger men, as are currently married men and those living together, men with living children, men living in the Affar and Amhara regions, and men with no education. 26 * Respondent’s Characteristics and Status Table 3.6.2 Employment: men Percent distribution of men by employment status, according to background characteristics, Ethiopia 2000_________________________________________________________________ Employment in the 12 months Not preceding the survey employed ____________________ in the Not 12 months Background Currently currently preceding characteristic employed employed the survey Total Number_________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Current marital status Never married Currently married/ living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Afar Amhara Oromiya Somali Ben-Gumz SNNP Gambela Harari Addis Dire Dawa Education No education Primary Secondary and higher Total 66.9 10.9 22.1 100.0 600 85.4 6.6 8.0 100.0 408 94.7 3.9 1.4 100.0 343 94.6 3.3 2.1 100.0 276 96.5 1.9 1.6 100.0 304 95.8 2.5 1.7 100.0 182 97.9 0.1 2.0 100.0 207 91.8 2.6 5.6 100.0 142 94.7 1.9 3.4 100.0 146 74.2 9.5 16.3 100.0 1,040 96.6 2.2 1.3 100.0 1,460 86.1 1.7 12.2 100.0 107 77.1 8.3 14.5 100.0 1,206 95.9 2.6 1.5 100.0 452 96.7 1.3 1.9 100.0 398 95.3 2.5 2.1 100.0 551 73.0 7.2 19.8 100.0 379 89.7 4.7 5.6 100.0 2,228 75.7 7.4 16.5 100.0 136 93.2 0.8 6.0 100.0 34 92.5 2.3 5.2 100.0 630 86.3 4.4 9.2 100.0 1,054 86.0 5.6 8.4 100.0 36 89.6 7.4 3.0 100.0 31 88.9 8.2 2.9 100.0 566 76.7 7.9 15.4 100.0 7 74.9 7.3 17.8 100.0 7 70.2 7.4 22.4 100.0 95 71.3 9.1 19.6 100.0 12 94.0 2.9 3.1 100.0 1,358 84.0 7.3 8.6 100.0 860 70.6 7.6 21.8 100.0 388 87.2 5.0 7.7 100.0 2,607 _________________________________________________________________ Note: Total includes men whose employment status is missing or not known, who are not shown separately. Respondent’s Characteristics and Status * 27 Table 3.7.1 Occupation: women Percent distribution of women who worked in the 12 months preceding the survey by occupation (agricultural and nonagricultural) and type of agricultural land worked or type of nonagricultural employment, according to background characteristics, Ethiopia 2000__________________________________________________________________________________________________________________ Agricultural Nonagricultural_______________________________ ______________________________________ Someone Prof./ Sales Manual Background Own Family Rented else's Tech./ and ________________ characteristic land land land land Manag. Clerical services Skilled Unskilled Total Number__________________________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Current marital status Never married Currently married or living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 46.7 2.9 2.8 1.5 0.0 0.3 28.5 15.3 1.0 100.0 2,085 45.4 1.9 3.9 2.4 1.0 1.2 27.1 14.8 1.3 100.0 1,801 52.8 1.0 3.0 2.3 2.2 1.8 21.6 13.7 1.0 100.0 1,718 56.6 0.4 1.7 1.8 1.6 0.7 19.3 15.6 1.5 100.0 1,188 57.1 0.1 0.9 2.6 1.8 1.2 19.5 15.7 1.1 100.0 1,110 58.5 0.5 0.7 1.0 1.0 0.5 17.9 18.8 1.1 100.0 971 65.1 0.4 0.6 1.1 0.2 0.4 18.9 12.5 0.3 100.0 857 32.8 1.4 0.4 1.2 1.1 2.0 39.3 19.6 1.2 100.0 2,069 61.6 1.3 3.2 1.9 1.2 0.6 16.0 12.9 0.7 100.0 6,194 43.2 1.2 0.7 2.6 0.7 0.6 29.4 18.1 2.6 100.0 1,467 39.9 2.0 1.2 1.4 1.3 1.6 33.0 17.3 1.2 100.0 3,024 50.8 2.1 4.5 2.1 1.5 0.9 20.9 15.3 1.4 100.0 2,562 59.4 0.2 2.4 2.3 0.8 0.5 17.8 14.8 1.3 100.0 2,018 67.0 0.4 1.0 1.8 0.6 0.3 16.2 12.1 0.3 100.0 2,126 2.5 0.3 0.1 0.4 4.6 5.4 53.1 27.8 3.9 100.0 1,576 62.4 1.5 2.7 2.2 0.4 0.0 17.1 12.7 0.5 100.0 8,154 66.6 4.3 2.1 1.0 1.8 1.6 13.3 6.2 2.5 100.0 775 53.5 1.1 0.7 1.1 2.3 1.6 22.4 10.5 5.7 100.0 107 72.5 1.2 5.0 1.8 0.5 0.2 8.8 8.3 0.6 100.0 2,903 50.4 1.3 1.4 2.4 0.8 0.3 23.1 19.1 0.6 100.0 3,351 26.9 0.4 0.0 1.0 0.7 1.5 52.1 15.6 1.4 100.0 67 77.2 2.6 2.6 1.5 0.6 0.5 8.2 5.7 1.0 100.0 127 31.9 0.5 0.4 1.6 1.0 0.9 39.6 23.6 0.4 100.0 1,964 21.6 1.3 0.0 1.7 2.8 2.0 26.3 28.6 14.6 100.0 19 6.4 0.2 0.0 19.1 4.5 3.4 53.3 8.7 3.9 100.0 24 0.3 0.0 0.1 0.1 7.6 9.7 62.6 11.5 7.9 100.0 342 25.9 0.2 0.0 5.1 3.0 5.1 48.0 8.4 4.2 100.0 50 59.9 1.4 2.6 2.2 0.0 0.0 19.2 13.6 0.8 100.0 7,572 36.9 1.1 1.6 0.9 0.2 0.2 34.6 20.5 1.9 100.0 1,454 8.6 0.7 0.3 0.6 14.5 11.9 39.3 20.6 1.8 100.0 704 52.7 1.3 2.3 1.9 1.1 0.9 23.0 15.1 1.1 100.0 9,730 __________________________________________________________________________________________________________________ Note: Prof./Tech./Manag. includes professional, technical, and managerial occupations. Total includes women with missing information on type of agricultural land and occupation, who are not shown separately. 3.6 OCCUPATION Tables 3.7.1 and 3.7.2 show data on employed women and men by their occupation. Agriculture is the dominant sector of the economy; 58 percent of employed women and 84 percent of employed men work in agriculture. Most of the women and men currently working in nonagricultural sectors are engaged in sales and services followed by skilled manual professions. For women working in agriculture, the data are also presented by type of land holding. Comparable data on land holding is not available for men. The majority of women (53 percent) work on their own land. 28 * Respondent’s Characteristics and Status Table 3.7.2 Occupation: men Percent distribution of men who worked in the 12 months preceding the survey by occupation, according to background characteristics, Ethiopia 2000_________________________________________________________________________________________________________________ Prof./ Sales Manual Background Agri- Tech./ and __________________ characteristic culture Manag. Clerical services Skilled Unskilled Total Number_________________________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Current marital status Never married Currently married/ living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 88.3 0.0 0.1 5.5 3.5 1.5 100.0 467 83.3 2.0 1.3 6.7 4.1 2.3 100.0 375 81.2 4.2 0.7 6.2 5.5 2.2 100.0 338 77.8 5.9 1.2 7.0 5.4 1.9 100.0 270 76.0 5.2 1.2 7.8 7.6 2.0 100.0 299 76.5 10.4 0.1 4.1 7.3 1.6 100.0 179 95.0 0.7 0.3 2.9 1.1 0.0 100.0 203 90.9 3.7 0.0 4.7 0.2 0.0 100.0 134 91.8 1.9 0.0 3.2 2.7 0.2 100.0 141 83.2 2.3 0.7 7.0 4.6 1.5 100.0 870 84.1 3.9 0.6 5.2 4.3 1.5 100.0 1,442 86.5 4.2 0.0 2.9 3.6 2.8 100.0 94 83.2 2.4 0.7 6.8 4.6 1.8 100.0 1,031 78.8 5.7 0.7 4.7 5.7 3.8 100.0 445 85.6 2.1 0.8 6.4 4.5 0.4 100.0 390 88.1 4.3 0.3 4.2 3.0 0.0 100.0 540 12.2 20.1 4.3 30.3 22.1 9.2 100.0 304 94.2 0.9 0.1 2.2 1.9 0.4 100.0 2,102 76.3 4.5 2.5 9.2 5.7 0.6 100.0 113 62.6 7.7 3.6 15.8 2.5 7.1 100.0 32 91.4 2.7 0.0 2.7 2.1 0.8 100.0 597 87.6 2.1 0.5 3.8 4.6 1.4 100.0 957 70.1 9.0 0.2 12.9 5.4 1.3 100.0 33 86.5 4.2 0.0 6.5 1.3 1.1 100.0 30 85.2 2.8 0.2 6.8 2.4 1.7 100.0 550 56.0 7.3 3.2 17.1 10.7 5.7 100.0 6 52.9 9.0 1.5 13.0 19.7 3.8 100.0 6 1.9 20.5 7.1 31.0 31.6 6.6 100.0 74 27.8 9.5 3.4 25.4 27.1 6.4 100.0 10 93.8 0.4 0.0 2.2 2.5 0.8 100.0 1,316 85.6 1.0 0.1 6.1 3.9 2.7 100.0 786 36.4 22.0 4.7 20.2 14.0 1.8 100.0 304 83.9 3.4 0.6 5.8 4.4 1.6 100.0 2,406 _________________________________________________________________________________________________________________ Note: