Philippines - Demographic and Health Survey - 1994

Publication date: 1994

Philippines National Demographic Survey 1993 ® National Statistics Office ®DHS Demographic and Health Surveys Macro International Inc. REPUBLIC OF THE PHILIPPINES National Demographic Survey 1993 National Statistics Office Manila, Philippines Macro InteYnational Inc. Catverton, Maryland USA May 1994 This report summarizes the findings of the 1993 National Demographic Survey (NDS) undertaken by the Na- tional Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other concerned agencies in the Philippine government. Funding for the 1993 NDS was provided by the U.S. Agency for International Development. The 1993 NDS is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect, analyze, and disseminate demographic data on fertility, family planning, and maternal and child health. Additional information on the 1993 NDS may be obtained from the National Statistics Office, Solicarel Building,Ramon Magsaysay Boulevard, Santa Mesa, Manila, Philippines. Additional information about the DHS program may be obtained by writing to: Macro International Inc., 11785 Beltsville Drive, Calverton, MD 20705-3119, US A (Telephone 301-572-0200, Fax 301-572-0999). Recommended citation: National Statistics Office (NSO) [Philippines] and Macro International Inc. (MI). 1994. National Demographic Survey 1993. Calverton, Maryland: NSO and MI. CONTENTS Page Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Summary and Recommendat ions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Map of Philippines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii i CHAPTER 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Geography, history, and economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I Population growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Population polices and programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Health plan and programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Objectives and organization of the survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Sample design and implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Training and fieldwork . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g Data processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Response rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 CHAPTER2 2.1 2.2 2.3 BACKGROUND CHARACTERIST ICS OF HOUSEHOLDS AND RESPONDENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Population composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 CHAPTER3 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 FERT IL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Current fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Fertility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Fertility trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Fertility by marital duration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Birth intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Teenage fertility . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Children born to teenagers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 CHAPTER 4 4.1 4.2 FAMILY PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Knowledge of family planning methods and their sources . . . . . . . . . . . . . . . . . . . . . . 39 Ever use of family planning methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 iii 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 Page Current use of family planning methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Number of children at first use of family planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Problems with current method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 T iming of sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Source of supply of modem contraceptive methods currently used . . . . . . . . . . . . . . . 49 Contraceptive discontinuation rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Intentions for future family planning use among nonusers . . . . . . . . . . . . . . . . . . . . . . 52 Family planning messages on radio and television . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 CHAPTER 5 5,1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 OTHER PROXIMATE DETERMINANTS OF FERT IL ITY . . . . . . . . . . . . . . . . 59 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Marital exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Median age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Recent sexual activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Postpartum amenorrhea, abstinence, and insusceptibility . . . . . . . . . . . . . . . . . . . . . . . 66 Median duration of postpartum amenorrhea, abstinence and insusceptibility . . . . . . . . 67 Termination of exposure to pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 CHAPTER6 6.1 6.2 6.3 6.4 FERT IL ITY PREFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Desire for more children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Demand for family plarming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Ideal number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Unplanned and unwanted fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 CHAPTER 7 7.1 7.2 7.3 7.4 7.5 INFANT AND CHILD MORTAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Levels and trends in infant and child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Infant and child mortality differentials by socioeconomic characteristics . . . . . . . . . . 84 Infant and child mortality differentials by demographic and health-related characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 High-risk fertility behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 CHAPTER 8 8.1 8.2 8.3 8.4 MATERNAL AND CHILD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Tetanus immunization of pregnant women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Delivery assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Immunization of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 iv 8.5 8.6 8.7 Page Prevalence of fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Acute respiratory infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Diarrheal disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 CHAPTER 9 9.1 9.2 INFANT FEEDING AND SUPPLEMENTATION . . . . . . . . . . . . . . . . . . . . . . . . 111 Prevalence of breastfeeding and supplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Duration of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 CHAPTERIO 10.1 10.2 10.3 10.4 10.5 MATERNAL MORTAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Assessment of data quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Direct estimates of adult mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Direct estimates of maternal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 CHAPTER 11 I1.1 11.2 LOCAL AVAILABIL ITY OF FAMILY PLANNING AND HEALTH SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Distance and time to nearest family planning services . . . . . . . . . . . . . . . . . . . . . . . . 121 Distance to nearest maternal and child health services . . . . . . . . . . . . . . . . . . . . . . . . 125 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 APPENDIX A SAMPLE DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 APPENDIX B EST IMATES OF SAMPL ING ERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 APPENDIX C QUAL ITY OF THE DATA: NONSAMPL ING ERRORS . . . . . . . . . . . . . . . . . . 159 APPENDIX D PERSONS INVOLVED IN THE 1993 NAT IONAL DEMOGRAPHIC SURVEY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 APPENDIX E SURVEY QUEST IONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 V TABLES Table 1.1 Table 1.2 Table 2.1 Table 2.2 Table 2.3 Table 2.4.1 Table 2.4.2 Table 2.5 Table 2.6 Table 2.7 Table 2.8.1 Table 2.8.2 Table 2.9 Table 2.10 Table 3.1 Table 3.2 Table 3.3 Table 3.4 Table 3.5 Table 3.6 Table 3.7 Table 3.8 Table 3.9 Table 3.10 Table 3.11 Table 4.1 Table 4.2 Table 4.3 Table 4.4 Table 4.5 Page Demographic indicators, Philippines 1970-1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Results of the household and individual interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Household population by age, residence and sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Population by age from selected sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Educational level of the male household population . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Educational level of the female household population . . . . . . . . . . . . . . . . . . . . . . . . . 16 School enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Household durable goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Background characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Background characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Level of education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Exposure to mass media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Current fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Fertility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Fertility trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Age-specif ic fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Fertility by marital duration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Birth intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Median age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Teenage pregnancy and motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Children born to teenagers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Knowledge of contraceptive methods and source for methods . . . . . . . . . . . . . . . . . . . 40 Knowledge of modem contraceptive methods and source for methods . . . . . . . . . . . . 41 Ever use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Current use of contraception by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Trends in contraceptive use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 vii Table 4.6 Table 4.7 Table 4.8 Table 4.9 Table 4.10 Table 4. I 1 Table 4.12 Table 4.13 Table 4.14 Table 4.15 Table 4.16 Table 4.17 Table 4.18 Table 4.19 Table 5.1 Table 5.2 Table 5.3 Table 5.4 Table 5.5 Table 5.6 Table 5.7 Table 5.8 Table 5.9 Table 5.10 Table 6.1 Table 6.2 Table 6.3 Table 6A Table 6.5 Table 6.6 Table 6.7 Table 6.8 Page Current use of contraception by background characteristics . . . . . . . . . . . . . . . . . . . . . 46 Number of children at first use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Problems with current method of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 T iming of sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Source of supply for modem contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . 50 T ime to source of supply for modem contraceptive methods . . . . . . . . . . . . . . . . . . . . 50 First-year discontinuation rates for contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Reasons for discontinuation of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Future use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Reasons for not using contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Preferred method of contraception for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Family planning messages on radio and television . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Acceptability of the use of mass media for disseminating family planning messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Marital exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Median age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Median age at first intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Recent sexual activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Postpartum amenorrhea, abstinence and insusceptibility . . . . . . . . . . . . . . . . . . . . . . . 66 Median duration of postpartum insusceptibility by background characteristics . . . . . . 68 Indicators of termination of exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Fertility preferences by number of l iving children . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Fertility preferences by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Desire to fimit (stop) childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Need for family planning services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Ideal number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Mean ideal number of children by background characteristics. . . . . . . . . . . . . . . . . . . 78 Fertility planning status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Wanted fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 viii Table 7.1 Table 7.2 Table 7.3 Table 7.4 Table 7.5 Table 8.1 Table 8.2 Table 8.3 Table 8.4 Table 8.5 Table 8.6 Table 8.7 Table 8.8 Table 8.9 Table 8.10 Table 8.11 Table 8.12 Table 8.13 Table 8.14 Table 8.15 Table 9.1 Table 9.2 Table 9.3 Table 9.4 Table 10.1 Table 10.2 Table 10.3 Table 11.1 Table 11.2 Table 11.3 Table 11.4 Table 11.5 Table 11.6 Page Infant and child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Trend in infant mortality rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Infant and child mortality by socioeconomic characteristics . . . . . . . . . . . . . . . . . . . . . 85 Infant and child mortality by demographic characteristics . . . . . . . . . . . . . . . . . . . . . . 87 High-risk fertility behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Number of antenatal care visits and stage of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . 93 Tetanus toxoid vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Place of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Characteristics of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 "Vaccinations by source of information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Vaccinations in the first year of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Prevalence and treatment of fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Prevalence and treatment of acute respiratory infection . . . . . . . . . . . . . . . . . . . . . . . 105 Prevalence of diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Knowledge and use of ORS packets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Treatment of diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Feeding practices during diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Breastfeeding status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Breastfeeding and supplementation by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Median duration and frequency of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Data on siblings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Estimates of age-specific adult mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Maternal mortality rates by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Distance to nearest health or family planning services . . . . . . . . . . . . . . . . . . . . . . . . 121 Distance to nearest health or family planning services . . . . . . . . . . . . . . . . . . . . . . . . 122 Distance to nearest family planning service by use of family planning . . . . . . . . . . . 122 Distance to nearest family planning services by type of facility . . . . . . . . . . . . . . . . . 123 T ime to nearest family planning services by type of facility . . . . . . . . . . . . . . . . . . . . 124 Distance to nearest maternal and child health services by type of care received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 ix Table A. 1 Table A.2 Table B. 1 Table B.2.1 Table B.2.2 Table B.2.3 Table B.2.4 Table B.2.5 Table B.2.6 Table B.2.7 Table B.2.8 Table B.2.9 Table B.2.10 Table B.2.11 Table B.2.12 Table B.2.13 Table B.2.14 Table B.2.15 Table B.2.16 Table B.2.17 Table C. 1 Table C.2 Table C.3 Table C.4 Table C.5 Table C.6 Table C.7 Table C.8 Page Sample implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Distribution of sample PSUs, households and women . . . . . . . . . . . . . . . . . . . . . . . . 135 List of selected variables for sampling errors, Philippines, 1993 . . . . . . . . . . . . . . . . 141 Sampling errors: Entire sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Sampling errors: Urban sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Sampling errors: Rural sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Sampling errors: Metropolitan Manila sample, Philippines, 1993 . . . . . . . . . . . . . . . 145 Sampling errors: Cordillera Administrative Region sample, Philippines, 1993 . . . . . 146 Sampling errors: Ilocos sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Sampling errors: Cagayan Valley sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . 148 Sampling errors: Central Luzon sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . 149 Sampling errors: Southem Tagalog sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . 150 Sampling errors: Bicol sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Sampling errors: Western Visayas sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . 152 Sampling errors: Central Visayas sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . 153 Sampling errors: Eastern Visayas sample, Philippines, 1993 . . . . . . . . . . . . . . . . . . . 154 Sampling errors: Western Mindanao sample, Philippines, 1993 . . . . . . . . . . . . . . . . . 155 Sampling errors: Northern Mindanao sample, Philippines, 1993 . . . . . . . . . . . . . . . . 156 Sampling errors: Southem Mindanao sample, Philippines, 1993 . . . . . . . . . . . . . . . . 157 Sampling errors: Central Mindanao sample, Philippines, 1993 . . . . . . . . . . . . . . . . . 158 Household age distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Births by calendar year since birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Reporting of age at death in days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Reporting of age at death in months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Percent distribution of respondents and siblings by year, Philippines, 1993 . . . . . . . . 167 Mean sibsbip size and sex ratio of births, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . 167 X Figure 2.1 Figure 2.2 Figure 2.3 Figure 3.1 Figure 3.2 Figure 3.3 Figure 3.4 Figure 4.1 Figure 4.2 Figure 4.3 Figure 4.4 Figure 5.1 Figure 6.1 Figure 6.2 Figure 7.1 Figure 7.2 Figure 7.3 Figure 8.1 Figure 8.2 Figure 8.3 Figure 8.4 Figure 9.1 FIGURES Page Single-year distribution by sex, Philippines ,1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Population pyramid, Philippines, 1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Housing characteristics by residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Age-specific fertility rates by residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Total fertility rate among women 15-49 by residence and education . . . . . . . . . . . . . . 28 Total fertility rates, Philippines, 1970-1991 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Percentage of teenagers who have begun childbearing . . . . . . . . . . . . . . . . . . . . . . . . . 37 Knowledge of contraception married women 15-49 . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Use of contraception, married women 15-49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Trend in contraception use, Philippines, 1968-1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Contraceptive Discontinuation rates for first year of use . . . . . . . . . . . . . . . . . . . . . . . 52 Percentage of births whose mothers are amenorrheic, abstaining and insusceptible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Fertility preferences, married women 15-49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Percentage of married women who want no more children by residence and education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Deaths among children under two years for three 5-year periods preceding the survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Trends in infant mortality, Philippines, 1971-1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Infant mortality by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Number of antenatal care visits anti stage of pregnancy at first visit . . . . . . . . . . . . . . 93 Delivery characteristics of births in the five years preceding the survey . . . . . . . . . . . 99 Vaccination coverage among children 12-23 months . . . . . . . . . . . . . . . . . . . . . . . . . 102 Feeding practices among children under five with diarrhea . . . . . . . . . . . . . . . . . . . . 109 Distribution of children by breastfeeding (BF) status, according to age . . . . . . . . . . . 113 xi To the women respondents whose cooperation made this survey possible. Finally, to those who helped in one way or another but who were not mentioned here. TOMAS P. AFRICA Administrator Manila, Philippines February 1994 xiv SUMMARY OF FINDINGS The 1993 National Demographic Survey (NDS) is a nationally representative sample survey of women age 15-49 designed to collect information on fertility; family planning; infant, child and maternal mortality; and maternal and child health. The survey was conducted between April and June 1993. The 1993 NDS was carried out by the National Statistics Office in collaboration with the Department of Health, the University of the Philippines Population Institute, and other agencies concerned with population, health and family planning issues. Funding for the 1993 NDS was provided by the U.S. Agency for International Development through the Demographic and Health Surveys Program. Close to 13,000 households throughout the country were visited during the survey and more than 15,000 women age 15-49 were interviewed. The results show that fertility in the Philippines continues its gradual decline. At current levels, Filipino women will give birth on average to 4.1 children during their reproductive years, 0.2 children less than that recorded in 1988. However, the total fertility rate in the Philippines remains high in comparison to the level achieved in the neighboring Southeast Asian countries. Fertility varies significantly by region and socioeconomic characteristics. Urban women have on average 1.3 children less than rural women, and uneducated women have one child more than women with college education. Women in Bicol have on average 3 more children than women living in Metropolitan Manila. Virtually all women know of a family planning method; the pill, female sterilization, IUD and condom are known to over 90 percent of women. Four in 10 married women are currently using contraception. The most popular method is female sterilization ( 12 percent), followed by the piU (9 percent), and natural family planning and withdrawal, both used by 7 percent of married women. Contraceptive use is highest in Northern Mindanao, Central Visayas and Southern Mindanao, in urban areas, and among women with higher than secondary education. The contraceptive prevalence rate in the Philippines is markedly lower than in the neighboring Southeast Asian countries; the percentage of married women who were using family planning in Thailand was 66 percent in 1987, and 50 percent in Indonesia in 199l. The majority of contraceptive users obtain their methods from a public service provider (70 percent). Government health facilities mainly provide permanent methods, while barangay health stations or health centers are the main sources for the pill, IUD and condom. Although Filipino women already marry at a relatively higher age, they continue to delay the age at which they first married. Half of Filipino women marry at age 21.6. Most women have their first sexual intercourse after marriage. Half of married women say that they want no more children, and 12 percent have been sterilized. An additional 19 percent want to wait at least two years before having another child. Almost two thirds of women in the Philippines express a preference for having 3 or less children. Results from the survey indicate that if all unwanted births were avoided, the total fertility rate would be 2.9 children, which is almost 30 percent less than the observed rate, More than one quarter of married women in the Philippines are not using any contraceptive method, but want to delay their next birth for two years or more (12 percent), or want to stop childbearing (14 percent). If the potential demand for family planning is satisfied, the contraceptive prevalence rate could XV increase to 69 percent. The demand for stopping childbearing is about twice the level for spacing (45 and 23 percent, respectively). Information on various aspects of maternal and child health---antenatal care, vaccination, breastfeeding and food supplementation, and illness was collected in the 1993 NDS on births in the five years preceding the survey. The findings show that 8 in 10 children under five were bom to mothers who received antenatal care from either midwives or nurses (45 percent) or doctors (38 percent). Delivery by a medical personnel is received by more than half of children born in the five years preceding the survey. However, the majority of deliveries occurred at home. Tetanus, a leading cause of infant deaths, can be prevented by immunization of the mother during pregnancy. In the Philippines, two thirds of bitlhs in the five years preceding the survey were to mothers who received a tetanus toxoid injection during pregnancy. Based on reports of mothers and information obtained from health cards, 90 percent of children aged 12-23 months have received shots of the BCG as well as the first doses of DPT and polio, and 81 percent have received immunization from measles. Immunization coverage declines with doses; the drop out rate is 3 to 5 percent for children receiving the full dose series of DPT and polio. Overall, 7 in 10 children age 12-23 months have received immunization against the six principal childhood diseases---polio, diphtheria, ~rtussis, tetanus, measles and tuberculosis. During the two weeks preceding the survey, 1 in 10 children under 5 had diarrhea. Four in ten of these children were not treated. Among those who were treated, 27 percent were given oral rehydration salts, 36 percent were given recommended home solution or increased fluids. Breasffeeding is less common in the Philippines than in many other developing countries. Overall, a total of 13 percent of children born in the 5 years preceding the survey were not breastfed at all. On the other hand, bottle feeding, a widely discouraged practice, is relatively common in the Philippines. Children are weaned at an early age; one in four children age 2-3 months were exclusively breastfed, and the mean duration of breastfeeding is less than 3 months. Infant and child mortality in the Philippines have declined significantly in the past two decades. For every 1,000 live births, 34 infants died before their first birthday. Childhood mortality varies significantly by mother's residence and education. The mortality of urban infants is about 40 percent lower than that of rural infants. The probability of dying among infants whose mother had no formal schooling is twice as high as infants whose mother have secondary or higher education. Children of mothers who are too young or too old when they give birth, have too many prior births, or give birth at short intervals have an elevated mortality risk. Mortality risk is highest for children born to mothers under age 19. The 1993 NDS also collected information necessary for the calculation of adult and maternal mortality using the sisterhood method. For both males and females, at all ages, male mortality is higher than that of females. Matemal mortality ratio for the 1980-1986 is estimated at 213 per 100,000 births, and for the 1987-1993 period 209 per 100,000 births. However, due to the small number of sibling deaths reported in the survey, age-specific rates should be used with caution. Information on health and family planning services available to the residents of the 1993 NDS barangay was collected from a group of respondents in each location. Distance and time to reach a family planning service provider has insignificant association with whether a woman uses contraception or the choice of contraception being used. On the other hand, being close to a hospital increases the likelihood that antenatal care and births are to respondents who receive ANC and are delivered by a medical personnel or delivered in a health facility. xvi PHILIPPINES CORDILLERA ADMINISTRATIVE '~ REGION (CAR)\ ~ ILOCOS REGION II CAGAYAN VALLEY China Sea Pacific Ocean REGION 111~ CENTRAL LUZON NATIONAL CAPITAL / REGION (NCR) REGION IV SOUTHERN TAGALOG i # qt REGION VI WESTERN VISAYAS REGION VIV \ CENTRAL VISAYAS REGION V REGION VIII EASTERN VISAYAS % • REGION X NORTHERN MINDANAO WESTERN MINDANAO ~1~,~ ".