Myanmar - Demographic and Health Survey - 2017

Publication date: 2017

Myanmar 2015-16Demographic andHealth Survey M yanm ar 2015-16 D em ographic and H ealth S urvey MYANMAR DEMOGRAPHIC AND HEALTH SURVEY 2015-16 Ministry of Health and Sports Nay Pyi Taw, Myanmar The DHS Program ICF Rockville, Maryland, USA March 2017 The 2015-16 Myanmar Demographic and Health Survey (2015-16 MDHS) was implemented by the Ministry of Health and Sports of the Republic of the Union of Myanmar. The funding for the MDHS was provided by the United States Agency for International Development (USAID) and the Three Millennium Development Goal Fund (3MDG). ICF provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2015-16 MDHS may be obtained from the Ministry of Health and Sports, Building No 47, Nay Pyi Taw, Myanmar; Telephone: (+) 95-067-431075; Fax: (+) 95-067-431076; Website: www.mohs.gov.mm. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; Telephone: +1-301-407-6500; Fax: +1-301-407-6501; E-mail: info@DHSprogram.com; Internet: www.DHSprogram.com. Cover photo: ©2015 Dr. Htin Aung Latt Suggested citation: Ministry of Health and Sports (MoHS) and ICF. 2017. Myanmar Demographic and Health Survey 2015-16. Nay Pyi Taw, Myanmar, and Rockville, Maryland USA: Ministry of Health and Sports and ICF. Contents • iii CONTENTS TABLES AND FIGURES . vii FOREWORD . xv READING AND UNDERSTANDING THE 2015-16 MYANMAR DEMOGRAPHIC AND HEALTH SURVEY (MDHS) . xvii CONTRIBUTORS TO THE REPORT . xxv ACRONYMS AND ABBREVIATIONS . xxvii MAP OF MYANMAR . xxx 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.4 Anthropometry, and Anemia Testing . 3 1.5 Training of Trainers and Pretest . 3 1.6 Training of Field Staff . 4 1.7 Fieldwork . 4 1.8 Data Processing . 5 1.9 Response Rates . 6 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 2.1 Drinking Water Sources and Treatment . 7 2.2 Sanitation . 8 2.3 Exposure to Smoke inside the Home . 9 2.4 Household Wealth . 9 2.5 Hand Washing . 10 2.6 Household Population and Composition . 11 2.7 Birth Registration . 11 2.8 Children’s Living Arrangements and Parental Survival . 13 2.9 Education . 13 2.9.1 Educational Attainment . 13 2.9.2 School Attendance . 14 3 CHARACTERISTICS OF RESPONDENTS . 27 3.1 Basic Characteristics of Survey Respondents . 27 3.2 Education and Literacy . 28 3.3 Mass Media Exposure . 29 3.4 Employment . 30 3.5 Occupation . 31 3.6 Tobacco Use . 32 3.7 Knowledge of Tuberculosis . 33 4 MARRIAGE AND SEXUAL ACTIVITY . 53 4.1 Marital Status . 53 4.2 Polygyny . 54 4.3 Age at First Marriage . 55 4.4 Age at First Sexual Intercourse . 55 4.5 Recent Sexual Activity . 56 iv • Contents 5 FERTILITY . 67 5.1 Current Fertility . 67 5.2 Children Ever Born and Living . 69 5.3 Birth Intervals . 69 5.4 Insusceptibility to Pregnancy . 70 5.5 Age at First Birth . 70 5.6 Teenage Childbearing . 71 6 FERTILITY PREFERENCES . 79 6.1 Desire for Another Child . 79 6.2 Ideal Family Size . 80 6.3 Fertility Planning Status . 81 6.4 Wanted Fertility Rates . 82 7 FAMILY PLANNING . 89 7.1 Contraceptive Knowledge and Use . 89 7.2 Timing of Female Sterilization . 91 7.3 Source of Modern Contraceptive Methods . 92 7.4 Social Marketing Brands . 92 7.5 Informed Choice . 92 7.6 Discontinuation of Contraceptives . 93 7.7 Demand for Family Planning . 93 7.8 Contact of Nonusers with Family Planning Providers . 95 8 INFANT AND CHILD MORTALITY . 111 8.1 Early Childhood Mortality . 112 8.2 Biodemographic Risk Factors . 113 8.3 Perinatal Mortality . 114 9 MATERNAL HEALTH CARE . 121 9.1 Antenatal Care Coverage and Content . 122 9.1.1 Skilled Providers . 122 9.1.2 Timing and Number of ANC Visits . 122 9.2 Components of ANC Visits . 123 9.3 Protection against Neonatal Tetanus . 123 9.4 Delivery Services . 124 9.4.1 Institutional Deliveries . 124 9.4.2 Skilled Assistance during Delivery . 125 9.4.3 Delivery by Caesarean . 126 9.5 Postnatal Care . 126 9.5.1 Postnatal Health Check for Mothers . 126 9.5.2 Postnatal Health Checks for Newborns . 127 9.6 Problems in Accessing Health Care . 127 10 CHILD HEALTH . 141 10.1 Birth Weight . 141 10.2 Vaccination of Children . 142 10.3 Symptoms of Acute Respiratory Infection . 144 10.4 Fever . 145 10.5 Diarrheal Disease . 145 10.5.1 Prevalence of Diarrhea . 145 10.5.2 Treatment of Diarrhea . 146 10.5.3 Feeding Practices . 147 10.5.4 Knowledge of ORS Packets . 147 10.6 Knowledge regarding Treatment of Childhood Illnesses . 148 10.7 Disposal of Children’s Stools . 148 Contents • v 11 NUTRITION OF CHILDREN AND WOMEN . 161 11.1 Nutritional Status of Children . 161 11.1.1 Measurement of Nutritional Status among Young Children . 161 11.1.2 Data Collection . 163 11.1.3 Levels of Child Malnutrition . 163 11.2 Infant and Young Child Feeding Practices . 164 11.2.1 Breastfeeding . 164 11.2.2 Exclusive Breastfeeding . 165 11.2.3 Median Duration of Breastfeeding . 166 11.2.4 Complementary Feeding . 166 11.2.5 Minimum Acceptable Diet . 167 11.3 Anemia Prevalence in Children . 168 11.4 Micronutrient Intake and Supplementation among Children. 169 11.5 Presence of Iodized Salt in Households . 170 11.6 Nutritional Status of Women . 170 11.7 Anemia Prevalence in Women . 171 11.8 Micronutrient Intake among Mothers . 172 12 MALARIA . 189 12.1 Ownership of Insecticide-Treated Nets . 190 12.2 Household Access to and Use of ITNs . 191 12.3 Use of ITNs by Children and Pregnant Women . 192 12.4 Case Management of Malaria in Children . 193 12.5 Prevalence of Low Hemoglobin in Children . 194 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR . 205 13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods . 205 13.2 Knowledge about Mother-to-Child Transmission . 207 13.3 HIV/AIDS Attitudes . 207 13.3.1 Attitudes toward People Living with HIV/AIDS . 207 13.3.2 Attitudes toward Negotiating Safer Sexual Relations with Husbands . 208 13.3.3 Attitudes toward Condom Education for Young People . 209 13.4 Paid Sex . 209 13.5 Coverage of HIV Testing Services . 209 13.5.1 Awareness of HIV Testing Services and Experience with HIV Testing . 209 13.5.2 HIV Testing of Pregnant Women . 211 13.6 Male Circumcision . 211 13.7 Self-reporting of Sexually Transmitted Infections . 211 13.8 Injections . 212 13.9 HIV/AIDS-related Knowledge and Behavior among Young People . 212 13.9.1 Knowledge . 212 13.9.2 First Sex . 213 13.9.3 Coverage of HIV Testing Services . 213 14 ADULT AND MATERNAL MORTALITY . 235 14.1 Data . 235 14.2 Direct Estimates of Adult Mortality . 236 14.3 Direct Estimates of Pregnancy-related Mortality . 237 15 WOMEN’S EMPOWERMENT . 241 15.1 Married Women’s and Men’s Employment . 242 15.2 Control over Women’s Earnings . 242 15.3 Control over Men’s Earnings . 243 vi • Contents 15.4 Women’s and Men’s Ownership of Assets . 243 15.5 Women’s Participation in Decision Making . 244 15.6 Attitudes toward Wife Beating . 245 15.7 Women’s Empowerment and Demographic and Health Outcomes . 246 16 DOMESTIC VIOLENCE . 261 16.1 Measurement of Violence . 261 16.2 Experience of Physical Violence from Anyone . 262 16.2.1 Prevalence of Physical Violence . 262 16.2.2 Perpetrators of Physical Violence . 263 16.3 Experience of Sexual Violence . 264 16.3.1 Prevalence of Sexual Violence . 264 16.3.2 Perpetrators of Sexual Violence . 264 16.4 Experience of Different Forms of Violence . 264 16.5 Marital Control . 265 16.6 Spousal Violence . 265 16.6.1 Prevalence of Spousal Violence . 265 16.6.2 Onset of Spousal Violence . 267 16.7 Injuries due to Spousal Violence . 267 16.8 Violence Initiated by Women against Husbands . 268 16.9 Response to Violence . 268 16.9.1 Help-seeking Behavior to Stop the Violence . 268 16.9.2 Sources for Help . 269 17 EARLY CHILD DEVELOPMENT AND CHILD DISCIPLINE . 285 17.1 Early Childhood Education . 285 17.2 Childhood Learning . 286 17.2.1 Support for Learning . 286 17.2.2 Children’s Books and Playthings . 287 17.3 Adequate Care for Young Children . 288 17.4 Child Discipline . 289 17.4.1 Prevalence of Disciplinary Approaches . 289 17.4.2 Disciplinary Approaches by Background Characteristics . 290 REFERENCES. 297 APPENDIX A SAMPLE DESIGN . 299 A.1 Introduction . 299 A.2 Sample Frame . 299 A.3 Sample Design and Implementation . 301 A.4 Sample Probabilities and Sampling Weights . 302 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 307 APPENDIX C DATA QUALITY TABLES . 329 APPENDIX D QUESTIONNAIRES . 335 Tables and Figures • vii TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 Table 1.1 Results of the household and individual interviews . 6 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 Table 2.1 Household drinking water . 16 Table 2.2 Household sanitation facilities . 17 Table 2.3 Household characteristics . 18 Table 2.4 Household possessions . 19 Table 2.5 Wealth quintiles . 19 Table 2.6 Handwashing . 20 Table 2.7 Household population by age, sex, and residence . 20 Table 2.8 Household composition . 21 Table 2.9 Birth registration of children under age 5 . 22 Table 2.10 Children’s living arrangements and orphanhood . 23 Table 2.11.1 Educational attainment of the female household population . 24 Table 2.11.2 Educational attainment of the male household population . 25 Table 2.12 School attendance ratios . 26 Figure 2.1 Household drinking water by residence . 8 Figure 2.2 Household toilet facilities by residence . 8 Figure 2.3 Household wealth by residence. 10 Figure 2.4 Population Pyramid . 11 Figure 2.5 Birth registration by household wealth . 12 Figure 2.6 Birth registration by states and regions . 12 Figure 2.7 Secondary school net attendance ratio by household wealth . 14 3 CHARACTERISTICS OF RESPONDENTS . 27 Table 3.1 Background characteristics of respondents . 34 Table 3.2.1 Educational attainment: Women . 35 Table 3.2.2 Educational attainment: Men . 36 Table 3.3.1 Literacy: Women . 37 Table 3.3.2 Literacy: Men . 38 Table 3.4.1 Exposure to mass media: Women . 39 Table 3.4.2 Exposure to mass media: Men . 40 Table 3.5.1 Employment status: Women . 41 Table 3.5.2 Employment status: Men . 42 Table 3.6.1 Occupation: Women . 43 Table 3.6.2 Occupation: Men . 44 Table 3.7 Type of employment: Women . 45 Table 3.8.1 Use of tobacco: Women . 46 Table 3.8.2 Use of tobacco: Men . 47 Table 3.9.1 Use of betel quid: Women . 48 Table 3.9.2 Use of betel quid: Men . 49 Table 3.10.1 Knowledge of tuberculosis: Women . 50 Table 3.10.2 Knowledge of tuberculosis: Men . 51 viii • Tables and Figures Figure 3.1 Education of survey respondents . 28 Figure 3.2 Women with some, completed, or more than secondary education by states and regions . 29 Figure 3.3 Exposure to mass media . 29 Figure 3.4 Employment by education . 31 Figure 3.5 Occupation . 31 4 MARRIAGE AND SEXUAL ACTIVITY . 53 Table 4.1 Current marital status . 58 Table 4.2.1 Number of women’s co-wives . 58 Table 4.2.2 Number of men’s wives . 59 Table 4.3 Age at first marriage . 60 Table 4.4 Median age at first marriage by background characteristics . 61 Table 4.5 Age at first sexual intercourse . 62 Table 4.6 Median age at first sexual intercourse by background characteristics . 63 Table 4.7.1 Recent sexual activity: Women. 64 Table 4.7.2 Recent sexual activity: Men . 65 Figure 4.1 Marital status . 53 Figure 4.2 Polygyny by states and regions . 54 Figure 4.3 Median age at first sex and first marriage . 56 5 FERTILITY . 67 Table 5.1 Current fertility . 72 Table 5.2 Fertility by background characteristics . 72 Table 5.3 Trends in age-specific fertility rates . 73 Table 5.4 Children ever born and living . 73 Table 5.5 Birth intervals . 74 Table 5.6 Postpartum amenorrhea, abstinence, and insusceptibility . 75 Table 5.7 Median duration of amenorrhea, postpartum abstinence, and postpartum insusceptibility . 75 Table 5.8 Menopause . 76 Table 5.9 Age at first birth . 76 Table 5.10 Median age at first birth . 77 Table 5.11 Teenage pregnancy and motherhood . 78 Figure 5.1 Age-specific fertility rates . 68 Figure 5.2 Fertility by mother’s education . 68 Figure 5.3 Fertility by states and regions . 69 Figure 5.4 Birth intervals . 69 Figure 5.5 Teenage childbearing by education . 71 6 FERTILITY PREFERENCES . 79 Table 6.1 Fertility preferences by number of living children . 84 Table 6.2.1 Desire to limit childbearing: Women . 85 Table 6.2.2 Desire to limit childbearing: Men . 85 Table 6.3 Ideal number of children by number of living children . 86 Table 6.4 Mean ideal number of children . 87 Table 6.5 Fertility planning status . 87 Table 6.6 Wanted fertility rates . 88 Tables and Figures • ix Figure 6.1 Desire to limit childbearing by number of living children . 80 Figure 6.2 Ideal family size . 81 Figure 6.3 Ideal family size by number of living children . 81 Figure 6.4 Fertility planning status . 82 Figure 6.5 Wanted and actual fertility by residence . 82 7 FAMILY PLANNING . 89 Table 7.1 Knowledge of contraceptive methods . 96 Table 7.2 Knowledge of contraceptive methods by background characteristics . 97 Table 7.3 Current use of contraception by age . 98 Table 7.4 Current use of contraception by background characteristics . 99 Table 7.5 Timing of sterilization . 100 Table 7.6 Source of modern contraception methods . 100 Table 7.7 Use of social marketing brand pills . 101 Table 7.8 Informed choice . 102 Table 7.9 Twelve-month contraceptive discontinuation rates . 103 Table 7.10 Reasons for discontinuation . 103 Table 7.11 Knowledge of fertile period . 104 Table 7.12.1 Need and demand for family planning among currently married women . 105 Table 7.12.2 Need and demand for family planning for all women . 106 Table 7.13 Future use of contraception . 106 Table 7.14.1 Exposure to family planning messages: Women . 107 Table 7.14.2 Exposure to family planning messages: Men . 108 Table 7.15 Contact of nonusers with family planning providers . 109 Figure 7.1 Contraceptive use . 90 Figure 7.2 Use of modern methods by education . 91 Figure 7.3 Use of modern methods by states and regions . 91 Figure 7.4 Source of modern contraceptive methods . 92 Figure 7.5 Demand for family planning . 94 Figure 7.6 Unmet need for family planning by states and regions . 94 8 INFANT AND CHILD MORTALITY . 111 Table 8.1 Early childhood mortality rates . 116 Table 8.2 Early childhood mortality rates by socioeconomic characteristics . 116 Table 8.3 Early childhood mortality rates by demographic characteristics . 117 Table 8.4 Perinatal mortality . 118 Table 8.5 High-risk fertility behavior . 119 Figure 8.1 Trends in early childhood mortality rates . 112 Figure 8.2 Under-5 mortality by household wealth . 113 Figure 8.3 Under-5 mortality by states and regions . 113 Figure 8.4 Under-5 mortality by previous birth interval . 114 9 MATERNAL HEALTH CARE . 121 Table 9.1 Antenatal care . 129 Table 9.2 Number of antenatal care visits and timing of first visit . 130 Table 9.3 Components of antenatal care . 131 Table 9.4 Tetanus toxoid injections . 132 Table 9.5 Place of delivery . 133 Table 9.6 Assistance during delivery . 134 Table 9.7 Timing of first postnatal checkup for the mother . 135 Table 9.8 Type of provider of first postnatal checkup for the mother . 136 x • Tables and Figures Table 9.9 Timing of first postnatal checkup for the newborn . 137 Table 9.10 Type of provider of first postnatal checkup for the newborn . 138 Table 9.11 Problems in accessing health care . 139 Figure 9.1 Antenatal care coverage . 122 Figure 9.2 Institutional deliveries by education . 124 Figure 9.3 Institutional deliveries by states and regions . 125 Figure 9.4 Delivery assistance. 125 Figure 9.5 Delivery assistance by household wealth . 126 Figure 9.6 Postnatal care by place of delivery . 127 10 CHILD HEALTH . 141 Table 10.1 Child’s size and weight at birth. 150 Table 10.2 Vaccinations by source of information . 151 Table 10.3 Vaccinations by background characteristics . 151 Table 10.4 Vaccinations in first year of life . 152 Table 10.5 Prevalence and treatment of symptoms of ARI . 153 Table 10.6 Prevalence and treatment of fever . 154 Table 10.7 Prevalence of diarrhea . 155 Table 10.8 Diarrhea treatment . 156 Table 10.9 Feeding practices during diarrhea . 157 Table 10.10 Symptoms of childhood illness that prompt treatment. 158 Table 10.11 Disposal of children’s stools . 159 Figure 10.1 Childhood vaccinations . 143 Figure 10.2 Vaccination coverage by states and regions. 144 Figure 10.3 Diarrhea prevalence by age . 146 Figure 10.4 Treatment of diarrhea . 146 Figure 10.5 Feeding practices during diarrhea . 147 Figure 10.6 Prevalence and treatment of childhood illnesses . 148 11 NUTRITION OF CHILDREN AND WOMEN . 161 Table 11.1 Nutritional status of children . 173 Table 11.2 Mid-upper-arm circumference among children . 175 Table 11.3 Initial breastfeeding . 177 Table 11.4 Breastfeeding status by age . 178 Table 11.5 Median duration of breastfeeding . 178 Table 11.6 Foods and liquids consumed by children in the day or night preceding the interview . 179 Table 11.7 Infant and young child feeding (IYCF) practices . 180 Table 11.8 Prevalence of anemia in children . 182 Table 11.9 Micronutrient intake among children . 183 Table 11.10 Presence of iodized salt in household . 184 Table 11.11 Nutritional status of women . 185 Table 11.12 Prevalence of anemia in women . 186 Table 11.13 Micronutrient intake among mothers . 187 Figure 11.1 Nutritional status of children . 163 Figure 11.2 Stunting in children by mother’s education . 163 Figure 11.3 Stunting in children by states and regions . 164 Figure 11.4 Breastfeeding practices by age . 165 Figure 11.5 IYCF breastfeeding indicators . 166 Figure 11.6 IYCF indicators on minimum acceptable diet . 168 Tables and Figures • xi Figure 11.7 Childhood anemia status by residence . 169 Figure 11.8 Anemia prevalence in children by states and regions . 169 Figure 11.9 Anemia in women . 171 12 MALARIA . 189 Table 12.1 Household possession of mosquito nets . 196 Table 12.2 Source of mosquito nets . 197 Table 12.3 Access to an insecticide-treated net (ITN) . 197 Table 12.4 Use of mosquito nets by persons in the household . 198 Table 12.5 Use of existing ITNs . 199 Table 12.6 Use of mosquito nets by children . 200 Table 12.7 Use of mosquito nets by pregnant women . 201 Table 12.8 Prevalence, diagnosis, and prompt treatment of children with fever . 202 Table 12.9 Source of advice or treatment for children with fever . 203 Table 12.10 Hemoglobin <8.0 g/dl in children . 204 Figure 12.1 Household ownership of ITNs . 190 Figure 12.2 ITN ownership by household wealth . 191 Figure 12.3 Access to and use of ITNs by residence . 192 Figure 12.4 Access to ITNs by states and regions . 192 Figure 12.5 Use of ITNs . 193 Figure 12.6 Low hemoglobin by age . 194 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR . 205 Table 13.1 Knowledge of AIDS . 214 Table 13.2 Knowledge of HIV prevention methods . 215 Table 13.3.1 Comprehensive knowledge about HIV: Women . 216 Table 13.3.2 Comprehensive knowledge about HIV: Men . 217 Table 13.4 Knowledge of prevention of mother-to-child transmission of HIV . 218 Table 13.5.1 Accepting attitudes toward those living with HIV/AIDS: Women . 219 Table 13.5.2 Accepting attitudes toward those living with HIV/AIDS: Men . 220 Table 13.6 Attitudes toward negotiating safer sexual relations with husband . 221 Table 13.7 Adult support of education about condom use to prevent AIDS . 222 Table 13.8 Payment for sexual intercourse and condom use at last paid sexual intercourse . 223 Table 13.9.1 Coverage of prior HIV testing: Women . 224 Table 13.9.2 Coverage of prior HIV testing: Men . 225 Table 13.10 Pregnant women counseled and tested for HIV . 226 Table 13.11 Male circumcision . 227 Table 13.12 Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms . 228 Table 13.13 Prevalence of medical injections. 229 Table 13.14 Comprehensive knowledge about AIDS and a source of condoms among young people . 231 Table 13.15 Age at first sexual intercourse among young people . 232 Table 13.16 Recent HIV tests among young people . 233 Figure 13.1 Knowledge of HIV prevention methods by residence . 206 Figure 13.2 Knowledge of HIV prevention methods by states and regions . 206 Figure 13.3 Knowledge of mother-to-child transmission (MTCT) of HIV . 207 Figure 13.4 Discriminatory attitudes towards people living with HIV by education . 208 Figure 13.5 HIV testing . 210 Figure 13.6 HIV testing by education . 210 Figure 13.7 Recent HIV testing (or ever tested) by states and regions . 211 Figure 13.8 STI advice or treatment seeking-behavior . 212 xii • Tables and Figures 14 ADULT AND MATERNAL MORTALITY . 235 Table 14.1 Completeness of information on siblings . 239 Table 14.2 Adult mortality rates . 239 Table 14.3 Adult mortality probabilities . 239 Table 14.4 Pregnancy-related mortality rates . 240 Figure 14.1 Adult mortality rates by age . 237 15 WOMEN’S EMPOWERMENT . 241 Table 15.1 Employment and cash earnings of currently married women and men . 248 Table 15.2.1 Control over women’s cash earnings and relative magnitude of women’s cash earnings . 249 Table 15.2.2 Control over men’s cash earnings . 250 Table 15.3 Women’s control over their own earnings and over those of their husbands . 251 Table 15.4.1 Ownership of assets: Women . 252 Table 15.4.2 Ownership of assets; Men . 253 Table 15.5 Participation in decision making . 253 Table 15.6.1 Women’s participation in decision making by background characteristics . 254 Table 15.6.2 Men’s participation in decision making by background characteristics . 255 Table 15.7.1 Attitude toward wife beating: Women . 256 Table 15.7.2 Attitude toward wife beating: Men . 257 Table 15.8 Indicators of women’s empowerment . 258 Table 15.9 Current use of contraception by women’s empowerment . 258 Table 15.10 Ideal number of children and unmet need for family planning by women’s empowerment . 259 Table 15.11 Reproductive health care by women’s empowerment . 259 Table 15.12 Early childhood mortality rates by women’s status . 260 Figure 15.1 Control over women’s earnings . 242 Figure 15.2 Ownership of house and land . 243 Figure 15.3 Women’s participation in decision making. 244 Figure 15.4 Attitudes toward wife beating . 245 16 DOMESTIC VIOLENCE . 261 Table 16.1 Experience of physical violence . 270 Table 16.2 Experience of violence during pregnancy . 271 Table 16.3 Persons committing physical violence . 272 Table 16.4 Experience of sexual violence. 273 Table 16.5 Persons committing sexual violence . 274 Table 16.6 Experience of different forms of violence . 274 Table 16.7 Marital control exercised by husbands . 275 Table 16.8 Forms of spousal violence . 276 Table 16.9 Spousal violence by background characteristics . 277 Table 16.10 Spousal violence by husband’s characteristics and empowerment indicators . 278 Table 16.11 Physical or sexual violence in the past 12 months by any husband . 279 Table 16.12 Experience of spousal violence by duration of marriage . 280 Table 16.13 Injuries to women due to spousal violence . 280 Table 16.14 Women’s violence against their spouse by background characteristics . 281 Table 16.15 Women’s violence against their spouse by husband’s characteristics and empowerment indicators . 282 Table 16.16 Help seeking to stop violence . 283 Table 16.17 Sources for help to stop the violence . 284 Tables and Figures • xiii Figure 16.1 Women’s experience of violence by marital status . 263 Figure 16.2 Violence during pregnancy by education . 263 Figure 16.3 Spousal violence by states and regions . 266 Figure 16.4 Spousal violence by husband’s alcohol consumption . 267 Figure 16.5 Help seeking by type of violence experienced . 268 17 EARLY CHILD DEVELOPMENT AND CHILD DISCIPLINE . 285 Table 17.1 Early childhood education . 291 Table 17.2 Support for learning . 292 Table 17.3 Learning materials . 293 Table 17.4 Child care arrangements . 294 Table 17.5 Child discipline . 295 Table 17.6 Child discipline by background characteristics . 296 Figure 17.1 Early childhood education by mother’s education . 286 Figure 17.2 Adult support for learning by parent’s education . 287 Figure 17.3 Child discipline by household wealth . 290 APPENDIX A SAMPLE DESIGN . 299 Table A.1 Distribution of residential households by state/region and type of residence . 300 Table A.2 Distribution of residential household population by state/region and type of residence . 300 Table A.3 Master sample allocation of clusters by state/region and type of residence. 