Prof./Tech./Manag. refers to professional, technical, and managerial occupations. Total includes men with missing information on occupation who are not shown separately. The age pattern of occupation varies by the type of work. The proportion of women and men currently working in agriculture increases with age, whereas the opposite is true for those working in sales and services. The majority of women working in agriculture are made up of currently married women and those who have many children. As expected, rural women and men are more likely to be employed in agriculture; 69 percent of women and 94 percent of men living in the rural areas work in agriculture. On the other hand, 53 percent of urban women and 30 percent of urban men are employed in sales and services. Respondent’s Characteristics and Status * 29 Table 3.8 Employer and form of earnings Percent distribution of women who worked in the 12 months preceding the survey by employer and type of earnings (cash, in kind, no payment), according to background characteristics, Ethiopia 2000__________________________________________________________________________________________ Employed by a Employed by Self-employed nonfamily member a family member_______________ ______________ _______________ Does Does Does Background Earns not earn Earns not earn Earns not earn characteristic cash1 cash2 cash1 cash2 cash1 cash2 Total Number__________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Occupation Agriculture Non-agriculture Total 27.2 11.2 8.4 2.3 4.0 46.9 100.0 2,085 29.1 19.1 8.8 1.8 4.9 36.3 100.0 1,801 25.0 23.4 9.8 0.9 4.2 36.7 100.0 1,718 24.5 22.5 9.2 0.8 5.4 37.6 100.0 1,188 27.9 28.2 7.9 1.3 4.6 29.9 100.0 1,110 26.2 23.5 5.8 0.6 6.6 37.3 100.0 971 27.9 27.8 3.4 0.0 3.3 37.2 100.0 857 35.3 7.1 36.6 2.9 6.1 12.0 100.0 1,576 25.2 23.5 2.6 1.0 4.3 43.3 100.0 8,154 16.5 28.6 4.7 2.9 1.6 45.7 100.0 775 1.8 20.3 20.9 0.4 3.2 52.9 100.0 107 18.7 42.3 4.7 1.3 1.6 31.3 100.0 2,903 23.1 11.5 5.0 1.7 7.7 51.0 100.0 3,351 48.4 24.2 8.9 0.0 9.3 9.3 100.0 67 18.3 29.0 4.2 1.0 2.8 44.6 100.0 127 51.1 5.3 6.9 0.2 5.4 31.1 100.0 1,964 45.5 7.1 22.9 0.0 4.2 20.0 100.0 19 27.4 24.8 26.2 0.6 11.1 10.0 100.0 24 20.5 0.1 71.8 1.6 2.9 3.0 100.0 342 41.6 8.7 38.8 0.3 0.6 9.8 100.0 50 25.5 23.7 4.6 1.2 4.4 40.6 100.0 7,572 35.4 12.0 8.5 1.7 5.1 37.1 100.0 1,454 23.8 7.7 44.1 2.2 6.6 15.6 100.0 704 4.7 32.5 1.3 1.1 0.5 59.8 100.0 5,687 58.0 4.4 17.6 1.6 10.4 7.9 100.0 4,043 26.9 20.8 8.1 1.3 4.6 38.3 100.0 9,730 __________________________________________________________________________________________ Note: Total includes women with missing information on type of employer or earnings and/or employment status. 1 Includes both women who receive only cash and those who receive cash and in-kind payment. 2 Includes both women who receive only in-kind payment and those who receive no payment. Education influences the type of occupation. Sixty-six percent of women and 94 percent of men who are employed and have never attended school work in agriculture. Eighty-eight percent of women and 63 percent of men with secondary or higher education are employed in nonagricultural occupations. 3.7 EMPLOYER AND FORM OF EARNINGS Table 3.8 shows that nearly half of the working women (48 percent) are self-employed, 43 percent work for a family member, and only 9 percent work for someone else. Almost all working women in rural areas are either self-employed or work for a family member, while 40 percent of working women in urban areas work for a nonfamily member. Similarly, less educated women and women engaged in agriculture are much more likely to work for a family member. 30 * Respondent’s Characteristics and Status Ethiopia DHS 2000 Figure 3.2 Percent Distribution of Employed Women Age 15-49 by Type of Earnings Cash 35% No payment 41% In kind 19% Cash and in kind 5% Employment is assumed to go hand in hand with payment for work. Not all women receive earnings for the work they do, however, and among women who do receive earnings not all receive earnings in cash. Thirty-five percent of women receive cash only for their work, 5 percent are paid in cash and in kind, 19 percent are paid in kind only, and 41 percent do not receive any form of payment (Figure 3.2). Highly educated women and those engaged in nonagricultural occupations are much more likely to earn cash than other women. Seventy-five percent of women with secondary and higher education earn cash, compared with 35 percent of uneducated women (Table 3.8). Additionally, 86 percent of women involved in nonagricultural occupations earn cash, compared with only 7 percent of women working in agriculture. 3.8 DECISION ON USE OF EARNINGS To assess women’s autonomy, information was sought in the Ethiopia DHS on the extent of control women exercise over their earnings. Employed women who earn cash for their work were asked for the main decisionmaker on the use of their earnings. Table 3.9 shows that three-fourths of women report that they are mainly responsible for making decisions on how their earnings will be spent, 16 percent say that they make these decisions jointly with their husband/partmer, and only 2 percent say that the husband/partner alone decides. Younger women age 15-24 and older women age 40-49 are somewhat more likely to make independent decisions on their earnings than women in the middle age groups. Among currently married women, 62 percent report that they alone make the decisions about how their earnings will be used, while 32 percent say that decisions are made jointly with their husband/partner. Women with no children are more likely than women with one or more children to make independent decisions on the use of their earnings and are also more likely than other women to make joint decisions with someone other than their husband. There are no significant differences between urban and rural women in who makes the decision about how the woman’s earnings will be spent. However, regional differences exist, with the proportion of women making independent decisions ranging from 82 percent in the SNNP Region to 35 percent in the Benishangul-Gumuz Region. Working women are more likely to decide jointly with their husband on how to spend the money they earn if they have completed secondary school or higher than if they have only primary education. Respondent’s Characteristics and Status * 31 Table 3.9 Decision on use of earnings Percent distribution of women who worked in the 12 months preceding the survey receiving cash earnings by person who decides how earnings are used, according to background characteristics, Ethiopia 2000 ____________________________________________________________________________________________________ Person who decides how earnings are used ___________________________________________ Jointly Jointly with with Number Background Self Husband/ husband/ Someone someone of characteristic only Partner partner else else Missing Total women ____________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Current marital status Never married Currently married/ living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 78.9 0.6 3.5 6.3 10.4 0.2 100.0 826 74.4 2.5 16.2 0.8 