~ ~' REGION Xll CENTRAL MINDANAO Celebes Sea ,b REGION XI SOUTHERN MINDANAO xviii CHAPTER 1 INTRODUCTION 1.1 Geography, History, and Economy The Philippine archipelago lies strategically within the arc of nations that sweeps southeastward from mainland Asia to Australia, spanning 1,094 kilometers from west to east. The archipelago is composed of about 7,100 islands, many of which are still uninhabited. Ithas a total area of 300,000 square kilometers, 92 percent of which is found in the 11 largest islands. There are three major island groups: Luzon, the largest island situated in the north accounts for 47 percent of the land area; Mindanao in the south has 34 percent of the total land area; and the Visayas, a group of smaller islands between Luzon and Mindanao, which constitute the remaining 19 percent of land area. Administratively, the Philippines is divided into 15 regions as follows: LUZON National Capital Region (NCR) Cordillera Autonomous Region (CAR) Region 1 - llocos Region Region 2 - Cagayan Valley Region 3 - Central Luzon Region 4 - Southern Tagalog Region 5 - Bicol VISAYAS Region 6 - Region 7 - Region 8 - Westem Visayas Central Visayas Eastern Visayas MINDANAO Region 9 - Westeru Mindanao Region 10 - Northern Mindanao Region 11 - Southern Mindanao Region 12 - Central Mindanao Autonomous Region in Muslim Mindanao - ARMM The next lower administrative units are provinces/subprovinces, cities, and municipalities, and barangays. Barangays are the smallest political subdivisions in the country. In 1990, there were 73 provinces, 2 subprovinces, 60 cities, 1,537 municipalities and some 41,000 barangays. Classification of urban and rural areas is made at the barangay level using the 1970 Census urban-rural definitions. The Philippines has the longest discontinuous coastline in the world. It has 61 natural harbors, 31 of which are developed and could accommodate large vessels. Manila Bay, the finest natural harbor in the Far East, is an asset which has given Metropolitan Manila a locational advantage for rapid industrial development. The archipelago has a diverse topography and climate. The mountain ranges which traverse the major islands are contrasted sharply by adjacent valleys and plateaus. Because of their topography and geographic location, the provinces are exposed to varying climatic conditions and degree of weather disturbances. The northeastern parts of Luzon and the Bicol Region are generally wet and more vulnerable to typhoons. On the whole, the Visayas have more rainy days than Luzon and Mindanao. Mindanao is almost free from typhoons, which makes agriculture a very valuable industry in that island. The Philippines became a republic in 1946. Since the latter part of the 1960s, the government faced several political and social problems caused by ideological and ethnic differences. Threat of communist takeover and student unrest precipitated the declaration of Martial Law by former President Marcos in 1972. Rebellions led by Muslim leftists exacerbated the political and economic situation. Under the shroud of Martial Law, Marcos extended his dictatorial leadership for two decades. The ouster of Marcos in 1986 brought new hope for political stability and economic recovery. Several attempts to topple the new government failed. Sporadic encounters of govemment forces with both the leftist and rightist groups are no longer considered threats as the Ramos administration gears itself toward the attainment of a Newly Industrialized Country status by the year 2000. The 1970s witnessed a substantial growth in the Philippine economy, with a growth rate higher than the world average for developing countries. Real GNP increased at an average rate of 6.2 percent annually during the period 1972-80. While the country experienced substantial growth in the 1970s, the income distribution structure improved only very slightly during the period 1961 to 1988. A large percentage of the nation's wealth remained concentrated in the hands of a few families. The income share of the lowest 50 percent reached its highest level at only 20.5 percentin 1975, from 17.6 percent in 1961. The corresponding proportion in 1988 and 1991 is 20.3 percent and 18.9 percent, respectively. The worldwide recession in the 1980s, however, affected the top 20 percent income group. This is reflected in the continued decline of its share from 56.5 percent in 1961 to 51.8 percent in 1988. The income share of the top 20 percent improved slightly in 1990 (53.9 percent), which is comparable to that in the early 1970s. This is because international markets for Philippine exports became weak, which adversely affected the trade and industrial sectors. Balance of payment deficit widened as a result of accelerated outflow of short-term capital and the unwillingness of some creditors to extend new credit lines. The debt servicing capacity of the country underwent stresses and strains from both the high cost of borrowing and the difficulty ofeamlng foreignexchange, ltwas agriculture whichpropelledeconomicgrowthinthe 1980s, butitsoutput was affected by the eight-month drought which struck the country in the late 1982. The worsening employment situation was partly offset by the overseas deployment of workers and the implementation of the national livelihood program. After President Aquino came into power in 1986, the government underwent political and economic reform. The 1984-1987 Development Plan was updated, with the commitment to strengthen the national will and capability for self-reliant development through a conscious effort to raise productivity and attain self- sufficiency. Its fundamental goals are to increase productivity for sustainable development, more equitable distribution of the fruits of development, and total human development. Over the years, development has not been distributed equitably among regions and provinces within a region. Infrastructure and development eflbrts have been concentrated in Metropolitan Manila and its environs, and selected cities. Because of the locational advantage of Metropolitan Manila, economic and social policies in the past administrations have been biased, resulting in the rapid industrialization of Metropolitan Manila. Later, an overspill of economic development was seen in the neighboring provinces. Uneven development and perceived economic opportunities in urban centers stimulated rural-urban migration and the continued influx of migrants has exerted pressure on the urban resources and environment. 2 In 1991, the Philippine economy suffered from disturbances caused by the Gulf War which disrupted employment in the Middle East where many Filipinos work. Millions of US dollars were lost, not only from overseas remittances but also from the damage caused by the continued eruption of Mt. Pinatubo and the flash floods in Ormoc City. The economic slowdown was manifested in all the major sectors, posting lower growth rates over the previous year. As with economic development, social development has not been distributed equitably among geographic units of the country. Although the national level of literacy has improved from 83 percent for persons aged 10 and over in 1970 to 94 percent in 1990, pockets of illiteracy are still prevalent in remote barangays of nearly all provinces. The present government policy on this issue is aimed at eradicating illiteracy by the year 2000 by providing education for all. There are wide differences in the economic participation between males and females. Sex differentials in education, however, are minimal. In fact, in terms of higher educational attainment, females have an advantage over males. The differential impact of development on women has been integrated in the development plan for 1989-92 by providing women equal opportunities in the economic, political, and social activities of the country. In 1982, the Filipino diet was found to be adequate in protein but inadequate in energy and micronutrients, except niacin. Nutrient intake was generally higher among those with higher education and income, in urban than in rural areas, with Metro Manila being worse off than other urban and rural areas. Breastfeeding practices and duration have been slowly declining but a reversal in trend was observed among urban and more educated women. A declining trend persists among the disadvantaged women where the benefits of breastfeeding are most needed. 1.2 Population Growth The 1990 Census of Population reported a total population of 60.7 million, up by 12.6 million persons over the previous decade. About 30 million or 49 percent of the population lived in urban areas, an increase of 11 percentage points from 1980 (see Table 1.1.). The population growth rate has been declining at a slow pace. The average annual growth rate decreased by 0.4 percentage points, from 2.75 percent during the intercensal period 1970-80 to 2.35 percent in 1980-1990. The Philippine population is unevenly distributed over the 15 regions. In 1990, the National Capital Region (NCR), which accounted for only 0.2 percent of the total land area, had 13 percent of the total population, surpassed only by Southern Tagalog which registered 14 percent of the population. These two regions, together with Central Luzon, accounted for more than a third of the country's population. The six least populated regions are Cordillera Administrative Region (CAR), Cagayan Valley, Bicol, Eastern Visayas, Western Mindanao and Central Mindanao, which are at the same time the least developed regions, as well as experiencing a relatively high level of civil unrest. The overall population density increased from 122 persons per square kilometer in 1970 to 160 in 1980, and 202 in 1990. The average density in 1990 ranged from 12,498 persons per square kilometer in Metro Manila to 30 in Kalinga-Apayao in CAR. The slow decline in population growth has partly been brought about by a decline in both the fertility and mortality levels. In 1970, the crude birth rate was estimated at 39 births per 1,000 population, dropping slightly to 36 in 1980 and 29 in 1990. The total fertility rate for women 15-49 years dropped by about one child in two decades, from an estimated level of 5.1 children in 1970, to 4.7 in 1980 and 4.1 in 1990. 3 Table I. l Demographic indicators, Philippines 1970-1990 Indicator 1970 1980 1990 Population (millions)" 36.7 48.1 60.7 Density (Pop./sq. km.~ 122 160 202 Urban population (percen0 m 31.8 37.3 48.7 Rate of annual increase (percent)" 3.08 2.74 2.35 Population doubling time (years) 23 26 30 Crude birth rate (per 1,000 pop.) b 39 36 29 Crude death rate (per 1,000 pop.) b 10 9 7 Total fertility rate 5.1 4.7 4.1 Infant mortality rate 63 c 63 d 570 Life expectancy at birth, both sexes (years) 55.9 e 61.6 b 64.8 ~ Soui-ce$: s1990 Census of Population and Housing. Report no.3. b1980-based projection eFlieger.n.d. C~Task Force on Infant Mortality Rate *University of the Philippines Population Institute. Baseline Estimation Project. While the overall mortality rate showed a decline during the period from 1948-1960, the pace has slowed down since 1960. The crude death rate was estimated at 10 deaths per 1,000 population in 1970, declining to 6 in 1990. Likewise, infant mortality rates hovered around 63 per 1,000 live births during the period 1977-1986, and was estimated at 57 in 1990. Life expectancy at birth which slowed in the 1970s resumed a more rapid increase in the 1980s, rising by 3 years, from 61.6 in 1980 to 64.8 in 1990. 