301 Table A.4 Sample allocation of EAs and households by state/region and type of residence . 302 Table A.5 Sample allocation of expected number of interviews by state/region and type of residence . 302 Table A.6 Sample implementation: Women . 305 Table A.7 Sample implementation: Men . 306 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 307 Table B.1 List of selected variables for sampling errors, Myanmar 2015-16. 309 Table B.2 Sampling errors: National sample, Myanmar 2015-16 . 310 Table B.3 Sampling errors: Urban sample, Myanmar 2015-16 . 311 Table B.4 Sampling errors: Rural sample, Myanmar 2015-16 . 312 Table B.5 Sampling errors: Kachin sample, Myanmar 2015-16 . 313 Table B.6 Sampling errors: Kayah sample, Myanmar 2015-16 . 314 Table B.7 Sampling errors: Kayin sample, Myanmar 2015-16 . 315 Table B.8 Sampling errors: Chin sample, Myanmar 2015-16 . 316 Table B.9 Sampling errors: Sagaing sample, Myanmar 2015-16 . 317 Table B.10 Sampling errors: Tanintharyi sample, Myanmar 2015-16 . 318 Table B.11 Sampling errors: Bago sample, Myanmar 2015-16 . 319 Table B.12 Sampling errors: Magway sample, Myanmar 2015-16 . 320 Table B.13 Sampling errors: Mandalay sample, Myanmar 2015-16 . 321 Table B.14 Sampling errors: Mon sample, Myanmar 2015-16 . 322 Table B.15 Sampling errors: Rakhine sample, Myanmar 2015-16. 323 Table B.16 Sampling errors: Yangon sample, Myanmar 2015-16 . 324 Table B.17 Sampling errors: Shan sample, Myanmar 2015-16 . 325 Table B.18 Sampling errors: Ayeyarwady sample, Myanmar 2015-16 . 326 Table B.19 Sampling errors: Nay Pyi Taw sample, Myanmar 2015-16 . 327 Table B.20 Sampling errors for adult and maternal mortality rates, Myanmar 2015-16 . 328 xiv • Tables and Figures APPENDIX C DATA QUALITY TABLES . 329 Table C.1 Household age distribution . 329 Table C.2.1 Age distribution of eligible and interviewed women . 330 Table C.2.2 Age distribution of eligible and interviewed men . 330 Table C.3 Completeness of reporting . 331 Table C.4 Births by calendar years . 331 Table C.5 Reporting of age at death in days . 332 Table C.6 Reporting of age at death in months . 333 Table C.7 Sibship size and sex ratio of siblings . 333 Foreword • xv FOREWORD he Myanmar Demographic and Health Survey (MDHS) 2015-16 is the first survey of its kind to be implemented in the country as part of the worldwide Demographic and Health Surveys (DHS) Program. It was implemented by the Ministry of Health and Sports (MoHS), with the objective of providing reliable, accurate, and up-to-date data for the country. We hope that the information in this report will assist policymakers and program managers in policy formulation and monitoring and designing programs and strategies for improving maternal, child health, and family planning services in Myanmar. This report presents the findings of the survey. The 2015-16 MDHS is a national sample survey that provides up-to-date information on fertility levels; marriage; fertility preferences; awareness and use of family planning methods; child feeding practices; nutrition; adult and childhood mortality; awareness and attitudes regarding HIV/AIDS; women’s empowerment; and domestic violence. The target groups were women and men age 15-49 residing in randomly selected households across the country. In addition to national estimates, the report provides estimates of key indicators for both urban and rural areas in Myanmar and also for the 15 states and regions. The successful completion of the 2015-16 MDHS was made possible through contributions from a number of like-minded organizations and professionals. In this regard, the MoHS especially appreciates the overall support, including funding, given by the United States Agency for International Development in Myanmar (USAID) and the Three Millennium Development Goal Fund (3MDG). We would like to put on record that the United Nations Children’s Fund (UNICEF) provided technical support for training of surveyors. The technical advice provided by the Technical Committee and the Steering Committee during different phases of the survey was critical for the success of the survey. The MoHS would also like to appreciate the invaluable assistance provided by the Department of Population, Ministry of Labor, Immigration and Population, for providing the sampling frame and household lists and maps of the selected enumeration areas for the survey. Furthermore, the support and collaboration rendered by the national, state, and regional administration, nongovernmental and international development organizations, and other major stakeholders is greatly acknowledged. We are grateful to the 2015 MDHS core team for managing technical, administrative, and logistical aspects of the survey; the master trainers for their support in training and monitoring of the field work; the field staff, for data collection; the data processing team; and, in particular, the survey respondents. Similarly, we wish to express our deep appreciation to ICF International for its technical assistance in all stages of the survey. We wish to also acknowledge Baker Tilly Consulting (Myanmar) for providing accounting and disbursement services that allowed for the timely and efficient transfer of project funds throughout the survey period. Dr. Myint Htwe Union Minister for the Ministry of Health and Sports T Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) • xvii READING AND UNDERSTANDING THE 2015-16 MYANMAR DEMOGRAPHIC AND HEALTH SURVEY (MDHS) n 2016, The DHS Program began producing final reports with a new format and style. The new style features about 90 figures to highlight subnational patterns and background characteristics. The text has been simplified to highlight key points in bullets and to clearly identify indicator definitions in boxes. All of the standard tables that have historically been included in the DHS continue to be included in this new style. They are located at the end of each chapter. Each DHS final report is based on approximately 200 tables of data. While the text and figures featured in each chapter highlight some of the most important findings from the tables, not every finding can be discussed or displayed graphically. For this reason, DHS data users should be comfortable reading and interpreting tables. The following pages provide an introduction to the organization of DHS tables, the presentation of background characteristics, and a brief summary of sampling and understanding denominators. In addition, this section provides some exercises for users as they practice their new skills in interpreting DHS tables. I xviii • Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) EXAMPLE 1: EXPOSURE TO MASS MEDIA Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Myanmar 2015-16 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 18.5 68.8 30.2 8.9 24.3 1,810 20-24 17.6 63.3 28.6 8.0 28.2 1,867 25-29 16.4 59.9 24.2 7.0 32.9 1,867 30-34 13.7 60.7 24.1 5.5 30.7 2,037 35-39 15.9 58.2 21.5 5.1 33.8 1,954 40-44 11.9 52.4 21.5 3.6 37.6 1,733 45-49 14.3 53.8 22.9 4.5 36.0 1,617 Residence Urban 29.8 80.6 21.0 10.2 14.9 3,768 Rural 9.6 51.1 26.3 4.4 38.8 9,117 States/Regions Kachin 19.2 48.3 25.6 7.5 40.3 374 Kayah 15.7 67.4 26.1 6.2 27.0 65 Kayin 12.5 53.2 15.5 4.8 40.5 303 Chin 17.7 54.8 19.2 8.2 40.3 102 Sagaing 8.5 55.3 26.8 4.0 35.1 1,410 Tanintharyi 9.6 54.1 19.9 3.8 39.3 283 Bago 15.3 63.9 26.7 6.4 28.0 1,244 Magway 14.5 50.9 40.6 6.6 31.3 1,081 Mandalay 16.2 55.1 25.8 4.7 33.8 1,541 Mon 18.7 47.9 28.5 6.0 37.3 463 Rakhine 8.5 28.5 13.3 2.9 64.7 777 Yangon 22.2 88.3 12.7 6.2 9.8 1,927 Shan 11.6 51.1 19.0 5.1 43.9 1,368 Ayeyarwady 20.1 65.4 35.3 11.3 24.9 1,650 Nay Pyi Taw 14.7 68.1 27.4 5.6 25.4 300 Education1 No education 1.1 33.8 13.6 0.3 59.9 1,606 Primary 7.4 52.3 24.3 2.8 37.3 5,305 Secondary 21.1 71.4 27.9 8.8 21.3 4,646 More than secondary 45.6 80.1 28.9 17.0 12.2 1,325 Wealth quintile Lowest 5.0 33.1 22.1 2.1 56.2 2,274 Second 9.6 45.9 26.0 4.4 42.9 2,408 Middle 10.5 57.0 27.5 4.7 31.6 2,633 Fourth 15.5 73.6 25.7 6.7 20.4 2,702 Highest 33.4 81.8 22.3 11.6 13.9 2,868 Total 15.5 59.7 24.7 6.1 31.8 12,885 1 Total includes three women with missing information on education. Step 1: Read the title and subtitle. They tell you the topic and the specific population group being described. In this case, the table is about exposure to mass media among women age 15-49. All eligible female respondents age 15-49 were asked these questions. Step 2: Scan the column headings—highlighted in green in Example 1. They describe how the information is categorized. In this table, the first column of data shows the percentage of women who read a newspaper at least once a week. The second column shows the percentage of women who watch television at least once a week. The third column shows the percentage of women who listen to the radio at least once a week. The fourth column shows the percentage of women who access all three types of mass media (newspaper, television, and radio) weekly, while the fifth column indicates women who do not access any of these three forms of media weekly. The last column lists the number of women age 15-49 who were included in the survey in each subgroup. 1 2 3 4 Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) • xix Step 3: Scan the row headings—the first vertical column highlighted in blue in Example 1. These show the different ways the data are divided into categories based on population characteristics. In this case, the table presents women’s exposure to mass media by age, urban-rural residence, state/region, educational level, and wealth quintile. Step 4: Look at the row at the bottom of the table highlighted in pink. These percentages represent the total percentage of women age 15-49 who are exposed to each type of media. In this case, 15.5%* of women read a newspaper at least once a week, while 59.7% watch television at least once a week. Step 5: To find out what percentage of women age 15-49 in rural areas listen to the radio weekly, draw two imaginary lines, as shown on the table. This shows that 26.3% of women age 15-49 in rural areas listen to the radio at least once a week. Step 6: By looking at patterns by background characteristics, we can see how exposure to the media varies across Myanmar. Access to media is not universal; knowing how women access media can help program planners and policy makers determine how to most effectively use resources to communicate health messages. *For the purpose of this document data are presented exactly as they appear in the table including decimal places. However, the text in the standard DHS final report chapters rounds data to the nearest whole percentage point. Practice: Use the table in Example 1 to answer the following questions about women’s exposure to media: a) Which of the three types of mass media is most commonly accessed? b) Is there a clear pattern in access to media by a woman’s education? c) What are the lowest and highest percentages (range) of access to all 3 types of media by state/region? d) Is there a clear pattern in access to media by wealth quintile? Answers: a) Television is the most commonly accessed type of media, viewed by 59.7% of Myanmar women at least once a week b) Yes, access to each of the three types of media increase with a woman’s education. Conversely, access to NONE of these 3 types of media decreases with education. c) Very few women in Myanmar access all three types of media weekly, ranging from 2.9% in Rakine State to 11.3% in Ayeyarwady Region. d) In general, access to media increases with household wealth. This relationship is strong for newspapers and television watching, while listening to the radio is not closely tied to household wealth. xx • Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) EXAMPLE 2: PREVALENCE AND TREATMENT OF ARI Table 10.5 Prevalence and treatment of symptoms of ARI Among children under age five, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey and among children with symptoms of ARI, the percentage for whom advice or treatment was sought from a health facility or provider and the percentage who received antibiotics as treatment, according to background characteristics, Myanmar 2015-16 Among children under age five: Among children under age five with symptoms of ARI: Background characteristic Percentage with symptoms of ARI1 Number of children Percentage for whom advice or treatment was sought from a health facility or provider2 Percentage who received antibiotics Number of children Age in months <6 2.0 404 * * 8 6-11 1.6 403 * * 7 12-23 4.7 852 71.1 54.2 40 24-35 3.9 782 66.2 38.3 30 36-47 3.4 866 (47.2) (30.1) 29 48-59 2.1 792 (44.4) (45.1) 17 Sex Male 3.8 2,131 64.8 44.5 81 Female 2.6 1,968 47.6 41.5 51 Mother's smoking status Smokes cigarettes/tobacco 5.4 85 * * 5 Does not smoke 3.2 4,014 58.2 44.7 127 Cooking fuel3 Electricity or gas 2.5 728 (77.4) (54.7) 18 Charcoal 4.0 593 (63.0) (55.3) 24 Wood/straw4 3.2 2,758 53.5 37.3 88 Animal dung * 13 * * 1 No food cooked in household * 5 * * 0 Residence Urban 3.0 925 (76.6) (53.8) 28 Rural 3.2 3,174 53.2 40.5 103 States/Regions Kachin 7.5 162 (34.2) (25.1) 12 Kayah 7.6 31 (61.1) (71.4) 2 Kayin 5.3 140 * * 7 Chin 15.6 60 40.4 47.2 9 Sagaing 0.3 456 * * 1 Tanintharyi 5.9 125 * * 7 Bago 2.2 360 * * 8 Magway 4.8 299 * * 14 Mandalay 2.0 411 * * 8 Mon 2.2 140 * * 3 Rakhine 8.3 294 (79.1) (69.1) 24 Yangon 0.4 423 * * 2 Shan 1.7 564 * * 10 Ayeyarwady 3.7 542 * * 20 Nay Pyi Taw 1.9 92 * * 2 Mother's education No education 3.3 730 (45.3) (40.4) 24 Primary 3.3 1,879 55.3 45.2 62 Secondary 3.1 1,175 63.0 41.8 37 More than secondary 2.7 314 * * 8 Wealth quintile Lowest 4.1 1,211 45.3 38.0 50 Second 3.5 906 62.1 54.7 32 Middle 2.9 691 (58.8) (20.1) 20 Fourth 2.7 699 (71.4) (57.1) 19 Highest 1.9 593 * * 11 Total 3.2 4,099 58.2 43.3 131 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. 1 Symptoms of ARI include cough accompanied by short, rapid breathing which was chest-related and/or by difficult breathing which was chest-related 2 Excludes pharmacy, shop, market, and traditional practitioner 1 3 3 4 a 4 b 2 Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) • xxi Step 1: Read the title and subtitle. In this case, the table is about two separate groups of children: all children under age five (a) and children under age five who had symptoms of acute respiratory infection (ARI) in the two weeks before the survey (b). Step 2: Identify the two panels. First, identify the columns that refer to all children under age five (a), and then isolate the columns that refer only to those children under age five who had symptoms of ARI in the two weeks before the survey (b). Step 3: Look at the first panel. What percentage of children under age five had symptoms of ARI in the two weeks before the survey? It’s 3.2%. Now look at the second panel. How many children under age five are there who had symptoms of ARI in the two weeks before the survey? It’s 131 children or 3.2% of the 4,099 children under age five (with rounding). The second panel is a subset of the first panel. Step 4: Only 3.2% of children under age five had symptoms of ARI in the two weeks before the survey. Once these children are further divided into the background characteristic categories, there may be too few cases for the percentages to be reliable.  What percentage of children under age five in urban areas who had symptoms of ARI in the two weeks before the survey received antibiotics? 53.8%. This percentage is in parentheses because there are between 25 and 49 children (unweighted) in this category. Readers should use this number with caution—it may not be reliable. (For more information on weighted and unweighted numbers, see Example 3.)  What percentage of children under age five in Kayin state who had symptoms of ARI in the two weeks before the survey received antibiotics? There is no number in this cell—only an asterisk. This is because fewer than 25 children under age five in Kayin state had symptoms of ARI in the two weeks before the survey. Results for this group are not reported. The subgroup is too small, and therefore the data are not reliable. Note: When parentheses or asterisks are used in a table, the explanation will be noted under the table. If there are no parentheses or asterisks in a table, you can proceed with confidence that enough cases were included in all categories that the data are reliable. xxii • Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) EXAMPLE 3: UNDERSTANDING SAMPLING WEIGHTS IN MDHS TABLES A sample is a group of people who have been selected for a survey. In the 2015-16 MDHS, the sample is designed to represent the national population age 15-49. In addition to national data, most countries want to collect and report data on smaller geographical or administrative areas. However, doing so requires a minimum sample size per area. For the 2015-16 MDHS, the survey sample is representative at the national, state/regional levels, and for urban and rural areas. To generate statistics that are representative of the country as a whole and the 15 states/regions, the number of women surveyed in each state/region should contribute to the size of the total (national) sample in proportion to size of the district. However, if some states/regions have small populations, then a sample allocated in proportion to each state’s/region’s population may not include sufficient women from each state/region for analysis. To solve this problem, states/regions with small populations are oversampled. For example, let’s say that you have enough money to interview 12,885 women and want to produce results that are representative of Myanmar as a whole and its 15 states/regions (as in Table 3.1). However, the total population of Myanmar is not evenly distributed among the states/regions: some regions, such as Yangon, are heavily populated while others, such as Kayah State, are not. Thus, Kayah State must be oversampled. A sampling statistician determines how many women should be interviewed in each state/region in order to get reliable statistics. The blue column (1) in the table at the right shows the actual number of women interviewed in each state/district. Within the states/districts, the number of women interviewed ranges from 717 in Tanintharyi Region to 1,065 in Yangon Region. The number of interviews is sufficient to get reliable results in each district. With this distribution of interviews, some regions/states are overrepresented and some regions/states are underrepresented. For example, the population in Yangon Region is about 15% of the population in Myanmar, while Kayah State’s population contributes less than 1% of the population in Myanmar. But as the blue column shows, the number of women interviewed in Yangon Region accounts for only about 8% of the total sample of women interviewed (1,065/12,885) and the number of women interviewed in Kayah State accounts 6% of the total sample of women interviewed (757/12,885). This unweighted distribution of women does not accurately represent the population. In order to get statistics that are representative of Myanmar, the distribution of the women in the sample needs to be weighted (or mathematically adjusted) such that it resembles the true distribution in the country. Women from a small state, like Kayah, should only contribute a small amount to the national total. Women from a large region, like Yangon, should contribute much more. Therefore, DHS statisticians mathematically calculate a “weight” which is used to adjust the number of women from each state/region so that each state/region’s contribution to the total is proportional to the actual population of the state/region. The numbers in the purple column (2) represent the “weighted” values. The weighted values can be smaller or larger than the unweighted values at state/regional level. The total national sample size of 12,885 women has not changed after weighting, but the distribution of the women in the states/regions has been changed to represent their contribution to the total population size. How do statisticians weight each category? They take into account the probability that a woman was selected in the sample. If you were to compare the pink column (3) to the actual population distribution of Myanmar, you would see that women in each region/state are contributing to the total sample with the same weight that they contribute to the population of the country. The weighted number of women in the Table 3.1 Background characteristics of respondents Percent distribution of women age 15-49 by selected background characteristics, Myanmar 2015-16 Women Background characteristic Weighted percent Weighted number Unweighted number States/Regions Kachin 2.9 374 804 Kayah 0.5 65 757 Kayin 2.4 303 751 Chin 0.8 102 750 Sagaing 10.9 1,410 1,039 Tanintharyi 2.2 283 717 Bago 9.7 1,244 939 Magway 8.4 1,081 947 Mandalay 12.0 1,541 963 Mon 3.6 463 789 Rakhine 6.0 777 911 Yangon 15.0 1,927 1,065 Shan 10.6 1,368 778 Ayeyarwady 12.8 1,650 919 Nay Pyi Taw 2.3 300 756 Total 100.0 12,885 12,885 3 2 1 Reading and Understanding the 2015-16 Myanmar Demographic and Health Survey (MDHS) • xxiii survey now accurately represents the proportion of women who live in Yangon Region and the proportion of women who live in Kayah State. With sampling and weighting, it is possible to interview enough women to provide reliable statistics at national and regional/state levels. In general, only the weighted numbers are shown in each of the MDHS tables, so don’t be surprised if these numbers seem low: they may actually represent a larger number of women interviewed. Contributors to the Report • xxv CONTRIBUTORS TO THE REPORT Dr. Thet Thet Mu, Director, Health Management Information Systems, Ministry of Health and Sports Dr. Yin Nyein Htut, Medical Officer, Occupational and Environmental Health, Ministry of Health and Sports Dr. Nan Naing Naing Shein, Deputy Director, Noncommunicable Disease Program Dr. Thida, Deputy Director, Department of Medical Research, Pyin Oo Lwin Daw Kay Thi Aung, Staff Officer, Planning Department Daw Myo Thandar, Staff Officer, Department of Population Dr. Hnin Hnin Lwin, Deputy Director, Maternal and Reproductive Health, Ministry of Health and Sports Daw Thin Thin Kyu, Assistant Director, Central Statistical Organization Dr. Nyan Hein, Medical Officer, Maternal and Reproductive Health, Ministry of Health and Sports Dr. Tin Tun Win, Medical Officer, Expanded Program on Immunization, Ministry of Health and Sports Dr. Khine Mar Zaw, Deputy Director, National Nutrition Center, Ministry of Health and Sports Dr. Tint Wai, Team Leader, Malaria Program, Ministry of Health and Sports Dr. Kyaw Zin Linn, Team Leader, National AIDS Program, Pyin Oo Lwin Dr. Ei Shwe Sin Win, Assistant Director, Health Management Information Systems, Ministry of Health and Sports Dr. Zaw Myo Aung, Assistant Director, Child Health Development Dr. Kyaw Thu Soe, Research Officer, Department of Medical Research, Pyin Oo Lwin Dr. Lwin Lwin Aung, Assistant Director, Health Management Information Systems, Ministry of Health and Sports Daw Ei Pyae Win, Staff Officer, Ministry of Education Acronyms and Abbreviations • xxvii ACRONYMS AND ABBREVIATIONS ACT artemisinin-based combination therapy AIDS acquired immunodeficiency syndrome AMW auxiliary mid-wives ANC antenatal care API annual parasite incidence ARI acute respiratory infection ART antiretroviral therapy ASFR age-specific fertility rate BCG Bacille-Calmette-Guerin vaccine against tuberculosis BMI body mass index CAFE computer-assisted field editing CCM community case management CHW community health worker CSG community-based support group DHS Demographic and Health Survey DPT Diphtheria, pertussis, and tetanus vaccine EA enumeration area EPI Expanded Program on Immunization F-IMNCI facility-based integrated management of neonatal and childhood illnesses GAR gross attendance ratio GFR general fertility rate GPI gender parity index HIV human immunodeficiency virus HMIS health management information system ICD International Classification of Diseases IMNCI integrated management of neonatal and childhood illnesses ITN insecticide-treated net IU international unit IUD intrauterine device IYCF infant and young child feeding LAM lactational amenorrhea method LHV lady health visitor LLIN long-lasting insecticide-treated net LPG liquid petroleum gas MARC Myanmar Artemisinin Resistance Containment MCH maternal and child health 3MDG Three Millennium Development Goal Fund MDHS Myanmar Demographic and Health Survey MICS Multiple Indicators Cluster Survey xxviii • Acronyms and Abbreviations MR measles and rubella MoHS Ministry of Health and Sports MTCT mother-to-child transmission MUAC mid-upper-arm circumference NAR net attendance ratio NGO nongovernmental organization NN neonatal mortality OPV oral polio vaccine ORS oral rehydration salts ORT oral rehydration therapy PCV pneumococcal conjugate vaccine PNN postneonatal mortality PPS probability proportional to size PRM pregnancy-related mortality PSU primary sampling unit RHC rural health center RHF recommended homemade fluids SD standard deviation STI sexually transmitted infection TB tuberculosis TFR total fertility rate UHC urban health center UNAIDS Joint United Nations Programme on HIV/AIDS UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAD vitamin A deficiency VIP ventilated improved pit WHO World Health Organization ZnSO4 zinc sulphate xxx • Map of Myanmar Introduction and Survey Methodology • 1 INTRODUCTION AND SURVEY METHODOLOGY 1 he 2015-16 Myanmar Demographic and Health Survey (2015-16 MDHS) is the first Demographic and Health Survey to be conducted in Myanmar. The survey was implemented by the Ministry of Health and Sports (MoHS), and data collection took place from December 7, 2015, to July 7, 2016. Funding was provided by the United States Agency for International Development (USAID) and the Three Millennium Development Goal Fund (3MDG). ICF provided technical assistance through The DHS Program. 