5.2 0.9 100.0 769 71.1 2.8 20.6 1.0 4.1 0.4 100.0 671 70.8 2.5 26.3 0.1 0.0 0.3 100.0 465 69.9 3.7 23.7 0.3 1.5 0.9 100.0 450 77.9 1.2 18.6 0.1 0.9 1.3 100.0 375 82.1 1.0 14.1 0.0 0.6 2.2 100.0 297 82.9 0.0 0.0 5.3 11.6 0.2 100.0 1,127 62.4 4.1 32.3 0.1 0.3 0.9 100.0 1,956 94.3 0.0 0.1 0.8 3.7 1.2 100.0 769 80.1 0.5 4.7 4.5 9.3 0.9 100.0 1,446 70.1 2.8 23.9 0.2 3.0 0.0 100.0 1,036 75.3 2.8 20.8 0.0 0.0 1.1 100.0 725 69.7 3.4 25.8 0.0 0.0 1.0 100.0 645 75.8 1.8 15.2 2.0 4.4 0.8 100.0 1,229 74.3 2.2 17.0 1.6 4.2 0.7 100.0 2,623 66.8 4.0 16.0 0.6 11.6 1.1 100.0 176 65.6 0.6 27.1 4.6 2.1 0.0 100.0 28 56.1 4.2 29.4 3.3 4.7 2.4 100.0 728 79.7 1.4 14.0 0.9 3.5 0.6 100.0 1,200 67.8 4.9 12.3 6.3 8.7 0.0 100.0 45 35.1 16.3 41.6 3.2 3.6 0.2 100.0 32 81.9 1.1 11.6 1.1 4.1 0.2 100.0 1,246 68.9 5.0 24.1 0.2 1.2 0.6 100.0 14 80.9 0.9 8.7 3.2 6.2 0.0 100.0 15 80.8 0.8 11.5 3.4 3.4 0.0 100.0 326 75.1 1.3 21.3 0.7 1.4 0.2 100.0 41 73.9 2.5 17.3 1.9 3.7 0.8 100.0 2,611 80.7 0.4 11.0 1.5 5.6 0.8 100.0 716 71.2 2.1 19.3 1.4 5.6 0.5 100.0 524 74.8 2.1 16.4 1.7 4.3 0.7 100.0 3,852 3.9 WOMEN’S ATTITUDE TOWARD WIFE BEATING The Ethiopia DHS gathered information on women’s attitude toward wife beating, a proxy for women’s perception of their status. Women were asked whether a husband is justified in beating his wife under a series of circumstances. The results are summarized in Table 3.10. A sizable majority of women (85 percent) believe that a husband is justified in beating his wife for at least one reason. Two in three women believe that a husband is justified in beating his wife if she burns the food or neglects 32 * Respondent’s Characteristics and Status Table 3.10 Women's agreement with reasons for wife beating Percentage of women who agree with specific reasons justifying a husband hitting or beating his wife and percentage who agree with at least one of the reasons, by background characteristics, Ethiopia 2000__________________________________________________________________________________________ Reasons justifying a husband hitting or beating his wife________________________________________________ Agrees Goes out with at Burns Argues without Neglects Refuses least one Background the with telling the sexual specified characteristic food him him children relations reason Number__________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Current marital status Never married Married or living together Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Employment Not employed Employed for cash Employed not for cash All women 62.6 59.1 52.9 62.8 43.5 82.1 3,710 64.1 61.4 56.4 64.3 49.5 84.5 2,860 63.0 61.5 55.4 63.7 52.1 83.9 2,585 66.7 63.5 57.9 65.2 54.2 85.3 1,841 64.3 60.9 57.1 67.6 53.5 85.2 1,716 64.7 60.9 57.6 64.3 56.2 85.6 1,392 70.2 65.3 61.5 66.9 58.9 89.6 1,264 57.7 53.5 49.4 60.3 38.7 77.9 3,688 67.9 64.7 59.4 66.4 55.9 87.3 9,789 59.5 59.2 52.5 63.1 48.5 83.0 1,890 59.6 56.2 51.2 61.5 42.5 80.4 5,191 66.0 62.8 56.7 64.7 53.3 85.6 3,882 67.3 64.9 59.1 67.7 55.6 87.1 3,032 67.7 64.4 60.7 66.2 56.9 87.4 3,262 41.0 39.6 38.2 51.6 29.0 69.0 2,791 69.7 66.1 60.2 67.4 55.7 87.9 12,576 57.7 56.5 55.9 68.1 41.0 85.7 969 72.6 71.1 70.6 75.0 70.5 85.7 178 66.6 67.9 59.4 65.1 51.6 88.4 3,820 64.7 62.2 55.5 61.5 54.0 84.1 5,937 48.8 61.5 63.9 65.2 52.0 80.6 175 70.4 61.4 59.0 68.7 51.1 85.0 160 73.2 62.3 60.1 73.4 55.2 87.6 3,285 57.1 54.4 52.7 56.5 36.1 83.4 40 28.7 25.8 17.7 28.6 19.9 49.8 41 23.3 20.8 22.9 40.0 11.8 54.4 684 42.2 46.7 44.0 55.3 37.8 66.9 79 69.5 65.6 60.4 67.0 56.2 88.1 11,551 61.6 59.6 53.0 65.8 44.8 83.0 2,425 27.4 28.3 27.0 41.8 17.1 56.9 1,391 63.7 59.5 54.8 62.5 49.6 84.0 5,630 60.1 56.9 52.6 63.9 47.1 81.4 3,852 68.0 65.9 59.9 66.8 54.5 87.0 5,885 64.5 61.3 56.2 64.5 50.9 84.5 15,367 the children. A slightly smaller percentage agree that if a woman argues with her husband (61 percent) or goes out without telling him (56 percent), then he is justified in beating her. One in two women believe that a husband is justified in beating his wife if she refuses to have sex with him. The percentage of women who agree with at least one of the reasons justifying a husband beating his wife is slightly higher if the woman is older; married; has one or more children; or if she is employed, but not for cash. The differences are more notable by level of education and urban-rural residence. Educated women and urban women are less likely to agree that a man is justified in beating his wife for any reason at all compared with uneducated women. For example, 57 percent of women with secondary and higher education agree with at least one specified reason, compared with 88 percent of uneducated women Respondent’s Characteristics and Status * 33 Table 3.11 Prevalence of female circumcision Percentage of women who have been circumcised and the percentage who support continuation of the practice of female circumcision, by background characteristics, Ethiopia 2000 ___________________________________________________ Percentage Percentage Background of women who support characteristic circumcised practice Number ___________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Employment Not employed Employed for cash Employed not for cash Total 70.7 53.4 3,710 78.3 57.0 2,860 81.4 58.5 2,585 86.1 65.2 1,841 83.6 63.6 1,716 85.8 66.3 1,392 86.8 66.7 1,264 79.8 31.0 2,791 79.9 66.1 12,576 35.7 25.3 969 98.6 76.5 178 79.7 60.3 3,820 89.8 69.6 5,937 99.7 77.3 175 73.7 53.8 160 73.5 59.8 3,285 42.9 26.8 40 94.3 51.3 41 79.8 16.2 684 95.1 45.5 79 80.4 67.0 11,551 78.4 48.5 2,425 78.2 18.6 1,391 79.5 59.1 5,630 84.4 56.1 3,852 77.3 62.7 5,885 79.9 59.7 15,367 and 83 percent of those with primary education. Furthermore, 88 percent of rural women agree with at least one of the reasons justifying a husband beating his wife, compared with 69 percent among urban women. 3.10 FEMALE CIRCUMCISION Women interviewed in the survey were asked a series of questions on female circumci- sion in order to obtain information on the prac- tice in Ethiopia and women’s attitudes toward it. Women were asked about both their own experi- ence with circumcision and the experience of their daughters. As seen in Table 3.11, the practice of female circumcision is widespread in Ethiopia; 80 percent of all women have been circumcised. The prevalence of female circumcision is lower among women living in the Tigray (36 percent) and Gambela (43 percent) regions, while it reaches almost 100 percent in the Somali and Affar regions. Urban-rural residence, education, and work status do not make any notable differ- ence in the practice of female circumcision. The practice is slightly lower among younger women. There is widespread support for female circumcision among Ethiopian women. When asked whether the practice should continue, 60 percent of all women stated that they sup- ported circumcision (Table 3.11). Support for the practice is greatly influenced by residence and level of education. Rural women are twice as likely to support the practice as urban women. Women living in Addis Ababa and in the Tigray and Gambela regions are relatively less likely to support the continuation of the practice. Women with secondary and higher