1.3 Population Policies and Programs The family planning movement in the Philippines was initiated by the private sector in the 1960s. The government's commitment to family planning was manifested with the issuance of Executive Order No. 171 in 1969 to establish the Commission on Population (POPCOM) to undertake studies on all aspects of the population and to formulate policy and program recommendations on population as it relates to economic and social development. Executive Order No. 233 of 1970 empowers the POPCOM to conduct and direct the national population program as an integral part of the national development strategy. When the Population Act was passed in 1971, family planning became an integral part of the national development plan. Reduction of the population growth rate was embodied as a goal in the country's five-year and ten- year development plans. Specifically, the goal was to reduce the growth rate from 2.5 percent in 1978 to 2.1 percent in 1987. The target was to achieve a contraceptive prevalence rate of 40 percent in 1982 and 50 percent in 1987. Cognizant of the close interrelationship between population, resources and environment, the population policy of 1987 broadens the scope of population concerns beyond fertility reduction, to include family formation, the status of women, matemal and child health, child survival, morbidity and mortality, population distribution and urbanization, internal and international migration and population structure. In 4 the 1987-92 Population Development (POPDEV) Program, rapid population growth which remains an important national development issue, took on a more complex dimension as it is linked to welfare and sustainable development. The policy places emphasis on the following objectives (DOH, 1990): 1. To pursue and promote policies and measures that will ensure the attainment of rational population size, growth, composition and balanced distribution; 2. To promote and ensure explicit, full and conscious consideration of population and sustainable development interrelationships in policy formulation, development planning and decision-making; 3. To strengthen, institutionalize and ensure greater political support of the local government units in the coordination and implementation of the local population program; 4. TO promote the values of responsible parenthood, delayed marriage, birth spacing and a small family norm; and 5. To ensure maximum participation of govemment and non-government organizations as well as population organizations in the implementation of population and population-related programs, projects and activities. Under the Aquino administration (1986 to 1992), the family planning program suffered from a vacillating political and financial support because of the strong influence of the Catholic Church. The program was transferred from POPCOM to the Department of Health. It became mainly a health program with the primary goal of improving the health of the mother and the child, with fertility reduction as only a consequence. The integration of population and development (POPDEV) which considers the interaction of socioeconomic and demographic variables in development planning has laid down the foundation for the application of POPDEV approaches and concepts through advocacy, research, training and technology dissemination and adoption. Although a few sectors have attempted to operationalize POPDEV in their development efforts, the program has failed to develop a unified framework and a more vigorous strategy for integration of population in various development concerns. A more recent population program is currently being updated for the 1993-1998 period. 1.4 Health Plan and Programs The Health Plan of 1987-1992 aimed at health, nutrition and family planning as the foundation of the sector's contribution to the development of healthy and productive citizens and to their participation in the socioeconomic development of the country. a) b) e) The main objectives were: to improve the health and nutritional status of the population; to contribute to the achievement of Health for All by the year 2000 through primary health care; and to promote family planning as a means to improve family well-being. The Plan alms to improve the accessibility of high quality health services particularly to the poor, unserved, underserved and high risk groups. It focuses on the integration and promotion of individual and collective responsibility for health, self-reliance, preventive actions, the status of women, environmental sanitation and workers' safety. It relies heavily on the primary health care to further the establishment of a network to meet the health needs of the people. Another strategy is to involve the private sector in the provision of preventive and creative health services and to more actively participate in the implementation of the Plan. The priority health programs include, among others, the following: . Expanded Program on Immunization. The goal of this program is to protect children from the six immunizable diseases by providing specific protection through the use of effective vaccine against TB, diphtheria, pertussis, tetanus, measles and poliomyelitis, and protect newborns from tetanus by immunizing pregnant mothers; . Maternal and Child Health. This program is designed to improve the well-being of mothers and children through a comprehensive approach of providing preventive, promotive, and curative health care. The specific objective is to reduce matemal, infant and child mortality; the target populations are women of reproductive age (15-49 years); infants (under 1 year); and children (1-6 years). The major activities undertaken are increased coverage of pregnant women given antenatal, natal, and postnatal care and immunization of pregnant mothers against tetanus; and establishment of under-six clinics in all government facilities to monitor the growth and health status of infants and children. The program components of the maternal and child health program are as follows: Maternal Care, Immunization of Pregnant Mothers, Under-Six Clinic, and Breastfeeding Promotion; . Nutrition Program. The program alms to improve the nutritional status of pre-schoolers, pregnant women and lactating mothers. It is directed towards the prevention and reduction of the prevalence of protein-energy malnutrition, Vitamin A de ficiency disorders through effective growth monitoring, nutrition education, food and micronutrients supplementation, and rehabilitation of malnourished children. . Family Planning Program. This program is a delivery program systematically aimed to provide information and services necessary for couples of reproductive age to plan their families according to their beliefs and circumstances. It gives couples the choice of when to start having children, how many to have, how far apart, when to have them and when to stop, at the least risk to the health of the mother and best chance of survival for the child. . Dental Health Program. The objective of this program is to reduce the incidence and prevalence of dental caries including reduction of periodontal diseases, particularly among pregnant women and children. . Acquired Immuno-Deficiency Syndrome. The program aims to control the spread of AIDS in the country winch is considered to be in the early stage of AIDS epidemic. The central measures undertaken are generally preventive such as surveillance of high-risk populations including monitoring blood banks, health education, and development of capabilities for dealing with the disease. 6 1.5 Objectives and Organization of the Survey The 1993 Philippine National Demographic Survey (1993 NDS) is a nationwide sample survey designed to collect information on fertility, family planning, maternal and child health and child survival. It is the sixth of the series of demographic surveys taken at five-year intervals since 1968. The 1993 NDS was undertaken as part of the worldwide program known as the Demographic and Health Survey (DHS). It was conducted by the National Statistics Office in collaboration with Department of Health (DOH), the University of the Philippines Population Institute, and other concerned agencies of the Philippine government. Macro International, Inc., which is based in Calverton, Maryland (USA), provided funding and technical assistance to the project through its contract with the U.S. Agency for International Development (USAID). The primary objective of the 1993 NDS is to provide up-to-date inform ation on fertility and mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programs and strategies for improving health and family planning services in 'the country. 1.6 Sample Design and Implementation The main objective of the 1993 NDS sample is to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country, and to provide estimates with an acceptable precision for sociodemographic characteristics, like fertility, family planning, health and mortality variables. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region. Detailed discussion of the 1993 NDS is presented in Appendix A, and sampling errors for selected variables can be found in Appendix B. The Integrated Survey of Households (ISH) was used as a frame, to generate a nationally repre- sentative sample of women aged 15 to 4-9 years. The ISH was developed in 1980 to collect information on employment and other socioeconomic characteristics of households. It consists of 2,100 samples of primary sampling units (PSUs) systematically selected, with a probability proportional to size, in each of the 14 regions. The PSUs were again selected in 1991, using the 1990 Population Census data on population size, but retaining the maximum number of PSUs selected in 1980. The sample is sel f-weighted in each of the 14 regions, but not at the national level. The selection was done separately for the urban and the rural areas, using a two-stage sample design. The first stage is the se•ecti•n•fbarangays•andthesec•ndisthese•ecti•n•fh•useh••dsinthesamp•edbarangays. Of the 2,100 PSUs in the ISH, 750 were selected for the 1993 NDS. Individual households were selected with a probability of selection inversely proportional to the barangay's size to maintain a fixed overall sampling fraction within each region. Eligible respondents for the individual interview were all females age 15-49 years, who are members of the sample household or visitors present at the time of interview and had slept in the sample households the night prior to the time of interview, regardless of marital status. 1.7 Questionnaires Three types of questionnaires were used for the 1993 NDS: the Household Questionnaire, the Individual Woman's Questionnaire and the Service Availability Questionnaire. The contents of the first two questionnaires were based on the DHS Model Questionnaire, which was designed for use in countries with high levels of contraceptive use. Additions and modifications to the model questionnaires were made after consultation with members of a Technical Working Group convened for the purpose of providing technical assistance to the NSO in the implementation of the survey. The questionnaires used in the 1993 NDS are presented in Appendix E. The household and individual questionnaires were developed in English and then translated into and printed in six of the most widely spoken languages in the Philippines, namely: Tagalog, Cebuano, Ilocano, Hiligaynon, Bicol and Waray. The Household Questionnaire was used to list all the usual members and visitors of selected households. Some basic information was collected on the characteristics of each person listed, including his/her age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women who were eligible for individual interview. In addition, information was collected about the dwelling, such as the source of water, type of toilet facilities, materials used for the floor of the house, and ownership of various consumer goods. The Individual Woman's Questionnaire was used to collect information from women aged 15-49. An important change from the past practice in large-scale demographic surveys in the Philippines is that the 1993 NDS covered all women 15-49 instead of limiting the interview to ever-married women. In keeping with past practice, the questionnaire contained a pregnancy history instead of the usual DHS birth history. Women were asked questions on the following topics: Background characteristics (education, religion, etc.) Reproductive behavior and intentions Knowledge and use of contraception Availability of family planning supplies and services Breastfeeding and child health Maternal mortality The Health Service Availability Questionnaire was designed to collect information about health and family planning services available to the individual women respondents. This questionnaire was administered at the cluster level, that is, one questionnaire was filled for each of the 750 sample points. Combined with information collected in the main survey, data from the two surveys can identify subgroups of women who are underserved by the health and family planning providers. 1.8 Tra in ing and F ie ldwork The 1993 NDS questionnaires were pretested in December 1992. Three pretest areas were selected; namely, the barangays of Malolos and Calumpit, Bulacan Province, and Barangay Tatalon in Metropolitan Manila. Fifteen female interviewers were recruited. Three NSO employees were assigned as field editors, and three statisticians from the NSO were assigned to supervise the fieldwork. About 180 interviews of women 15-49 were completed in the pretest. The pretest results were used as basis for revising the questionnaires and the translations into the six dialects. They also provided a basis for firming up survey operational procedures. Training of field staff for the main survey was conducted in the following designated training sites: Baguio City, Manila, Cebu City and Davao City. The training course consisted of instructions in general interviewing techniques, field procedures, a detailed review of items on the questionnaires, mock interviews between participants in the classroom, and practice interviews in the field. Trainees who performed satisfactorily in the training program were selected as interviewers, while those whose performance was rated as superior were selected as field editors. The fieldwork for the Philippine NDS was carried out by 31 interviewing teams. Each team consisted of one team supervisor, one field editor, and an average of five interviewers. The Regional Administrators of NSO served as field coordinators during the data collection phase of the survey. During the first two weeks of the field work, statisticians from the Central Office, who served as trainers during the training of interviewers, went on field trips to observe and guide the teams in their initial interviews. 