1.1 SURVEY OBJECTIVES The primary objective of the 2015-16 MDHS was to provide up-to-date estimates of basic demographic and health indicators. Specifically, the survey collected information on fertility levels, marital status, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, mother and child mortality and health, HIV/AIDS and other sexually transmitted infections (STIs), and other health-related issues, such as smoking and knowledge of tuberculosis. The information collected through the 2015-16 MDHS is intended to assist policy makers and program managers in evaluating and designing programs and strategies for improving the health of the country’s population. Moreover, this survey has come at a beneficial time for Myanmar, as the results will be used to develop the next 5-year National Health Plan (2017-2021) and to update the national comprehensive development plan. 1.2 SAMPLE DESIGN The sampling frame consisted of 76,990 primary sampling units (PSUs) across the country. A PSU is either a census enumeration area (EA) or a ward or village tract in a sensitive area not enumerated during the census. Each PSU had cartographic materials that delineated its geographic location, boundaries, main access points, and landmarks. The sampling frame contained information about each PSU’s administrative subordinations (state or region and district), the type of residence (urban or rural), and the estimated number of residential households. The sampling frame excluded institutional populations, such as persons in hotels, barracks, and prisons, but included those from internally-displaced population camps. A master sample was created under the aegis of the Department of Population within the Ministry of Labor, Immigration and Population. The sample was based on the 2014 census frame, which is used to coordinate household-based surveys conducted in Myanmar, including the current 2015-16 MDHS. The master sample is a large, nationally representative sample consisting of 4,000 PSUs drawn from the entire census frame; these can be used for sub-selecting multi-stage household-based survey samples. The master sample is large enough to provide design flexibility for the various household-based surveys in Myanmar. The master sample is a stratified sample, selected with probability proportional to size (PPS). Stratification is achieved by separating each state or region into urban and rural areas, each of which formed a separate sampling stratum. In total, 30 sampling strata were created. Samples were selected independently in each sampling stratum. Implicit stratification and proportional allocation were achieved at each of the lower administrative unit levels. This was done before sample selection by sorting the sampling frame within the explicit stratum, according to administrative unit, and by using a PPS selection procedure. The 2015-16 MDHS followed a stratified two-stage sample design and was intended to allow estimates of key indicators at the national level, in urban and rural areas, and for each of the seven States and eight Regions of Myanmar. The first stage involved selecting sample points (clusters) consisting of EAs or ward/village tracts. A total of 442 clusters (123 urban and 319 rural) were selected from the master sample. T 2 • Introduction and Survey Methodology At the second stage, a fixed number of 30 households was selected from each of the selected clusters (a total of 13,260 households), using equal probability systematic sampling. For the clusters, which were completely enumerated during the population census, the census household listings were taken as the base and updated in the field by the household listing teams. These updated lists were used for selecting the sample households. For the clusters that were not enumerated or partially enumerated during the census, an independent household listing operation was carried out. Because of the non-proportional sample allocation, the sample was not a self-weighting sample. Weighting factors had to be calculated, added to the data file, and applied so that results are representative at the national as well as regional level. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the households the night before the survey were eligible to be interviewed. In half of the selected households (every second household), all men age 15-49 who were either residents or visitors who stayed in the household the night before the survey were eligible to be interviewed. During the course of the fieldwork, 4 clusters were identified as insecure and were replaced with other clusters in the vicinity. In addition, 1 urban cluster had to be dropped due to worsening security. Overall, the survey was successfully carried out in 441 clusters. 1.3 QUESTIONNAIRES Three sets of questionnaires were used in the 2015-16 MDHS: a Household Questionnaire, a Woman’s Questionnaire, and a Man’s Questionnaire. These questionnaires, developed for the worldwide DHS program, were revised to accord with Myanmar culture as well as to reflect some country-specific health issues. A questionnaire design workshop was conducted with multiple stakeholders from MoHS and other related ministries, UN agencies, donor groups, and local and international nongovernmental organizations. The final draft was approved by the MDHS Technical Committee, translated into Myanmar, and back translated to English. The survey protocol was reviewed and approved by the Ethics Review Committee on Medical Research including Human Subjects in the Department of Medical Research, Ministry of Health and Sports. Similarly, the survey protocol was approved by the ICF Institutional Review Board. The Household Questionnaire listed all usual household members and any visitors who stayed in the household the night before the survey, along with basic information on their age, sex, education, relationship to the head of the household, marital status, and, for children under age 18, survival status of the parents. Data on age and sex were used to identify women and men eligible for individual interviews. The Household Questionnaire also collected information on the household’s dwelling characteristics, such as water source, toilet facilities, fuel use, and flooring materials, and on possessions, such as durable goods and mosquito nets. In addition, a small sample of salt was requested from each household and was tested for iodine content using a rapid test kit. Measurements of height, weight, and mid-upper arm circumference (MUAC) were taken, and results of blood testing for anemia were entered. The Woman’s Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics:  Background characteristics (including age, education, and media exposure)  Complete birth history and child mortality  Knowledge and use of family planning methods  Fertility preferences  Antenatal, delivery, and postnatal care  Breastfeeding and infant feeding practices  Vaccinations and childhood illnesses Introduction and Survey Methodology • 3  Women’s work and husbands’ background characteristics  Knowledge, awareness, and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs)  Adult mortality, including maternal mortality  Knowledge, attitudes, and behavior related to other health issues (e.g., tuberculosis)  Domestic violence (questions asked of one woman per household in the subsample of households selected for the male survey) The Man’s Questionnaire was administered to all men age 15-49 in half of the selected households. The questionnaire was similar to the Woman’s Questionnaire but shorter because it did not contain the complete birth history, sections on maternal and child health, or the section on domestic violence. 1.4 ANTHROPOMETRY, AND ANEMIA TESTING The 2015-16 MDHS incorporated several “biomarkers”: anthropometry, including mid-upper-arm circumference measurement, and anemia testing. Anthropometry. Height and weight measurements were recorded for children age 0-59 months and women age 15-49. In addition, mid-upper-arm circumference (MUAC) was recorded for children age 0-59 months. Measurements were taken using measuring boards specially made by Shorr Productions for use in survey settings and lightweight SECA scales with digital screens. Anemia testing. Blood specimens for anemia testing were collected from women age 15-49 who voluntarily consented to be tested and from all children age 6-59 months for whom consent was obtained from their parents or the adult responsible for the children. Blood samples were drawn from a drop of blood taken from a finger prick (or a heel prick in the case of children age 6-11 months) and collected in a microcuvette. Hemoglobin analysis was carried out on site using a battery-operated portable HemoCue analyzer. Results were provided verbally and in writing. Parents/guardians of children with a hemoglobin level under 7 g/dl were instructed to take the child to a health facility for follow-up care. Likewise, nonpregnant women and pregnant women were referred for follow-up care if their hemoglobin levels were below 7 g/dl and 9 g/dl, respectively. All households in which anthropometry and anemia testing were conducted were given a brochure explaining the causes and prevention of anemia. 1.5 TRAINING OF TRAINERS AND PRETEST The training of trainers was conducted from October 18 to November 3, 2014, for nine master trainers from the Department of Public Health of MoHS. The purpose of the training was to familiarize the participants with some key components of the Demographic and Health Survey (DHS), as it was the first such survey in the country. The DHS Program survey manager facilitated the sessions, highlighting the concept of adult learning principles and guidelines on conducting effective training of field staff. The training focused on key components like probing for age, types of interview techniques, and procedures for completing the MDHS questionnaires; filling out a contraceptive calendar; completing the vaccination section; and standardization procedures for anthropometry. The participants worked in groups to develop teach-backs on these topics using various training techniques, for example, slide presentation, use of flip charts, interactive question-and-answer session, case study, and role play. They were encouraged to develop participatory methods for the training. These participants were trained to be involved during the pretest, lead the sessions during the main training, and also monitor the fieldwork of the survey. Over a 3-week period in January 2015, 19 women and 3 men participated in a training to pretest the MDHS survey protocol. Most of the participants were staff of the various divisions of the Department of 4 • Introduction and Survey Methodology Public Health such as Health Information, HIV, TB, and Maternal and Reproductive Health. One representative from the Central Statistical Organization also participated. Twelve days of classroom training were provided at the training hall of the MoHS. The training was led by The DHS Program staff, and supported by the in-country MDHS core team that had members who participated in the training of trainers. Further, resource persons from the Child Health Department, Expanded Immunization Program, and Maternal and Reproductive Health Department of MoHS attended the sessions to provide technical background on topics such as family planning, reproductive health, child health, and nutrition. The fieldwork for the pretest was carried out in one urban and two rural locations of Mandalay, using the Myanmar language questionnaires. Following the field practice, a debriefing session was held with the pretest field staff, and modifications to the questionnaires were made based on lessons drawn from the exercise. 1.6 TRAINING OF FIELD STAFF Fourteen trainers, who were previously taught during the training of trainers session in October/November 2014 and in the pretest training in January 2015, participated in a 5-day refresher training held from September 14-18, 2015, which was conducted in preparation for the main training. Because the main training was carried out 8 months after the pretest, a refresher course for the trainers was held so that they could facilitate the main training efficiently. For the main fieldwork, the MoHS recruited 148 people, including 108 candidates from the government and 40 candidates from the nongovernment sector, which included the Central Statistical Organization, the Health Assistants Association, and various ethnic group associations from Kachin State, Kayin State, and Shan State (Pao and Danu). They served as supervisors, field editors, interviewers, and reserve interviewers. The field staff main training took place from September 28 to October 23, 2015, at the Shwe Pyi Taw Hotel in Nay Pyi Taw. The main fieldwork training was led by the master trainers of the MoHS and by The DHS Program trainers. The training course consisted of instructions regarding interviewing techniques and field procedures, a detailed review of questionnaire content, and instruction on how to administer the paper questionnaires. Also taught were measuring height and weight, anemia testing of eligible women and children, and computer-assisted field editing (CAFE) procedures. The sessions included discussion of concepts, procedures, and methodology of conducting the survey. Participants were guided through the questionnaires. Further, resource persons from the MoHS and UNICEF attended the sessions to provide technical advice. The master trainers used various techniques they had learned to facilitate the training sessions. These included presentations, lectures, hands-on exercises, mock interviews, role plays, group work, and quizzes. In-class exercises included probing for age, checking age consistency, filling out vaccination dates, completing the reproductive calendar, and practicing interviews. The trainees were taken for field practice in nonsampled areas near the training site, where they had an opportunity to implement the survey in a real world situation. Additional practice for anemia testing among children was carried out in the Outpatient Department of the General Hospital run under the aegis of the MoHS. Participants were evaluated through in-class exercises, quizzes, and observations made during field practice. Ultimately, 19 supervisors and 19 field editors were identified based on their performance. Similarly, 110 participants were selected to serve as interviewers; some were specially recruited to carry out fieldwork in sensitive areas in Shan and Rakhine. The supervisors received additional training in data quality control procedures, fieldwork coordination, and management, while the field editors received extra training on editing the questionnaires. 1.7 FIELDWORK Although the training of the field staff was completed on October 23, 2015, there was no permission to carry out the field practice or launch the fieldwork because of the uncertain outcome of the upcoming Introduction and Survey Methodology • 5 general election. The election was held peacefully on November 8, 2015. After approval for conducting the fieldwork was received, a refresher training was carried out on November 30 in three locations: Yangon, Mawlamyine, and Mandalay. A field practice was then held for 2 days with review sessions conducted in the end. The fieldwork was launched in these three locations under close supervision on December 7, 2015. Data collection was carried out by 19 field teams, each consisting of one team supervisor, one field editor, three to four female interviewers, and one male interviewer. However, the team composition had to be adjusted during the different phases of the fieldwork operation. Data collection took place from December 7, 2015, through July 7, 2016, although most of the teams completed the fieldwork by April 2015. The extension of fieldwork in some states and regions reflected sensitivity toward ethnic groups and occurred in non-state-controlled areas where additional advocacy strategies had to be implemented. Karen Department Health and Welfare facilitated the data collection in some enumeration areas of Kayin State. The Wa Health Department and Health Poverty Action also supported data collection in two enumeration areas from Wa Special Region. Despite substantial challenges in the field, the MDHS field teams successfully completed the fieldwork. Travel plans for data collection by the teams were shared with the central health office and state and regional offices, including local administrative offices. Each team had to inform the MDHS core team as well as the respective state and regional public health departments of their fieldwork’s location and progress. Field supervision was carried out by the state and regional public health directors and officers. A standard supervisory protocol was developed to monitor coverage, and an orientation was conducted by the MDHS team. Technical monitoring was carried out by the MDHS core team and the master trainers. In addition, field supervision visits were conducted by the Deputy Health Minister, two Deputy Survey Managers, the DHS resident advisor from ICF, and other members of the MDHS Technical Committee. The DHS Program survey manager from ICF conducted field monitoring at different stages of field data collection. Additionally, a mechanism was developed to generate weekly field check tables to monitor the data quality, and immediate feedback was provided to the field teams. 1.8 DATA PROCESSING The 2015-16 MDHS used computer-assisted field editing (CAFE) procedures with tablet computers. Thus, data processing began simultaneously with the fieldwork. All completed questionnaires were entered into the tablets while in the field by the field editors after they edited them on paper. Entries were checked by the supervisors before the questionnaires were dispatched to the data processing center at the MoHS central office in Nay Pyi Taw. These completed questionnaires were reviewed and re-entered by 13 data processing personnel specially trained for this task. All data were thus entered twice (100 percent verification), once in the field by the field editors and then again in the data processing center in Nay Pyi Taw. Data were entered using the CSPro computer package. The operation included secondary editing, using CSPro software, to resolve computer-identified inconsistencies and to code open-ended questions. The concurrent processing of the data offered a distinct advantage, because it maximized the likelihood of the data being error-free and accurate. Moreover, the double entry of data enabled easy comparison and identification of errors and inconsistencies. Inconsistencies were resolved by tallying with the paper questionnaire entries. The secondary editing was implemented by four editors and was completed in the second week of July 2016. The final cleaning of the data set was carried out by the DHS Program data processing specialist by the end of July 2016. 6 • Introduction and Survey Methodology 1.9 RESPONSE RATES Table 1.1 shows the response rates for household and individual interviews. The total number of households selected was 13,238, of which 12,780 households were occupied. Of those occupied, 12,500 households were interviewed, yielding a 98% response rate. In the interviewed households, 13,454 women were identified as eligible for the individual Woman’s Questionnaire. Interviews were successfully completed with 12,885 women, yielding a 96% response rate. In the subsample of one-half of the households, 5,218 men were identified as eligible for individual interview. Interviews were completed for 4,737 men, with a 91% response rate. The response rates are lower in the urban areas than in the rural areas. The difference is slightly more noticeable among men than women, probably reflecting the fact that men in urban areas are often away from their households for employment. Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence (unweighted), Myanmar DHS 2015-16 Residence Result Urban Rural Total Household interviews Households selected 3,672 9,566 13,238 Households occupied 3,524 9,256 12,780 Households interviewed 3,399 9,101 12,500 Household response rate1 96.5 98.3 97.8 Interviews with women age 15-49 Number of eligible women 4,039 9,415 13,454 Number of eligible women interviewed 3,785 9,100 12,885 Eligible women response rate2 93.7 96.7 95.8 Interviews with men age 15-49 Number of eligible men 1,512 3,706 5,218 Number of eligible men interviewed 1,321 3,416 4,737 Eligible men response rate2 87.4 92.2 90.8 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents Housing Characteristics and Household Population • 7 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION 2 Key Findings  Drinking water: Eighty percent of all households have access to an improved drinking water source, as do 89% of urban households and 77% of rural households.  Sanitation: Almost half of all households have an improved sanitation facility; however, less than 1% have a flush toilet linked to a sewer system.  Household population and composition: Twenty-nine percent of the Myanmar population is under age 15. The sex ratio in Myanmar is 85 men per 100 women.  Indoor smoke: Seventy-seven percent of all households use solid fuel for cooking. Forty-five percent of households are exposed daily to secondhand smoke.  Birth registration: Eighty-one percent of children under age 5 have had their births registered.  Orphans: Seventy-five percent of children under age 18 live with both parents, 8% are orphans, and 9% do not live with either parent.  School attendance: The net attendance rate decreases from 83% in primary school to 60% in secondary school. There is no difference by gender in school attendance in primary school, but more girls than boys attend secondary school. nformation on the socioeconomic characteristics of the household population in the 2015-16 MDHS provides context to interpret demographic and health indicators and can furnish an approximate indication of the representativeness of the survey. In addition, this information sheds light on the living conditions of the population. This chapter presents information on source of drinking water, sanitation, exposure to smoke inside the home, wealth, handwashing, household population composition, educational attainment, school attendance, birth registration, and family living arrangements. 