levels of education are also significantly less likely to support the practice (19 percent), compared with women with no education (67 percent), as are women working for cash (56 percent), compared with other women. Women interviewed in the survey who had at least one living daughter were asked questions about the circumcision experience of their daughters. Table 3.12 shows that more than half of the women reported that at least one of their daughters has been circumcised. Older, rural, and less- educated women are more likely to have at least one circumcised daughter, compared with the other women. Women with secondary education or higher are least likely (26 percent) to have a circumcised daughter, compared with 56 percent among uneducated women and 36 percent among those with 34 * Respondent’s Characteristics and Status Table 3.12 Daughters' circumcision experience Percentage of women with daughters who report that they have at least one circumcised daughter by background characteristics, Ethiopia 2000________________________________________ Percentage with a Number Background daughter of characteristic circumcised women________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Employment Not employed Employed for cash Employed not for cash Total 32.6 181 27.1 980 31.9 1,520 43.5 1,436 61.9 1,325 74.7 1,152 80.8 1,065 43.8 1,091 53.2 6,568 39.0 423 93.6 94 78.5 2,016 43.2 3,102 57.7 101 63.8 77 37.0 1,556 43.4 11 44.8 19 39.8 226 39.9 33 55.8 6,371 35.7 878 25.9 410 44.1 2,599 53.2 1,857 57.5 3,203 51.9 7,659 Table 3.13 Age at circumcision for daughters Percent distribution of most recently circumcised daughters according to age at the time of circumcision, Ethiopia 2000_____________________________ Percentage Age at of circumcision daughters_____________________________ <1 1-2 3-4 5-6 7-8 9-10 11-12 13-14 15+ Don't know/Missing Total Number of daughters Median age Mean age 52.5 5.4 6.2 7.6 9.5 6.8 4.0 2.7 4.7 0.6 100.0 3,984 0.0 3.8 primary education. There is substantial variation by region in the percentage of women with at least one circumcised daughter, ranging from 94 percent among women in the Affar Region to 37 percent in the SNNP Region. Surpris- ingly, women who are not employed are less likely than women who are employed to have at least one circumcised daughter. Table 3.13 presents the distribution of most recently circumcised daughters by age at circumcision. More than half of the daughters were reported by their mothers to have been circumcised before age one. The median age at the time of circumcision is zero years. Respondent’s Characteristics and Status * 35 Table 3.14 Person who performed the circumcision Percent distribution of most recently circumcised daughters , according to the person who performed the circumcision, Ethiopia 2000 ___________________________________ Person Percentage performing of circumcision daughters ___________________________________ Traditional circumciser 92.0 Traditional birth attendant 5.5 Other traditional 0.9 Health professional 0.8 Don't know/Missing 0.8 Total 100.0 Number 3,984 Table 3.15 Severity of circumcision Percent distribution of women who have been circumcised and of most recently circumcised daughters, according to severity of the circumcision, Ethiopia 2000 ________________________________________ Severity of circumcision Women Daughters ________________________________________ Vaginal area sewn closed 2.9 3.4 Vaginal area not sewn 96.2 96.5 Don't know/Missing 0.9 0.1 Total 100.0 100.0 Number 12,280 3,984 Ninety-two percent of the circumcisions were performed by a traditional circumciser (Table 3.14). A traditional birth attendant was responsible for 6 percent of the circumcisions, and less than 1 percent were performed by some other health professional. In an effort to obtain basic information on the severity of female circumcision, women who have been circumcised were asked whether their vaginal area was sewn closed. The same information was asked about their most recently circumcised daughters. Only 3 percent of circumcised women and an equal proportion of the most recently circumcised daughters had had their vaginal area sewn closed (Table 3.15). This suggests that the most severe form of circumcision is not common in Ethiopia. 1 Numerators of the ASFRs are calculated by summing the number of live births that occurred in the period 1-60 months preceding the survey (determined by the date of interview and the date of birth of the child) and classifying them by age (in five-year groups) of the mother at the time of birth (determined by the mother’s birth date). The denominators of the rates are the number of woman-years lived in each of the specified five-year age groups during the 1-60 months preceding the survey. Fertility* 37 Table 4.1 Current fertility Age-specific and cumulative fertility rates and the crude birth rate for the five years preceding the survey, by residence, Ethiopia 2000____________________________________________________ Residence______________ Age group Urban Rural Total____________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 TFR 15-49 TFR 15-44 GFR CBR 60 123 110 149 266 244 156 289 264 160 264 248 97 199 183 33 109 100 4 27 24 3.3 6.4 5.9 3.3 6.3 5.7 111 211 193 30.7 42.9 41.3 ____________________________________________________ Note: Rates are for the period 1-60 months preceding the survey. Rates for age group 45-49 may be slightly biased due to truncation. TFR: Total fertility rate for ages 15-49 expressed per woman GFR: General fertility rate (births ÷ no. of women 15-44) expressed per 1,000 women CBR: Crude birth rate expressed per 1,000 population ASFR: Age-specific fertility rate expressed per 1,000 women FERTILITY 4 Fertility is the most important component of population dynamics and plays a major role in changing the size and structure of the population of a given area. Ethiopia, like most countries in sub- Saharan Africa, is characterized by rapid population growth, which is influenced by a high level of fertility. Comprehensive information on fertility and the factors affecting it were not totally available until the results of the 1990 National Family and Fertility Survey became available (CSA, 1993). Since then, no detailed information has been obtained to evaluate fertility trends and the magnitude of change in fertility. The Ethiopia DHS fills this data gap and generates detailed information on fertility that will be useful for the formulation of policies and the design of programs. Current fertility levels, trends and differentials in fertility, cumulative fertility, birth intervals, age at first birth, and adolescent fertility are examined in this chapter. The fertility indicators presented in this chapter are based on information obtained from women age 15-49. All women who were interviewed in the survey were asked to report on the total number of sons and daughters who were living at home, the number living elsewhere, and the number who had died. A complete birth history was then obtained, including for each birth, name, whether the birth was single or multiple, month and year of birth, survival status, and age at death for dead children. 