1.9 Data Processing Editing of the questionnaires was an integral part of the field data collection in the sense that questionnaires based on successful interviews were immediately edited by field editors. Further review and coding of some variables were done at the NSO central office. Machine processing was also done at the central office. Processing of the NDS data was done with the use of the DHS computer program ISSA (Integrated System for Survey Analysis), from data entry to tabulation. Seven microcomputers were made available by NSO for data entry while Macro International provided four microcomputers for data management as well as for running edit and tabulation programs. Initial tabulations were generated by the end of August 1993, and a preliminary report was released in October 1993. 1.10 Response Rate Table 1.2 gives a summary of the response rates for the survey. A total of 13,728 households was selected for the survey, of which 12,995 were successfully interviewed. The difference was due to one of the following reasons: some selected households had moved out or could not be located by the NDS team; there were no eligible respondents found for the selected household during the NDS team's visit; or the household simply refused to be interviewed. (See Appendix Table A.1 for details.) The household interviews identified 15,332 eligible women. Of these, 15,029 were successfully interviewed, giving a response rate of 98 percent. The principal reason for nonresponse among eligible women was the failure of interviewers to find them at home despite repeated visits to the household. Refusals were few in number (less than one percent). Table 1.2 Results of the household and individual interviews Number of households, number of interviews and response rates, according to urban-rural residence, Philippines 1993 Residence Result Urban Rural Total Household Interviews Households sampled 6542 7186 13728 Households found 6201 6901 13102 Households interviewed 6131 6864 12995 Household response rate 98.9 99.5 99.2 Individual Interviews Number of eligible women 8056 7276 15332 Number of eligible women interviewed 7908 7121 15029 Eligible woman response rate 98.2 97.9 98.0 9 CHAPTER 2 BACKGROUND CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS Presented in this chapter are the background characteristics of the sample households and the respondents to the survey. Information on the characteristics of the households and respondents is deemed important in the interpretation of the survey results. The behavior of women concerning demographic phenomena is known to be influenced by their characteristics and their environment. Also, analysis of the reported characteristics of the sample households and the respondents can serve to indicate the representativeness and quality of the data collected in the survey. The chapter is divided into three parts. The first part deals with the characteristics of the household population in terms of age-sex composition, household size and distribution, and educational background. The second part describes the housing environment in which the respondents live. The characteristics of the individual women respondents to the survey are discussed in the third part of this chapter. 2.1 Population Composition The household questionnaire used in the 1993 National Demographic Survey (NDS) collected data on the demographic and social characteristics of the members and visitors of each sample household. A household, as defined in the survey, refers to a person or group of persons who usually sleep in the same housing unit and have a common arrangement for the preparation and consumption of food. A visitor, on the other band, is someone who is not a usual resident of the household but had slept in the household the night prior to the time of interview and is still present in the household during the time of interview. In this report, except in Table 2.2, the population is presented according to the place where they spent the night before the interview (de facto). Age-Sex Composition Age reporting in the Philippines is relatively accurate. The present generation of residents, including those living in the rural areas, seem to be conscious of calendar dates especially those relating to important events in their personal lives such as birthdays. The distribution of the sampled population by single year of age and by sex is presented in Figure 2.1 and in Appendix Table C.1. Examination of the data and the graph reveals only a slight preference for digits ending in 0 and 5 when reporting ages. It will be noted, however, that the number of women age 15 and age 49 relative to those age 14 and 50, respectively, is conspicuously small. This seems to indicate that there was intentional displacement of women from age 15 to age 14 and from age49 to 50. Since the respondents for the main questionnaire are women age 15 to 49 years, this was probably done intentionally by the interviewers, to reduce their assigned workload. For each sex, the proportions below 15 years are larger in rural than in urban areas, indicating a younger age structure of the rural population (Table 2.1). Within the urban areas, the proportion is, however, larger for males than for females but it does not differ much between the sexes in rural areas. On the whole, it can be said that the composition of the Philippine population by age and sex depicts a population pyramid (Figure 2.2) with a wide base and narrow top, a pattcm that is typical of high fertility societies. II Figure 2.1 Single-year Age Distribution by Sex Philippines, 1993 Number of Persons 1,000, 800 600 4OO 200 0 I I I I t I I I I I I I I 0 5 10 15 20 25 30 35 40 45 50 55 60 65 Age 1993 NDS Table 2.1 Household population by age~ residence and sex Percent distribution of the de facto household poptdation by five-year age group, according to urban-rural residence mad sex, Philippines 1993 Urban Rural Total Age group Male Female Total Male Female Total Male Female Total 0-4 14.0 12.3 13.2 14.8 14.7 14.7 14.4 13.5 13.9 5-9 13.0 11.5 12.2 15.0 14.6 14.8 14.0 13.0 13.5 10-14 12.0 12.2 12.1 13.8 14.1 13.9 12.9 13.1 13.0 15-19 10.9 11.3 11.1 10.7 8.7 9.7 10.8 10.0 10.4 20-24 9.7 9.3 9.5 7.7 7.2 7.4 8.7 8.3 8.5 25-29 8.0 8.5 8.3 6.6 6.8 6.7 7.3 7.7 7.5 30-34 6.5 7.4 6.9 6.0 6.2 6.1 6.3 6.8 6.5 35-39 6.1 6.0 6.1 5.5 5.8 5.6 5.8 5.9 5.9 40-44 5.1 5.0 5.0 4.4 4.8 4.6 4.7 4.9 4.8 45-49 3.8 3,7 3.8 3.6 3.5 3.5 3.7 3.6 3.7 50-54 2.9 3.6 3.2 3.2 4.0 3.6 3.0 3.8 3.4 55-59 2.5 2.9 2.7 2.8 2.9 2.8 2.6 2,9 2.8 60-64 2.1 2.2 2.1 2.2 2.3 2.2 2.1 2.2 2.2 65-69 1.3 1.7 1.5 1.4 1.7 1.6 1.4 1.7 1.5 70-74 1.0 1.2 1.1 1.0 1.3 1.1 1.0 1.2 1.1 75-79 0.5 0.6 0.5 0.6 0.8 0.7 0.6 0.7 0.6 80 + 0.6 0.7 0.6 0.6 0.8 0.7 0.6 0.7 0.7 Missing/Don't know 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number I 16734 17376 34117 16585 15907 32491 33319 33283 66608 qncludes 8 cases with missing information on sex. 12 Age 80+ 75-79 70-74 65-69 6O-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 Figure 2.2 Population Pyramid Philippines, 1993 0-4 8 6 4 2 0 2 4 6 8 Percent 1993 NDS In Table 2.2, the percent distributions of the population by broad age groups, according to the 1970, 1980, and 1990 Censuses of Population and the 1993 NDS are presented. There appears to be a progressive decline since 1970 in the proportion of the young population and, concomitantly, an increasing value of the median age. The growing proportion in the 15-64 group results in declining dependency ratio, defined as the ratio of persons in the "dependem" ages (under 15 and 65 and over) to those in the "economically active" ages (15-64). This slight ageing of the population has taken place in the recent past as a result of a continuous, albeit slow decline in fertility levels. The 1993 NDS data and 1990 census show fairly similar distributions by age which supports the representativeness of the survey population. Table 2.2 Population by age from selected sources Percent distribution of the de jure population by age group, selected sources, Philippines 1970 1980 1990 1993 Age group Census Census Census NDS Less than 15 45.7 42.0 39.5 39.3 15-64 51.4 54.6 57.1 56.8 65+ 2.9 3.4 3.4 3.9 Total 100.0 100.0 100.0 100.0 Median age 16 18 19 20.1 Dependency ratio 94.6 83.2 75.1 76.1 13 Househo ld Compos i t ion Information on the size and composition of the sample households by urban-rural residence is presented in Table 2.3. About 14 percent of the households are headed by women. As expected, a higher proportion of female-headed households is noted in the urban areas (16 percent) than in the rural areas (12 percent). On average, a household is composed of 5.3 persons. A negligible difference in average household size is observed between the urban and rural areas. Taking into consideration the adult composition of the household population, about half of the households contain 3 or more related adults, while 39 percent consist of two adults of opposite sex. About f ive percent of the households have one adult member, while households with two related adults of the same sex are very rare (2 percent). About one-tenth of the households had foster children, that is, children below 15 years whose natural mother or father is not a member of the household. Table 2.3 Household composition Percent distribution of households by sex of head of household, household size, kinship structure, and presence of foster children, according to urban-rural residence, Philippines 1993 Resideaee Characteristic Urbaaa Rural Total Household headship Male 84.2 87.8 86.0 Female 15.8 12.2 14.0 Total 100.0 100.0 100.0 Number of usual members 1 2.6 3.0 2.8 2 7.0 7.9 7.4 3 12.0 13.0 12.5 4 17.6 16.2 16.9 5 17.5 17.5 17.5 6 15.2 15.0 15.1 7 11.2 11.7 11.4 8 6.8 6.7 6.7 9+ 10.1 9.1 9.6 Total 100.0 100.0 100.0 Mean size 5.4 5.3 5.3 Relationship structure One adult 4.0 5.1 4.5 Two related adults: Of opposite sex 35.1 42.4 38.7 Of same sex 1.6 1.9 1.8 Three or more related adults 50.7 48.4 49.6 Other 8.6 2.1 5.4 Total 100.0 100.0 100.0 With foster children I 9.1 10.2 9.7 1Foster children are those under age 15 living in households with neither their natural mother nor father. 14 Education Tables 2.4.1 and 2.4.2 present information on the highest educational level attained by the population classified by sex, age, residence, and region. The value of education is highly regarded by Filipino families. The constitution of the country respects this and states that education, at least up to high school level, is a basic right of all Filipino children. The results of the survey indicate that the vast majority of the population do have some formal education. Among the population age 5 and over, only 8 percent have no formal education, and no more than 4 percent among those between the ages of 10 and 50 never went to school. Of both men and women, around half attended primary school, one in four attended high school, and one in six attended higher education. Table 2.4.1 Educational level of the male household population Percent distribution of the de facto male household population age six and over by highest level of education attended, according to selected background characteristics, Philippines 1993 College Median Background High or Don't know/ number characteristic None Elementary school higher missing Total Number of years Age 1 6-9 37.9 58.9 0.4 0.0 2.8 100.0 3660 1.4 10-14 2.4 80.5 16.9 0.0 0,1 100.0 4306 5.2 15-19 1,1 27.3 58.3 13.1 0.1 100.0 3602 9.0 20-24 1.6 27.7 41.1 29.5 0.0 100.0 2896 10.2 25-29 1.9 29.3 40.6 28.1 0.1 100.0 2437 10.2 30-34 2.3 34.7 35.7 27.2 0.1 100.0 2085 10.0 35-39 2.3 41.7 32.9 22.8 0.3 100.0 1929 8.6 40-44 2.3 44.2 30.3 23.1 0.0 100.0 1571 8.1 4549 2.6 51.8 24.9 20.6 0.2 100.0 1244 6.8 50-54 4.3 56.6 22.1 16.8 0.2 100.0 1015 6.6 55-59 5.8 56.5 23.3 14.1 0.3 100.0 881 6.5 60-64 9.5 53.6 21.1 15.2 0.6 100.0 710 6.4 65+ 16.9 58.5 13.5 10.9 0.I 100.0 1181 4.9 Residence Urban 6.0 38.8 32.7 22.0 0.5 100.0 13942 8.1 Rural 9.7 56.9 24.8 8.1 0.6 100.0 13583 6.1 Region Metro. Manila 4.2 26.0 38.6 30.8 0.4 lll0.0 3732 10.2 Cordillera Admin. 6.4 44.1 29.5 19.9 0.2 100.0 479 6.9 llocos 7.0 45.9 33.3 13.5 0.2 100.0 1631 6.8 Caga)an Valley 6.4 53.1 28.7 10.7 1.1 100.0 1060 6,5 C-Luzon 4.6 48.1 33.7 13.2 0.4 100.0 2799 6.9 S-Tagalo 8 6.4 47,7 31.8 13.8 0.3 100,0 3612 6.8 Bicol 9.3 55.4 25.0 9.6 0.7 100.0 1729 6.3 W-Visayas 8.1 50,7 25.9 15.3 0.0 1120.0 2463 6.4 C-Visa)as 8.8 53.2 22.8 14.1 1.2 100.0 2142 6.1 E-Visa)as 8.5 57.6 22.2 11.5 0.2 100.0 1366 6.0 W-Mindanao 12.2 54.3 20.0 11.3 2.1 100.0 1467 5.5 N-Mindanao 7.3 56.1 25.0 10.8 0.8 100.0 1581 6.2 S-Mindanao 11.8 52.5 24.1 11.5 0.0 100.0 2018 6.1 C-Mindanao 15.6 48.1 25.4 10.5 0.4 100.0 1447 6.0 Total 7.8 47.7 28.8 15.2 0.5 100.0 27525 6.6 IExcludes 9 people with age information missing. 