2.1 DRINKING WATER SOURCES AND TREATMENT Improved sources of drinking water Include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, rainwater, and bottled water Sample: Households I 8 • Housing Characteristics and Household Population Improved sources of water protect against outside contamination so that water is more likely to be safe to drink. In Myanmar, 80% of households have an improved source of drinking water, including 89% of households in urban areas and 77% in rural areas. One in five households has an unimproved source of drinking water (Figure 2.1). The most common improved source of drinking water in urban areas is bottled water (48%), and in rural areas is a tubewell or borehole (33%) (Table 2.1). Thirty-seven percent of all households have drinking water on their premises, including 30% of urban households and 39% of rural households. Over half (56%) of households in Myanmar must get their water off their premises and spend less than 30 minutes round-trip. Only 6% of households spend 30 minutes or longer getting water. One in four households does not treat water to make it drinkable. Urban households are less likely to treat their drinking water (45%) than rural households (19%). This is likely because almost half of urban households use bottled water for drinking. Straining through a cloth is the most common water treatment method, used by 56% of all households, followed by boiling (25%). Overall 33% of households use an appropriate method to treat their drinking water. 2.2 SANITATION Improved toilet facilities Include any non-shared toilet of the following types: flush/pour flush toilets to piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP) latrines; pit latrines with slabs; and composting toilets Sample: Households Use of improved toilet facilities, defined as non- shared facilities that prevent people from coming into contact with human waste, helps reduce the transmission of communicable diseases such as cholera and typhoid. Nearly half of households in Myanmar (48%) have improved toilet facilities, including 65% in urban areas and 42% in rural areas (Table 2.2). Eleven percent of households have no toilet facility, and rural households are more likely to lack a toilet facility than urban households (14% versus 1%) (Figure 2.2). The most common type of toilet facility in rural areas is an open pit or a pit latrine without a slab (31%). By contrast, a toilet that flushes to a pit latrine is the most common type of toilet in urban areas (37%). Figure 2.1 Household drinking water by residence Figure 2.2 Household toilet facilities by residence 6 8 6 3 3 3 28 16 33 25 13 29 16 48 4 20 11 23 Total Urban Rural Unimproved source Bottled water Protected well or spring Tubewell or borehole Public tap/standpipe Piped water into dwelling/yard/plot Percent distribution of households by source of drinking water 48 65 42 10 12 9 31 22 35 11 1 14 Total Urban Rural No facility/bush/field Unimproved facility Shared facility Improved facility Percent distribution of households by type of toilet facilities Housing Characteristics and Household Population • 9 2.3 EXPOSURE TO SMOKE INSIDE THE HOME Cooking with solid fuel and smoking of tobacco are the main sources of smoke inside the home. Exposure to smoke has potentially harmful health effects, particularly for young children, mothers, and the elderly who spend most of their time indoors. In Myanmar, 62% of households cook inside their home, including 73% in urban areas and 57% in rural areas. Most households (77%) use solid fuels for cooking, which can be harmful to health. Use of solid fuels is more common in rural households (90%) than in urban households (39%). Wood is the most common type of fuel used in rural areas (77%), while electricity (58%) is the most common type of fuel in urban areas. Charcoal is also often used in urban households (23% ) (Table 2.3). Exposure to smoke from persons smoking tobacco inside the home is also high in Myanmar. In nearly half of the households (45%), someone smokes daily inside the home, and in 6% of households someone smokes at least weekly inside the home. Persons living in rural households (48%) are more likely to be exposed to secondhand smoke than persons living in urban households (36%). Other Housing Characteristics The survey also collected data on access to electricity, flooring materials, and the number of rooms used for sleeping. Electrification in Myanmar is far from complete. Only 56% of households have electricity. Urban households are more likely to have access to electricity than rural households (92% versus 42%). Wood planks are the most common flooring material used in the country (39%), and this material is more widely used in rural areas (41%) than urban areas (35%). Palm and bamboo is the second most common flooring material used in Myanmar. Table 2.3 provides complete information about housing characteristics. 2.4 HOUSEHOLD WEALTH Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, plus housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by their score, and then dividing the distribution into five equal categories, each with 20% of the population. Sample: Households 10 • Housing Characteristics and Household Population More than half of the urban de jure population (56%) belong to the wealthiest quintile, compared with only 7% of the rural population (Figure 2.3). Twenty-six percent of the rural population is in the lowest quintile, compared with only 4% of the urban population. Among states and regions, Yangon Region has the highest share of population in the wealthiest quintile (47%) and the lowest in the lowest quintile (6%), whereas, Rakhine State has the highest share of population in the lowest quintile (53%) and the lowest in the highest quintile (4%) (Table 2.5). Table 2.5 also includes the Gini coefficient, a measure of the level of concentration of wealth, with 0 being an equal wealth distribution and 1 a totally unequal wealth distribution. The Gini coefficient of Myanmar is 0.27, which suggests that wealth is fairly evenly distributed across the population. Household Durable Goods Information about household effects, means of transportation, agricultural land, and farm animals is shown in Table 2.4. Seventy-three percent of households have mobile telephones. While almost all households in urban areas (93%) have a mobile phone, only two-thirds of households in rural areas have one. Only 4% of households own a computer, 14% of urban households and 1% of rural households. Half of households own a motorcycle or scooter for transportation, including 53% in urban areas and 49% in rural areas. Only 5% of households own a car or truck. Urban households are more likely than rural households to own a car or truck (12% versus 3%). Rural households are more likely to own agricultural land (51%) than urban households (9%). 2.5 HAND WASHING Handwashing is one of the most effective ways to prevent germs from spreading. In Myanmar, 84% of households have soap and water for washing hands, while 3% of households have no water, soap, or other cleansing agent on the premises (Table 2.6). This information is based on 94% of the households in which the place for handwashing was observed, making the data fairly representative. Patterns by background characteristics  Ninety-five percent of urban households have soap and water available for washing hands, compared with 80% of rural households.  Twelve percent of households in Kayin State have no water, soap, or other cleansing agent, followed by 10% of households in Kayah State.  The availability of soap and water on the premises increases with wealth. Almost all the households in the wealthiest quintile have soap and water for handwashing on the premises, whereas in the lowest quintile only 67% of households do. Figure 2.3 Household wealth by residence 4 265 25 10 24 26 18 56 7 Urban Rural Percent distribution of de jure population by wealth quintiles Wealthiest Fourth Middle Second Poorest Housing Characteristics and Household Population • 11 2.6 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same dwelling unit(s), who acknowledge one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit. De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors) De jure population All persons who are usual residents of the selected households, whether or not they stayed in the household the night before the interview The 2015-16 MDHS found a de- facto population of 51,130 people in the 12,500 interviewed households. Forty-six percent of the total population is male and 54% is female, yielding a sex ratio of 85 males per 100 females. Twenty-nine percent of the population is under age 15 (Table 2.7 and Figure 2.4). Women head 23% of households. Households headed by a woman are slightly more common in urban areas (27%) than in rural areas (21%). On average, households in Myanmar have 4.2 members. There is little difference in household size by urban-rural residence. Thirteen percent of households have one or more foster or orphan children under age 18 (Table 2.8). 2.7 BIRTH REGISTRATION Registered birth Child has a birth certificate or the birth is registered with the civil authority Sample: De jure children under age 5 Figure 2.4 Population Pyramid 10 6 2 2 6 10 <5 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+ Age Percent distribution of the household population Male Female 261210 12 • Housing Characteristics and Household Population Birth registration helps ensure access to basic services, including immunizations, health care, and school enrollment at the appropriate age (UNICEF 2006). Eighty-one percent of children under age 5 have had their births registered; 74% also have a birth certificate (Table 2.9). Patterns by background characteristics  Urban children are more likely to have their births registered than rural children (94% versus 78%).  Ninety-seven percent of children in the wealthiest quintile, but only 69% of children in the poorest quintile, have had their birth registered (Figure 2.5).  Birth registration varies by states and regions. Children are most likely to have their births registered in Kayah State (96%) and least likely in Rakhine State (45%) (Figure 2.6).  Figure 2.6 Birth registration by states and regions Percentage of de jure children under age 5 whose births are registered with the civil authorities Figure 2.5 Birth registration by household wealth 69 76 86 91 97 Lowest Second Middle Fourth Highest Percentage of de jure children under age 5 whose births are registered with the civil authorities Poorest Wealthiest Housing Characteristics and Household Population • 13 2.8 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL Orphan A child with one or both parents dead Sample: Children under age 18 Seventy-five percent of children under age 18 live with both of their parents. Eight percent of children under age 18 in Myanmar are orphans, and 9% of children under age 18 do not live with either biological parent (Table 2.10). Patterns by background characteristics  Orphanhood is more prevalent among children age 15-17 (14%) than among children under age 2 (1%).  Rural children are more likely to live with both parents than urban children (77% versus 70%).  The highest proportion of orphaned children is in Kachin State (10%), and the lowest proportion is in Chin State (5%). 2.9 EDUCATION 2.9.1 Educational Attainment Median educational attainment Number of years of schooling completed by half of the population Sample: De facto household population age 6 and older In Myanmar, about one in five women and men age 6 and older have no education. A relatively high proportion of women and men have some secondary education or more: 36% of women and 41% of men. There is little difference by sex in the median years of education completed (4.2 versus 4.5) (Tables 2.11.1 and 2.11.2). Patterns by background characteristics  Urban residents are much more likely to have completed secondary school than rural residents: among women in urban households, 22% have completed secondary school or have higher education compared with 4% of women in rural households. Men in urban areas are also more likely than men in rural areas (19% versus 4%) to have completed secondary school.  Educational attainment varies by states and regions. Forty-three percent of women and 40% of men in Shan State have no education; by contrast, only 10% of women and 8% of men in Yangon Region have no education.  Educational attainment is associated with wealth. Thirty-four percent of women and 29% of men from the poorest households have never been to school, compared with only 10% of women and 9% of men from the wealthiest households. 14 • Housing Characteristics and Household Population 2.9.2 School Attendance Net attendance ratio (NAR) Percentage of the school-age population that attends primary or secondary school Sample: Children age 5-9 for primary school NAR and children age 10-15 for secondary school NAR Gross attendance ratio (GAR) The total number of primary and secondary school students expressed as a percentage of the official primary and secondary school-age population Sample: Children age 5-9 for primary school GAR and children age 10-15 for secondary school GAR The net attendance ratio for primary school is 83%, and there is little difference by sex of child. The NAR is much lower for secondary school. Only 60% of children age 10-15 attend secondary school. The NAR for secondary school is slightly higher for girls (62%) than for boys (58%) (Table 2.12). Patterns by background characteristics  Seventy-five percent of urban children age 10-15 attend secondary school compared with 56% of rural children. The primary school NAR does not differ much by urban-rural residence.  Shan has the lowest NAR for both primary (72%) and secondary (36%) school. Mon has the highest NAR for primary school (89%) and Yangon has the highest for secondary school (72%).  Children in the wealthiest quintile are more likely to attend school at appropriate ages than children in the poorest quintile. The primary school NAR varies from 89% in the highest quintile to 75% in the poorest quintile, and the secondary school NAR varies from 81% in the highest quintile to 37% in the lowest quintile (Table 2.12). The pattern is similar for girls and boys (Figure 2.7). Other Measures of School Attendance The gross attendance ratio (GAR) and Gender Parity Index (GPI) are also shown in Table 2.12. A value of more than 100 percent for the GAR for primary school means that a significant number of primary school students are not of the official primary- school-age. In Myanmar, the primary school GAR is 109%, and the secondary school GAR is 70%. A GPI of more than 1 means that more girls are attending school than boys. In Myanmar, the GPI is 0.99 in primary school, suggesting that boys and girls are equally likely to attend primary school; however, the GPI for secondary school is 1.07, indicating that more girls than boys attend secondary school. Figure 2.7 Secondary school net attendance ratio by household wealth 38 59 67 76 84 37 53 60 72 78 Lowest Second Middle Fourth Highest Girls Boys WealthiestPoorest Net attendance ratio for secondary school among children age 10-15 Housing Characteristics and Household Population • 15 LIST OF TABLES For more information on household population and housing characteristics, see the following tables:  Table 2.1 Household drinking water  Table 2.2 Household sanitation facilities  Table 2.3 Household characteristics  Table 2.4 Household possessions  Table 2.5 Wealth quintiles  Table 2.6 Handwashing  Table 2.7 Household population by age, sex, and residence  Table 2.8 Household composition  Table 2.9 Birth registration of children under age 5  Table 2.10 Children’s living arrangements and orphanhood  Table 2.11.1 Educational attainment of the female household population  Table 2.11.2 Educational attainment of the male household population  Table 2.12 School attendance ratios 16 • Housing Characteristics and Household Population Table 2.1 Household drinking water Percent distribution of households and de jure population by source of drinking water, time to obtain drinking water, and treatment of drinking water, according to residence, Myanmar DHS 2015-16 Households Population Characteristic Urban Rural Total Urban Rural Total Source of drinking water Improved source 89.2 76.9 80.2 89.5 77.0 80.4 Piped into dwelling/yard plot 8.1 5.7 6.3 8.4 6.1 6.7 Public tap/standpipe 3.2 3.1 3.2 3.0 3.0 3.0 Tubewell/borehole 15.7 32.7 28.1 16.1 32.5 28.1 Protected dug well 12.7 25.8 22.3 13.1 25.7 22.3 Protected spring 0.7 3.5 2.7 0.7 3.5 2.8 Rain water 0.7 2.4 2.0 0.5 2.5 1.9 Bottled water 48.1 3.8 15.5 47.7 3.6 15.5 Non-improved source 10.7 22.9 19.6 10.4 22.8 19.5 Unprotected dug well 4.0 10.2 8.5 3.9 10.5 8.8 Unprotected spring 0.5 2.5 1.9 0.5 2.6 2.0 Tanker truck/cart with drum 4.0 1.6 2.3 3.8 1.7 2.2 Surface water 2.2 8.6 6.9 2.2 8.0 6.4 Other source 0.1 0.2 0.2 0.1 0.2 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Time to obtain drinking water (round trip) Water on premises 30.0 39.2 36.8 30.0 40.4 37.6 Less than 30 minutes 66.0 52.5 56.1 65.9 51.1 55.1 30 minutes or longer 2.4 7.6 6.2 2.5 7.8 6.3 Don’t know/missing 1.6 0.7 1.0 1.7 0.7 1.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 Water treatment prior to drinking1 Boiled 23.8 25.6 25.1 22.6 25.1 24.4 Bleach/chlorine added 0.3 0.6 0.6 0.3 0.7 0.6 Strained through cloth 39.0 61.5 55.5 39.3 61.3 55.4 Ceramic, sand or other filter 6.6 9.5 8.7 7.3 9.0 8.6 Let it stand and settle 4.8 8.4 7.4 4.3 8.3 7.2 Other 1.3 1.4 1.4 1.1 1.3 1.3 No treatment 44.8 18.6 25.6 44.5 19.3 26.1 Percentage using an appropriate treatment method2 29.0 34.1 32.7 28.2 33.3 31.9 Number 3,315 9,185 12,500 14,216 38,581 52,797 1 Respondents may report multiple treatment methods, so the sum of treatment may exceed 100 percent. 2 Appropriate water treatment methods include boiling, bleaching, filtering, and solar disinfecting. As only four households used solar disinfection, the category not shown separately. Housing Characteristics and Household Population • 17 Table 2.2 Household sanitation facilities Percent distribution of households and de jure population by type and location of toilet/latrine facilities, according to residence, Myanmar DHS 2015-16 Households Population Type and location of toilet/latrine facility Urban Rural Total Urban Rural Total Improved, not shared facility Flush/pour flush to piped sewer system 0.7 0.1 0.3 0.7 0.1 0.3 Flush/pour flush to septic tank 15.7 2.3 5.9 15.7 2.3 6.0 Flush/pour flush to pit latrine 36.5 24.6 27.7 37.5 25.2 28.5 Ventilated improved pit (VIP) latrine 2.9 2.3 2.5 2.9 2.4 2.6 Pit latrine with slab 8.6 11.3 10.6 8.9 11.1 10.5 Composting toilet 0.1 1.6 1.2 0.1 1.7 1.2 Total 64.5 42.2 48.1 65.9 42.9 49.1 Shared facility1 Flush/pour flush to piped sewer system 0.1 0.0 0.0 0.1 0.0 0.0 Flush/pour flush to septic tank 2.3 0.2 0.8 2.2 0.2 0.7 Flush/pour flush to pit latrine 7.1 5.1 5.6 6.4 4.7 5.1 Ventilated improved pit (VIP) latrine 0.6 0.7 0.7 0.5 0.7 0.6 Pit latrine with slab 2.0 2.8 2.6 1.9 2.3 2.2 Composting toilet 0.0 0.4 0.3 0.0 0.4 0.3 Total 12.2 9.2 10.0 11.0 8.2 9.0 Unimproved facility Flush/pour flush not to sewer/septic tank/pit latrine 2.1 1.3 1.5 2.1 1.3 1.5 Pit latrine without slab/open pit 19.4 31.4 28.2 19.1 31.3 28.0 Bucket 0.0 0.1 0.1 0.0 0.1 0.1 Hanging toilet/hanging latrine 0.4 1.5 1.2 0.5 1.7 1.3 No facility/bush/field 1.2 13.9 10.5 1.1 14.2 10.7 Other 0.3 0.4 0.4 0.3 0.3 0.3 Total 23.4 48.6 41.9 23.1 48.9 41.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 3,315 9,185 12,500 14,216 38,581 52,797 1 Facilities that would be considered improved if they were not shared by two or more households 18 • Housing Characteristics and Household Population Table 2.3 Household characteristics Percent distribution of households by housing characteristics, percentage using solid fuel for cooking, and percent distribution by frequency of smoking in the home, according to residence, Myanmar DHS 2015-16 Residence Housing characteristic Urban Rural Total Electricity Yes 92.3 42.3 55.6 No 7.7 57.7 44.4 Total 100.0 100.0 100.0 Flooring material Earth/sand 5.6 12.3 10.6 Dung 0.1 0.2 0.2 Wood planks 34.9 40.8 39.2 Palm/bamboo 5.4 22.0 17.6 Parquet or polished wood 19.3 13.8 15.3 Vinyl or asphalt strips 0.1 0.0 0.1 Ceramic tiles 3.1 0.4 1.1 Cement 30.6 10.2 15.6 Carpet 0.5 0.0 0.2 Other 0.3 0.1 0.2 Total 100.0 100.0 100.0 Rooms used for sleeping One 41.8 52.3 49.5 Two 36.0 34.2 34.7 Three or more 20.5 11.6 14.0 Missing 1.8 1.8 1.8 Total 100.0 100.0 100.0 Place for cooking1 In the house 73.0 57.4 61.5 In a separate building 15.6 28.9 25.4 Outdoors 10.4 13.2 12.5 No food cooked in household 0.9 0.5 0.6 Total 100.0 100.0 100.0 Cooking fuel2 Electricity 57.7 9.5 22.3 LPG/natural gas/biogas 1.9 0.1 0.6 Coal/lignite 0.2 0.1 0.1 Charcoal 22.6 10.2 13.5 Wood 16.5 77.4 61.2 Straw/shrubs/grass 0.0 0.2 0.2 Agricultural crop 0.1 1.9 1.4 Animal dung 0.0 0.2 0.1 No food cooked in household 0.9 0.5 0.6 Total 100.0 100.0 100.0 Percentage using solid fuel for cooking3 39.4 89.9 76.5 Frequency of smoking in the home Daily 36.0 48.4 45.1 Weekly 6.3 5.3 5.5 Monthly 1.1 1.4 1.3 Less than monthly 3.6 3.3 3.4 Never 53.0 41.7 44.7 Total 100.0 100.0 100.0 Number 3,315 9,185 12,500 LPG = Liquefied petroleum gas 1 As only one household used other place for cooking, it is not shown separately. 2 As only four households used other type of cooking fuel, it is not shown separately. 3 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, agricultural crops, and animal dung Housing Characteristics and Household Population • 19 Table 2.4 Household possessions Percentage of households possessing various household effects, means of transportation, and ownership of agricultural land and livestock/farm animals by residence, Myanmar DHS 2015-16 Residence Possession Urban Rural Total Household effects Radio 30.6 35.1 33.9 Television 85.3 46.9 57.1 Mobile telephone 92.7 65.9 73.0 Non-mobile telephone 12.0 5.1 6.9 Refrigerator 44.8 5.5 16.0 Table 79.7 66.5 70.0 Chair 80.2 54.2 61.1 Sofa 8.5 1.4 3.3 Bed 59.7 35.2 41.7 Cupboard 81.6 58.1 64.3 Electric fan 67.0 12.5 27.0 Air conditioner 12.4 0.5 3.7 Sewing machine 23.2 12.0 15.0 Computer 13.7 0.8 4.2 Means of transport Bicycle 54.9 37.7 42.2 Animal drawn cart 1.0 21.4 16.0 Motorcycle/scooter 52.9 49.2 50.2 Tuk Tuk/htawlargyi (trailer) 2.0 5.1 4.3 Car/truck 12.2 2.6 5.1 Boat with a motor 0.2 1.1 0.9 Boat without a motor 1.0 7.5 5.8 Ownership of agricultural land 9.2 50.6 39.6 Ownership of farm animals1 13.4 64.4 50.9 Number 3,315 9,185 12,500 1 Cattle, cows, bulls, horses, donkeys/mules, goats, sheep, pigs, chickens, or ducks Table 2.5 Wealth quintiles Percent distribution of the de jure population by wealth quintiles, and the Gini Coefficient, according to residence and region, Myanmar DHS 2015-16 Residence/States or Regions Wealth quintile Total Number of persons Gini coefficient Lowest Second Middle Fourth Highest Residence Urban 3.6 5.4 10.0 25.5 55.6 100.0 14,216 0.17 Rural 26.1 25.4 23.7 18.0 6.9 100.0 38,581 0.26 States/Regions Kachin 13.2 23.0 22.0 25.1 16.7 100.0 1,619 0.29 Kayah 11.3 21.3 25.2 26.5 15.7 100.0 285 0.26 Kayin 24.3 18.5 17.1 21.5 18.5 100.0 1,510 0.31 Chin 21.3 29.4 27.6 13.7 8.0 100.0 506 0.29 Sagaing 8.0 22.4 28.0 27.9 13.7 100.0 5,856 0.20 Tanintharyi 24.9 22.3 17.8 20.6 14.4 100.0 1,349 0.32 Bago 18.9 23.6 23.4 20.1 14.0 100.0 4,929 0.30 Magway 18.5 23.4 27.4 18.4 12.3 100.0 4,179 0.24 Mandalay 6.9 17.8 23.3 24.3 27.7 100.0 5,986 0.23 Mon 20.2 15.7 21.0 21.2 21.9 100.0 2,004 0.30 Rakhine 52.8 21.8 12.9 8.2 4.2 100.0 3,377 0.35 Yangon 6.0 9.1 14.9 23.1 46.9 100.0 7,066 0.22 Shan 18.5 20.4 15.2 20.8 25.0 100.0 5,924 0.28 Ayeyarwady 41.8 24.6 15.8 11.4 6.4 100.0 7,005 0.32 Nay Pyi Taw 22.8 20.7 19.4 16.3 20.7 100.0 1,202 0.38 Total 20.0 20.0 20.0 20.0 20.0 100.0 52,797 0.27 20 • Housing Characteristics and Household Population Table 2.6 Handwashing Percentage of households in which the place most often used for washing hands was observed, and among households in which the place for handwashing was observed, percent distribution by availability of water, soap, and other cleansing agents, Myanmar DHS 2015-16 Percentage of households in which place for washing hands was observed Number of households Among households where place for handwashing was observed, percentage with: Number of households with place for hand- washing observed Background characteristic Soap and water1 Water and cleansing agent2 other than soap only Water only Soap but no water3 Cleansing agent other than soap only2 No water, no soap, no other cleansing agent Total Residence Urban 97.2 3,315 94.6 0.3 2.4 1.5 0.1 1.1 100.0 3,221 Rural 92.8 9,185 79.5 0.6 12.1 3.6 0.1 4.1 100.0 8,520 States/Regions Kachin 91.0 365 85.6 1.4 4.1 5.0 0.6 3.3 100.0 332 Kayah 88.0 65 63.2 0.1 23.3 3.5 0.0 9.8 100.0 57 Kayin 94.6 335 74.3 1.6 6.6 5.8 0.1 11.6 100.0 317 Chin 98.6 105 73.1 2.9 21.1 1.5 0.1 1.2 100.0 104 Sagaing 99.6 1,295 82.0 0.9 13.3 2.4 0.0 1.4 100.0 1,289 Tanintharyi 92.0 306 91.0 0.6 5.2 2.0 0.0 1.2 100.0 281 Bago 89.5 1,269 73.8 0.7 11.1 8.7 0.4 5.3 100.0 1,135 Magway 99.3 1,062 82.9 0.2 13.8 0.6 0.0 2.6 100.0 1,054 Mandalay 95.2 1,461 84.8 0.4 7.1 3.4 0.2 4.0 100.0 1,390 Mon 97.7 466 89.7 1.3 7.7 0.7 0.0 0.7 100.0 456 Rakhine 77.7 695 77.1 0.6 18.9 1.3 0.0 2.1 100.0 540 Yangon 99.3 1,730 98.3 0.1 1.1 0.2 0.0 0.2 100.0 1,718 Shan 87.1 1,339 77.8 0.0 10.8 4.9 0.1 6.3 100.0 1,167 Ayeyarwady 94.4 1,705 82.3 0.2 11.0 2.6 0.0 3.9 100.0 1,610 Nay Pyi Taw 95.6 303 81.7 1.0 7.4 4.8 0.7 4.6 100.0 290 Wealth quintile Lowest 85.2 2,583 66.7 0.8 17.8 5.5 0.2 9.0 100.0 2,202 Second 92.3 2,593 76.3 0.8 13.8 4.2 0.1 4.6 100.0 2,394 Middle 96.7 2,503 85.4 0.4 8.7 3.0 0.2 2.4 100.0 2,420 Fourth 97.6 2,424 90.9 0.3 6.1 1.9 0.1 0.7 100.0 2,365 Highest 98.4 2,397 97.7 0.2 1.3 0.6 0.0 0.2 100.0 2,360 Total 93.9 12,500 83.6 0.5 9.4 3.0 0.1 3.3 100.0 11,740 1 Soap includes soap or detergent in bar, liquid, powder, or paste form. This column includes households with soap and water only as well as those that had soap and water and another cleansing agent. 