4.1 CURRENT FERTILITY The current level of fertility refers to data on live births occurring in the five-year period preceding the survey, which was obtained from the birth history data. From this information, reported measures of fertility were computed and presented in Table 4.1. The reported summary measures include age-specific fertility rates (ASFRs),1 total fertility rates (TFRs) for women age 15-44 and 15-49, the general fertility rate (GFR), and the crude birth rate (CBR). The ASFRs represent the number of live births per 1,000 women in the age group. The TFR is the number of children a woman would have by the end of her reproductive years if she experienced the current rate of childbearing at each age of her childbearing years assuming that she survived to the end of her reproductive age. The GFR is defined as the annual number of births per 2 A three-year rate is usually shown for DHS surveys but it was decided that a five-year rate would be more appropriate in Ethiopia since it is closer to estimates of fertility that are currently being used. 38 * Fertility & & & & & & & ) ) ) ) ) ) ) ' ' ' ' ' ' ' 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age Group 0 50 100 150 200 250 300 Births per 1,000 Women Urban Rural Total' ) & Ethiopia DHS 2000 Figure 4.1 Age-specific Fertility Rates by Urban-Rural Residence 1,000 women age 15-44, and the CBR refers to the total number of births occurring in a given year per 1,000 population. The total fertility rate in Ethiopia for the five years2 preceding the survey (representing early 1995 to early 2000) is 5.9 children per woman. The TFR in the rural areas is 6.4 and is almost twice as high as the TFR in the urban areas (3.3). The ASFRs presented in Table 4.1 and Figure 4.1 by urban- rural residence indicate that in Ethiopia, childbearing begins at early ages. The ASFR is lower among adolescents and increases up to age 25-29 and declines thereafter. The rates are higher in rural areas than in urban areas at all ages. The maximum fertility occurs at age 25-29 among rural women and 30- 34 among urban women. At the current rate of childbearing, an Ethiopian woman would have more than half of her lifetime births (3.1) by age 30 and nearly three-fourths of the total children she will ever have (4.3) by age 35. The GFR, also presented in Table 4.1, is 193 per 1,000 women age 15-44 for the five years prior to the survey. Like the TFR, the GFR and CBR also vary by urban-rural residence. Thus, with a GFR of 211 per 1,000, the average annual number of births to rural women is double that for urban women (111 per 1,000). Similarly, the CBR in the rural areas (43 per 1,000) is much higher than the CBR in the urban areas (31 per 1,000). Fertility* 39 Table 4.2 Fertility by background characteristics Total fertility rate for the five years preceding the survey, percentage currently pregnant, and mean number of children ever born to women age 40-49 years, by background charac- teristics, Ethiopia 2000___________________________________________________ Mean number of children Total Percentage ever born Background fertility currently to women characteristic rate pregnant1 age 40-49___________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 3.3 6.1 5.5 6.4 10.2 7.2 5.8 7.9 6.8 4.9 8.6 6.4 5.9 8.5 6.9 6.4 10.3 7.2 5.7 13.1 7.7 5.4 10.5 6.6 5.9 10.7 7.2 4.5 8.4 6.0 4.4 7.3 6.3 1.9 3.3 4.7 3.6 6.9 5.4 6.2 10.6 7.1 5.1 6.6 5.9 3.1 4.8 4.6 5.9 9.4 7.0 ___________________________________________________ 1 Women age 15-49 years 4.2 FERTILITY DIFFERENTIALS Table 4.2 and Figure 4.2 present differentials in fertility by urban-rural residence, region, and education. The figures show large differences in the level of fertility among regions. Fertility is lowest in Addis Ababa at 1.9 children per woman and highest in Oromiya at 6.4 children per woman. High levels of fertility are also observed in the Amhara and SNNP regions, with TFRs at 5.9 in each of these regions. Female education is known to be inversely related to fertility. With a TFR of 6.2, a woman with no education has about 1 child more than a woman with primary education (5.1) and about 3 children more than a woman with at least some secondary education (3.1). The mean number of children ever born to women by the end of their reproduc- tive period, age 40-49, is a measure of the average completed fertility (Table 4.2). If fertility remained constant in the recent past and the reported data on both children ever born and births during the five years preceding the survey are reasonably accurate, the aver- age completed fertility should be equal to the total fertility rate. Comparison of the mean number of children ever born to women age 40-49 with the TFR suggests a decline of about one child per woman in Ethiopia over the past 10 to 15 years. Even though fertility has de- clined both in urban and rural areas, the difference between the level of completed and current fertility is more pronounced in urban areas (2.2) than in rural areas (0.8). Although fertility decline has occurred in all regions and at all educational levels, a noticeably large decline is observed in Addis Ababa. Table 4.2 also shows the percentage of women who reported being pregnant at the time of the survey. This percentage may be underreported since women may not be aware of a pregnancy, especially at the very early stages, and some women who are early in the pregnancy, may not want to reveal that they are pregnant. Nine percent of women reported that they were pregnant at the time of the survey. The proportion of pregnant women is lower in urban areas (6 percent) than in rural areas (10 percent). Addis Ababa has the lowest proportion currently pregnant (3 percent), whereas the highest proportion pregnant is reported in the Somali Region (13 percent). Regarding differentials in current pregnancy status by level of education, the pattern is similar to that observed for the TFR. 40 * Fertility Table 4.3 Trends in fertility Age-specific fertility rates (per 1,000 women) and total fertility rates, Ethiopia 1990 and 2000__________________________________ 2000 1990 Ethiopia Age group NFFS1 DHS__________________________________ 15-19 95 110 20-24 275 244 25-29 289 264 30-34 257 248 35-39 199 183 40-44 105 100 45-49 56 24 Total fertility rate 6.4 5.9__________________________________ Note: Rates for the 1990 NFFS are for the 12 months preceding the survey, and rates for the Ethiopia DHS are for the five years preceding the survey. 