15 Table 2.4.2 Educational level of the female household population Percent distribution of the de facto female household population age six and over by highest level of education attended, according to selected backgrotmd characteristics. Philippines 1993 College Median Background High or Don't know/ number characteristic None Elemmtary school higher missing Total Number of years Age 1 6-9 35.7 61.6 0.2 0,0 2.5 100.0 3448 1.5 10-14 1,7 75.0 23.2 0.0 0.1 100.0 4351 5,6 15-19 1.1 18.6 63.9 16.3 0.1 100.0 3333 9.6 20-24 1,8 21.7 39.6 36.9 0.1 100,0 2762 10.5 25-29 2.4 25.2 38.6 33.6 0.2 100.0 2552 10.3 30-34 2,3 34,5 32.0 31.3 0.0 100.0 2262 10,1 35-39 2.7 42.0 31.0 24.2 0.1 100.0 1979 8.3 40-44 2.7 47,1 26.9 23,2 0,2 1(30.0 1636 7.0 45-49 3.8 56.0 20.4 19.7 0.1 100.0 1192 6.7 50-54 6.2 59.3 19.2 15.0 0.2 100.0 1255 6.5 55-59 8,1 60.5 18.6 12.4 0.4 100.0 959 6.3 60-64 11.2 58.7 18,2 11.1 0.9 100.0 740 6.0 65+ 22.5 61.3 7.6 7.7 0.9 100.0 1441 4.4 Residence Urban 5.9 38.5 31.9 23.2 0.5 100.0 14819 8.1 Rural 10,2 55.2 24.2 9.8 0.5 100.0 13104 6.2 Region Metro. Manila 3.0 28,6 36,9 30.8 0.7 100.0 4268 10.1 Cordillera Admin, 10.4 40,2 26.9 22.4 0.1 100.0 474 6.9 llccos 7.9 46.5 29.9 15.4 0,3 100.0 1723 6.8 Cagayan Valley 7.4 52.3 25,2 14,2 0.8 100.0 945 6,5 C-Luzon 5.8 48.5 31.0 14,5 0.2 100.0 2870 6.8 S-Tagalog 6.3 48.8 28.7 16.1 0.I I00.0 3873 6.7 Biool 6,9 59.5 22,6 10.0 0.9 1OO.0 1658 6.3 W-Visayas 7.2 48.1 26.9 17.6 0.2 100.0 2388 6.7 C-Visayas 9.1 52.6 22.9 14.5 1.0 100.0 208I 6.3 E-Visayas 8.8 53.4 25.2 12.4 0.2 100.0 1366 6.3 W-Mindanao 15.2 50.1 20.7 12.1 2,0 100.0 1435 5.7 N-Mindanao 6.6 5111 28,6 13,1 0.7 100.0 1501 6.6 S-Mindanao 11.5 45.7 29.3 13.4 0.1 100.0 1961 6.5 C-Mindanao 20.4 43,9 22.7 12.6 0,4 100.0 1380 5,8 Total 7.9 46.3 28.3 16.9 0.5 100.0 27923 6.7 tExc, ludes 13 people with age information missing, No profound gender difference may be observed as far as education is concemed. However, a significant difference is noted in the educational level between the urban and rural population. The educational system obviously favors residents of the urban areas. The distribution of the population by highest level of education attended differs greatly among the regions of the country. Metropolitan Manila has a much better educated population compared to the rest of the country; the median duration of schooling in this region is 10 years, compared to 6 or 7 for the other regions. Residents of Western Mindanao and Central Mindanao have the lowest median duration of schooling. 16 School Enrollment Table 2.5 shows the percent distribution of the household population 6-24 years of age enrolled in school by age, sex and urban-rural residence. Close to four-fifths of persons age 6 to 10 and 88 percent of those age 11-15 are attending school. Between the ages of 16 and 20, when most everybody is still supposed to be in school, the proportion of those actually enrolled diminishes significantly. Economic reasons possibly pull the youth of the country from the school system into the job market. The probability of being in school is fairly equal for the male and female populations in the urban areas except at ages 16-24, where men are more likely to be enrolled than women. In the rural areas, however, the female population seems to get the advantage as far as schooling is concerned. This is possibly due to the fact that male children are more needed to help on the farm. Table 2.5 School enrollment Percentage of the de facto household population age 6-24 years ettrolled in school by age group, sex, and urban-rural residence, Philippines 1993 Age group Male Female Total Urban Rural Total Urban Rural Total Urban Rural Total 6-10 80.4 73.8 76.9 81.4 77.0 79.0 80.8 75.3 77.9 11-15 91.0 83.2 86.9 91.8 87.2 89.5 91.4 85.2 88.2 6-15 85.4 78.3 81.6 86.6 81.8 84.2 86.0 80.0 82.9 16-20 56.3 41.4 48.9 50.3 47.3 49.1 53.1 44.0 49.0 21-24 18.0 10.7 14.9 12.8 8.8 11.2 15.5 9.8 13.1 2.2 Housing Characteristics Table 2.6 shows the distribution of households with selected housing characteristics by urban-rural residence. The information on the source of water, type of sanitary facility, type of floor material and number of persons per sleeping room are indicators of the health and socioeconomic condition of households which, in turn, are associated with demographic behavior. About two thirds of the households have electricity. However, a significant difference was noted between the urban and rural areas; 84 percent of urban households have electricity, compared to less than half (46 percent) of rural households (Figure 2.3). One in 3 households has piped water (37 percent) and 28 percent have water piped into the residence. Again, a significant difference is noted between the urban and rural areas. In the urban areas, more than half (54 percent) of the households have water piped into the residence, compared to only 21 percent in the rural areas. Open dug well and developed spring are among the main sources of water in the rural areas, but only a few households in the urban areas get their water from these sources. 17 Table 2.6 Houshi~ charactenstics. Percent distribution of households by housing characteristics, according to urhan-raral residence, philippines 1993 Residence Housing characteristic Urban Rural Total Electricity Yes 83.7 46.4 65.4 No 16.1 53.3 34.4 Missing 0.2 0.3 0.2 To¢~[ 100.0 I00.0 100.0 Source of drinking water Piped into residence 44.1 12.0 28.3 Public tap 9.4 8.6 9.0 Tubed~iped well/improved dug well within residence 13.7 20.2 16.9 Tubed/piped well/unproved dug well outside residence 6.0 10.4 8.2 Private weU 5.9 4.3 5.2 Public well 10.8 11.9 11.3 Open dug well 3.8 15.8 9.7 Developed spring 2.1 12.3 7.1 Rainwater 0.5 l. 1 0. 8 Other 3.4 3.2 3.3 Missing/Don't know 0.2 0.3 0.3 Total 100.0 100.0 1(30.0 Sanitation facility Own flush toilet 62.8 43.5 53.3 Shared flush toilet 13.0 6.9 10.0 Trad. own pit toilet 8.7 12.0 10,3 Trad. shared pit toilet 3.6 3.3 3.5 Open p6vy 3.8 10.0 6.8 Drop/overhang type 2.0 3.9 2.9 No facilities 5.8 20.1 12.8 Other 0.2 0.0 0.1 Missing/Don't know 0.2 0.2 0.2 Total 100.0 100.0 100.0 Flooring Eaah/sand 5.1 7.9 6.5 Wood planks 20.3 20.9 20.6 Palm/bamboo 14.3 36.4 25.2 Parquet/polished wood 0.8 0.5 0.7 Viny//asphalt strips 1.3 0.2 0.8 Ceramic tiles 2.7 0.9 1.8 Cement 50.4 31.9 41.3 Marble 3.0 0.5 1.8 Other 1.7 0.6 1.2 Missing/Don't know 0.3 0.2 0.3 Tc~al I00.0 100.0 100.0 Persons per sleeping room 1-2 47.3 41.4 44.4 3-4 33.0 35.1 34.0 5-6 12.8 14.7 13.7 7 + 5.3 7.5 6.4 MJ ssing/Don 't know 1.6 1.3 1.4 Total 100.0 100.0 100.0 Mean persons per room 3.2 3.4 3.3 Number of households 6613 6382 12995 18 Figure 2.3 Housing Characteristics by Residence Percent of Households 100 80 60 40 20 Electricity Piped Water Flush Toilet Note: Piped water includes public tap. 1993 NDS The majority of the households (64 percent) have their own toilet facility. The proportion is much higher in urban (72 percent) than in rural areas (56 percent). A large proportion (20 percent) of rural households have no toilet facility. As to the type of flooring material, 41 percent of the households have cement floors, and one in four have palm or bamboo floors. Urban households are more likely to use cement than rural households (50 and 32 percent, respectively). One fifth of the households in both the urban and rural areas have wood plank floors. In the NDS, a question was asked about the number of rooms the household used for sleeping. The purpose was to get a measure of household crowding. On average, there were 3 persons per sleeping room. No significant difference was noted between the urban and rural areas in this respect. Durable Consumer Goods The percentage ofbeuseholds owning specific durable consumer goods by urban- rural residence is presented in Table 2.7. Among the durable consumer goods, tele- vision is available in 43 percent of the house- holds, followed by refrigerator (28 percent). Table 2.7 Household durable goods Percentage of households possessing specific durable consumer goods, by urban-rural residence, Philippines 1993 Residence Durable goods Urbma Rural Total Oas/electaic range 21.1 8.0 14.6 Television 61.5 23.8 43.0 Refrigerator 41.9 13.0 27.7 Bicycle 24.1 18.5 21.4 Momrcycle 7.3 4.7 6.0 PrivaLe cer 9.9 2.1 6.1 Number of households 6613 6382 12995 19 The proportion of households with such appliances varies greatly between the urban and rural areas; 62 percent of urban households reported having a television, compared to only 24 percent of rural households, and 42 percent of urban households have a refrigerator, compared to 13 percent of rural households. Twenty- one percent of urban households have either an electric or a gas range, compared to only 8 percent of rural households. Urban households are more likely than rural households to own some means of transportation (either a bicycle, motor cycle or private car). 2.3 Characteristics of Respondents In the household questionnaire, a total of 15,332 women were identified as eligible for interview for the NDS individual ques- tionnaire. Of these women, 15,029 or 98 per- cent were successfully interviewed. In each age group, the proportion of women inter- viewed was about the same. General Characteristics Table 2.8.1 shows the distribution of women in the NDS sample by selected back- ground characteristics. More than half (55 percent) of the women interviewed in the sur- vey are under age 30. Married women com- prise 54 percent of the total women inter- viewed, while never-married women consti- tute just over one third. Almost all of the women who were interviewed have had some formal education. More than one fourth are in college or are college graduates, and a large proportion (40 percent) have attended high school. Roman Catholic is the most predomi- nant religion (83 percent). With respect to ethnicity, Tagalog and Cebuano groups com- prise more than half of the respondents. Table 2.8.2 shows that there are slightly more respondents from the urban areas than from the rural areas. Almost one in five respondents (18 percent) were from the Metropolitan Manila area, 10 percent were found in the Northern provinces (comprising Ilocos, Cagayan Valley, and Cordillera Administrative Region), while the rest of Luzon has about 30 percent of the respon- dents. Visayas and Mindanao have 20 and 22 percent of the respondents, respectively. Table 2.8.1 Background characteristics of respondents Percem distribution of women by selected background characteristics, Philippines 1993 Number of women Background Weighted Un- characteristic percent Weighted weighted Age 15-19 21.0 3158 3139 20-24 17.6 2649 2602 25-29 16.2 2430 2412 30-34 14.6 2196 2228 35-39 12.6 1889 1907 40-44 10.5 1571 1597 45-49 7.6 1137 1144 Marital status Never married 36.7 5518 5343 Married 54.4 8180 8372 Living together 5.2 781 773 Widowed 1.8 273 276 Divorced 0.2 29 31 Separated 1.6 248 234 Education No education 2.1 320 382 Elementary 31.2 4690 4863 High school 39.7 5967 5868 College or higher 26.9 4049 3913 Don't know~missing 0.0 3 3 Religion Catholic 83.2 12507 12246 Protestant 2.8 426 454 Iglesia ni Kristo 2.8 414 403 Aglipay 1.5 228 241 Islam 3.5 521 671 Other 6.0 908 989 None 0.1 13 14 Missing 0.1 11 11 Ethnlclty Tagalog 28.2 4237 3256 Cobuuno 26.0 3907 4345 Iloca~o 10.4 1556 1773 nonggo 11.1 1670 1659 Ricolano 6.2 926 902 Waray 4.0 597 638 Other 14.1 2117 2437 Missing 0.1 19 19 Total 100.0 15029 15029 20 Table 2.8.2 Background characteristics of respondents Percem distribution of women by type of residence and region, Philippines 1993 Number of women Background Weighted Un- characteristic percent Weighted weighted Residence Urban 56.6 8501 7908 Rural 43.4 6528 7121 Region Metro. Manila 18.2 2733 1882 Cordillera Admin. 1.6 241 473 Ilocos 5.5 832 967 Cagayan Valley 3.2 486 689 C-Luzon 10.6 1599 1391 S-Tagalog 13.5 2025 1516 Bicol 5.4 805 849 W-Visayas 8.1 1216 1206 C-Visayas 7.5 1121 1165 E-Visayas 4.3 645 802 W-Mindanao 4.8 729 945 N-Mindanao 5.3 794 996 S-Mindanao 7.3 1095 1205 C-Mindanan 4.7 707 943 Education by Age, Urban-Rural Residence and Region Table 2.9 presents the percent distribution of the respondents by the highest level of education attended, according to age, urban-rural residence and region. The data show that younger women have higher educational attainment than older women. About 80 percent of women 15-24 have attended at least secondary level of education, compared to less than half of women age 40 and older. As expected, women in the urban areas are better educated than women in the rural areas. About three fourths of urban women have attended at least secondary school compared to only 54 percent of rural women. Women in Metropolitan Manila, Ilocos and the Cordillera Administrative Region (CAR) are better educated than in other regions. On the other hand, Bicol, Western Mindanao and Central Mindanao had the lowest proportion of women with secondary or higher level of education. Exposure to Mass Media Presented in Table 2.10 is the percentage of the respondents who were exposed to different types of mass media by age, educational level, urban-rural residence and by region. The table shows that about 90 percent of the women listen to the radio at least once a week while 72 percent or more watch television and read newspapers. Younger women are more likely to have been exposed to mass media than older women. A positive relationship is noted between exposure to mass media and educational attainment. Women with higher educational level are more likely to have been exposed to mass media. Between urban and rural areas, the proportion differs greatly for those who read newspapers and watch television but not for those who listen to the radio. 21 Table 2.9 Level of education Percent distribution of women by the highest level of education attended, according to selected background characteristics, Philippines 1993 Level of education College Background High or characteristic None Elementary school higher Total Number Age 15-19 1.2 17.9 64.6 16.4 100.0 3158 20-24 1.7 21.1 40.2 37.1 100.0 2649 25-29 2.3 25.5 38.4 33.8 100.0 2430 30-34 2.1 34.6 31.9 31,4 100.0 2196 35-39 2.8 42.7 30.5 24,0 100.0 1889 40~4 2.8 47.3 26.8 23.1 100.0 1571 45-49 3.7 56.0 20.7 19.6 100.0 1137 Residence Urban 1.3 22.6 41.9 34.2 100.0 8501 Rural 3.2 42.5 36.8 17.5 100.0 6528 Region Metro. Manila 0.5 14.4 44.8 40.2 100.0 2733 Cordillera Admin. 1.1 23.5 37.0 38.5 100.0 241 Ilocos 0.4 29.5 43,2 26,9 100.0 832 Cagayan Valley 1.6 38.5 35.4 24.5 I00.0 486 C-Luzon 0.4 34.9 41.9 22.8 100.0 1599 S-Tagalog 0.8 31.7 40.6 26.9 100.0 2026 Bicol 0.2 45.0 37.0 17.8 100.0 805 W-Visayas 0.9 32.5 38.1 28,4 100.0 1216 C-Visayas 2.1 42.7 32.4 22.7 100.0 1121 E-Visayas 1.1 38.2 39.8 20.9 109.0 645 W-Mindanao 10.9 38.5 28.9 21.7 100.0 729 N-Mindanao 0.9 35.2 41.9 21.9 100.0 794 S-Mindanao 4.1 31.9 42,9 21.2 100.0 1095 C-Mindanao - 13.6 30.6 32,9 22.8 100.0 707 Total 1 2.1 31.2 39,7 26.9 100.0 15029 alncludes 3 women with no information on level of education. 