2 Cleansing agents other than soap include locally available materials such as ash, mud, or sand. 3 Includes households with soap only as well as those with soap and another cleansing agent Table 2.7 Household population by age, sex, and residence Percent distribution of the de facto household population by 5-year age groups, according to sex and residence, Myanmar DHS 2015-16 Urban Rural Age1 Male Female Total Male Female Total Male Female Total <5 8.5 6.5 7.4 10.9 8.6 9.7 10.3 8.0 9.0 5-9 9.1 7.1 8.0 11.3 10.1 10.7 10.8 9.2 9.9 10-14 10.2 7.9 8.9 11.7 10.4 11.0 11.3 9.7 10.4 15-19 8.3 8.0 8.1 7.3 6.6 6.9 7.6 7.0 7.2 20-24 8.1 7.9 7.9 6.4 7.0 6.7 6.9 7.2 7.1 25-29 7.6 7.6 7.6 6.8 7.3 7.1 7.0 7.4 7.2 30-34 7.3 7.3 7.3 6.6 7.9 7.3 6.8 7.7 7.3 35-39 6.5 7.7 7.2 6.9 7.2 7.1 6.8 7.4 7.1 40-44 6.6 6.7 6.7 5.8 6.5 6.2 6.0 6.6 6.3 45-49 6.5 6.9 6.7 5.9 5.9 5.9 6.0 6.2 6.1 50-54 6.1 7.3 6.8 5.7 6.3 6.0 5.8 6.5 6.2 55-59 4.8 6.2 5.6 4.5 4.9 4.7 4.6 5.2 4.9 60-64 3.8 4.7 4.3 3.6 3.8 3.7 3.6 4.0 3.8 65-69 2.7 2.9 2.8 2.5 2.9 2.7 2.6 2.9 2.8 70-74 1.8 2.1 2.0 1.6 1.8 1.7 1.7 1.9 1.8 75-79 1.1 1.4 1.3 1.2 1.4 1.3 1.2 1.4 1.3 80 + 1.0 1.9 1.5 1.2 1.6 1.4 1.2 1.7 1.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 6,300 7,662 13,962 17,247 19,921 37,168 23,547 27,583 51,130 1 Total includes six cases with missing information on age, not shown separately. Housing Characteristics and Household Population • 21 Table 2.8 Household composition Percent distribution of households by sex of head of household and by household size; mean size of household, and percentage of households with orphans and foster children under age 18, according to residence, Myanmar DHS 2015-16 Residence Characteristic Urban Rural Total Household headship Male 72.6 79.3 77.5 Female 27.4 20.7 22.5 Total 100.0 100.0 100.0 Number of usual members 1 6.3 5.0 5.4 2 14.6 13.0 13.4 3 19.0 20.5 20.1 4 21.4 23.0 22.6 5 15.0 17.1 16.6 6 9.9 10.4 10.3 7 5.9 5.4 5.5 8 3.0 3.0 3.0 9+ 4.9 2.7 3.3 Total 100.0 100.0 100.0 Mean size of households 4.3 4.2 4.2 Percentage of households with orphans and foster children under age 18 Foster children1 9.8 8.9 9.2 Double orphans 0.5 0.6 0.5 Single orphans2 7.1 5.8 6.2 Foster and/or orphan children 14.5 12.8 13.2 Number of households 3,315 9,185 12,500 Note: Table is based on de jure household members, that is, usual residents. 1 Foster children are those under age 18 living in households with neither their mother nor their father present. 2Single orphans are children with one dead parent and an unknown survival status of the other parent. 22 • Housing Characteristics and Household Population Table 2.9 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Myanmar DHS 2015-16 Children whose births are registered Background characteristic Percentage who had a birth certificate Percentage who did not have birth certificate Percentage registered Number of children Age <2 71.8 9.5 81.3 1,810 2-4 75.6 5.7 81.3 2,823 Sex Male 75.5 6.4 81.9 2,420 Female 72.6 7.9 80.6 2,213 Residence Urban 89.6 4.3 93.9 1,029 Rural 69.7 8.0 77.7 3,604 States/Regions Kachin 77.9 14.2 92.1 165 Kayah 92.6 3.8 96.4 33 Kayin 77.7 9.0 86.8 192 Chin 62.3 9.5 71.7 64 Sagaing 84.2 2.0 86.3 506 Tanintharyi 76.8 11.7 88.5 149 Bago 72.4 6.3 78.7 409 Magway 86.9 5.7 92.6 335 Mandalay 85.2 7.8 92.9 444 Mon 78.1 9.2 87.3 194 Rakhine 33.0 12.1 45.0 323 Yangon 85.1 6.5 91.6 485 Shan 59.5 4.8 64.2 651 Ayeyarwady 78.6 7.3 85.9 584 Nay Pyi Taw 64.3 14.1 78.5 97 Wealth quintile Lowest 59.0 9.6 68.5 1,344 Second 68.5 7.4 75.8 1,005 Middle 79.6 6.3 85.9 807 Fourth 85.6 5.7 91.4 796 Highest 92.5 4.6 97.2 681 Total 74.1 7.1 81.3 4,633 H ou si ng C ha ra ct er is tic s an d H ou se ho ld P op ul at io n • 2 3 Ta bl e 2. 10 C h ild re n’ s liv in g a rr an g em en ts a n d or p ha nh o od P er ce nt d is tr ib ut io n of d e ju re c hi ld re n un de r ag e 18 b y liv in g ar ra ng em en ts a nd s ur vi va l s ta tu s of p ar en ts , t he p er ce nt ag e of c hi ld re n no t l iv in g w ith a b io lo gi ca l p ar en t, an d th e pe rc en ta ge o f c hi ld re n w ith o ne o r bo th p ar en ts d ea d, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, M ya nm ar D H S 2 01 5- 16 B ac kg ro un d ch ar ac te ris tic Li vi ng w ith bo th pa re nt s Li vi ng w ith m ot he r bu t no t w ith fa th er Li vi ng w ith fa th er b ut no t w ith m ot he r N ot li vi ng w ith e ith er p ar en t T ot al P er ce nt ag e no t l iv in g w ith a bi ol og ic al pa re nt P er ce nt ag e w ith o ne o r bo th pa re nt s de ad 1 N um be r of ch ild re n Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad B ot h al iv e O nl y fa th er al iv e O nl y m ot he r al iv e B ot h de ad M is si ng in fo rm at io n on fa th er / m ot he r A ge 0- 4 81 .3 10 .7 1. 7 0. 6 0. 3 4. 6 0. 4 0. 2 0. 1 0. 1 10 0. 0 5. 3 2. 6 4, 63 3 <2 84 .3 11 .9 0. 7 0. 1 0. 2 2. 3 0. 3 0. 0 0. 1 0. 0 10 0. 0 2. 7 1. 3 1, 81 0 2- 4 79 .4 9. 9 2. 3 0. 9 0. 3 6. 0 0. 4 0. 3 0. 1 0. 1 10 0. 0 6. 9 3. 5 2, 82 3 5- 9 75 .4 9. 0 3. 4 1. 5 0. 5 8. 1 0. 6 0. 9 0. 3 0. 3 10 0. 0 9. 8 5. 8 5, 12 6 10 -1 4 72 .1 6. 9 6. 5 1. 5 1. 3 8. 1 0. 7 1. 5 0. 9 0. 3 10 0. 0 11 .3 11 .0 5, 44 4 15 -1 7 70 .2 6. 2 9. 0 1. 4 1. 8 7. 9 0. 6 1. 5 1. 0 0. 4 10 0. 0 11 .0 14 .0 2, 43 3 S ex M al e 75 .8 8. 3 4. 7 1. 4 0. 9 6. 9 0. 5 0. 8 0. 5 0. 2 10 0. 0 8. 7 7. 4 8, 97 2 Fe m al e 74 .6 8. 6 4. 7 1. 1 0. 8 7. 4 0. 7 1. 2 0. 5 0. 3 10 0. 0 9. 7 7. 9 8, 66 4 R es id en ce U rb an 70 .3 8. 9 6. 3 1. 7 0. 9 9. 3 0. 7 1. 1 0. 5 0. 4 10 0. 0 11 .6 9. 5 4, 10 5 R ur al 76 .7 8. 3 4. 2 1. 1 0. 9 6. 5 0. 6 0. 9 0. 5 0. 3 10 0. 0 8. 5 7. 1 13 ,5 32 S ta te s/ R eg io ns K ac hi n 75 .7 6. 4 7. 4 1. 4 0. 4 6. 1 0. 3 1. 1 1. 0 0. 2 10 0. 0 8. 5 10 .2 58 6 K ay ah 75 .9 10 .8 4. 7 1. 3 0. 5 5. 2 0. 4 0. 4 0. 7 0. 0 10 0. 0 6. 8 6. 8 11 5 K ay in 58 .2 11 .7 4. 1 2. 1 1. 1 20 .1 0. 9 0. 9 0. 5 0. 5 10 0. 0 22 .3 7. 5 64 4 C hi n 83 .5 6. 7 3. 2 0. 9 0. 6 4. 1 0. 3 0. 4 0. 3 0. 1 10 0. 0 5. 0 4. 8 22 2 S ag ai ng 75 .0 10 .4 4. 1 1. 6 1. 5 4. 9 0. 9 0. 8 0. 6 0. 1 10 0. 0 7. 3 7. 9 1, 99 9 T an in th ar yi 63 .4 10 .0 4. 1 1. 5 0. 4 18 .2 0. 8 1. 0 0. 5 0. 1 10 0. 0 20 .4 6. 8 56 6 B ag o 77 .2 6. 5 3. 2 0. 8 1. 0 7. 6 1. 2 1. 7 0. 3 0. 5 10 0. 0 10 .8 7. 4 1, 56 8 M ag w ay 79 .6 9. 6 3. 4 0. 4 0. 9 4. 5 0. 6 0. 4 0. 6 0. 0 10 0. 0 6. 1 5. 9 1, 30 8 M an da la y 76 .7 6. 9 5. 3 1. 2 1. 5 6. 3 0. 5 0. 9 0. 4 0. 4 10 0. 0 7. 9 8. 6 1, 70 9 M on 59 .2 13 .3 3. 4 1. 2 1. 0 19 .8 0. 2 0. 8 0. 7 0. 6 10 0. 0 21 .4 6. 1 75 2 R ak hi ne 74 .0 12 .4 4. 6 0. 8 0. 9 4. 9 0. 3 1. 0 1. 0 0. 1 10 0. 0 7. 2 7. 8 1, 28 8 Y an go n 78 .1 6. 7 6. 0 1. 5 0. 2 5. 6 0. 5 0. 8 0. 0 0. 7 10 0. 0 6. 8 7. 6 1, 95 3 S ha n 74 .9 8. 4 4. 7 1. 9 0. 6 6. 9 0. 5 1. 2 0. 7 0. 2 10 0. 0 9. 3 7. 7 2, 17 4 A ye ya rw ad y 80 .2 5. 8 5. 7 1. 1 0. 8 4. 4 0. 5 1. 0 0. 4 0. 0 10 0. 0 6. 3 8. 4 2, 35 6 N ay P yi T aw 79 .6 6. 4 3. 4 1. 0 1. 1 5. 1 0. 6 1. 4 0. 9 0. 4 10 0. 0 8. 0 7. 4 39 7 W ea lt h q ui nt ile Lo w es t 78 .8 7. 5 5. 8 0. 6 0. 9 4. 2 0. 5 0. 9 0. 5 0. 3 10 0. 0 6. 0 8. 6 4, 55 9 S ec on d 77 .9 8. 0 3. 8 1. 1 1. 3 6. 0 0. 5 0. 9 0. 5 0. 1 10 0. 0 7. 9 6. 9 3, 95 2 M id dl e 73 .5 8. 1 4. 6 1. 7 0. 8 8. 7 0. 7 1. 1 0. 7 0. 2 10 0. 0 11 .2 7. 9 3, 35 4 Fo ur th 72 .1 9. 3 4. 6 1. 5 0. 9 9. 0 0. 5 1. 2 0. 5 0. 3 10 0. 0 11 .3 7. 8 3, 05 1 H ig he st 71 .1 10 .0 4. 3 1. 8 0. 4 9. 8 0. 8 0. 9 0. 4 0. 5 10 0. 0 11 .9 6. 8 2, 72 0 T ot al < 15 76 .0 8. 8 4. 0 1. 2 0. 7 7. 0 0. 6 0. 9 0. 4 0. 3 10 0. 0 8. 9 6. 7 15 ,2 03 T ot al < 18 75 .2 8. 4 4. 7 1. 3 0. 9 7. 2 0. 6 1. 0 0. 5 0. 3 10 0. 0 9. 2 7. 7 17 ,6 36 N ot e: T ab le is b as ed o n de ju re m em be rs , t ha t i s, u su al r es id en ts . 1 In cl ud es c hi ld re n w ith fa th er d ea d, m ot he r d ea d, b ot h de ad , a nd o ne p ar en t d ea d bu t m is si ng in fo rm at io n on s ur vi va l s ta tu s of th e ot he r pa re nt 24 • Housing Characteristics and Household Population Table 2.11.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Myanmar DHS 2015-16 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number Median years completed Age3 6-9 24.2 74.7 1.0 0.1 0.0 0.0 100.0 2,074 1.1 10-14 4.2 25.4 19.2 51.3 0.0 0.0 100.0 2,670 5.1 15-19 7.1 12.3 12.3 53.8 13.1 1.5 100.0 1,928 7.6 20-24 7.7 14.8 16.8 40.6 8.0 12.2 100.0 1,994 6.9 25-29 12.1 16.1 20.5 33.6 3.4 14.3 100.0 2,031 5.2 30-34 12.0 23.5 23.1 25.8 3.3 12.4 100.0 2,127 4.6 35-39 14.1 28.7 20.4 22.2 2.3 12.3 100.0 2,031 4.4 40-44 16.5 29.8 21.4 23.2 1.6 7.6 100.0 1,820 4.2 45-49 21.2 26.5 22.1 21.5 1.0 7.7 100.0 1,698 4.1 50-54 29.2 27.8 20.4 16.6 0.9 5.1 100.0 1,806 3.5 55-59 32.3 23.7 19.2 17.7 1.7 5.5 100.0 1,445 3.5 60-64 39.8 22.5 18.8 14.6 1.4 2.8 100.0 1,114 2.9 65+ 57.5 19.4 12.4 7.5 1.5 1.7 100.0 2,159 0.0 Residence Urban 10.5 19.9 11.6 36.0 6.0 16.0 100.0 7,079 6.5 Rural 24.0 29.5 19.6 22.5 1.7 2.6 100.0 17,822 3.7 States/Regions Kachin 10.5 34.2 10.9 34.8 3.9 5.7 100.0 721 4.5 Kayah 22.1 25.1 10.2 32.8 3.7 6.1 100.0 128 4.2 Kayin 25.5 32.0 12.2 22.6 2.8 4.9 100.0 685 3.2 Chin 21.9 25.9 14.0 30.9 3.5 3.8 100.0 215 4.2 Sagaing 19.2 23.3 24.7 27.4 1.7 3.7 100.0 2,689 4.3 Tanintharyi 10.6 36.1 18.3 28.5 0.7 5.7 100.0 601 4.2 Bago 14.4 26.7 20.5 29.8 2.6 6.0 100.0 2,420 4.4 Magway 20.7 25.1 20.9 24.5 2.8 5.9 100.0 2,035 4.2 Mandalay 20.9 24.3 19.6 25.3 2.3 7.6 100.0 2,948 4.2 Mon 15.4 33.2 14.4 26.8 2.8 7.5 100.0 944 4.1 Rakhine 30.6 31.7 12.9 19.1 2.5 3.1 100.0 1,606 2.8 Yangon 9.6 24.0 12.6 34.8 5.0 13.9 100.0 3,521 5.7 Shan 43.1 22.9 9.9 17.9 3.3 2.9 100.0 2,653 1.5 Ayeyarwady 16.6 30.6 21.4 24.4 2.7 4.3 100.0 3,172 4.1 Nay Pyi Taw 16.8 27.2 18.7 25.2 2.9 9.2 100.0 563 4.3 Wealth quintile Lowest 33.7 37.6 15.6 12.5 0.4 0.2 100.0 4,557 2.2 Second 24.4 33.0 19.9 20.9 1.1 0.7 100.0 4,840 3.4 Middle 18.5 28.0 22.1 27.0 2.3 2.1 100.0 5,008 4.2 Fourth 17.0 22.4 17.7 33.7 3.2 6.1 100.0 5,102 4.6 Highest 9.7 15.1 11.6 35.4 7.1 21.0 100.0 5,393 7.5 Total 20.2 26.8 17.3 26.4 2.9 6.4 100.0 24,901 4.2 1 Completed grade 5 at the primary level 2 Completed grade 11 at the secondary level 3 Total includes four cases with missing information on age, not shown separately. Housing Characteristics and Household Population • 25 Table 2.11.2 Educational attainment of the male household population Percent distribution of the de facto male household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Myanmar DHS 2015-16 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know/ missing Total Number Median years completed Age3 6-9 26.1 73.2 0.6 0.1 0.0 0.0 0.0 100.0 2,049 1.0 10-14 4.3 30.8 19.0 45.8 0.0 0.0 0.1 100.0 2,663 4.8 15-19 7.3 11.6 12.4 60.2 7.8 0.6 0.0 100.0 1,778 7.4 20-24 9.4 13.5 13.4 48.3 9.3 6.0 0.1 100.0 1,619 7.1 25-29 10.2 13.3 17.8 42.4 5.8 10.5 0.0 100.0 1,649 6.7 30-34 13.2 19.4 19.4 36.0 3.9 8.1 0.0 100.0 1,604 4.9 35-39 14.4 21.8 21.6 29.7 3.6 8.9 0.0 100.0 1,598 4.6 40-44 14.4 19.9 21.5 35.8 2.2 6.2 0.0 100.0 1,422 4.7 45-49 19.2 17.7 21.6 34.2 2.7 4.4 0.1 100.0 1,424 4.6 50-54 24.9 20.3 22.6 24.8 2.1 5.1 0.1 100.0 1,361 4.2 55-59 25.6 20.4 20.0 26.9 2.2 4.9 0.0 100.0 1,076 4.2 60-64 31.7 17.1 18.5 23.9 3.6 5.2 0.0 100.0 854 4.1 65+ 49.1 13.1 15.0 16.6 2.2 4.0 0.0 100.0 1,551 1.0 Residence Urban 8.0 17.5 10.2 45.8 7.1 11.4 0.1 100.0 5,661 7.2 Rural 21.5 26.8 19.1 28.8 1.9 1.9 0.0 100.0 14,989 4.1 States/Regions Kachin 10.7 29.8 12.4 39.3 3.5 4.3 0.0 100.0 628 4.8 Kayah 16.2 31.5 9.9 35.0 3.3 4.1 0.0 100.0 113 4.2 Kayin 29.5 29.5 11.7 23.6 3.2 2.5 0.1 100.0 565 2.9 Chin 13.2 25.3 14.2 38.9 4.9 3.4 0.0 100.0 189 4.8 Sagaing 16.0 20.2 23.8 34.2 3.2 2.6 0.0 100.0 2,312 4.6 Tanintharyi 14.4 34.6 14.5 31.8 0.9 3.8 0.0 100.0 516 4.1 Bago 11.5 24.4 20.2 36.0 3.1 4.9 0.0 100.0 1,930 4.7 Magway 19.3 21.2 21.4 30.9 3.0 4.1 0.1 100.0 1,580 4.4 Mandalay 15.6 20.7 20.2 34.0 3.1 6.3 0.0 100.0 2,355 4.7 Mon 17.9 30.2 11.8 32.6 3.9 3.7 0.0 100.0 746 4.2 Rakhine 23.9 28.0 13.6 29.3 2.6 2.6 0.0 100.0 1,182 3.8 Yangon 7.6 20.9 10.6 45.4 5.4 10.0 0.1 100.0 2,882 6.9 Shan 40.3 24.5 10.6 20.0 2.4 2.2 0.1 100.0 2,335 2.0 Ayeyarwady 14.9 28.0 18.3 33.1 3.3 2.4 0.0 100.0 2,815 4.4 Nay Pyi Taw 12.2 21.1 20.2 37.2 3.4 5.9 0.0 100.0 502 4.8 Wealth quintile Lowest 28.5 34.7 17.2 18.9 0.4 0.2 0.0 100.0 3,877 2.9 Second 21.2 30.2 19.9 27.1 1.0 0.6 0.0 100.0 4,077 3.9 Middle 16.9 24.4 19.7 35.5 2.2 1.3 0.0 100.0 4,223 4.4 Fourth 14.3 19.5 17.0 41.1 3.7 4.4 0.0 100.0 4,269 5.0 Highest 9.0 13.4 9.4 43.3 9.2 15.6 0.1 100.0 4,203 7.9 Total 17.8 24.2 16.6 33.5 3.4 4.5 0.0 100.0 20,649 4.5 1 Completed grade 5 at the primary level 2 Completed grade 11 at the secondary level 3 Total includes two cases with missing information on age, not shown separately. 26 • Housing Characteristics and Household Population Table 2.12 School attendance ratios Net attendance ratio (NAR) and gross attendance ratio (GAR) for the de facto household population by sex and level of schooling; and the Gender Parity Index (GPI), according to background characteristics, Myanmar DHS 2015-16 Net attendance ratio1 Gross attendance ratio2 Background characteristic Male Female Total Gender Parity Index3 Male Female Total Gender Parity Index3 PRIMARY SCHOOL Residence Urban 87.4 85.0 86.2 0.97 109.9 99.1 104.6 0.90 Rural 82.6 82.5 82.6 1.00 113.6 108.0 110.8 0.95 States/Regions Kachin 87.0 90.9 88.8 1.05 110.3 109.9 110.1 1.00 Kayah 85.9 85.5 85.7 1.00 118.2 107.4 113.2 0.91 Kayin 82.3 82.9 82.6 1.01 111.4 118.1 114.6 1.06 Chin 81.5 81.4 81.4 1.00 113.7 110.8 112.3 0.97 Sagaing 87.4 86.3 86.8 0.99 112.3 102.8 107.6 0.92 Tanintharyi 82.7 88.2 85.2 1.07 121.8 128.6 124.9 1.06 Bago 83.0 81.6 82.3 0.98 115.1 103.7 109.2 0.90 Magway 85.6 87.5 86.6 1.02 111.6 104.3 108.0 0.93 Mandalay 86.4 89.7 88.1 1.04 109.7 107.3 108.5 0.98 Mon 88.5 89.4 89.0 1.01 126.0 111.7 118.4 0.89 Rakhine 76.6 75.6 76.1 0.99 111.2 109.8 110.5 0.99 Yangon 86.5 83.2 84.9 0.96 109.0 98.1 103.6 0.90 Shan 72.9 72.0 72.4 0.99 107.0 97.5 101.8 0.91 Ayeyarwady 85.9 81.9 84.0 0.95 118.1 109.7 114.1 0.93 Nay Pyi Taw 86.7 89.1 87.8 1.03 107.8 114.6 111.0 1.06 Wealth quintile Lowest 76.7 74.0 75.3 0.96 114.2 106.2 110.2 0.93 Second 85.3 85.4 85.3 1.00 118.6 110.1 114.2 0.93 Middle 84.6 86.4 85.5 1.02 114.2 107.1 110.6 0.94 Fourth 87.4 85.4 86.5 0.98 105.4 105.3 105.3 1.00 Highest 88.8 88.7 88.8 1.00 108.2 98.4 103.3 0.91 Total 83.7 83.0 83.4 0.99 112.8 106.0 109.4 0.94 SECONDARY SCHOOL Residence Urban 72.9 76.2 74.5 1.05 86.1 93.8 89.8 1.09 Rural 53.4 58.1 55.7 1.09 61.8 66.4 64.1 1.08 States/Regions Kachin 62.5 76.8 70.1 1.23 77.2 87.8 82.8 1.14 Kayah 55.1 71.9 63.0 1.30 62.9 87.1 74.3 1.39 Kayin 44.7 55.2 50.3 1.23 50.3 63.3 57.3 1.26 Chin 57.0 66.8 62.1 1.17 71.7 89.3 80.9 1.25 Sagaing 66.9 68.4 67.6 1.02 77.2 81.9 79.4 1.06 Tanintharyi 52.2 57.0 54.6 1.09 59.9 67.9 63.8 1.13 Bago 58.6 69.1 64.3 1.18 64.1 80.9 73.2 1.26 Magway 65.8 72.7 69.2 1.11 74.0 81.3 77.6 1.10 Mandalay 64.1 75.1 69.5 1.17 78.1 85.0 81.5 1.09 Mon 49.8 59.9 54.6 1.20 53.9 71.7 62.3 1.33 Rakhine 51.5 45.9 48.6 0.89 66.4 54.5 60.2 0.82 Yangon 72.1 70.9 71.5 0.98 85.4 85.0 85.2 1.00 Shan 35.6 36.2 35.9 1.02 38.3 43.1 40.7 1.12 Ayeyarwady 57.5 60.6 59.0 1.05 68.3 68.7 68.5 1.01 Nay Pyi Taw 69.2 67.3 68.3 0.97 77.1 81.7 79.3 1.06 Wealth quintile Lowest 36.6 37.7 37.1 1.03 42.5 41.0 41.8 0.96 Second 53.0 58.6 55.9 1.11 60.0 65.4 62.8 1.09 Middle 59.9 66.7 63.3 1.11 71.0 79.7 75.3 1.12 Fourth 71.9 75.9 73.9 1.06 81.4 90.7 86.0 1.11 Highest 78.3 84.0 81.0 1.07 94.4 102.8 98.4 1.09 Total 58.2 62.3 60.2 1.07 67.8 72.8 70.3 1.07 1 The NAR for primary school is the percentage of the primary-school (age 5-9) population that is attending primary school. The NAR for secondary school is the percentage of the secondary-school (age 10-15) 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, expressed as a percentage of the official primary- school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary-school-age population. If there are significant numbers of over- and underage students at a given level of schooling, the GAR can exceed 100%. 3 The Gender Parity Index for primary school is the ratio of the primary school NAR(GAR) for females to the NAR(GAR) for males. The Gender Parity Index for secondary school is the ratio of the secondary school NAR(GAR) for females to the NAR(GAR) for males. Characteristics of Respondents • 27 CHARACTERISTICS OF RESPONDENTS 3 Key Findings  Education: Forty-six percent of women and 52% of men age 15-49 in Myanmar have attended secondary school. However, only 10% of women and 7% of men have completed more than secondary education.  Literacy: About 9 in 10 women (88%) and men (91%) age 15-49 can read.  Exposure to mass media: About 3 in 10 women (32%) and men (29%) have no regular exposure to any mass media.  Employment: Sixty-seven percent of women and 91% of men are currently employed.  Tobacco use: Two percent of women and 32% of men smoke cigarettes, while 2% of women and 14% of men smoke pipes or cheroots, and 18% of women and 59% of men chew betel quid. his chapter presents information on demographic and socioeconomic characteristics of the survey respondents, such as age, education, place of residence, marital status, employment, and wealth status. This information is useful for understanding the factors that affect use of contraceptives and reproductive health services as well as other health behaviors. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS The 2015-16 MDHS interviewed 12,885 women and 4,737 men age 15-49 (Table 3.1). Women and men are more or less similarly distributed across all age groups (14% to 16%), except for the age group 45-49, to which 13% of women and 12% of men belong. In Myanmar, adolescents (age 15-19) constitute 14% of women and 15% of men, while youth age 15-24 constitute 29% of women and 30% of men. About 6 in 10 women and men are currently married. Women are more likely to be divorced or separated and widowed (3% each) than men (2% and 1%, respectively). Women and men are similarly distributed by residence and across regions and states. About 7 in 10 live in rural areas. The highest proportion lives in Yangon Region (15% each of women and men), while the lowest proportion resides in Kayah State (0.5% each). About one in eight women (13%) and men (12%) have no education. Women and men are more or less equally likely to share wealth across a range of wealth quintiles (18% to 22%). T 28 • Characteristics of Respondents 3.2 EDUCATION AND LITERACY Literacy Respondents who have attended secondary or a higher level of school are assumed to be literate. All other respondents were given a sentence to read, and they were considered to be literate if they could read all or part of the sentence. Sample: Women and men age 15-49 About half of women (46%) and men (52%) have attended secondary school or higher (Figure 3.1, Tables 3.2.1 and 3.2.2). Women and men age 15-49 have, on average, completed 5 years of schooling, although youth (age group 15-24) have completed more than 7 years (Tables 3.2.1 and 3.2.2). In Myanmar, the literacy rate is high among both women (85%) and men (91%) age 15-49 (Tables 3.3.1 and 3.3.2). Patterns by background characteristics  Young respondents have the most education. Women and men age 15-24 are twice as likely to have completed secondary school or higher compared with those age 45-49 (18% versus 9% for women and 13% versus 7% for men) Tables 3.2.1 and 3.2.2.  Urban women are almost five times more likely than rural women to have studied beyond secondary school (24% versus 5%), and urban men are about four times as likely as rural men to have higher education (15% versus 4%). Notably, a much higher proportion of urban women have more than a secondary education compared with urban men in the same age group. Figure 3.1 Education of survey respondents 13 12 23 18 18 17 32 41 4 5 10 7 Women Men Percent distribution of women and men age 15-49 by highest level of schooling attended or completed More than secondary Completed secondary Some secondary Primary complete Primary incomplete No education Characteristics of Respondents • 29  The proportion of both women and men who have no education is highest in Shan State (35%) followed by Rakhine State (26%) and Kayin State (22%) for women and Kayin State (32%) and Rakhine State (15%) for men. The percentage of women with completed secondary or higher education is highest in Yangon Region (25%) followed by Mon State (17%) (Figure 3.2).  Literacy also varies by state and region. The proportion of literate women is highest in Kachin State (95%) and lowest in Shan State (61%), while for men, it is highest in Yangon Region (98%) and lowest in Shan State (67%) (Tables 3.3.1 and 3.3.2).  The literacy rate increases with wealth for both women and men, rising from 66% for women in the lowest wealth quintile to 95% for women in the highest quintile; the corresponding increase for men is from 78% to 95%. 3.3 MASS MEDIA EXPOSURE Exposure to mass media Respondents were asked how often they read a newspaper, listened to the radio, or watched television. Those who responded at least once a week are considered to be regularly exposed to that form of media. Sample: Women and men age 15-49 Mass media convey messages on preventing communicable diseases, including HIV/AIDS, tuberculosis, and malaria; healthy life styles for preventing noncommunicable diseases; and other health topics. In Myanmar, men are slightly more likely than women to be regularly exposed to all forms of media, but especially newspapers. Television is the most common form of media used by women and men (60% each). About one-fourth of women (25%) and men (28%) listen to the radio. Exposure to newspapers varies most by gender: 16% of women and 27% of men read newspapers at least once a week (Tables Figure 3.2 Women with some, completed, or more than secondary education by states and regions Percent of women age 15-49 with some secondary education or higher Figure 3.3 Exposure to mass media 16 60 25 6 3227 60 28 9 29 Reads newspaper Watches television Listens to radio All three media None of these media Percentage of women and men age 15-49 who are exposed to media on a weekly basis Women Men 30 • Characteristics of Respondents 3.4.1 and 3.4.2). About 3 in 10 women (32%) and men (29%) are not regularly exposed to any of these forms of media (Figure 3.3). Patterns by background characteristics  The exposure to all three media is highest among women age 15-19 (9%). Media exposure generally declines with age for women, but varies inconsistently by age for men.  