1 CSA, 1993 5.9 3.3 6.4 6.2 5.1 3.1 5.8 4.9 5.9 6.4 5.7 5.4 5.9 4.5 4.4 1.9 3.6 ETHIOPIA RESIDENCE Urban Rural REGION Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa EDUCATION No education Primary Secondary and higher 0.0 2.0 4.0 6.0 8.0 Number of Children Ethiopia DHS 2000 Figure 4.2 Total Fertility Rates by Selected Background Characteristics 4.3 TRENDS IN FERTILITY Table 4.3 shows the reported ASFRs and the TFRs for the 1990 NFFS (CSA, 1993) and the 2000 Ethiopia DHS. The TFR declined from 6.4 births per woman in the 1990 NFFS to 5.9 births per woman in the Ethiopia DHS, a drop of 0.5 children on average. Fertility has declined in every age group, except for the age group 15-19. The greatest decline was among women age 45-49 (57 percent), followed by women age 20-24 (11 percent). Data from the Ethiopia DHS on age-specific fertility rates for successive five-year periods preceding the survey provide further evidence of a decline in fertility (Table 4.4). Figures in brackets represent partial fertility rates due to truncation. For example, rates cannot be calculated for women age 35-39 for the period 15-19 years before the survey, because these women were 50 years and older at the time of the survey and were not interviewed. A substantial decline in ASFRs is seen between five to nine years before the survey and zero to four years before the survey. In fact, the ASFRs had started to decline even earlier than this period (from 10 to14 years before the survey) among women age 15-19, 20-24, and 35-39. The cumulative fertility rates computed for women age 15-34 for the successive five years preceding the survey also show a sustained decline in the level of fertility for the period 0 to19 years prior to the survey. The level of fertility decreased from a cumulative fertility of 5.3 for the period 15 to 19 years before the survey to 4.3 for the period 0 to 4 years before the survey. Fertility* 41 Table 4.4 Trends in age-specific fertility rates Age-specific fertility rates for five-year periods preceding the survey by mother's age at the time of the birth, Ethiopia 2000 ______________________________________________ Number of years preceding survey Mother's _________________________________ age at birth 0-4 5-9 10-14 15-19 ______________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 110 128 176 192 244 283 291 288 264 300 297 299 248 278 266 [285] 183 213 [254] 100 [130] [24] ______________________________________________ Note: Age-specific fertility rates are per 1,000 women. Estimates in brackets are truncated. 4.4 CHILDREN EVER BORN AND LIVING The level of lifetime fertility is based on information about the total number of children ever born. From this information, the mean number of children born per woman (average parity) in a given age is computed to measure the cumulative experience from the beginning of the reproductive time to the age at the time of the survey. Table 4.5 shows the percent distribution of women by the number of children ever born and the mean number of children ever born and living, by five-year age groups, for all women and currently married women. The mean number of children ever born increases with women’s age. From an average of 0.2 children among adolescents, the average parity is 2.7 children among women in their late twenties and 7.2 children among those at the end of their reproductive years. The distribution of women by the number of children ever born shows that childbearing in Ethiopia starts at an early age. Among teenage women, 13 percent have given birth to at least one child, and among women in their early twenties, more than one-third already have two or more children. Among women in their early thirties, more than 72 percent have had at least four children, and more than half of the women age 45-49 have given birth to eight or more children. A similar pattern is observed for currently married women except that mean parities are higher among currently married women than among all women at every age. The Ethiopia DHS results also indicate that childlessness decreases with increasing age. Among teenage women, 87 percent of all women and 52 percent of currently married women are childless. However, among women in their early twenties, the proportion decreases to 38 percent for all women and 13 percent for currently married women. The percentage childless among currently married women at the end of the reproductive period (age 45-49) is a rough estimate of primary infertility. Voluntary childlessness is rare in Ethiopia, and married women with no live births are likely to be unable to bear children at all. The results indicate that primary infertility among currently married women is low (2 percent). The level of primary infertility has decreased from 3.9 percent reported in the 1990 NFFS (CSA, 1993). Information on children ever born was collected for all men interviewed in the survey. They were asked to report on the total number of children living at home, the number living elsewhere, and those who had died. The average number of children by age group is computed from the total number of children ever born. The proportion of children ever born for all men and for currently married men is presented in the bottom two panels of Table 4.5. The average number of children ever born increases with increasing age. Men in their early twenties have an average of less than 1 child (0.2); this increases to almost 3 children among men in their early thirties, 6 children among men in their early forties, and 8 or more children among men age 45 and over. The results for men who are currently married differ from those for all men particularly at younger ages. For example, the proportion of men in the age group 20-24 who had never had a child is two and a half times higher among all men than among currently married men. 42 * Fertility Table 4.5 Children ever born and living Percent distribution of all women and currently married women and of all men and currently married men by number of children ever born (CEB), and mean number of children ever born and mean number of living children, according to age group, Ethiopia 2000______________________________________________________________________________________________________ Mean Mean number Number of children ever born number of __________________________________________________________ of living Age 0 1 2 3 4 5 6 7 8 9 10+ Total Number CEB children ______________________________________________________________________________________________________ ALL WOMEN______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total 87.2 10.5 2.0 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 3,710 0.15 0.13 38.1 24.3 22.2 11.3 3.3 0.5 0.2 0.0 0.0 0.1 0.0 100.0 2,860 1.20 1.02 14.6 12.7 19.7 22.2 16.1 9.3 3.4 1.3 0.7 0.1 0.0 100.0 2,585 2.65 2.17 4.5 4.6 9.0 10.4 17.0 19.8 16.9 10.2 5.2 1.7 0.7 100.0 1,841 4.57 3.62 3.5 2.9 5.8 8.0 8.3 14.8 18.9 15.6 10.6 6.2 5.3 100.0 1,716 5.66 4.40 1.8 3.4 3.6 3.7 6.2 11.1 12.4 15.4 15.3 12.9 14.0 100.0 1,392 6.74 4.99 2.4 2.4 4.0 4.1 5.3 6.9 10.3 12.6 16.2 13.1 22.8 100.0 1,264 7.23 5.21 31.9 10.6 10.3 8.7 7.3 7.3 6.7 5.6 4.6 3.2 3.8 100.0 15,367 3.09 2.39 ______________________________________________________________________________________________________ CURRENTLY MARRIED WOMEN______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total 51.5 39.9 7.8 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 862 0.58 0.50 13.4 31.8 31.8 16.7 5.0 0.8 0.3 0.0 0.0 0.1 0.0 100.0 1,807 1.73 1.48 5.1 10.8 21.7 25.6 19.1 11.3 3.9 1.4 0.9 0.1 0.0 100.0 2,051 3.06 2.52 2.0 3.7 7.1 9.6 17.3 22.0 19.1 11.4 5.1 2.0 0.8 100.0 1,572 4.87 3.89 2.7 2.7 4.3 7.0 8.3 14.5 19.4 16.8 11.7 6.7 6.1 100.0 1,441 5.90 4.63 1.5 3.1 2.6 2.5 5.4 10.1 11.0 15.5 16.3 15.2 16.7 100.0 1,096 7.10 5.32 1.9 1.4 3.0 3.7 4.4 4.9 9.5 13.3 17.6 14.2 26.1 100.0 961 7.65 5.60 9.2 13.1 