22 Table 2.10 Exposure to mass media Percentage of women who usually read a newspaper once a week, watch television once a week, or listen to radio once a week. by selected background characteristics, Philippines 1993 Read Watch Listen to Number Background newspaper tele-~islon radio of characteristic weekly weekly weekly women Age 15-19 80.9 81.1 93.2 3158 20-24 77.0 74.7 91.1 2649 25-29 74.6 71.2 89.8 2430 30-34 70.0 67.0 88.4 2196 35-39 67.9 66.5 87.5 1889 40M4 64.6 67.5 88.9 1571 45-49 61.8 67.1 88.9 1137 Education No education 6,7 17.7 51.5 320 Elementary 50.2 53.0 84.6 4690 High school 79,9 77.6 92.7 5967 College or higher 93.7 90.0 95.7 4049 Residence Urban 81.8 85.4 92.2 8501 Rural 61,1 54.5 87.3 6528 Region Metro. Manila 94.7 97,8 93.8 2733 Cordillera Adrnin. 71.9 44.6 89.4 241 IIocos 78.6 83.5 92.5 832 Cagayen Valley 62.0 43.1 93.3 486 C-Luzon 84.1 90.5 91,I 1599 S-Tagalog 80.7 82.1 93.1 2026 Bicol 65.0 43.7 85.6 805 W-Visayas 72.0 69.7 93.1 1216 C-Visayas 45.4 61.8 90.2 1121 E-Visayas 77.4 58.1 91.4 645 W-Mindanao 46.9 41.1 72.6 729 N-Mindenao 49.5 54.0 84.9 794 S-Mindmaao 63.7 66.0 90.1 1095 C-Mindenao 57.4 43.9 82.6 707 Total 1 72.8 72.0 llaxcludes 3 women with no information on lave| of education. 90.1 15029 23 CHAPTER 3 FERTILITY In line with the objective of measuring fertility levels, trends, and differentials, spocial care was given to administer a set of carefully worded questions to obtain accurate and reliable data on fertility. Data on fertility come from a full pregnancy history asked of all women aged 15-49 at the time of survey. The sequence of questions was intended to derive information on all pregnancies which resulted in either a live birth or a miscarriage or still birth. For live births, the women were asked questions about children stitl living at home, those living elsewhere, and those who had died. Since pregnancies were listed in the order of occurrence, it was possible to probe cases where any lengthy or too brief time gap between pregnancies was reported. For pregnancies not ending in a live birth, the women were asked the month and year of pregnancy termination as well as the duration of the pregnancy. For pregnancies that were lost before full term, the women were asked whether a doctor or anyone else did something to end the pregnancy. This approach maximizes recall of all pregnancies and provides a richer data set for fertility analysis than a full birth history. The analysis in this chapter revolves around females who were 10om in a given time period (birth cohorts) and on those who married during a given time period (marriage cohorts). The fertility measures presented here are derived directly from the pregnancy history. The total fertility rate (TFR) is calculated by summing the age-specific fertility rates, and can be interpreted as the average number of births a hypothetical group of women would have at the end of their reproductive lives if they were subject to the currently prevailing age-specific rates from age 15 to 49. The'l VI< remains the most significant demographic indicator in the analysis of the impact of national population programs, in particular, family planning programs, on individual or group reproductive behavior. A three-year "l'l~R was computed to provide the most recent estimates of current levels of fertility to reduce sampling error and to avoid problems of displacements of births reported from 5 to 6 years prior to survey. ~ 3.1 Current Fertility Reproductive behavior in the.Philippines around 1993 remains at a level not substantially different from what prevailed in 1988, as measured by TFR. Data in Table 3.1 show that for the country as a whole, TFR was estimated at 4.09 children per woman. This is indicative of a slight decline from 4.26 children per woman in 1988. The age-specific fertility rates show an age pattern that peaks at ages 25-29 and tapers off at the older ages. Table 3.1 also shows a general fertility rate (GFR) of 138 live births per 1,000 women age 15M4 years and a crude birth rate (CBR) of 29.7 births per 1,000 population. By all indicators, the current fertility level in the Philippines remains relatively high when compared with its Southeast Asian neighbors. In addition to the slow pace of decline from the most recent survey prior to 1993, another notable feature of current fertility is the lower fertility of urban women in the country. The "FUR for urban areas is 3.5 births per woman, 1.3 less than the rural TFR. Lower urban fertility is observed across all age groups (Figure 3.1). ~The distribution of all children by calendar year of birth shows a slight heaping of births in 1989 and 1990 and a deficit in the year prior to and after those years (see Table C.4). The transference of births out of 1988 was apparent for living children. This pattern has been observed in other DHS surveys; it is believed to be the result of transference of births by interviewers out of the period for which the health and calendar data were collected (January 1988 through the date of the survey). 25 Table 3.1 Current fertilh~' Age-specific and cumulative fertility rates and the crude birth rate for the thr~c years preceding the sur~cy, by urban- rural realdenc~, Philippines 1993 Residence Age group Urban Rural Total 15-19 36 72 50 20-24 157 239 190 25-29 203 236 217 30-34 161 205 181 35-39 102 140 120 40~4 42 62 51 45-49 5 12 8 TFR 15-49 3.53 4.82 4.09 TFR 15-44 3.50 4.77 4.05 GFR 119 163 138 CBR 28.5 30.9 29.7 Not*: Rates are for the period 1-36 months preceding the survey. Ratss for age group 45-49 may be slighfy biased due to truncadon. TFR: Total fertility rate expressed per woman GFR: General fertility rate (births divided by number of womcn 15-44), expressed per 1,000 women CBR: Crude bitlh rate, expressed per 1,000 populatinn 250 2O0 150 Figure 3.1 Age-Specific Fertility Rates by Residence Births per 1,000 Women / / / / / / y I I [ I I 15-19 20-24 25-29 30-34 35-39 40-44 Age 45-49 1993 NDS 26 3.2 Fertility by Background Characteristics Variations in fertility are evident from the data on current and cumulative fertility shown in Table 3.2. The mean number of children ever born (CEB) to the oldest women (40-49 years of age) is an indicator of completed fertility for it reflects the fertility per- formance of older women who are nearing the end of their reproductive life span. If fertility has remained stable over time, the two fertility measures, TFR and CEB, would be equal or similar. Although a comparison of completed fertility among women aged 40-49 years with the total fertility rate provides an indication of fertility change, this approach may be somewhat biased due to understatement of parity reported by older wom- en. Nevertheless, consistency in the two measures with respect to urban-rural differentials and educational attainment is observed. As noted earlier, urban women are inclined to have fewer children than their rural counterparts. On average, urban women have at least one child less than rural women have. This may be interpreted as arising from differences in levels of development between the urban and rural areas (Figure 3.2). Such differences are also substantiated by the regional variation in fertility. Note that Metropolitan Manila, the most developed region, exhibits the lowest I 'FR of 2.76 children per woman, and the lowest mean number of children ever bom of 3.46 children per wom- an. By contrast, Bicol, the least developed region in the country, shows the highest TFR of 5.87 and mean CEB of 6.14 children per woman. The difference in fertility between the two contrasting regions is at least 3 chil- dren. The widely accepted nonlinear negative effect of education on fertility is clearly bome out by the data. The depressing effect of education on fertility is best indicated by the difference in fertility rate between those with an elementary education estimated at 5.5 children Table 3.2 Fertility by background characteristics Total fertility rate for the three years preceding the survey and mean number of children ever born to women age 40-49. by selected background characteristics. Philippines 1993 Mean number of children Total ever born Background fertility to women characteristic rate I age 40-49 Residence Urban 3.53 4.34 Rural 4.82 5.65 Region Metro. Manila 2.76 3.46 Cordillera Admin. 5.05 4.44 llocos 4.25 5.12 Cagayan Valley 4.20 4.60 C-Luzon 3.87 4.58 S-Tagalog 3.86 4.81 Bicol 5.87 6.14 W-Visayas 4.24 5.17 C-Visayas 4.38 5.04 E-Visayas 4.86 5.70 W-Mindanao 4.46 5.46 N-Mindanao 4.81 5.79 S-Mindanao 4.23 5.43 C-Mindanao 4.81 6.09 Education No education 4.93 6.07 Elementary 5.51 5.93 High school 3.93 4.40 College or higher 2.82 3.10 Total 4.09 4.95 IRate for women age 15.49 years per woman and those with higher education estimated at 2.8 children per woman. Thus, a Filipino woman without education can be expected to have almost twice as many children as a highly educated woman. The data suggest that a good, perhaps the best mechanism, for fertility reduction is to improve education of women. This would free women to spend more time on economic and other pursuits rather than childbearing which in turn would aid the family as a whole. 27 Figure 3.2 Total Fertility Rate among Women 15-49 by Residence and Education Total Fertility Rate 6 5 4 3 2 1 0 Urban Rural No Elemen- High Collge Education tary School or Higher RESIDENCE EDUCATION Note: Rates are for the period 0-3 years preceding preceding the survey, 1993 NDS 3.3 Fertility Trends To validate the data obtained from the 1993 NDS, age-specific fertility rates are compared with corresponding rates from periodic national demographic surveys from 1973 to 1993. Discrepancies will reflect a combination of real change, of differences in geographic coverage, of change in data collection procedures, and of estimation techniques in one or in all surveys. Nonetheless, they serve the purpose of reflecting recent change in fertility trends in the Philippines. Data inTable 3.3 for the 20-year period preceding the survey are fertility rates reflecting a three-year rate from the 1993 survey and five-year averages centered on mid-period years as calculated from the 1973, 1978, 1983, and 1988 surveys, respectively. In general, however, the TPR declined from 6.0 children per woman in 1970 to 4.1 in 1991 or a decrease of 2.0 births per woman during the 20-year period. The pace of decline in fertility over time is varied. During the period roughly 1970-1975, the "l't'R declined by 2.4 percent annually. This was followed by a smaller decline of 0.6 percent during the succeeding five-year period. The largest decline was during the first half of the eighties estimated at 3.2 percent annually. The latter half of the eighties once again revealed a slide back in the progress of fertility reduction with just 1.2 percent annual decline during the period 1985-1991 (see Figure 3.3). Through most of the 20 years, the female mean age at marriage has remained high and relatively stable, averaging about 23 years for the past two decades. The observed decline in fertility can be attributed primarily to changes in family planning practices (see Chapter 4). 28 Table 3.3 Fertility trends Age-specific and total fertility rates from various surveys, Phliipp'mes 1973-1993 Age 1973 1978 1983 1986 1993 NDS RPFS NDS CPS NDS (1970) (1975) (1980) (1984) (1991) 15-19 56 50 55 48 50 20-24 228 212 220 192 190 25-29 302 251 258 229 217 30-34 268 240 221 198 181 35-39 212 179 165 140 120 40-44 100 89 78 62 51 45-49 28 27 20 15 8 TFR 5.97 5.24 5.08 4.42 4.09 Note: Rates for 1970-1980 are five-year averages, and 1984 and 1991 are three- year averages centered on the years in parentheses. Source: Concepcidn, 1991, Table 4.10 Births per Woman Figure 3.3 Total Fertility Rates Philippines, 1970-1991 7,0 6.0 5.0 4.0 3.0 2.0 1,0 0.0 1973 NDS 1978 RPFS Note: Rates are based on 5-year averages except for the 1993 NDS, which is based on a 3-year average, 1983 NDS 1986 CPS 1993 NDS 29 Retrospective data from a single survey can also be used to establish fertility trends overtime. Age- specific fertility rates (ASFRs) from the 1993 NDS for the last 20 years by five-year periods are shown in Table 3.4. The ASFRs therefore are progressively truncated with increasing number of years from time of survey. Due to truncation, changes over the past 20 years are observed for women up to age 29 years. Table 3.4 Age-specific fertili~ rates Age-specific fertility rates for five-year periods preceding the survey, by mother's age, Philippines 1993 Number of years preceding the survey Mother's age 0-4 5-9 10-14 15-19 15-19 52 62 70 75 20-24 190 216 238 239 25-29 216 232 263 277 30-34 175 192 216 [250] 35-39 123 133 [167] 40-44 56 [76] 45-49 [10] Note: Age-specific ferdfity rates are per 1,000 women. Estimates enclosed in brackets are truncated. In terms of intemal consistency, the data substantiate a fertility decline, as the ASFRs are higher in the distant past than in the more recent past. The minimal decline of fertility among women age 20-24 as shown by ASFRs 15-19 and 10-14 years from the survey is similar to the trend observed in previous surveys and, therefore, does not necessarily suggest recall or omission of problems by older women in the survey. Overall, fertility decline during the past 20 years has been moderate. For women aged 15-29, the "I'FR declined from 3.0 in 15-19 years before the survey to 2.3 in 0-4 years before the survey. The data also show variation across age groups. A closer look at the more recent fertility change by comparing the ASFRs between 0-4 years and 5-9 years prior to survey reveal that the reduction is largest for those under 20 years. 