More urban than rural women read newspapers (30% versus 10%) and watch television (81% versus 51%), while more rural than urban women listen to the radio (26% versus 21%). Consequently, women in urban areas (10%) are more than twice as likely to be exposed to all three media as their rural counterparts (4%). A similar pattern by residence occurs for men.  The proportion of women and men who access none of the three media at least once a week is highest in Rakhine State (65% and 61%, respectively) and lowest in Yangon Region (10% and 6%, respectively).  For both women and men, exposure to newspapers and television increases sharply with both education and wealth; exposure to radio also increases with education, but does not vary much or vary consistently by wealth. 3.4 EMPLOYMENT Currently employed Respondents who were employed in the 7 days before the survey Sample: Women and men age 15-49 Men are more likely to be currently employed than women are. Ninety-one percent of men age 15-49 currently work compared with 67% of women in the same age group (Tables 3.5.1 and 3.5.2). Patterns by background characteristics  More than half of women age 15-19 and about two-thirds of older women are currently employed; 7 in 10 men age 15-19 and 9 in 10 older men are currently employed.  Women are more likely to work if they are divorced, separated, or widowed than if they are married (78% versus 64%), but the reverse is true for men (87% versus 97%). Never-married men are less likely to be employed than ever-married men.  Women with no living children are more likely to be employed (69%) than women with children (62% to 66%), but the reverse is true for men. Eighty-three percent of men with no children are employed compared with 94% to 97% of men with one or more children.  Both women and men in rural areas are more likely to be employed than those in urban areas, although the differences in percentage currently employed are not large: 69% versus 61% for women and 92% versus 87% for men.  The proportion of currently employed women is highest in Mandalay Region (84%) and lowest in Rakhine State (47%), while the proportion of currently employed men is highest in Nay Pyi Taw (95%) and lowest in Kayin State (76%). Characteristics of Respondents • 31  The employment status of women does not vary consistently by education or wealth. Among men, the percentage currently employed tends to decline with wealth, but does not vary consistently by education (Figure 3.4). 3.5 OCCUPATION Occupation Categorized as professional/technical/managerial, clerical, sales and services, skilled manual, unskilled manual, domestic service, and agriculture Sample: Women and men age 15-49 who were currently employed or had worked in the 12 months before the survey Women age 15-49 most often work in unskilled manual labor (34%), followed by sales and services (25%) and agriculture (20%) (Table 3.6.1). Men age 15-49 are also most commonly employed in unskilled manual labor (31%), followed by agriculture (29%) and skilled manual labor (21%) (Table 3.6.2). Eight percent of women and 7% of men work in professional, technical, or managerial occupations (Figure 3.5). Patterns by background characteristics  Unskilled manual labor is the most common occupation for women irrespective of age, marital status, and number of living children. This pattern is also generally true for men. Only divorced, separated, or widowed women are more likely to labor in sales and services (34%).  In urban areas, the most common occupations are sales and services for women (44%) and skilled manual labor for men (39%). In rural areas, the leading occupation is unskilled manual labor for women (41%) and agriculture (38%) for men.  Unskilled manual labor is the common occupation for women in most states and regions except Kachin State, Kayin State, Chin State, and Sagaing Region, where agricultural jobs predominate, and Tanintharyi Region and Yangon Region where sales and services is the most common occupation. For men, unskilled manual labor or agriculture is the most common occupation in all states and regions, except Yangon Region where skilled manual labor accounts for the highest proportion of employed men. Figure 3.4 Employment by education Figure 3.5 Occupation 71 69 61 71 94 96 86 89 No education Primary Secondary More than secondary Percentage of women and men age 15-49 who are currently employed Women Men 7 2 10 21 31 29 8 2 25 11 34 20 Professional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Agriculture Percentage of women and men age 15-49 employed in the 12 months before the survey by occupation Men Women 32 • Characteristics of Respondents  Professional, technical or managerial occupations account for the highest proportion of employed women (45%) and men (33%) with more than secondary education. Women and men with no education most often work at unskilled manual labor (50% and 46%, respectively).  Employed women and men in the lowest wealth quintile are concentrated in unskilled manual labor (56% and 51%, respectively), whereas, in the highest wealth quintile, the most common occupations are sales and services for women (41%) and skilled manual labor for men (34%). Most employed women (86%) earn cash only. Work for cash only is more prevalent in nonagricultural occupations (90%) than in agricultural occupations (69%). Thirty-eight percent of employed women work for a nonfamily member, 32% are self-employed, and 30% work for a family member. About two-thirds of employed women (65%) work all year, while 28% work specific seasons, and 7% work occasionally. Women employed in agriculture are more likely than other employed women to work only seasonally (Table 3.7). 3.6 TOBACCO USE In Myanmar, most women age 15-49 (96%) do not smoke or use other tobacco products (Table 3.8.1). Two percent each of women smoke cigarettes and pipes or cheroots. By contrast, 32% of men age 15-49 smoke cigarettes and 14% smoke pipes or cheroots (Table 3.8.2). About 1 in 6 male cigarette smokers reported smoking 10 or more cigarettes in the 24 hours prior to the interview. In Myanmar, 18% of women and 59% of men age 15-49 chew betel quid (contains betel leaf, areca nut, and slaked lime, and may contain tobacco). Among those who chew betel quid, more than 1 in 5 women and about 2 in 5 men chewed 10 or more pieces in the 24 hours before the interview (Tables 3.9.1 and 3.9.2). Patterns by background characteristics  Cigarette and pipe or cheroot smoking and betel quid chewing rises with age in women. Among men, cigarette smoking is most prevalent (37% to 38%) in younger age groups (age 20-29) while pipe or cheroot smoking is mostly found (21% to 22%) in older age groups (age 40-49).  Smoking does not vary among women by maternity status, and betel quid chewing also remains as high among pregnant women and breastfeeding mothers as among other women (18-22%).  Tobacco use is slightly more prevalent among rural women than among urban women (5% versus 1%). Men in urban areas are more likely to smoke cigarettes (35%) than men in rural areas (30%), whereas rural men are more likely to smoke pipes or cheroots (16%) and use other tobacco products (3%) than urban men (11% and 1%, respectively). The prevalence of betel quid chewing is higher among rural women (20%) and rural men (60%) than among their urban counterparts (13% and 57%, respectively).  Among women, cigarette smoking is highest in Kayin State (10%), smoking pipes or cheroots is highest in Rakhine State (11%), and use of other tobacco products is highest in Chin State (15%). Among men, cigarette smoking is most prevalent in Tanintharyi Region (51%), followed by Kayin State (49%) and Rakhine State (48%); pipe or cheroot smoking is most prevalent in Bago Region (28%); and use of other tobacco products is most prevalent in Sagaing Region (12%).  By state and region, women in Rakhine State are most likely (50%) to chew betel quid, followed by those in Kayin State (41%) and Kayah State (36%). Among men, betel quid chewing is most prevalent in Rakhine State (79%), followed by Bago Region (75%) and Ayeyarwady Region (68%). Characteristics of Respondents • 33  Tobacco use and betel quid chewing decline with increasing education and wealth in women, but among men, smoking tends to decline with increasing education but not consistently by wealth; betel quid chewing declines with wealth. 3.7 KNOWLEDGE OF TUBERCULOSIS More than nine in ten women and men age 15-49 have heard of tuberculosis (TB). The lowest level of knowledge about TB is among women and men in Shan State, where only two-thirds have heard of TB. Knowledge of TB is also relatively low among those with no education, with only about 7 in 10 having heard of TB. Among women and men who have heard of TB, a majority (71% of women and 63% of men) know that TB spreads through coughing. About 9 in 10 know that TB is curable. Three percent of women and 4% of men learned from a doctor or nurse that they have TB (Tables 3.10.1 and 3.10.2). LIST OF TABLES For more information on the characteristics of survey respondents, see the following tables:  Table 3.1 Background characteristics of respondents  Table 3.2.1 Educational attainment: Women  Table 3.2.2 Educational attainment: Men  Table 3.3.1 Literacy: Women  Table 3.3.2 Literacy: Men  Table 3.4.1 Exposure to mass media: Women  Table 3.4.2 Exposure to mass media: Men  Table 3.5.1 Employment status: Women  Table 3.5.2 Employment status: Men  Table 3.6.1 Occupation: Women  Table 3.6.2 Occupation: Men  Table 3.7 Type of employment: Women  Table 3.8.1 Use of tobacco: Women  Table 3.8.2 Use of tobacco: Men  Table 3.9.1 Use of betel quid: Women  Table 3.9.2 Use of betel quid: Men  Table 3.10.1 Knowledge of tuberculosis: Women  Table 3.10.2 Knowledge of tuberculosis: Men 34 • Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15-49 by selected background characteristics, Myanmar DHS 2015-16 Women Men Background characteristic Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Age 15-19 14.0 1,810 1,835 15.4 731 768 20-24 14.5 1,867 1,893 14.6 692 690 25-29 14.5 1,867 1,880 14.3 677 687 30-34 15.8 2,037 1,971 14.7 698 674 35-39 15.2 1,954 1,918 14.3 679 671 40-44 13.5 1,733 1,746 14.5 689 681 45-49 12.6 1,617 1,642 12.1 571 566 Marital status Never married 33.2 4,278 4,146 34.7 1,646 1,695 Married 60.2 7,759 7,870 62.4 2,957 2,916 Divorced/separated 3.3 431 448 2.1 100 94 Widowed 3.2 417 421 0.7 35 32 Residence Urban 29.2 3,768 3,785 28.5 1,350 1,321 Rural 70.8 9,117 9,100 71.5 3,387 3,416 States/Regions Kachin 2.9 374 804 3.4 161 328 Kayah 0.5 65 757 0.5 23 264 Kayin 2.4 303 751 2.4 115 300 Chin 0.8 102 750 0.8 39 296 Sagaing 10.9 1,410 1,039 10.9 514 394 Tanintharyi 2.2 283 717 2.2 103 249 Bago 9.7 1,244 939 9.6 454 346 Magway 8.4 1,081 947 6.8 320 291 Mandalay 12.0 1,541 963 12.7 601 372 Mon 3.6 463 789 3.4 162 269 Rakhine 6.0 777 911 4.7 222 261 Yangon 15.0 1,927 1,065 14.8 703 404 Shan 10.6 1,368 778 11.4 542 286 Ayeyarwady 12.8 1,650 919 13.8 653 364 Nay Pyi Taw 2.3 300 756 2.7 126 313 Education1 No education 12.5 1,606 1,592 12.1 575 559 Primary 41.2 5,305 5,129 35.5 1,684 1,630 Secondary 36.1 4,646 4,838 45.2 2,139 2,224 More than secondary 10.3 1,325 1,324 7.2 339 324 Wealth quintile Lowest 17.7 2,274 2,364 18.8 890 904 Second 18.7 2,408 2,451 19.3 916 933 Middle 20.4 2,633 2,633 20.7 979 1,016 Fourth 21.0 2,702 2,739 20.8 986 995 Highest 22.3 2,868 2,698 20.4 966 889 Total 100.0 12,885 12,885 100.0 4,737 4,737 Note: Education categories refer to the highest level of education attended, whether or not that level was completed. 1 Total includes three women with missing information on education. Characteristics of Respondents • 35 Table 3.2.1 Educational attainment: Women Percent distribution of women age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Myanmar DHS 2015-16 Highest level of schooling Median years completed Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number of women Age 15-24 7.2 13.9 13.7 47.4 9.3 8.6 100.0 7.3 3,677 15-19 6.9 12.1 11.4 53.2 12.5 3.9 100.0 7.6 1,810 20-24 7.5 15.6 15.9 41.9 6.1 13.0 100.0 6.8 1,867 25-29 10.7 17.2 19.8 34.8 2.6 15.0 100.0 5.4 1,867 30-34 11.8 24.2 22.4 25.5 3.4 12.5 100.0 4.6 2,037 35-39 14.4 31.8 18.2 22.0 2.0 11.7 100.0 4.2 1,954 40-44 16.9 31.7 18.4 24.0 1.6 7.3 100.0 4.1 1,733 45-49 20.3 30.0 19.9 21.2 1.1 7.5 100.0 4.0 1,617 Residence Urban 5.1 13.8 9.0 40.3 7.9 23.9 100.0 9.0 3,768 Rural 15.5 27.0 21.8 28.4 2.7 4.7 100.0 4.3 9,117 States/Regions Kachin 2.8 25.0 13.6 43.2 4.1 11.2 100.0 6.3 374 Kayah 14.7 18.5 11.7 40.1 4.7 10.4 100.0 6.0 65 Kayin 22.2 25.6 11.3 27.0 4.6 9.3 100.0 4.2 303 Chin 13.9 14.4 15.8 43.0 6.1 6.9 100.0 6.6 102 Sagaing 9.6 20.7 26.6 34.0 2.0 7.1 100.0 4.7 1,410 Tanintharyi 4.5 26.2 18.2 39.0 0.9 11.2 100.0 5.2 283 Bago 6.0 23.7 20.8 35.4 4.5 9.6 100.0 5.0 1,244 Magway 11.6 22.7 23.0 28.2 4.7 9.7 100.0 4.7 1,081 Mandalay 10.7 20.7 22.6 31.1 2.9 12.0 100.0 4.8 1,541 Mon 9.2 27.1 12.8 33.6 4.5 12.9 100.0 5.1 463 Rakhine 25.9 31.7 11.6 22.6 3.4 4.8 100.0 3.4 777 Yangon 4.7 19.9 10.4 39.7 6.3 18.9 100.0 7.9 1,927 Shan 35.3 18.5 11.9 22.8 5.2 6.2 100.0 3.4 1,368 Ayeyarwady 8.7 28.6 22.0 29.3 4.2 7.3 100.0 4.6 1,650 Nay Pyi Taw 9.8 26.3 19.6 28.4 4.5 11.4 100.0 4.7 300 Wealth quintile Lowest 28.3 37.8 18.3 14.5 0.6 0.5 100.0 2.9 2,274 Second 15.7 31.2 23.6 26.1 2.0 1.3 100.0 4.1 2,408 Middle 9.4 23.9 24.8 34.4 3.4 4.1 100.0 4.7 2,633 Fourth 8.0 17.9 16.4 42.4 5.1 10.3 100.0 6.3 2,702 Highest 4.3 9.0 8.5 38.1 8.9 31.2 100.0 9.4 2,868 Total 12.5 23.1 18.0 31.8 4.2 10.3 100.0 4.8 12,885 1 Completed grade 5 at the primary level 2 Completed grade 11 at the secondary level 36 • Characteristics of Respondents Table 3.2.2 Educational attainment: Men Percent distribution of men age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Myanmar DHS 2015-16 Highest level of schooling Median years completed Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number of men Age 15-24 7.6 12.7 11.0 55.9 6.9 5.8 100.0 7.5 1,423 15-19 8.0 10.8 10.2 62.1 6.8 2.2 100.0 7.6 731 20-24 7.3 14.6 12.0 49.3 7.1 9.7 100.0 7.2 692 25-29 9.6 15.3 17.4 38.4 7.1 12.2 100.0 6.7 677 30-34 12.8 20.5 20.0 35.0 4.4 7.2 100.0 4.8 698 35-39 14.7 25.9 20.4 27.8 2.9 8.4 100.0 4.5 679 40-44 15.1 22.9 21.2 33.0 1.8 6.0 100.0 4.6 689 45-49 19.0 17.6 21.7 35.2 2.2 4.3 100.0 4.6 571 Residence Urban 4.5 11.0 9.1 51.4 8.7 15.3 100.0 9.0 1,350 Rural 15.2 21.1 20.6 36.1 3.1 3.9 100.0 4.7 3,387 States/Regions Kachin 6.7 24.1 11.3 47.9 3.4 6.6 100.0 6.2 161 Kayah 11.1 19.9 11.7 48.5 2.4 6.4 100.0 6.0 23 Kayin 31.7 16.4 9.7 32.5 6.2 3.5 100.0 4.2 115 Chin 3.5 15.6 15.1 52.9 7.6 5.3 100.0 7.2 39 Sagaing 9.4 11.3 25.4 43.5 6.4 4.0 100.0 5.5 514 Tanintharyi 7.0 25.3 12.8 45.5 0.7 8.6 100.0 5.8 103 Bago 8.2 19.3 20.1 42.3 3.8 6.3 100.0 5.3 454 Magway 10.2 15.7 26.0 35.8 4.7 7.7 100.0 4.9 320 Mandalay 8.2 15.5 20.1 41.6 7.0 7.6 100.0 5.9 601 Mon 13.6 20.1 13.4 42.1 4.7 6.0 100.0 5.4 162 Rakhine 15.1 23.5 13.6 36.9 3.9 6.9 100.0 4.8 222 Yangon 3.8 15.6 9.2 53.4 4.4 13.5 100.0 8.4 703 Shan 35.4 23.3 11.2 20.9 4.1 5.0 100.0 3.2 542 Ayeyarwady 10.1 21.5 21.4 38.2 3.0 5.7 100.0 4.9 653 Nay Pyi Taw 7.4 13.2 22.9 43.4 6.7 6.4 100.0 5.9 126 Wealth quintile Lowest 24.1 32.0 20.1 23.2 0.5 0.1 100.0 3.6 890 Second 13.4 25.7 25.2 32.8 1.4 1.5 100.0 4.4 916 Middle 11.3 15.1 21.5 44.7 4.6 2.8 100.0 5.2 979 Fourth 7.7 13.4 14.5 51.2 5.8 7.4 100.0 7.1 986 Highest 5.3 6.4 6.0 48.4 10.6 23.2 100.0 9.4 966 Total 12.1 18.2 17.4 40.5 4.7 7.2 100.0 5.4 4,737 1 Completed grade 5 at the primary level 2 Completed grade 11 at the secondary level Characteristics of Respondents • 37 Table 3.3.1 Literacy: Women Percent distribution of women age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Myanmar DHS 2015-16 Background characteristic Secondary school or higher No schooling or primary school Total Percentage literate1 Number of women Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Age 15-24 65.2 19.1 5.3 10.3 0.1 0.0 100.0 89.6 3,677 15-19 69.6 15.9 4.7 9.7 0.1 0.0 100.0 90.2 1,810 20-24 61.0 22.2 5.8 10.8 0.2 0.0 100.0 88.9 1,867 25-29 52.4 28.8 5.6 13.2 0.0 0.0 100.0 86.7 1,867 30-34 41.5 38.0 7.4 13.2 0.0 0.0 100.0 86.8 2,037 35-39 35.7 37.3 9.5 17.4 0.0 0.0 100.0 82.5 1,954 40-44 33.0 39.6 8.8 18.4 0.0 0.1 100.0 81.4 1,733 45-49 29.8 39.8 10.7 19.1 0.0 0.6 100.0 80.3 1,617 Residence Urban 72.1 16.2 5.2 6.4 0.0 0.1 100.0 93.5 3,768 Rural 35.7 38.0 8.4 17.8 0.0 0.1 100.0 82.1 9,117 States/Regions Kachin 58.5 25.7 10.9 4.8 0.0 0.1 100.0 95.1 374 Kayah 55.2 25.1 5.0 14.6 0.1 0.0 100.0 85.3 65 Kayin 40.9 26.8 7.7 24.5 0.1 0.0 100.0 75.4 303 Chin 56.0 8.6 8.1 26.8 0.1 0.4 100.0 72.6 102 Sagaing 43.1 40.1 8.0 8.8 0.0 0.0 100.0 91.2 1,410 Tanintharyi 51.2 33.6 5.3 7.8 1.3 0.7 100.0 90.0 283 Bago 49.5 38.0 5.3 7.2 0.0 0.0 100.0 92.8 1,244 Magway 42.6 38.1 8.3 10.6 0.0 0.2 100.0 89.1 1,081 Mandalay 45.9 40.3 3.1 10.5 0.1 0.0 100.0 89.4 1,541 Mon 50.9 28.0 7.2 13.1 0.0 0.8 100.0 86.1 463 Rakhine 30.8 20.8 11.4 36.9 0.0 0.1 100.0 63.0 777 Yangon 65.0 16.6 12.5 5.8 0.0 0.1 100.0 94.1 1,927 Shan 34.2 21.1 5.2 39.4 0.0 0.0 100.0 60.5 1,368 Ayeyarwady 40.8 41.8 6.4 11.0 0.0 0.0 100.0 89.0 1,650 Nay Pyi Taw 44.4 37.6 4.6 13.4 0.0 0.0 100.0 86.6 300 Wealth quintile Lowest 15.6 39.5 10.9 33.9 0.0 0.1 100.0 66.0 2,274 Second 29.5 40.9 10.3 19.1 0.0 0.1 100.0 80.7 2,408 Middle 41.9 39.7 8.5 9.8 0.0 0.1 100.0 90.1 2,633 Fourth 57.7 28.1 5.3 8.7 0.1 0.1 100.0 91.1 2,702 Highest 78.3 13.4 3.4 4.8 0.0 0.1 100.0 95.0 2,868 Total 46.3 31.6 7.4 14.4 0.0 0.1 100.0 85.4 12,885 1 Refers to women who attended secondary school or higher and women who can read a whole sentence or part of a sentence 38 • Characteristics of Respondents Table 3.3.2 Literacy: Men Percent distribution of men age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Myanmar DHS 2015-16 Secondary school or higher No schooling or primary school Percentage literate1 Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Missing Total Number of men Age 15-24 68.6 16.4 6.2 8.6 0.0 0.0 0.0 100.0 91.3 1,423 15-19 71.1 15.7 4.8 8.5 0.0 0.0 0.0 100.0 91.5 731 20-24 66.1 17.2 7.8 8.8 0.1 0.0 0.0 100.0 91.1 692 25-29 57.7 24.8 8.7 8.8 0.0 0.0 0.0 100.0 91.2 677 30-34 46.7 35.6 8.0 9.7 0.0 0.0 0.0 100.0 90.3 698 35-39 39.1 38.3 12.2 10.4 0.0 0.0 0.0 100.0 89.6 679 40-44 40.8 38.4 10.5 10.0 0.1 0.1 0.0 100.0 89.8 689 45-49 41.7 38.8 9.6 9.7 0.1 0.1 0.0 100.0 90.2 571 Residence Urban 75.4 17.4 3.3 3.9 0.0 0.0 0.0 100.0 96.1 1,350 Rural 43.1 34.3 10.9 11.6 0.0 0.0 0.0 100.0 88.3 3,387 States/Regions Kachin 57.9 25.3 13.0 3.8 0.0 0.0 0.0 100.0 96.2 161 Kayah 57.3 20.1 10.4 12.2 0.0 0.0 0.0 100.0 87.8 23 Kayin 42.2 14.7 15.1 27.2 0.7 0.0 0.0 100.0 72.1 115 Chin 65.8 12.2 7.2 13.4 0.0 1.0 0.3 100.0 85.2 39 Sagaing 54.0 33.6 8.2 4.2 0.0 0.0 0.0 100.0 95.8 514 Tanintharyi 54.8 25.5 8.5 10.5 0.3 0.4 0.0 100.0 88.8 103 Bago 52.4 35.3 4.0 8.3 0.0 0.0 0.0 100.0 91.7 454 Magway 48.1 42.4 5.1 4.4 0.0 0.0 0.0 100.0 95.6 320 Mandalay 56.3 37.1 3.6 3.1 0.0 0.0 0.0 100.0 96.9 601 Mon 52.8 33.8 3.7 9.7 0.0 0.0 0.0 100.0 90.3 162 Rakhine 47.8 23.2 7.2 21.5 0.0 0.4 0.0 100.0 78.2 222 Yangon 71.3 24.7 2.1 1.9 0.0 0.0 0.0 100.0 98.1 703 Shan 30.1 22.7 14.0 33.2 0.0 0.0 0.0 100.0 66.8 542 Ayeyarwady 47.0 25.1 22.3 5.6 0.0 0.0 0.0 100.0 94.4 653 Nay Pyi Taw 56.5 36.3 4.5 2.7 0.0 0.0 0.0 100.0 97.3 126 Wealth quintile Lowest 23.9 37.0 17.3 21.8 0.0 0.0 0.0 100.0 78.1 890 Second 35.6 41.1 12.8 10.4 0.0 0.1 0.0 100.0 89.5 916 Middle 52.1 35.8 7.1 4.9 0.0 0.1 0.0 100.0 95.0 979 Fourth 64.4 24.2 5.2 6.2 0.1 0.0 0.0 100.0 93.8 986 Highest 82.3 10.6 2.4 4.8 0.0 0.0 0.0 100.0 95.2 966 Total 52.3 29.5 8.7 9.4 0.0 0.0 0.0 100.0 90.5 4,737 1 Refers to men who attended secondary school or higher and men who can read a whole sentence or part of a sentence Characteristics of Respondents • 39 Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Myanmar DHS 2015-16 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 18.5 68.8 30.2 8.9 24.3 1,810 20-24 17.6 63.3 28.6 8.0 28.2 1,867 25-29 16.4 59.9 24.2 7.0 32.9 1,867 30-34 13.7 60.7 24.1 5.5 30.7 2,037 35-39 15.9 58.2 21.5 5.1 33.8 1,954 40-44 11.9 52.4 21.5 3.6 37.6 1,733 45-49 14.3 53.8 22.9 4.5 36.0 1,617 Residence Urban 29.8 80.6 21.0 10.2 14.9 3,768 Rural 9.6 51.1 26.3 4.4 38.8 9,117 States/Regions Kachin 19.2 48.3 25.6 7.5 40.3 374 Kayah 15.7 67.4 26.1 6.2 27.0 65 Kayin 12.5 53.2 15.5 4.8 40.5 303 Chin 17.7 54.8 19.2 8.2 40.3 102 Sagaing 8.5 55.3 26.8 4.0 35.1 1,410 Tanintharyi 9.6 54.1 19.9 3.8 39.3 283 Bago 15.3 63.9 26.7 6.4 28.0 1,244 Magway 14.5 50.9 40.6 6.6 31.3 1,081 Mandalay 16.2 55.1 25.8 4.7 33.8 1,541 Mon 18.7 47.9 28.5 6.0 37.3 463 Rakhine 8.5 28.5 13.3 2.9 64.7 777 Yangon 22.2 88.3 12.7 6.2 9.8 1,927 Shan 11.6 51.1 19.0 5.1 43.9 1,368 Ayeyarwady 20.1 65.4 35.3 11.3 24.9 1,650 Nay Pyi Taw 14.7 68.1 27.4 5.6 25.4 300 Education1 No education 1.1 33.8 13.6 0.3 59.9 1,606 Primary 7.4 52.3 24.3 2.8 37.3 5,305 Secondary 21.1 71.4 27.9 8.8 21.3 4,646 More than secondary 45.6 80.1 28.9 17.0 12.2 1,325 Wealth quintile Lowest 5.0 33.1 22.1 2.1 56.2 2,274 Second 9.6 45.9 26.0 4.4 42.9 2,408 Middle 10.5 57.0 27.5 4.7 31.6 2,633 Fourth 15.5 73.6 25.7 6.7 20.4 2,702 Highest 33.4 81.8 22.3 11.6 13.9 2,868 Total 15.5 59.7 24.7 6.1 31.8 12,885 1 Total includes three women with missing information on education. 40 • Characteristics of Respondents Table 3.4.2 Exposure to mass media: Men Percentage of men age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Myanmar DHS 2015-16 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of men Age 15-19 25.2 67.1 28.9 9.9 25.5 731 20-24 29.2 65.1 25.3 6.1 25.9 692 25-29 31.3 64.0 28.2 11.6 27.0 677 30-34 28.3 57.9 23.8 9.5 33.8 698 35-39 23.4 57.2 26.9 7.8 30.5 679 40-44 25.6 53.8 29.2 9.4 33.7 689 45-49 27.1 53.3 37.1 8.0 28.6 571 Residence Urban 51.2 77.8 21.7 13.2 15.9 1,350 Rural 17.5 52.9 30.9 7.2 34.6 3,387 States/Regions Kachin 46.2 59.9 42.8 25.7 24.2 161 Kayah 18.1 46.3 28.1 6.8 39.2 23 Kayin 10.0 45.0 11.7 2.1 50.3 115 Chin 9.3 34.5 16.3 1.7 53.6 39 Sagaing 19.9 63.2 29.8 5.6 25.3 514 Tanintharyi 25.6 79.4 38.7 14.2 14.3 103 Bago 15.9 61.6 30.4 6.0 28.8 454 Magway 28.2 58.3 46.3 13.0 21.7 320 Mandalay 36.8 60.2 33.0 13.3 25.4 601 Mon 28.4 73.2 42.0 13.1 14.4 162 Rakhine 10.9 28.5 20.9 3.3 60.8 222 Yangon 55.9 89.5 16.3 9.7 6.2 703 Shan 11.8 52.6 14.8 3.3 42.2 542 Ayeyarwady 15.4 40.4 31.3 7.9 46.9 653 Nay Pyi Taw 41.1 60.0 42.7 14.6 20.0 126 Education No education 4.5 37.4 16.0 1.1 53.0 575 Primary 13.8 52.4 27.4 5.2 36.1 1,684 Secondary 37.3 68.7 31.5 11.4 20.3 2,139 More than secondary 67.5 81.4 32.9 25.0 11.5 339 Wealth quintile Lowest 11.2 30.7 26.2 4.2 54.8 890 Second 14.7 47.1 31.4 5.7 38.1 916 Middle 20.8 61.8 32.4 7.6 25.6 979 Fourth 31.5 72.6 28.3 12.3 20.8 986 Highest 55.6 84.5 23.0 14.3 9.7 966 Total 27.1 60.0 28.3 8.9 29.3 4,737 Characteristics of Respondents • 41 Table 3.5.1 Employment status: Women Percent distribution of women age 15-49 by employment status, according to background characteristics, Myanmar DHS 2015-16 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Background characteristic Currently employed1 Not currently employed Total Number of women Age 15-19 54.1 5.4 40.6 100.0 1,810 20-24 63.9 8.6 27.5 100.0 1,867 25-29 66.2 7.3 26.4 100.0 1,867 30-34 70.1 6.0 23.9 100.0 2,037 35-39 71.0 5.9 23.1 100.0 1,954 40-44 70.9 4.7 24.4 100.0 1,733 45-49 69.1 5.4 25.6 100.0 1,617 Marital status Never married 69.5 4.7 25.9 100.0 4,278 Married 63.6 7.1 29.2 100.0 7,759 Divorced/separated/ widowed 77.8 5.5 16.6 100.0 848 Number of living children 0 68.9 5.6 25.5 100.0 5,331 1-2 64.9 7.0 28.1 100.0 4,510 3-4 65.8 5.3 28.9 100.0 2,279 5+ 61.8 7.8 30.4 100.0 765 Residence Urban 60.7 4.5 34.8 100.0 3,768 Rural 68.9 6.9 24.2 100.0 9,117 States/Regions Kachin 58.9 3.3 37.7 100.0 374 Kayah 58.9 18.9 22.2 100.0 65 Kayin 48.2 8.2 43.5 100.0 303 Chin 65.7 8.7 25.6 100.0 102 Sagaing 65.0 9.2 25.8 100.0 1,410 Tanintharyi 61.3 9.6 29.1 100.0 283 Bago 68.7 7.6 23.7 100.0 1,244 Magway 79.0 6.0 14.9 100.0 1,081 Mandalay 84.4 3.2 12.4 100.0 1,541 Mon 58.7 6.3 35.0 100.0 463 Rakhine 46.8 10.7 42.4 100.0 777 Yangon 52.8 2.3 44.9 100.0 1,927 Shan 78.3 4.8 16.8 100.0 1,368 Ayeyarwady 65.3 8.1 26.7 100.0 1,650 Nay Pyi Taw 65.9 6.6 27.4 100.0 300 Education2 No education 70.5 5.7 23.8 100.0 1,606 Primary 69.2 7.1 23.7 100.0 5,305 Secondary 60.9 5.8 33.3 100.0 4,646 More than secondary 70.7 4.6 24.7 100.0 1,325 Wealth quintile Lowest 63.8 9.2 26.9 100.0 2,274 Second 67.3 7.4 25.2 100.0 2,408 Middle 70.5 5.7 23.8 100.0 2,633 Fourth 67.6 5.0 27.5 100.0 2,702 Highest 63.3 4.3 32.4 100.0 2,868 Total 66.5 6.2 27.3 100.0 12,885 1 Currently employed is defined as having done work in the past 7 days. Includes persons who did not work in the past 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 2 Total includes three women with missing information on education. 