13.5 11.7 10.0 9.8 9.0 7.6 6.3 4.4 5.5 100.0 9,789 4.21 3.30 ______________________________________________________________________________________________________ ALL MEN______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Total 99.7 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 600 0.00 0.00 85.5 9.1 3.7 1.0 0.6 0.0 0.0 0.0 0.1 0.0 0.0 100.0 408 0.22 0.19 40.8 22.5 17.5 11.9 4.1 2.4 0.8 0.0 0.0 0.0 0.0 100.0 343 1.27 1.06 20.2 8.3 24.7 17.8 11.2 12.0 2.4 2.0 0.1 0.1 1.2 100.0 276 2.59 2.14 7.0 2.8 9.8 17.3 19.1 14.2 14.1 10.4 2.7 0.6 1.9 100.0 304 4.26 3.44 6.4 6.0 5.0 11.0 5.0 6.6 18.0 13.4 10.9 8.1 9.6 100.0 182 5.88 4.37 2.1 0.4 2.4 4.4 6.0 5.6 12.8 10.6 14.6 13.9 27.3 100.0 207 7.95 5.87 0.0 1.1 3.0 2.4 0.3 4.4 11.9 15.7 18.8 12.6 29.7 100.0 142 8.45 6.48 2.4 1.8 1.7 4.7 4.6 4.8 2.8 15.9 19.6 13.6 28.1 100.0 146 8.03 5.87 45.4 6.3 7.5 7.1 5.1 4.7 5.1 4.9 4.4 3.2 6.4 100.0 2,607 2.92 2.25 ______________________________________________________________________________________________________ CURRENTLY MARRIED MEN______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Total * * * * * * * * * * * 100.0 7 0.25 0.00 33.9 40.1 17.2 5.3 3.2 0.0 0.0 0.0 0.3 0.0 0.0 100.0 76 1.06 0.87 12.5 32.5 26.8 16.9 6.3 3.7 1.3 0.0 0.1 0.0 0.0 100.0 222 1.88 1.59 6.3 7.5 29.8 21.4 13.5 14.6 2.8 2.4 0.1 0.1 1.4 100.0 228 3.11 2.56 3.8 2.9 10.5 17.6 18.8 15.2 14.6 11.1 2.9 0.6 2.0 100.0 284 4.43 3.58 3.4 6.2 3.7 11.6 5.1 6.2 19.2 14.3 11.7 8.5 10.2 100.0 171 6.16 4.57 1.0 0.2 1.4 4.7 4.8 6.0 12.8 10.2 14.7 14.8 29.4 100.0 192 8.22 6.10 0.0 1.1 3.1 2.3 0.4 4.5 12.1 16.0 19.1 11.4 30.2 100.0 139 8.46 6.51 1.1 1.9 0.3 4.8 4.7 4.9 2.9 16.4 20.2 14.0 28.9 100.0 142 8.24 6.02 6.4 9.9 12.6 12.3 8.6 8.2 8.8 8.6 7.7 5.5 11.4 100.0 1,460 5.10 3.92 ______________________________________________________________________________________________________ Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Fertility* 43 Comparison of these results with those obtained for women who are currently in union shows that at younger ages, the average number of children ever born increases more rapidly with increasing age among currently married women than among currently married men. However, at older ages, the average number of children ever born is higher for currently married men than that for currently married women (8.2 for men and 7.7 for women at age 45-49). The more rapid rise in number of children ever born among younger women than among younger men is due to their earlier entrance into marital union. Among men, the higher level of average number of children ever born at older ages may be explained by the fact that men are more likely to enter into multiple unions and therefore may have more children than their wives. 4.5 BIRTH INTERVALS Longer birth intervals contribute to improved health status of both mother and child. Infants born within two years of the birth of a previous child experience a higher risk of health problems. Table 4.6 shows the distribution of second and higher order births that occurred in the five years preceding the survey by the number of months since the previous birth, according to background variables. In Ethiopia, 20 percent of nonfirst births occur less than 24 months after the preceding birth, with 8 percent occurring less than 18 months after the preceding birth. Forty-three percent of women give birth at least 36 months after the previous birth. The overall median birth interval is 34 months. This means that half of the births in Ethiopia occur close to three years after the previous birth. Data also indicate that birth intervals increase with increasing age of women. Thirty-seven percent of births to women age 15-19 occurred within two years of the previous birth, compared with only 14 percent of births among women age 40 and above. The median birth interval rises from 26 months among women age 15-19 to 38 months among women age 40 and above. Birth intervals do not seem to vary much by birth order, sex of the preceding child, or urban-rural residence. However, the birth interval does vary markedly by the survival status of the preceding birth. Four times as many births occurred within an 18- month interval when the preceding child had died than when it was still alive. The median birth interval is 34 months if the previous child is living, but falls to 28 months if the preceding child is dead. Median birth intervals are shorter in the Somali and Harari regions and relatively longer in Addis Ababa and in the Gambela Region. The level of education of mothers does not significantly affect the length of the birth interval. 44 * Fertility Table 4.6 Birth intervals Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, according to demographic and background characteristics, Ethiopia 2000____________________________________________________________________________________________________ Median number of months Months since preceding birth since____________________________________________ preceding Characteristic 7-17 18-23 24-35 36-47 48+ Total birth Number____________________________________________________________________________________________________ Age 15-19 20-29 30-39 40-49 Birth order 2-3 4-6 7 + Sex of preceding birth Male Female Survival of preceding birth Dead Living Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 18.8 18.5 47.1 7.7 7.9 100.0 25.8 92 11.9 12.7 40.1 22.3 13.0 100.0 30.8 4,254 5.7 10.5 36.8 25.2 21.7 100.0 35.0 4,183 4.8 8.8 32.1 26.4 27.9 100.0 37.5 1,380 10.0 12.6 37.7 21.3 18.5 100.0 32.2 3,669 7.5 9.2 37.8 25.6 19.8 100.0 34.7 3,794 7.4 12.5 37.4 25.4 17.3 100.0 33.6 2,445 8.9 11.5 36.3 24.0 19.3 100.0 33.8 5,157 7.8 11.1 39.2 23.9 18.1 100.0 33.5 4,751 22.8 15.6 28.1 16.7 16.8 100.0 27.8 1,847 5.1 10.3 39.8 25.6 19.2 100.0 34.4 8,061 10.2 9.7 33.7 16.2 30.3 100.0 35.2 921 8.2 11.5 38.1 24.8 17.5 100.0 33.5 8,987 6.0 7.0 42.8 25.7 18.5 100.0 34.4 656 12.0 16.6 30.9 20.7 19.8 100.0 31.9 95 6.4 7.9 33.4 29.8 22.5 100.0 36.6 2,614 10.3 13.4 40.2 20.8 15.4 100.0 31.4 4,047 15.9 21.6 28.0 19.4 15.2 100.0 27.6 120 9.0 11.9 36.0 24.6 18.5 100.0 34.3 96 7.4 11.8 38.4 23.1 19.3 100.0 33.4 2,099 2.2 9.1 22.5 29.9 36.3 100.0 40.5 21 12.0 17.0 33.5 19.1 18.3 100.0 30.0 19 7.0 12.6 23.5 16.0 40.9 100.0 40.8 112 10.8 16.9 37.2 20.5 14.6 100.0 31.2 30 7.8 11.3 37.7 24.5 18.7 100.0 33.8 8,272 11.6 10.4 38.2 23.2 16.6 100.0 32.4 1,259 11.0 12.9 35.7 14.9 25.5 100.0 32.6 377 8.4 11.3 37.7 24.0 18.7 100.0 33.6 9,908 ____________________________________________________________________________________________________ Note: First-order births are excluded. The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. 