42 • Characteristics of Respondents Table 3.5.2 Employment status: Men Percent distribution of men age 15-49 by employment status, according to background characteristics, Myanmar DHS 2015-16 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Background characteristic Currently employed1 Not currently employed Total Number of men Age 15-19 69.3 5.1 25.6 100.0 731 20-24 89.6 3.5 6.8 100.0 692 25-29 95.2 3.3 1.6 100.0 677 30-34 95.5 3.1 1.3 100.0 698 35-39 95.7 3.4 1.0 100.0 679 40-44 96.5 2.0 1.6 100.0 689 45-49 94.6 3.7 1.7 100.0 571 Marital status Never married 80.2 4.7 15.1 100.0 1,646 Married 96.6 2.7 0.8 100.0 2,957 Divorced/separated/widowed 87.4 5.4 7.2 100.0 135 Number of living children 0 83.4 4.5 12.1 100.0 2,077 1-2 96.9 2.0 1.1 100.0 1,669 3-4 95.4 3.4 1.2 100.0 792 5+ 93.5 5.2 1.3 100.0 200 Residence Urban 86.8 3.4 9.8 100.0 1,350 Rural 92.1 3.5 4.4 100.0 3,387 States/Regions Kachin 90.9 5.5 3.6 100.0 161 Kayah 83.9 11.6 4.6 100.0 23 Kayin 75.8 11.9 12.3 100.0 115 Chin 94.0 3.3 2.7 100.0 39 Sagaing 89.6 2.5 7.9 100.0 514 Tanintharyi 90.5 3.3 6.1 100.0 103 Bago 89.5 5.3 5.2 100.0 454 Magway 91.2 0.3 8.6 100.0 320 Mandalay 92.2 1.7 6.1 100.0 601 Mon 91.5 4.5 3.9 100.0 162 Rakhine 81.7 10.8 7.5 100.0 222 Yangon 91.3 1.4 7.3 100.0 703 Shan 93.8 3.4 2.8 100.0 542 Ayeyarwady 91.6 3.6 4.8 100.0 653 Nay Pyi Taw 94.6 2.2 3.2 100.0 126 Education No education 93.5 4.5 2.0 100.0 575 Primary 96.0 2.8 1.2 100.0 1,684 Secondary 85.8 3.8 10.4 100.0 2,139 More than secondary 89.2 2.5 8.3 100.0 339 Wealth quintile Lowest 93.0 4.4 2.6 100.0 890 Second 92.1 4.6 3.2 100.0 916 Middle 91.8 2.9 5.3 100.0 979 Fourth 89.4 2.4 8.2 100.0 986 Highest 87.0 3.0 10.0 100.0 966 Total 90.6 3.4 5.9 100.0 4,737 1 Currently employed is defined as having done work in the past 7 days. Includes persons who did not work in the past 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. Characteristics of Respondents • 43 Table 3.6.1 Occupation: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Myanmar DHS 2015-16 Background characteristic Profes- sional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agriculture Missing Total Number of women Age 15-19 4.6 1.5 21.4 16.7 37.3 0.4 17.5 0.6 100.0 1,076 20-24 9.7 3.9 20.8 14.2 31.5 0.3 18.9 0.7 100.0 1,354 25-29 9.8 3.1 21.5 14.0 31.8 0.4 19.2 0.2 100.0 1,373 30-34 7.7 1.6 26.1 10.2 33.4 0.4 20.2 0.3 100.0 1,550 35-39 8.0 2.0 28.5 8.2 33.5 0.1 19.4 0.3 100.0 1,502 40-44 6.2 1.5 31.0 6.6 33.8 0.6 19.9 0.4 100.0 1,310 45-49 7.8 2.2 27.2 5.0 34.8 0.2 22.7 0.1 100.0 1,204 Marital status Never married 10.8 4.0 23.0 15.0 30.0 0.3 16.6 0.4 100.0 3,171 Married 6.4 1.5 25.6 8.4 35.8 0.3 21.8 0.4 100.0 5,489 Divorced/separated/ widowed 5.0 1.1 34.0 8.3 32.5 1.1 17.6 0.4 100.0 707 Number of living children 0 10.1 3.7 23.0 15.0 30.3 0.3 17.1 0.4 100.0 3,972 1-2 7.7 1.7 28.3 8.4 34.1 0.3 18.9 0.5 100.0 3,243 3-4 4.3 0.7 26.8 6.4 37.7 0.3 23.6 0.2 100.0 1,620 5+ 1.7 0.1 19.7 3.6 42.2 0.8 31.6 0.3 100.0 533 Residence Urban 15.1 6.8 43.9 16.9 13.0 1.1 2.5 0.7 100.0 2,457 Rural 5.2 0.7 18.7 8.4 40.9 0.1 25.8 0.3 100.0 6,910 States/Regions Kachin 14.9 1.2 34.7 6.5 13.3 0.0 29.4 0.0 100.0 233 Kayah 11.9 1.3 18.8 6.0 57.6 0.0 4.0 0.3 100.0 50 Kayin 11.4 0.7 36.9 4.8 14.9 0.0 30.8 0.5 100.0 171 Chin 12.9 3.6 12.7 3.1 7.8 0.0 59.9 0.0 100.0 76 Sagaing 4.7 1.6 26.8 13.1 26.7 0.0 26.8 0.3 100.0 1,046 Tanintharyi 6.6 3.7 36.2 10.4 35.3 0.2 7.6 0.0 100.0 201 Bago 4.9 2.1 23.8 8.8 31.6 0.2 28.6 0.1 100.0 949 Magway 5.8 1.5 15.8 5.0 41.9 0.1 28.9 1.1 100.0 919 Mandalay 5.6 1.8 21.5 13.0 55.0 0.0 2.8 0.3 100.0 1,350 Mon 10.0 2.5 33.5 13.6 37.3 0.0 3.0 0.2 100.0 301 Rakhine 9.0 1.4 26.3 11.4 40.2 0.2 11.3 0.1 100.0 446 Yangon 10.7 7.5 39.8 22.6 14.5 1.7 2.8 0.3 100.0 1,061 Shan 10.8 1.1 14.7 8.7 35.5 0.0 28.1 1.1 100.0 1,137 Ayeyarwady 7.0 1.1 27.8 5.2 30.1 0.2 28.7 0.0 100.0 1,210 Nay Pyi Taw 13.8 2.0 23.6 3.1 30.2 3.1 24.1 0.1 100.0 218 Education1 No education 5.4 0.0 12.8 3.1 50.2 0.4 27.8 0.3 100.0 1,223 Primary 1.3 0.2 21.6 8.1 43.5 0.3 24.8 0.3 100.0 4,047 Secondary 5.2 2.2 34.9 17.8 23.4 0.5 15.6 0.4 100.0 3,097 More than secondary 45.2 13.9 26.1 7.8 4.7 0.0 1.8 0.6 100.0 998 Wealth quintile Lowest 2.0 0.1 12.5 5.3 55.8 0.2 24.0 0.1 100.0 1,661 Second 2.3 0.3 17.5 7.1 42.8 0.3 29.5 0.3 100.0 1,800 Middle 4.2 0.9 21.4 11.0 37.1 0.2 24.9 0.3 100.0 2,008 Fourth 9.9 1.9 32.1 13.4 24.8 0.7 17.0 0.2 100.0 1,959 Highest 19.4 7.8 40.8 15.2 11.3 0.2 4.3 1.0 100.0 1,939 Total 7.8 2.3 25.3 10.6 33.6 0.3 19.7 0.4 100.0 9,367 1 Total includes three women with missing information on education. 44 • Characteristics of Respondents Table 3.6.2 Occupation: Men Percent distribution of men age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Myanmar DHS 2015-16 Background characteristic Profes- sional/ technical/ mana- gerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agricul- ture Missing Total Number of men Age 15-19 3.1 0.7 8.9 22.4 34.9 0.3 29.6 0.0 100.0 544 20-24 8.0 2.0 8.9 23.3 29.2 0.6 27.9 0.0 100.0 644 25-29 8.3 2.7 12.1 22.2 28.0 0.3 26.4 0.0 100.0 667 30-34 5.8 1.6 7.7 23.0 29.4 0.3 31.5 0.6 100.0 689 35-39 9.2 1.9 8.9 21.8 31.6 0.2 26.0 0.5 100.0 672 40-44 7.6 0.9 10.7 20.1 33.0 0.1 27.3 0.3 100.0 678 45-49 6.9 1.0 10.7 16.8 32.1 0.2 31.9 0.3 100.0 561 Marital status Never married 6.8 2.0 10.8 21.9 29.3 0.1 29.0 0.0 100.0 1,397 Married 7.2 1.5 9.1 21.1 32.0 0.4 28.4 0.3 100.0 2,933 Divorced/separated/ widowed 8.2 0.0 12.1 23.6 27.3 0.0 27.7 1.1 100.0 125 Number of living children 0 7.6 2.1 10.4 22.1 29.4 0.1 28.2 0.0 100.0 1,825 1-2 8.0 1.6 10.3 23.6 30.4 0.4 25.2 0.4 100.0 1,651 3-4 4.5 0.8 8.3 18.2 34.5 0.5 32.7 0.5 100.0 782 5+ 4.7 0.1 3.8 10.2 37.8 0.0 43.4 0.0 100.0 197 Residence Urban 13.6 3.6 22.5 38.7 16.9 0.8 3.7 0.3 100.0 1,218 Rural 4.6 0.8 4.9 15.0 36.4 0.1 37.9 0.2 100.0 3,237 States/Regions Kachin 8.8 0.7 4.5 31.0 11.9 0.0 43.2 0.0 100.0 155 Kayah 9.0 1.6 3.8 16.1 63.8 0.0 5.7 0.0 100.0 22 Kayin 4.4 0.8 10.2 17.9 19.2 0.0 47.1 0.4 100.0 101 Chin 16.6 3.3 3.0 25.5 14.2 0.4 37.0 0.0 100.0 38 Sagaing 5.0 0.5 8.2 18.4 15.9 0.3 51.3 0.3 100.0 474 Tanintharyi 2.9 1.5 4.6 25.7 48.8 0.0 16.1 0.4 100.0 96 Bago 4.5 1.5 7.3 17.5 23.1 0.6 45.5 0.0 100.0 430 Magway 6.7 0.5 3.1 15.7 47.0 0.0 25.7 1.2 100.0 292 Mandalay 4.7 3.5 9.7 29.2 47.8 0.0 5.0 0.0 100.0 564 Mon 4.6 0.9 13.2 26.7 44.8 0.0 9.9 0.0 100.0 156 Rakhine 6.9 2.5 8.0 13.1 52.9 0.0 16.6 0.0 100.0 205 Yangon 8.4 3.3 23.8 35.0 14.4 1.4 13.6 0.2 100.0 652 Shan 15.6 0.9 4.4 16.9 33.8 0.0 27.8 0.6 100.0 527 Ayeyarwady 4.0 0.3 8.8 10.9 35.5 0.0 40.5 0.0 100.0 621 Nay Pyi Taw 11.9 1.0 4.0 20.6 21.7 0.0 40.8 0.0 100.0 122 Education No education 8.5 0.0 2.3 10.8 45.9 0.2 31.8 0.5 100.0 564 Primary 2.3 0.1 6.6 16.2 39.8 0.2 34.5 0.3 100.0 1,663 Secondary 6.6 1.8 12.5 30.3 22.6 0.5 25.5 0.1 100.0 1,917 More than secondary 33.1 11.1 22.4 14.0 9.6 0.0 9.9 0.0 100.0 311 Wealth quintile Lowest 3.2 0.0 2.5 9.3 51.4 0.1 33.4 0.2 100.0 867 Second 3.1 0.3 4.4 15.4 35.8 0.2 40.5 0.2 100.0 886 Middle 4.0 1.0 6.7 21.0 32.4 0.2 34.5 0.3 100.0 928 Fourth 7.6 2.0 10.9 27.8 24.6 0.7 26.1 0.3 100.0 905 Highest 17.8 4.7 24.2 33.6 11.2 0.2 8.0 0.2 100.0 869 Total 7.1 1.6 9.7 21.4 31.1 0.3 28.6 0.2 100.0 4,455 Characteristics of Respondents • 45 Table 3.7 Type of employment: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural or nonagricultural), Myanmar DHS 2015-16 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 69.3 90.1 86.0 Cash and in-kind 13.1 4.0 5.8 In-kind only 10.4 1.4 3.2 Not paid 7.2 4.4 5.0 Total 100.0 100.0 100.0 Type of employer Employed by family member 59.8 22.4 29.8 Employed by nonfamily member 18.0 42.9 38.0 Self-employed 22.2 34.7 32.2 Total 100.0 100.0 100.0 Continuity of employment All year 45.3 70.3 65.4 Seasonal 49.4 22.4 27.7 Occasional 5.4 7.4 6.9 Total 100.0 100.0 100.0 Number of women employed during the last 12 months 1,846 7,486 9,367 Note: Total includes women with missing information on type of employment who are not shown separately. 46 • Characteristics of Respondents Table 3.8.1 Use of tobacco: Women Percentage of women age 15-49 who smoke cigarettes or a pipe/cheroot or use other tobacco products, according to background characteristics and maternity status, Myanmar DHS 2015- 16 Uses tobacco Does not use tobacco Number of women Background characteristic Cigarettes Pipe/ Cheroot Other tobacco Age 15-19 0.2 0.4 0.0 99.5 1,810 20-24 0.3 0.4 0.2 99.2 1,867 25-29 0.8 0.9 0.2 98.1 1,867 30-34 1.4 1.3 0.4 96.9 2,037 35-39 2.3 3.1 0.3 94.3 1,954 40-44 3.0 3.5 0.5 93.5 1,733 45-49 4.1 4.4 0.6 91.0 1,617 Maternity status Pregnant 1.6 1.8 0.2 96.6 466 Breastfeeding (not pregnant) 1.5 2.5 0.5 95.6 1,855 Neither 1.7 1.8 0.3 96.3 10,564 Residence Urban 0.8 0.3 0.2 98.8 3,768 Rural 2.0 2.6 0.4 95.1 9,117 States/Regions Kachin 1.1 0.8 0.0 98.3 374 Kayah 0.4 0.1 0.0 99.5 65 Kayin 9.7 7.5 0.1 83.2 303 Chin 4.3 2.7 15.3 79.2 102 Sagaing 1.4 0.2 0.3 98.2 1,410 Tanintharyi 3.1 0.0 0.9 96.0 283 Bago 1.2 2.4 0.2 96.4 1,244 Magway 0.8 0.7 0.3 98.3 1,081 Mandalay 0.3 0.2 0.0 99.5 1,541 Mon 3.3 3.9 0.2 92.9 463 Rakhine 1.9 10.8 0.5 87.0 777 Yangon 1.3 0.0 0.0 98.7 1,927 Shan 1.4 1.6 0.3 96.8 1,368 Ayeyarwady 2.3 3.3 0.2 94.3 1,650 Nay Pyi Taw 1.6 0.4 0.0 98.0 300 Education1 No education 4.6 5.3 0.4 90.0 1,606 Primary 2.1 2.8 0.4 94.8 5,305 Secondary 0.5 0.4 0.2 98.9 4,646 More than secondary 0.3 0.0 0.1 99.6 1,325 Wealth quintile Lowest 4.0 6.0 0.4 89.7 2,274 Second 2.0 2.7 0.6 94.9 2,408 Middle 1.5 1.2 0.3 97.1 2,633 Fourth 1.0 0.3 0.2 98.5 2,702 Highest 0.2 0.3 0.1 99.4 2,868 Total 1.7 1.9 0.3 96.2 12,885 1 Total includes three women with missing information on education. Characteristics of Respondents • 47 Table 3.8.2 Use of tobacco: Men Percentage of men age 15-49 who smoke cigarettes or a pipe/cheroot or use other tobacco products and the percent distribution of cigarette smokers by number of cigarettes smoked in preceding 24 hours, according to background characteristics, Myanmar DHS 2015-16 Uses tobacco Number of men Percent distribution of men who smoke cigarettes by number of cigarettes smoked in the past 24 hours Number of cigarette smokers Background characteristic Cigarettes Pipe/ Cheroot Other tobacco 0 1-2 3-5 6-9 10+ Total Age 15-19 20.2 6.1 0.6 731 9.2 34.6 30.8 9.2 16.2 100.0 148 20-24 37.6 9.5 1.2 692 5.3 29.0 38.2 9.0 18.4 100.0 260 25-29 37.0 13.5 2.3 677 7.0 30.7 40.6 10.9 10.7 100.0 250 30-34 31.2 15.8 2.3 698 3.0 34.5 39.2 6.1 17.2 100.0 218 35-39 34.9 14.7 2.6 679 3.4 26.8 40.1 7.6 22.2 100.0 237 40-44 34.2 20.7 2.0 689 5.0 31.5 39.3 9.9 14.4 100.0 236 45-49 27.1 22.0 3.9 571 3.4 39.1 36.8 7.1 13.6 100.0 155 Residence Urban 35.0 11.3 0.7 1,350 3.2 26.4 40.3 9.6 20.5 100.0 473 Rural 30.4 15.6 2.6 3,387 5.9 34.2 37.4 8.2 14.2 100.0 1,030 States/Regions Kachin 44.8 5.0 1.3 161 0.6 22.4 46.5 9.3 21.2 100.0 72 Kayah 23.7 15.5 0.0 23 16.5 34.4 27.9 8.3 12.8 100.0 5 Kayin 48.5 6.9 1.1 115 0.7 28.8 40.9 9.5 20.1 100.0 56 Chin 43.1 15.3 5.3 39 4.8 23.9 39.1 11.0 21.3 100.0 17 Sagaing 32.9 19.1 12.0 514 6.7 39.0 39.8 6.9 7.7 100.0 169 Tanintharyi 50.7 23.9 0.0 103 3.9 20.4 45.0 10.6 20.1 100.0 52 Bago 28.1 28.0 1.5 454 33.2 30.8 21.0 7.2 7.9 100.0 128 Magway 13.0 21.1 0.3 320 (6.3) (41.8) (30.8) (11.6) (9.6) 100.0 42 Mandalay 25.8 18.1 0.0 601 1.1 46.3 35.9 8.3 8.4 100.0 155 Mon 30.9 12.0 3.4 162 3.5 33.0 34.9 7.4 21.3 100.0 50 Rakhine 47.5 9.7 0.4 222 2.4 21.0 48.3 13.6 14.8 100.0 106 Yangon 32.0 11.4 0.2 703 1.5 31.3 41.5 5.0 20.7 100.0 225 Shan 41.4 3.5 1.4 542 2.7 21.7 31.7 14.9 29.0 100.0 224 Ayeyarwady 26.6 8.6 1.2 653 0.0 34.5 49.4 3.4 12.7 100.0 174 Nay Pyi Taw 23.0 25.0 0.0 126 0.0 55.9 24.9 10.5 8.7 100.0 29 Education No education 41.8 14.7 2.3 575 4.1 26.6 35.3 8.2 25.9 100.0 240 Primary 30.0 17.8 2.9 1,684 4.2 35.6 39.2 8.4 12.6 100.0 505 Secondary 31.2 12.6 1.7 2,139 5.8 31.1 39.8 7.7 15.6 100.0 667 More than secondary 27.1 7.6 0.0 339 7.7 28.2 30.8 18.1 15.1 100.0 92 Wealth quintile Lowest 33.0 18.8 2.5 890 4.7 27.9 40.3 8.1 18.9 100.0 294 Second 31.1 16.8 3.1 916 3.1 37.2 40.0 8.9 10.8 100.0 285 Middle 29.2 16.8 2.8 979 8.0 35.0 35.5 7.1 14.4 100.0 286 Fourth 33.7 10.3 1.3 986 5.6 30.3 41.4 8.9 13.8 100.0 332 Highest 31.8 9.5 0.7 966 4.0 28.8 34.1 10.1 23.0 100.0 307 Total 31.7 14.3 2.1 4,737 5.1 31.7 38.3 8.6 16.2 100.0 1,504 Note: Figures in parentheses are based on 25-49 unweighted cases. 48 • Characteristics of Respondents Table 3.9.1 Use of betel quid: Women Percentage of women age 15-49 who chew betel quid, and the percent distribution of women who chew betel quid by number of pieces consumed in preceding 24 hours, according to background characteristics, Myanmar DHS 2015-16 Percentage of women chewing betel quid Number of women Percent distribution of women who chew betel quid by number of betel quid chewed in the past 24 hours Total Number of women Background characteristic 0 1-2 3-5 6-9 10+ Age 15-19 4.9 1,810 10.7 58.9 20.7 4.0 5.7 100.0 88 20-24 10.7 1,867 5.7 38.9 32.2 8.8 14.4 100.0 200 25-29 13.9 1,867 3.6 33.1 32.1 8.7 22.5 100.0 259 30-34 20.2 2,037 3.4 28.5 34.4 10.4 23.2 100.0 412 35-39 24.9 1,954 2.6 24.9 36.2 13.1 23.2 100.0 486 40-44 26.0 1,733 1.7 20.4 42.5 8.7 26.8 100.0 450 45-49 27.7 1,617 0.6 22.0 42.1 10.9 24.3 100.0 448 Maternity status Pregnant 17.6 466 1.5 31.7 44.7 6.9 15.2 100.0 82 Breastfeeding (not pregnant) 21.9 1,855 3.6 28.0 35.7 8.9 23.8 100.0 406 Neither 17.6 10,564 2.8 27.2 36.7 10.6 22.7 100.0 1,855 Residence Urban 12.8 3,768 3.2 22.2 29.2 15.9 29.5 100.0 483 Rural 20.4 9,117 2.8 28.9 38.8 8.7 20.8 100.0 1,860 States/Regions Kachin 5.2 374 (32.4) (25.2) (27.3) (8.8) (6.3) 100.0 19 Kayah 36.1 65 4.4 26.0 34.4 8.4 26.9 100.0 23 Kayin 41.2 303 7.1 33.6 40.9 7.4 10.9 100.0 125 Chin 12.9 102 11.5 37.5 35.4 6.3 9.3 100.0 13 Sagaing 11.5 1,410 1.8 23.0 45.8 6.5 23.0 100.0 162 Tanintharyi 17.7 283 4.1 29.0 34.4 6.5 26.0 100.0 50 Bago 25.6 1,244 1.9 18.3 44.0 11.1 24.7 100.0 318 Magway 6.4 1,081 3.0 18.7 43.0 15.6 19.8 100.0 69 Mandalay 7.3 1,541 2.1 22.1 44.1 7.7 24.0 100.0 113 Mon 21.2 463 3.0 36.1 32.8 9.1 18.9 100.0 98 Rakhine 50.2 777 4.5 32.3 36.3 9.5 17.4 100.0 390 Yangon 11.7 1,927 0.0 24.8 22.0 19.9 33.3 100.0 226 Shan 10.8 1,368 1.5 26.6 34.9 13.5 23.6 100.0 148 Ayeyarwady 30.7 1,650 1.5 32.3 36.7 7.2 22.2 100.0 506 Nay Pyi Taw 27.9 300 4.3 22.9 27.8 10.1 34.8 100.0 84 Education1 No education 28.1 1,606 1.4 24.8 39.9 13.1 20.7 100.0 452 Primary 24.7 5,305 2.3 27.6 39.0 9.0 22.1 100.0 1,311 Secondary 11.2 4,646 5.0 28.7 29.5 10.7 26.1 100.0 519 More than secondary 4.6 1,325 7.0 34.9 30.9 8.9 18.3 100.0 61 Wealth quintile Lowest 35.0 2,274 2.0 28.4 40.6 10.2 18.8 100.0 796 Second 22.8 2,408 2.2 29.0 38.7 10.4 19.7 100.0 548 Middle 16.2 2,633 2.9 29.5 36.0 7.8 23.9 100.0 427 Fourth 12.5 2,702 4.9 24.5 33.0 11.9 25.8 100.0 336 Highest 8.2 2,868 4.2 21.8 26.9 11.4 35.6 100.0 235 Total 18.2 12,885 2.9 27.5 36.8 10.2 22.6 100.0 2,343 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 Total includes three women with missing information on education. Characteristics of Respondents • 49 Table 3.9.2 Use of betel quid: Men Percentage of men age 15-49 who chew betel quid, and the percent distribution of men who chew betel quid by number of pieces consumed in preceding 24 hours, according to background characteristics, Myanmar DHS 2015-16 Percent of men chewing betel quid Percent distribution of men who chew betel quid by number of betel quid chewed in the past 24 hours Background characteristic Number of men 0 1-2 3-5 6-9 10+ Total Number of men Age 15-19 39.1 731 6.0 25.2 28.6 16.0 24.2 100.0 286 20-24 60.1 692 3.0 14.3 28.3 20.3 34.1 100.0 416 25-29 65.1 677 1.8 13.3 22.6 12.3 49.9 100.0 441 30-34 62.8 698 3.9 10.4 20.3 16.1 49.2 100.0 438 35-39 64.5 679 1.7 10.6 29.7 14.9 42.7 100.0 438 40-44 63.3 689 1.2 7.9 24.0 16.6 50.2 100.0 436 45-49 59.0 571 1.1 10.2 27.5 17.0 44.3 100.0 337 Residence Urban 57.1 1,350 2.4 8.3 17.8 17.9 53.3 100.0 771 Rural 59.7 3,387 2.6 14.2 28.6 15.5 39.1 100.0 2,021 States/Regions Kachin 33.4 161 0.8 32.5 29.3 9.0 28.4 100.0 54 Kayah 66.1 23 7.3 10.2 36.2 14.4 31.8 100.0 15 Kayin 62.4 115 1.1 16.9 33.2 17.0 31.7 100.0 72 Chin 52.4 39 33.9 16.0 23.8 7.4 19.0 100.0 20 Sagaing 57.8 514 5.2 19.6 28.4 14.5 32.4 100.0 297 Tanintharyi 55.8 103 5.1 26.9 32.6 10.5 24.8 100.0 57 Bago 75.0 454 5.1 10.1 22.3 15.8 46.6 100.0 341 Magway 54.5 320 1.1 12.9 29.3 19.7 37.0 100.0 174 Mandalay 53.7 601 0.5 11.0 24.3 18.3 45.8 100.0 323 Mon 58.2 162 0.6 20.5 31.3 15.0 32.6 100.0 94 Rakhine 79.0 222 0.0 18.9 37.4 16.7 27.0 100.0 175 Yangon 67.0 703 0.0 3.7 16.9 18.6 60.4 100.0 471 Shan 33.1 542 10.8 22.2 34.4 7.6 25.0 100.0 179 Ayeyarwady 68.2 653 0.4 7.2 23.5 15.6 53.2 100.0 445 Nay Pyi Taw 59.1 126 0.5 11.7 22.2 26.1 39.5 100.0 74 Education No education 50.8 575 1.5 17.0 32.4 15.3 33.7 100.0 292 Primary 66.3 1,684 1.8 12.6 25.4 16.7 43.3 100.0 1,117 Secondary 56.5 2,139 3.5 12.5 24.0 15.3 44.7 100.0 1,208 More than secondary 51.6 339 2.1 5.2 27.4 19.7 45.6 100.0 175 Wealth quintile Lowest 64.8 890 1.8 15.8 25.5 14.3 42.5 100.0 577 Second 62.1 916 3.0 13.1 30.0 17.8 36.1 100.0 569 Middle 59.5 979 2.2 14.2 27.8 16.8 39.0 100.0 583 Fourth 56.1 986 4.1 9.9 24.4 17.1 44.5 100.0 553 Highest 53.0 966 1.5 9.4 19.8 14.4 54.4 100.0 511 Total 58.9 4,737 2.5 12.6 25.6 16.1 43.0 100.0 2,792 50 • Characteristics of Respondents Table 3.10.1 Knowledge of tuberculosis: Women Percentage of women age 15-49 who have heard of tuberculosis (TB), and among women who have heard of TB, the percentage who know that TB is spread through the air by coughing, the percentage who believe that TB can be cured, and the percentage who have ever been told by a doctor or nurse that they have TB, according to background characteristics and maternity status, Myanmar DHS 2015-16 Among all respondents: Among respondents who have heard of TB: Background characteristic Percentage who have heard of TB Number Percentage who report that TB is spread though coughing Percentage who believe that TB can be cured Percentage who have been told by doctor/nurse that they have TB Number Age 15-19 89.6 1,810 67.3 83.1 1.9 1,621 20-24 92.8 1,867 69.3 87.9 2.4 1,732 25-29 92.9 1,867 74.1 89.5 2.6 1,735 30-34 94.7 2,037 72.5 90.0 2.2 1,929 35-39 93.8 1,954 73.4 91.3 2.9 1,832 40-44 94.6 1,733 71.5 88.1 2.6 1,639 45-49 94.2 1,617 70.7 90.7 3.0 1,523 Maternity status Pregnant 91.0 466 68.0 86.2 1.2 424 Breastfeeding (not pregnant) 91.9 1,855 67.5 84.9 1.8 1,705 Neither 93.6 10,564 72.1 89.5 2.7 9,883 Residence Urban 98.3 3,768 83.8 95.5 3.6 3,706 Rural 91.1 9,117 65.8 85.7 2.0 8,306 States/Regions Kachin 94.8 374 66.9 87.1 3.1 355 Kayah 94.7 65 64.1 85.9 2.0 61 Kayin 88.9 303 66.4 84.5 2.7 269 Chin 80.9 102 47.2 81.1 3.9 82 Sagaing 96.9 1,410 70.8 86.8 0.9 1,366 Tanintharyi 97.4 283 70.3 84.3 2.9 276 Bago 97.3 1,244 75.7 91.3 3.1 1,210 Magway 97.2 1,081 74.8 86.2 2.3 1,050 Mandalay 96.9 1,541 76.1 91.1 2.9 1,493 Mon 96.5 463 67.1 85.3 3.3 446 Rakhine 87.5 777 46.1 73.7 1.2 680 Yangon 99.1 1,927 85.2 97.4 3.5 1,910 Shan 68.0 1,368 58.8 77.5 1.9 930 Ayeyarwady 96.8 1,650 68.9 93.6 2.5 1,597 Nay Pyi Taw 95.1 300 66.1 88.8 2.1 285 Education1 No education 71.7 1,606 47.7 73.7 1.8 1,152 Primary 94.0 5,305 64.0 86.2 2.2 4,985 Secondary 97.9 4,646 79.0 92.5 2.6 4,547 More than secondary 100.0 1,325 93.1 98.0 4.0 1,325 Wealth quintile Lowest 85.5 2,274 53.2 80.1 2.0 1,945 Second 90.9 2,408 63.3 84.4 1.7 2,189 Middle 94.4 2,633 70.2 88.4 1.9 2,485 Fourth 96.1 2,702 77.3 91.8 2.7 2,595 Highest 97.5 2,868 85.7 95.5 3.9 2,797 Total 93.2 12,885 71.3 88.7 2.5 12,012 1 Total includes three women with missing information on education. Characteristics of Respondents • 51 Table 3.10.2 Knowledge of tuberculosis: Men Percentage of men age 15-49 who have heard of tuberculosis (TB), and among men who have heard of TB, the percentage who know that TB is spread through the air by coughing, the percentage who believe that TB can be cured, and the percentage who have ever been told by a doctor or nurse that they have TB, according to background characteristics, Myanmar DHS 2015-16 Among all respondents: Among respondents who have heard of TB: Background characteristic Percentage who have heard of TB Number Percentage who report that TB is spread though coughing Percentage who believe that TB can be cured Percentage who have been told by doctor/nurse that they have TB Number Age 15-19 88.3 731 51.7 83.7 4.3 646 20-24 89.7 692 63.5 89.4 3.2 620 25-29 95.0 677 64.4 89.4 3.1 644 30-34 91.6 698 64.0 90.7 3.9 639 35-39 92.6 679 65.7 88.1 3.3 629 40-44 93.5 689 65.1 91.0 3.3 644 45-49 93.8 571 68.5 91.0 4.5 535 Residence Urban 97.3 1,350 76.7 93.6 5.6 1,314 Rural 89.8 3,387 57.2 87.0 2.8 3,043 States/Regions Kachin 93.4 161 62.9 82.7 4.2 150 Kayah 96.3 23 43.4 79.0 2.7 22 Kayin 81.4 115 55.8 78.8 3.1 94 Chin 85.8 39 35.9 86.2 6.1 33 Sagaing 95.3 514 59.0 89.3 3.2 490 Tanintharyi 98.2 103 55.3 82.0 5.7 101 Bago 98.6 454 65.4 93.9 6.3 448 Magway 94.9 320 61.0 89.7 1.2 304 Mandalay 94.9 601 65.1 86.4 4.2 570 Mon 95.3 162 59.5 87.4 4.6 154 Rakhine 92.5 222 57.0 87.4 1.3 205 Yangon 99.6 703 81.0 98.2 3.1 700 Shan 66.8 542 58.0 74.8 4.1 362 Ayeyarwady 92.9 653 55.1 90.7 3.1 607 Nay Pyi Taw 92.6 126 57.7 90.1 3.1 116 Education No education 69.8 575 41.6 74.0 2.6 401 Primary 91.3 1,684 52.2 85.5 3.2 1,537 Secondary 97.2 2,139 71.0 92.9 4.2 2,079 More than secondary 100.0 339 90.0 99.1 3.3 339 Wealth quintile Lowest 85.3 890 44.5 82.9 2.6 759 Second 88.7 916 55.8 86.2 3.4 813 Middle 93.3 979 62.4 87.7 2.6 914 Fourth 94.5 986 67.2 90.2 3.3 932 Highest 97.2 966 81.2 96.5 6.0 939 Total 92.0 4,737 63.1 89.0 3.6 4,357 Marriage and Sexual Activity • 53 MARRIAGE AND SEXUAL ACTIVITY 4 Key Findings  Age at first marriage: The median age at first marriage is 22.1 for women and 24.5 for men, which means that women tend to marry 2 years earlier than men. Fourteen percent of women and 5% of men age 45-49 have never married.  Polygyny: Five percent of married women report that their husbands have other wives.  Sexual initiation: The median age at first sexual intercourse is slightly later than the median age at first marriage for women and earlier for men, suggesting that women, on average, have first sexual intercourse only after marriage and men, on average, engage in sex before marriage. arriage and sexual activity help determine the extent to which women are exposed to the risk of pregnancy. Thus, they are important determinants of fertility levels. However, the timing and circumstances of marriage and sexual activity also have profound consequences for women’s and men’s lives. 4.1 MARITAL STATUS Currently married Women and men who report being married or living together with a partner as though married at the time of the survey Sample: Women and men age 15-49 In Myanmar, 60% of women age 15-49 and 62% of men age 15-49 are married. Three percent of women and 2% of men are divorced or separated, and 3% of women and 1% of men are widowed. About one-third of women and men have never married (Figure 4.1). Not all women in Myanmar get married, although most men do: even among those age 45-49, 14% of women are never married, compared with only 5% of men. Seven percent of women age 40-44 and 10% of women age 45-49 are widows, but only 2% of men in this age group are widowers. This is likely because women marry men who are older than themselves, and widowers are generally more likely to re-marry than women who are widowed (Table 4.1). The proportion of the M Figure 4.1 Marital status Percent distribution of women and men age 15-49 Never married 33% Married 60% Divorced/ separated 3% Widowed 3% Women Never married 35% Married 62% Divorced/ separated 2% Widowed 1% Men 54 • Marriage and Sexual Activity population that is currently married increases with age, and by age 45-49, 72% of women and 90% of men are currently married. At age 15-19, the proportion of women who are married is two and a half times that of men (13% versus 5%). Early marriage increases the risk of teenage pregnancy which can have a profound effect on the health and lives of young women. 4.2 POLYGYNY Polygyny Women who report that their husband has other wives are considered to be in a polygynous marriage. Sample: Currently married women age 15-49 In the MDHS, currently married women were asked how many wives their husband had, and currently married men were also asked about the number of their wives. Results show that polygyny is relatively uncommon in Myanmar. Only 5% of currently married women said their husbands have more than one wife (Table 4.2.1), and 4% of currently married men said that they have more than one wife (Table 4.2.2). Patterns by background characteristics  A higher prevalence of polygyny is found among older age groups for both sexes. Six percent of married women age 45-49 say that their husband has one or more co-wives, and 8% of men age 45-49 say that they have more than one wife (Table 4.2.1 and Table 4.2.2).  As reported by women, the prevalence of polygyny is slightly higher in rural areas (6%) than in urban areas (4%), but the proportion of married men with more than one wife does not vary by rural and urban residence.  The proportion of married women who have one or more co-wives ranges from a high of 9% in Shan State, followed by 7% each for women in Bago Region, Rakhine State, Chin State, and Magway Region to a low of 1% in Kayah State (Figure 4.2). The pattern of variation in polygyny by states and regions according to men’s reports is somewhat different from the pattern based on women’s reports. According to men’s reports, polygyny is highest in Kayin State (10%) followed by Kachin State (9%) and Mandalay Region (8%), and lowest in Mon State, where no man reported having more than one wife.  Both women and men with no education are more likely than those with education to have polygynous marriages. According to women’s reports, polygyny is less than 1% among married women who have more than secondary education but is 11% among women with no education. According to men’s Figure 4.2 Polygyny by states and regions Percent of currently married women age 15-49 in a polygynous union Marriage and Sexual Activity • 55 reports, the proportion of men with more than one wife is also 1% among men with more than secondary education but is 6% among men with no education.  The prevalence of polygynous marriages declines with increasing wealth among both women and men. Nine percent of women in the lowest wealth quintile report having a co-wife compared with 3% of those in the highest wealth quintile. Among men, the proportion who report having more than one wife is 6% for men in the lowest wealth quintile and 2% for men in the highest wealth quintile. 4.3 AGE AT FIRST MARRIAGE Median age at first marriage Age by which half of respondents have been married. Sample: Women age 25-49 and men age 25-49 The median age at first marriage for women age 25-49 is 22.1, and for men age 25-49 the median age is 24.5. Women first marry more than 2 years earlier than men do (Table 4.3). Child marriage, that is marriage before age 18, is still quite common among Myanmar women: 19% of women age 20-49 were married before age 18. Among men age 20-49, by contrast, only 7% were married before their 18th birthday. Even though marriage before 18 is common, very early marriage (before age 15) is not. Patterns by background characteristics  The median age at first marriage among rural women is 21.3, 3 years younger than the median age at first marriage among urban women, which is 24.5 (Table 4.4).  The median age at first marriage among women from Mandalay Region is 24.0, and among those from Yangon Region is 24.2, while women from Shan State and Rakhine State marry earlier, at age 20.4 and age 20.3. Among men, the median age at first marriage varies by about one year across states and regions.  The median age at first marriage increases with education and wealth quintile among women. Women with secondary education marry four years later than women with no education (23.6 versus 19.3) and women in the fourth wealth quintile marry 3 years later than women in the lowest wealth quintile. 4.4 AGE AT FIRST SEXUAL INTERCOURSE Median age at first sexual intercourse Age by which half of respondents have had sexual intercourse. Sample: Women age 25-49 and men age 25-49 56 • Marriage and Sexual Activity The median age at first sexual intercourse among women age 25-49 is 22.5, older than the median age at first marriage (22.1) for women in this age group. By contrast, the median age at first sexual intercourse among men age 25-49 is 23.6 years, one year earlier than their median age at first marriage (24.5) (Figure 4.3). By age 18, 17% of women age 25-49 have had sexual intercourse (Table 4.5). This percentage is lower than that of women who are married by age 18 (19%) (Table 4.3). Eight percent of men age 25-49 have had sexual intercourse before the age of 18 (Table 4.5), which is higher than the percentage of men married by age 18 (7%) (Table 4.3). These findings suggest that women, on average, first have sexual intercourse after they are married, whereas men, on average, do so before they are married. The percentage who have never had sexual intercourse is 19% among women age 25-49 and as high as 14% among women age 45-49. Among men age 25-49 the percentage who have never had sex is 12%, but only 5% of men age 45-49 have never had sex (Table 4.5). Patterns by background characteristics  The median age at first sexual intercourse for rural women age 25-49 is 21.7, 3 years earlier than urban women (25.0). Similarly, rural men first have sex 2 years earlier than urban men (23.1 versus 24.8) (Table 4.6).  Regional variation in the median age at first sex is sizeable: it varies from age 20.6 for women in Shan State and age 20.7 in Rakhine State to age 24.6 for women in Yangon Region and age 24.4 in Mandalay Region. For men, the median age at first sex varies from age 21.7 in Chin State and age 22.3 in Kachin State to age 24.7 in Yangon Region and Tanintharyi Region to age 25.0 in Kayin State.  Median age at first sex among women and men increases with increasing education. Women with no education have a median age at first sexual intercourse of 19.5, 4 years younger than women with secondary education (median age of 23.9). The educational differential for men is much less, only 2 years.  The median age at first sex tends to increase with wealth for both women and men. 4.5 RECENT SEXUAL ACTIVITY Sexual activity exposes women to the risk of pregnancy if no contraceptive method is being used. Information on timing of last sexual intercourse can be used to refine measures of exposure to pregnancy. In the 2015-16 MDHS, women and men age 15-49 were asked when they last had sexual intercourse. Forty-seven percent of women and 53% of men age 15-49 had sexual intercourse during the 4 weeks preceding the survey; 33% of women and 31% of men had never had sex. An additional 11% of women and 10% of men had not had sex recently but had it in the year before the survey (Table 4.7.1 and Table 4.7.2). Patterns by background characteristics  Recent sexual activity among women increases sharply by age from 11% for women age 15-19 to 62% for women age 35-39, before falling to 49% for women age 45-49. For men, recent sexual activity also increases sharply from 5% at age 15-19 to 75% at age 35-39, after which it falls to 66% for men age 45-49. Figure 4.3 Median age at first sex and first marriage 22.5 22.1 23.6 24.5 Median age at first sex Median age at first marriage Median age in years Women age 25-49 Men age 25-49 Marriage and Sexual Activity • 57  Except for a slight decline after 25 years of marriage, recent sexual activity does not vary greatly by duration of marriage for either sex (Table 4.7.1 and Table 4.7.2).  Recent sexual activity is more common in rural than in urban areas for both women and men.  The proportion of women and men who recently had sex varies by states and regions. Recent sexual activity is highest in Nay Pyi Taw and Bago Region (52%) and lowest in Kachin State (38%) for women and is highest in Bago Region (60%) and lowest in Kachin State (42%) for men.  The proportion of women who had sexual intercourse in the 4 weeks before the survey decreases with increasing education level. Although the proportion of men with recent sexual activity does not vary consistently by education, it is lower among men with secondary schooling than among less educated men.  The likelihood of having had sex recently among both women and men is lower in the higher wealth quintiles than in the lower quintiles. Among women, the proportion is 39% in the highest quintile and 55% in the lowest quintile; the corresponding proportions for men are 47% in the highest wealth quintile and 59% in the lowest wealth quintile. LIST OF TABLES For more information on marriage and sexual activity, see the following tables:  Table 4.1 Current marital status  Table 4.2.1 Number of women’s co-wives  Table 4.2.2 Number of men’s wives  Table 4.3 Age at first marriage  Table 4.4 Median age at first marriage by background characteristics  Table 4.5 Age at first sexual intercourse  Table 4.6 Median age at first sexual intercourse by background characteristics  Table 4.7.1 Recent sexual activity: Women  Table 4.7.2 Recent sexual activity: Men 58 • Marriage and Sexual Activity Table 4.1 Current marital status Percent distribution of women and men age 15-49 by current marital status, according to age, Myanmar DHS 2015-16 Marital status Total Percentage of respondents currently in union Number of respondents Age Never married Married Divorced Separated Widowed WOMEN 15-19 86.4 12.6 0.8 0.1 0.1 100.0 12.6 1,810 20-24 51.9 44.6 2.8 0.4 0.3 100.0 44.6 1,867 25-29 27.5 67.4 3.5 0.4 1.2 100.0 67.4 1,867 30-34 20.9 73.9 3.0 0.2 1.9 100.0 73.9 2,037 35-39 16.9 75.9 3.5 0.3 3.4 100.0 75.9 1,954 40-44 14.7 74.0 4.2 0.5 6.5 100.0 74.0 1,733 45-49 13.5 72.3 3.3 0.5 10.4 100.0 72.3 1,617 Total 33.2 60.2 3.0 0.3 3.2 100.0 60.2 12,885 MEN 15-19 94.7 5.0 0.3 0.0 0.0 100.0 5.0 731 20-24 65.2 33.0 1.4 0.4 0.1 100.0 33.0 692 25-29 31.5 66.0 2.1 0.1 0.3 100.0 66.0 677 30-34 18.3 78.6 2.5 0.0 0.5 100.0 78.6 698 35-39 10.5 86.5 2.4 0.3 0.3 100.0 86.5 679 40-44 8.8 86.2 2.8 0.2 2.0 100.0 86.2 689 45-49 5.2 90.3 1.8 0.5 2.1 100.0 90.3 571 Total 34.7 62.4 1.9 0.2 0.7 100.0 62.4 4,737 Table 4.2.1 Number of women’s co-wives Percent distribution of currently married women age 15-49 by number of co-wives, according to background characteristics, Myanmar DHS 2015-16 Number of co-wives Number of women Background characteristic 0 1 2+ Don’t know/ missing Total Age 15-19 95.0 3.5 0.2 1.3 100.0 227 20-24 95.2 4.2 0.2 0.4 100.0 834 25-29 96.0 3.2 0.9 0.0 100.0 1,258 30-34 95.3 4.1 0.2 0.3 100.0 1,505 35-39 93.2 6.3 0.4 0.1 100.0 1,482 40-44 93.0 5.7 1.0 0.2 100.0 1,283 45-49 93.6 5.2 1.0 0.2 100.0 1,169 Residence Urban 95.9 3.8 0.1 0.2 100.0 2,022 Rural 93.8 5.1 0.8 0.2 100.0 5,737 States/Regions Kachin 94.2 4.3 1.3 0.2 100.0 238 Kayah 98.7 0.9 0.2 0.2 100.0 40 Kayin 95.2 4.5 0.3 0.0 100.0 201 Chin 93.5 5.2 1.3 0.0 100.0 66 Sagaing 95.2 4.1 0.3 0.3 100.0 828 Tanintharyi 93.4 5.4 0.5 0.7 100.0 174 Bago 92.3 6.9 0.4 0.4 100.0 780 Magway 93.5 5.9 0.6 0.0 100.0 642 Mandalay 96.2 3.3 0.4 0.0 100.0 838 Mon 95.2 4.5 0.4 0.0 100.0 278 Rakhine 92.9 6.0 0.7 0.4 100.0 454 Yangon 97.6 2.2 0.2 0.0 100.0 1,042 Shan 90.6 7.1 1.5 0.9 100.0 901 Ayeyarwady 93.9 5.2 0.8 0.1 100.0 1,083 Nay Pyi Taw 98.0 1.6 0.2 0.2 100.0 195 Education1 No education 89.0 9.0 1.6 0.4 100.0 1,193 Primary 93.8 5.3 0.7 0.2 100.0 3,656 Secondary 96.9 2.8 0.1 0.3 100.0 2,285 More than secondary 98.7 0.9 0.0 0.4 100.0 621 Wealth quintile Lowest 90.5 7.7 1.5 0.3 100.0 1,622 Second 94.1 4.7 0.9 0.3 100.0 1,586 Middle 95.1 4.4 0.4 0.1 100.0 1,556 Fourth 95.9 3.6 0.2 0.2 100.0 1,509 Highest 96.4 3.3 0.0 0.3 100.0 1,487 Total 94.4 4.8 0.6 0.2 100.0 7,759 1 Total includes three women with missing information on education. Marriage and Sexual Activity • 59 Table 4.2.2 Number of men’s wives Percent distribution of currently married men age 15-49 by number of wives, according to background characteristics, Myanmar DHS 2015-16 Background characteristic Number of wives Total Number of men 1 2+ Age 15-19 (100.0) (0.0) 100.0 36 20-24 97.4 2.6 100.0 228 25-29 98.9 1.1 100.0 447 30-34 97.5 2.5 100.0 549 35-39 97.5 2.5 100.0 587 40-44 94.1 5.9 100.0 593 45-49 92.3 7.7 100.0 516 Residence Urban 96.0 4.0 100.0 767 Rural 96.2 3.8 100.0 2,190 States/Regions Kachin 91.1 8.9 100.0 93 Kayah 99.4 0.6 100.0 15 Kayin 90.2 9.8 100.0 70 Chin 95.6 4.4 100.0 24 Sagaing 97.4 2.6 100.0 308 Tanintharyi 98.4 1.6 100.0 57 Bago 99.3 0.7 100.0 309 Magway 94.4 5.6 100.0 215 Mandalay 92.4 7.6 100.0 358 Mon 100.0 0.0 100.0 82 Rakhine 98.8 1.2 100.0 139 Yangon 98.8 1.2 100.0 413 Shan 97.1 2.9 100.0 371 Ayeyarwady 93.5 6.5 100.0 419 Nay Pyi Taw 96.8 3.2 100.0 81 Education No education 93.6 6.4 100.0 430 Primary 96.4 3.6 100.0 1,260 Secondary 96.4 3.6 100.0 1,085 More than secondary 98.6 1.4 100.0 181 Wealth quintile Lowest 94.4 5.6 100.0 627 Second 95.9 4.1 100.0 605 Middle 95.8 4.2 100.0 603 Fourth 96.7 3.3 100.0 590 Highest 98.2 1.8 100.0 531 Total 96.1 3.9 100.0 2,957 Note: Figures in parentheses are based on 25-49 unweighted cases. 60 • Marriage and Sexual Activity Table 4.3 Age at first marriage Percentage of women and men age 15-49 who were first married, by specific exact ages, and median age at first marriage, according to current age, Myanmar DHS 2015-16 Percentage first married by exact age: Percentage never married Number of respondents Median age at first marriage Current age 15 18 20 22 25 WOMEN 15-19 1.1 na na na na 86.4 1,810 a 20-24 1.9 16.0 30.5 na na 51.9 1,867 a 25-29 3.5 18.3 33.2 47.9 64.2 27.5 1,867 22.3 30-34 4.4 18.6 33.9 49.0 62.6 20.9 2,037 22.2 35-39 2.9 19.2 34.7 47.2 62.2 16.9 1,954 22.5 40-44 2.8 20.7 36.8 52.0 66.2 14.7 1,733 a 45-49 3.1 19.2 37.6 52.3 64.6 13.5 1,617 21.6 20-49 3.1 18.6 34.3 na na 24.5 11,075 a 25-49 3.4 19.2 35.1 49.5 63.9 18.9 9,208 22.1 MEN 15-19 0.0 na na na na 94.7 731 a 20-24 0.0 5.0 14.8 na na 65.2 692 a 25-29 0.0 5.8 15.5 31.7 52.7 31.5 677 24.6 30-34 0.0 7.6 18.4 32.1 52.5 18.3 698 24.7 35-39 0.0 8.1 18.3 33.1 52.4 10.5 679 24.6 40-44 0.0 7.8 21.2 39.3 54.9 8.8 689 a 45-49 0.0 6.0 17.1 36.0 54.8 5.2 571 24.3 20-49 0.0 6.7 17.6 na na 23.8 4,006 a 25-49 0.0 7.1 18.1 34.4 53.4 15.2 3,314 24.5 Note: The age at first marriage is defined as the age at which the respondent began living with her/his first spouse. na = Not applicable due to censoring a = Omitted because less than 50% of the women or men began living with their spouse for the first time before reaching the beginning of the age group Marriage and Sexual Activity • 61 Table 4.4 Median age at first marriage by background characteristics Median age at first marriage among women and men age 25- 49, according to background characteristics, Myanmar DHS 2015-16 Women age 25-49 Men age 25-49 Background characteristic Residence Urban 24.5 a Rural 21.3 23.8 States/Regions Kachin 21.7 a Kayah 22.1 a Kayin 21.8 24.9 Chin 21.3 24.1 Sagaing 22.0 23.8 Tanintharyi 22.1 25.0 Bago 21.8 24.5 Magway 22.9 23.8 Mandalay 24.0 24.2 Mon 22.3 24.9 Rakhine 20.3 23.7 Yangon 24.2 a Shan 20.4 23.8 Ayeyarwady 21.3 24.4 Nay Pyi Taw 21.7 24.7 Education No education 19.3 23.1 Primary 21.1 23.2 Secondary 23.6 a More than secondary a a Wealth quintile Lowest 19.8 22.8 Second 20.7 22.8 Middle 22.1 24.6 Fourth 22.9 a Highest a a Total 22.1 24.5 Note: The age at first marriage is defined as the age at which the respondent began living with her/his first spouse. a = Omitted because less than 50% of the respondents began living with their spouse for the first time before reaching the beginning of the age group 62 • Marriage and Sexual Activity Table 4.5 Age at first sexual intercourse Percentage of women and men age 15-49 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, Myanmar DHS 2015-16 Percentage who had first sexual intercourse by exact age: Percentage who never had intercourse Median age at first intercourse Current age 15 18 20 22 25 Number WOMEN 15-19 0.9 na na na na 86.4 1,810 a 20-24 1.3 14.0 29.4 na na 51.7 1,867 a 25-29 2.1 16.3 31.7 46.1 62.1 27.2 1,867 22.8 30-34 2.0 16.0 32.4 46.0 60.0 20.9 2,037 22.9 35-39 2.0 17.2 33.4 45.9 59.9 16.9 1,954 22.7 40-44 1.5 17.9 34.0 48.8 62.1 14.6 1,733 a 45-49 2.2 17.9 37.3 50.8 62.3 13.5 1,617 21.9 20-49 1.9 16.5 32.9 na na 24.4 11,075 a 25-49 2.0 17.0 33.6 na na 18.9 9,208 22.5 15-24 1.1 na na na na 68.8 3,677 a MEN 15-19 0.5 na na na na 92.5 731 a 20-24 0.0 5.6 20.5 na na 56.2 692 a 25-29 0.1 6.3 20.0 39.4 61.7 24.7 677 23.5 30-34 0.5 7.8 21.2 37.3 56.6 14.7 698 24.0 35-39 0.8 8.2 20.1 35.6 54.8 8.2 679 24.0 40-44 0.6 7.9 22.5 43.4 57.6 7.3 689 a 45-49 0.0 8.6 21.7 44.1 60.1 4.6 571 22.9 20-49 0.4 7.4 21.0 na na 19.7 4,006 a 25-49 0.4 7.7 21.1 na na 12.1 3,314 23.6 15-24 0.3 na na na na 74.9 1,423 a na = Not applicable due to censoring a = Omitted because less than 50% of the respondents had sexual intercourse for the first time before reaching the beginning of the age group Marriage and Sexual Activity • 63 Table 4.6 Median age at first sexual intercourse by background characteristics Median age at first sexual intercourse among women age 25-49, and median age at first sexual intercourse among men age 25-49, according to background characteristics, Myanmar DHS 2015-16 Women’s age Men’s age Background characteristic 25-49 25-49 Residence Urban 25.0 24.8 Rural 21.7 23.1 States/Regions Kachin 21.2 22.3 Kayah 21.9 a Kayin 22.0 25.0 Chin 21.5 21.7 Sagaing 22.2 23.6 Tanintharyi 22.2 24.7 Bago 22.1 23.6 Magway 23.3 23.7 Mandalay 24.4 23.0 Mon 22.9 23.5 Rakhine 20.7 22.9 Yangon 24.6 24.7 Shan 20.6 22.9 Ayeyarwady 21.9 23.7 Nay Pyi Taw 21.9 24.0 Education No education 19.5 22.0 Primary 21.4 22.8 Secondary 23.9 24.1 More than Secondary a a Wealth quintile Lowest 20.1 22.5 Second 20.9 22.5 Middle 22.3 23.8 Fourth 23.5 24.2 Highest a a Total 22.5 23.6 a = Omitted because less than 50% of the respondents had intercourse for the first time before reaching the beginning of the age group 64 • Marriage and Sexual Activity Table 4.7.1 Recent sexual activity: Women Percent distribution of women age 15-49 by timing of last sexual intercourse, according to background characteristics, Myanmar DHS 2015-16 Background characteristic Timing of last sexual intercourse Never had sexual intercourse Number of women Within the past 4 weeks Within 1 year1 One or more years Missing Total Age 15-19 10.5 1.8 0.9 0.4 86.4 100.0 1,810 20-24 36.0 8.1 3.7 0.4 51.7 100.0 1,867 25-29 53.6 12.5 6.2 0.6 27.2 100.0 1,867 30-34 58.4 12.2 7.8 0.7 20.9 100.0 2,037 35-39 61.7 11.9 8.9 0.6 16.9 100.0 1,954 40-44 54.7 14.4 15.4 0.9 14.6 100.0 1,733 45-49 49.2 17.6 19.0 0.7 13.5 100.0 1,617 Marital status Never married 0.1 0.1 0.1 0.0 99.7 100.0 4,278 Married 77.1 17.1 4.8 1.0 0.0 100.0 7,759 Divorced/separated/ widowed 1.6 11.9 86.1 0.4 0.0 100.0 848 Marital duration2 0-4 years 79.5 16.5 3.0 1.1 0.0 100.0 1,474 5-9 years 78.5 15.8 4.7 1.0 0.0 100.0 1,388 10-14 years 79.9 14.5 4.3 1.3 0.0 100.0 1,321 15-19 years 79.2 15.1 4.8 1.0 0.0 100.0 1,228 20-24 years 74.9 19.3 5.1 0.8 0.0 100.0 1,004 25+ years 68.9 22.2 8.4 0.5 0.0 100.0 899 Married more than once 72.7 21.2 4.8 1.2 0.0 100.0 445 Residence Urban 40.9 10.1 9.1 0.8 39.2 100.0 3,768 Rural 48.9 11.5 8.4 0.6 30.6 100.0 9,117 States/Regions Kachin 38.4 16.7 9.7 7.0 28.1 100.0 374 Kayah 39.7 11.2 8.0 9.8 31.4 100.0 65 Kayin 46.7 15.6 11.4 0.1 26.2 100.0 303 Chin 49.2 12.6 10.7 0.7 26.9 100.0 102 Sagaing 46.9 10.1 8.0 0.1 34.9 100.0 1,410 Tanintharyi 40.4 18.4 8.3 0.3 32.6 100.0 283 Bago 52.2 8.0 7.7 0.2 31.9 100.0 1,244 Magway 44.2 13.3 7.5 0.3 34.8 100.0 1,081 Mandalay 41.0 11.9 7.9 0.0 39.2 100.0 1,541 Mon 40.0 12.8 11.2 1.0 35.0 100.0 463 Rakhine 45.2 12.7 11.0 0.2 30.9 100.0 777 Yangon 46.1 5.9 8.0 0.2 39.8 100.0 1,927 Shan 49.8 12.5 10.0 1.2 26.4 100.0 1,368 Ayeyarwady 51.0 12.3 8.2 0.6 27.9 100.0 1,650 Nay Pyi Taw 52.4 11.7 7.8 0.1 27.9 100.0 300 Education3 No education 55.2 16.2 12.9 1.0 14.8 100.0 1,606 Primary 54.2 12.1 9.7 0.5 23.5 100.0 5,305 Secondary 38.3 8.7 6.8 0.6 45.7 100.0 4,646 More than secondary 34.8 9.4 5.3 0.7 49.8 100.0 1,325 Wealth quintile Lowest 55.0 14.3 9.6 0.6 20.5 100.0 2,274 Second 51.8 11.2 9.4 0.6 27.0 100.0 2,408 Middle 46.4 10.5 8.3 0.3 34.5 100.0 2,633 Fourth 43.6 9.6 8.2 0.6 38.0 100.0 2,702 Highest 38.5 10.5 7.7 0.8 42.5 100.0 2,868 Total 46.6 11.1 8.6 0.6 33.1 100.0 12,885 1 Excludes women who had sexual intercourse within the last 4 weeks 2 Excludes women who are not currently married 3 Total includes three women with missing information on education Marriage and Sexual Activity • 65 Table 4.7.2 Recent sexual activity: Men Percent distribution of men age 15-49 by timing of last sexual intercourse, according to background characteristics, Myanmar DHS 2015-16 Timing of last sexual intercourse Never had sexual intercourse Total Background characteristic Within the past 4 weeks Within 1 year1 One or more years Missing Number of men Age 15-19 4.8 2.0 0.7 0.1 92.5 100.0 731 20-24 32.5 6.6 4.1 0.5 56.2 100.0 692 25-29 59.8 8.1 6.9 0.6 24.7 100.0 677 30-34 66.6 12.7 5.5 0.5 14.7 100.0 698 35-39 75.3 10.3 5.7 0.5 8.2 100.0 679 40-44 70.2 13.8 8.2 0.5 7.3 100.0 689 45-49 66.1 19.3 9.3 0.7 4.6 100.0 571 Marital status Never married 1.9 3.2 5.6 0.2 89.1 100.0 1,646 Married 83.4 13.9 2.1 0.6 0.0 100.0 2,957 Divorced/separated/ widowed 3.5 11.7 83.9 0.0 0.9 100.0 135 Marital duration2 0-4 years 85.2 13.2 0.9 0.7 0.0 100.0 605 5-9 years 86.2 11.8 1.4 0.7 0.0 100.0 577 10-14 years 88.2 10.3 1.3 0.2 0.0 100.0 549 15-19 years 83.5 13.4 2.1 1.0 0.0 100.0 437 20-24 years 81.2 14.3 4.1 0.5 0.0 100.0 397 25+ years 66.7 26.3 6.6 0.4 0.0 100.0 227 Married more than once 79.0 18.6 1.3 1.1 0.0 100.0 165 Residence Urban 47.0 11.3 6.9 0.7 34.0 100.0 1,350 Rural 55.1 9.6 5.1 0.4 29.8 100.0 3,387 States/Regions Kachin 41.5 17.3 9.1 1.9 30.3 100.0 161 Kayah 43.5 8.3 3.8 11.7 32.7 100.0 23 Kayin 49.1 12.8 3.7 0.0 34.5 100.0 115 Chin 42.5 18.1 8.0 2.3 29.2 100.0 39 Sagaing 51.3 9.4 5.5 0.0 33.7 100.0 514 Tanintharyi 45.9 8.1 6.9 1.6 37.4 100.0 103 Bago 59.8 10.5 4.2 0.0 25.5 100.0 454 Magway 54.7 9.0 7.0 1.4 27.9 100.0 320 Mandalay 50.6 9.6 7.0 0.6 32.2 100.0 601 Mon 42.1 10.0 5.2 2.0 40.7 100.0 162 Rakhine 58.2 6.0 5.5 0.0 30.3 100.0 222 Yangon 54.5 7.9 2.8 0.3 34.6 100.0 703 Shan 52.2 14.9 8.6 0.0 24.3 100.0 542 Ayeyarwady 55.1 8.1 4.9 0.0 31.9 100.0 653 Nay Pyi Taw 53.6 14.2 5.4 0.3 26.5 100.0 126 Education No education 61.0 11.8 7.3 0.2 19.8 100.0 575 Primary 62.9 11.8 4.6 0.7 20.1 100.0 1,684 Secondary 43.7 8.3 6.2 0.4 41.4 100.0 2,139 More than secondary 46.9 10.2 4.9 0.2 37.9 100.0 339 Wealth quintile Lowest 59.1 11.2 4.0 0.4 25.2 100.0 890 Second 54.9 11.1 5.5 0.7 27.8 100.0 916 Middle 52.6 8.2 6.1 0.1 33.0 100.0 979 Fourth 51.2 9.6 4.8 0.4 33.9 100.0 986 Highest 46.9 10.6 7.7 0.6 34.2 100.0 966 Total 52.8 10.1 5.6 0.5 31.0 100.0 4,737 1 Excludes men who had sexual intercourse within the last 4 weeks 2 Excludes men who are not currently married Fertility • 67 FERTILITY 5 Key Findings  Total fertility rate: The current total fertility rate in Myanmar is 2.3 children per woman: 1.9 children in urban areas and 2.4 children in rural areas. Fertility peaks in the age group 25-29.  Patterns of fertility: Fertility levels are markedly lower among highly educated women and women living in wealthy households compared with other women.  Birth intervals: In Myanmar, intervals between births are generally quite long, with the median birth interval being 49 months. Thirty-two percent of births occur within 3 years of a previous birth, and only 13% occur within 24 months.  Age at first birth: The median age of a woman at her first birth is 24.7 years; only 7% of women give birth before they are 18. he number of children that a woman bears depends

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