4.6 AGE AT FIRST BIRTH Early age at childbearing has a detrimental effect on the health of both mother and child. It also indicates a longer reproductive span and higher level of fertility. Table 4.7 presents the distribution of women by age at first birth and median age at first birth according to age at the time of the survey. Childbearing begins early in Ethiopia. More than 50 percent of women age 30 and above have had their first birth in their teens, and even among the cohort age 20-24, a sizable proportion (44 percent) have had a birth before age 20. The median age at first birth is 20 years for the youngest cohort (age 25-29) for whom a median could be computed and varies between 18 and 19 for the older cohorts, indicating a rise in the median age at first birth during the most recent period. Fertility* 45 Table 4.7 Age at first birth Percent distribution of women by age at first birth, according to current age, Ethiopia 2000 ____________________________________________________________________________________________________ Median Age at first birth age at No _____________________________________________ first Current age birth <15 15-17 18-19 20-21 22-24 25+ Total Number birth ____________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 87.2 1.1 8.4 NA NA NA NA 100.0 3,710 a 38.1 3.3 20.9 19.4 13.8 NA NA 100.0 2,860 a 14.6 5.7 23.8 19.4 17.1 14.8 4.5 100.0 2,585 20.1 4.5 6.5 36.5 22.9 12.1 10.5 7.0 100.0 1,841 18.5 3.5 9.9 29.7 18.2 16.8 12.1 9.8 100.0 1,716 19.1 1.8 6.6 39.5 23.1 12.2 9.8 7.0 100.0 1,392 18.4 2.4 8.0 32.2 23.0 15.9 10.6 7.9 100.0 1,264 18.7 ____________________________________________________________________________________________________ NA = Not applicablea Omitted in populations where less than 50 percent of the women in the age group × to × + 4 have had a birth by age × Table 4.8 Median age at first birth by background characteristics Median age at first birth among women age 25-49 years, by current age and background characteristics, Ethiopia 2000__________________________________________________________________________________ Current age Women Background ____________________________________________ age characteristic 25-29 30-34 35-39 40-44 45-49 25-49_________________________________________________________________________________ Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher All women 22.5 18.8 18.8 18.8 18.4 20.0 19.6 18.5 19.1 18.3 18.8 18.9 19.1 18.7 19.0 19.0 19.2 19.0 21.0 20.1 19.6 21.5 19.4 20.2 18.8 17.5 18.3 17.4 17.7 18.0 20.1 18.5 18.8 18.3 18.8 19.0 20.3 19.3 19.0 18.0 20.1 19.5 19.3 18.4 19.4 19.7 18.8 19.1 21.3 19.5 20.6 18.8 19.7 20.1 19.8 17.3 18.7 18.2 20.6 18.7 20.6 19.9 18.0 17.6 19.6 19.3 a 23.7 19.3 19.2 19.2 21.7 23.6 20.8 21.2 20.4 19.4 21.4 19.6 18.4 19.0 18.2 18.7 18.8 20.3 19.0 20.5 20.0 17.9 19.8 24.4 21.0 20.4 20.6 21.6 22.9 20.1 18.5 19.1 18.4 18.7 19.0 _________________________________________________________________________________ a Omitted because less than 50 percent of the women ages 25 to 29 have had a birth by age 25 Table 4.8 presents the median age at first birth by background characteristics and age at the time of the survey. The median age at first birth is higher in urban areas than in rural areas, with a difference of one year among women age 25-49. Addis Ababa has the highest median age at first birth (21.7), followed closely by Dire Dawa (21.4). The Amhara Region has the lowest median age at first birth (18). There is a positive relationship between educational attainment and median age at first birth. 46 * Fertility Table 4.9 Teenage pregnancy and motherhood Percentage of women age 15-19 who are mothers or pregnant with their first child, by background characteristics, Ethiopia 2000_______________________________________________________________ Percentage who are: Percentage_________________ who have Pregnant begun Background with first child- characteristic Mothers child bearing Number_______________________________________________________________ Age 15 16 17 18 19 Residence Urban Rural Region Tigray Affar Amhara Oromiya Somali Benishangul-Gumuz SNNP Gambela Harari Addis Ababa Dire Dawa Education No education Primary Secondary and higher Total 0.7 0.5 1.2 892 3.5 3.0 6.5 798 12.0 3.5 15.5 659 22.0 5.4 27.4 827 33.8 5.9 39.7 534 6.8 2.4 9.1 816 14.5 3.8 18.3 2,894 18.6 2.3 20.9 234 16.6 4.5 21.1 34 21.9 3.2 25.0 842 11.4 4.4 15.8 1,594 10.1 2.7 12.7 43 17.1 5.2 22.2 41 5.5 2.6 8.1 688 21.9 4.1 26.0 8 9.1 3.8 12.9 9 3.5 1.2 4.7 199 7.2 3.8 11.0 18 16.4 4.4 20.8 2,265 7.4 1.5 8.9 977 6.5 3.0 9.5 468 12.8 3.5 16.3 3,710 The median age at first birth is 19 years among women with no educa- tion and increases to 20 years among women with primary education and to 23 years among women with at least secondary education. This means that women with no education become mothers four years earlier than those who have attained at least a secondary level of education. 4.7 TEENAGE PREGNANCY AND MOTHERHOOD In addition to the relatively higher level of pregnancy complica- tions among young mothers, due to physiological immaturity, inexperience associated with child care practices also influences maternal and infant health. Moreover, an early start to childbearing greatly reduces the edu- cational and employment opportuni- ties of women and is associated with higher levels of fertility. Table 4.9 presents the proportion of women age 15-19 (teenagers) who are mothers or pregnant with their first child, by background characteristics. Sixteen percent of women age 15-19 have already become mothers or are currently pregnant with their first child. The percentage of women who have begun childbearing increases rapidly with age, from 1 percent among women age 15, to 40 percent among women age 19. Twice as many teenagers residing in rural areas as in urban areas have begun childbearing. The level of teenage parenthood is also more than twice as high among women with no education than among women with primary or higher levels of education. Childbearing among teenagers is lowest in Addis Ababa (5 percent) and highest in the Gambela Region (26 percent). Fertility Regulation* 47 FERTILITY REGULATION 5 Information on knowledge of family planning methods provides a measure of the level of awareness of contraception in the population and indicates the success of information, education, and communication (IEC) programs. In addition, knowledge of at least one method and a positive attitude toward contraception is a prerequisite for the use of contraception. Information collected in the 2000 Ethiopia DHS on knowledge, behavior, and attitudes toward family planning methods, as well as exposure to media messages about family planning, is presented in this chapter. The levels and trends of ever use and current use of family planning are also discussed. 5.1 KNOWLEDGE OF CONTRACEPTION The level of knowledge of contraception was measured in two ways. Respondents were first asked to mention all the methods of contraception that they had heard of. When a respondent failed to mention a particular method spontaneously, the interviewer described the method to see if the respondent recognized it. Thus, in the Ethiopia DHS, those who have ever heard of a contraceptive method include those who spontaneously report having heard of a method and those who acknowledge having heard about a method after probing. Information was collected for eight modern methods—the pill, the IUD, injectables, implants, vaginal methods (including diaphragm, foam, jelly, or cream), condoms, and female and male sterilization—and two traditional methods—periodic abstinence and withdrawal. In addition, provision was made in

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