3.4 Fertility by Marital Duration Table 3.5 presents fertility rates for ever-m arried women by duration since first marriage for five-year periods preceding the survey. These rates are similar to the ones presented in Table 3.4 and are subject to similar problems of truncation. Declines are observed in all marital durations; for all five-year periods marital fertility is larger in the more distant past than in the recent past. 3.5 Children Ever Born and Living A basic measure of fertility is the number of children ever bom (CEB) or current parity. This measure is based on a cross-sectional view at the time of survey and does not refer directly to the timing of fertility of the individual respondents but is a measure of her completed fertility. The number of CEB by age of women for all women and currently married women and the corresponding mean CEB as well as mean number of living children is presented in Table 3.6. Among all women, at least 2 in 5 do not have children. 30 Table 3.5 Fertility by marital duration Fertility rates for ever-married women by duration since f'trst marr iage in years, for five-year periods preceding the survey, Phil ippines 1993 Marr iage duration at birth Number of yeats preceding the survey 0-4 5-9 10-14 15-19 04 384 392 411 425 5-9 235 258 291 325 10-14 165 183 234 274 15-19 114 151 187 [261] 20-24 76 106 [156] [312] 25-29 33 [83] Note: Fertility rates are per 1,000 women. Estimates enclosed in brackets are truncated. Table 3.6 Chi ldren ever born and living Percent distribution of all women and of currently married women by number of chi ldren ever born (CEB) and mean number ever born and living, according to five-year age groups. Philippines 1993 Mean Mean Number of children ever born (CEB) Number number number Age of of of livang group 0 1 2 3 4 5 6 7 8 9 10+ Total women CEB children ALL WOMEN 15-19 94.7 4.1 1.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 3158 0.07 0.06 20-24 59.9 17.7 13.8 6.3 1.9 0.4 0.0 0.1 0.0 0.0 0.0 100.0 2649 0.74 0.71 25-29 29.2 14.8 20.6 17.0 11.1 4.7 2.0 0.4 0.1 0.1 0.0 100.0 2430 1.92 1.81 30-34 14.9 11.1 16,0 17.8 15.7 10.1 7.3 4.1 1.9 0.8 0.2 100.0 2196 3.08 2.86 35-39 9.2 7.7 12.2 16.6 15.4 12.5 9.9 6.6 4.5 3.0 2.4 100.0 1889 4.01 3.71 40~14 8.0 4.7 8.7 14.1 17.5 12.2 9.1 7.3 6.6 5.3 6.4 100.0 1571 4.73 4.33 45-49 8.5 3.9 7.2 11.7 12.9 12.5 9.7 8.6 8.2 5.9 10.9 100.0 1137 5.26 4.76 Total 40.0 9.8 11.3 10.9 9.2 6.1 4.3 2.9 2.2 1.5 1.8 100.0 15029 2.30 2.13 CURRENTLY MARRIED WOMEN 15-19 33.8 50.3 14.4 1.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 234 0.83 0.80 20-24 13.5 37.0 30.5 13.8 4.2 0.8 0.l 0.1 0.0 0.0 0.0 100.0 1174 1.62 1.55 25-29 6.0 18.6 27.5 22.7 15.2 6.5 2.7 0.5 0.2 0.1 0.0 100.0 1763 2.58 2.44 30-34 4.1 10.7 17.7 20.4 18.2 11.9 8.6 4.9 2.3 0.9 0.3 100.0 1838 3.55 3.30 35-39 2.8 6.7 12.1 18.0 16.9 13.7 11.1 7.5 5.1 3.4 2.8 100.0 1652 4.40 4.07 40-44 2.9 3.8 8.6 15.1 18.5 13.1 10.0 8.1 6.9 6.0 6.9 100.0 1358 5.09 4.66 45-49 3.1 2.9 7.5 13.1 13.3 13.2 10.5 8.7 9.1 6.6 12.0 100.0 942 5.67 5.13 Total 6 0 14.1 17.7 17.5 14.6 9.7 7.0 4.6 3.5 2.4 2.9 100.0 8961 3.65 3.38 31 By contrast, only 6 percent of married women do not have children. The table shows marked differences in the proportion without any children at younger ages and between married women and all women. This is due to the fact that many women remain unmarried in their twenties. Considering that most of the births still occur within marriage despite sweeping social changes in the country, this rather small proportion of childlessness suggests that the potential for high fertility is great in Philippine society. The figures for childlessness may also be used to estimate primary sterility. On the other hand, 3 percent of married women age 45-49 are childless, the corresponding proportion without children among all women 45-49 is higher, at 9 percent. The differences at older ages reflect the combined impact of marital dissolution, infertility, and celibacy. It is worth stressing that while 1 in 12 Filipino women 45-49 remains childless, over 10 percent have 10 or more births. Table 3.6 also shows that while the proportion of women with no children or zero parity decreases with age, the proportion of women at higher parity increases with age, reflecting the process of family formation over time. Also, the mean CEB for both groups of women become larger with increasing age of the women indicating that the data were free from gross recall bias. The mean parity for the whole sample of women was 2.3 children; for the married women, it was 3.7 children. It is interesting to note that for women completing their childbearing at age 45-49, mean CEB was 5.3 children among all women and 5.7 children among married women. Besides describing average family size, information on number of living children at the time of interview reported by a respondent or the current family size derived from the pregnancy history can give some indications of infant and child mortality. The data show that on average, all women had 2.1 children still living and those married report 3.4 living children. It is notable that the mean number of CEB and children still living are not substantially different. On average, both groups of women had a loss of 7 percent of all live births. 3.6 Birth Intervals The timing of births has significant influence on both fertility and mortality. There has been evidence that women with closely spaced births have higher fertility than women with longer birth intervals. Similarly, studies in diverse settings consistently show that shorter birth intervals increase the incidence of infant and child mortality. Table 3.7 shows the percent distribution of births in the five years preceding the survey by length of interval since the previous birth, classified by some demographic and background characteristics of the women. In general, the median length of birth interval is slightly over 2 years, estimated at 28 months; about 1 in 5 births occurs four or more years after a previous birth, and more than one third of the births occur within two years of a previous birth. This finding is cause for concem as it has implications for maternal and child health and survival. It has been shown that short birth intervals, particularly those less than two years, elevate risks of death for both mother and child (see Chapter 7). Data on median birth interval by demographic and background characteristics reveal interesting differentials. Younger women who are just beginning tbeir reproductive years exhibit shorter median birth intervals; they are estimated at 19 and 25 months for women under 20 and 20-29 years old, respectively. By contrast, those 30-39 years old report a median birth interval of 31 months, and those 40 years and older report 36 months, an interval nearly twice as lung as that of women aged 15-19. 32 Table 3.7 Birth intervals Percent dis~ibudon of births in the five years preceding the survey by number of months since previous birth, according to demographic and socioeconomic chm-acterisdcs, Philippines 1993 Number of months since previous birth Characteristic 7-17 18-23 24-35 36-47 48+ Total Median number of Number months since of previous birth births Age of mother 15-19 36.0 32.5 31.5 0.0 0.0 I00.0 19.3 40 20-29 21.8 26.0 32.0 11.7 8.6 100.0 24.6 2779 30-39 13.7 16.3 30.5 15.5 24.1 100.0 30.9 3175 40 + 10.0 12.4 26.8 15.1 35.8 100.0 36.4 846 Birth order 2-3 19.8 21.8 28.1 12.8 17.6 100.0 26.6 3192 4-6 13.4 17.7 32,2 14.8 22.0 100.0 29.9 2460 7 + 14.9 19.4 34.5 14.4 16.9 100.0 28.3 1188 Sex of prior birth Male 17.4 19,4 29.9 13,5 19.8 100.0 28.3 3570 Female 15.8 20.4 31.5 14.0 18.3 100.0 27.9 3269 Survival or prior birth Living 15.6 20.1 30.9 14.0 19.4 100.0 28.4 6439 Dead 33.0 16.3 27.2 10.3 13.1 100.0 24.2 400 Residence Urban 18.1 19.9 28.4 12.4 21.1 100.0 27.8 3187 Rural 15.3 19.8 32.6 15.0 17.3 100.0 28.3 3652 Region Metro. Manila 23.2 17.0 25.5 11.9 22.4 100.0 27.2 719 Cordillera Admin. 19.4 21.2 33,8 11.9 13.7 100.0 26.7 142 llocos 17.2 19.5 30.7 14.2 18.5 100.0 27.7 376 Cagayaa Valley 15.2 15.2 33.0 14.3 22.3 100.0 29.7 249 C-Luzon 17.9 16.4 29.3 14.6 21.8 100.0 30.3 686 S-Tagalog 13.8 18.2 31.9 14.8 21.2 100.0 29.6 820 Bicol 16.6 20.1 34.7 12.0 16.6 100.0 27.5 560 W-Visaya.s 13.9 20.4 34.0 14.4 17.2 100.0 28.1 587 C-Visayas 16.1 22.9 28.4 14.6 17.9 100.0 27.2 579 E-Visayas 15.2 24.5 28.4 14.8 17.0 100.0 27.6 354 W-Mindanao 15.5 20.0 32.8 12.2 19.5 100.0 28.2 404 N-Mindanao 15.6 23.8 26.7 15.1 18.9 100.0 27.6 439 S-Mindanao 16.6 21.2 33.3 12.4 16.5 100.0 27.2 519 C- Mindanao 16.0 21.2 30.6 14.9 17.3 100.0 28.1 407 Ed uca~ol'l No education 18.4 16.5 3].8 16.6 16.8 100.0 28.0 209 Elementary 14.1 19.7 33,7 13.9 18.6 100.0 28.8 3140 High school 17.2 2L1 30.3 14.0 17.4 100.0 27.2 2307 College or higher 21.9 18.4 23.2 12.5 24.0 100.0 27.8 1184 Total 16.6 19.9 30.7 13.8 19.1 100.0 28.1 6839 Note: First-order births are exchided.The interval for multiple births is the number of months since the preceding pregnancy that ended in a l ive birth. 33 Birth order exhibits a generally curvilinear relationship with median birth interval, increasing from a minimum of 27 months for second to third birth orders, to a peak at 30 months for the fourth through the sixth order births, then declining to 28 months for the seventh or higher order births. It is apparent from these data that the interval between births is greater after the third child. The data in Table 3.7 show that birth interval does not vary by the sex of the previous child. The survival status of the previous birth influences the timing of the next birth. For women whose previous birth is still living, the next birth occurred after 28 months. For those whose previous births did not survive, the corresponding birth interval was shorter by 4.2 months. This finding raises interesting questions on the different mechanisms through which infant and child mortality influences birth intervals and fertility, particularly the question of whether mothers seek to replace deceased children as soon as possible. Urban-rural residence and mother's education do not seem to exert an effect on length of birth interval. The insignificant difference in median birth interval between those with no schooling and those with college education does not stand up to the usual expectation that better educated women would space their births more widely than uneducated women. The absence of any significant differential in spacing behavior is also evident when urban-rural residence of mother are examined. 3.7 Age at FirstBirth Onset of childbearing is an important fertility indicator. Postponing the first birth and lengthening the interval between subsequent births can contribute to fertility reductions. As can be seen in Table 3.8, early childbearing in the Philippines is not commonplace. Among women age 45-49, only 2 percent had their first birth below age 15. This proportion has diminished among women 15-19. Even among women 20-24, the proportion who had their first birth before reaching age 15 is less than 1 percent. The reduction in the proportions giving birth in the early teens could be attributed to the rise in age at first marriage which has been sustained during the past two decades. Even if reported age at first birth by older women may be subject to omission or misdating of early births, information gathered among women age 45-49 still give some indications of the timing of first birth and the tempo of fertility. Four in 10 of women in the oldest age group had their first birth during their early Table 3.8 Age at first birth Percent distribution of women 15~.9 by age at first birth, according to current age, Phil ippines 1993 Current age Women Median with Age at first birth Number age at no of first births <15 15-17 18-19 20-2I 22-24 25+ Total women birth 15-19 94.7 0.1 3.3 1.9 NA NA NA 100.0 3158 a 20-24 59.9 0.5 7.4 13.6 12.0 6.6 NA 100.0 2649 a 25-29 29.2 0.9 8.3 14.6 17.4 19.5 10.0 100.0 2430 23.1 30-34 14.9 0.5 9.3 16.5 16.7 20.3 21.8 100.0 2196 22.9 35-39 9.2 0.7 10.3 16.4 18.9 20.6 24.0 100.0 1889 22.4 40-44 8.0 1.1 8.8 15.8 17.7 22.0 26.6 100.0 1571 22.9 45-49 8.5 1.5 9.8 17.0 17.2 20.0 25.9 100.0 1137 22.6 NA = Not applicable aLess than 50 percent of the women in the age group x to x-~4 have had a birth by age x 34 twenties (37 percent), and one in four (26 percent) after age 25. A similar pattern is found for younger women, with a larger proportion of women 30-34 having their first birth at age 20-24 than after age 25 (37 and 22 percent, respectively). Clearly, most Filipino women had their first birth during their early twenties rather than in their teens. The median age at first birth shows a slight increase from 22.6 years among women age 45-49 to 23.1 years among women age 25-29. Differentials in age at first birth by selected background characteristics of the women are presented in Table 3.9. The median age at first birth among women age 25-49 is 22.8 years. This figure compares well with that of Thai women, and is almost three years higher than that of Indonesian women and 1.5 years higher than that of Pakistani women (Central Bureau of Statistics, 1992; Chavoyan et al., 1988; and National Institute for Population Studies, 1992). Table 3.9 Median age at first birth Median age at first birth among women age 25-49 years, by current age and selected background characteristics, Philippines 1993 Current age Background Ages chm-acteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 24.3 23.8 23.0 23.5 23.6 23.7 Rural 22.0 21.9 21.7 22.1 21.5 21.9 Region Metro. Manila a 26.1 23.5 24.6 24.5 a Cordillera Admin. 22.7 22.6 23.9 23.6 23.2 23.2 Iloces 23.7 22.6 23.2 22.6 22.8 23.0 Cagayan Valley 21.7 22.0 21.3 22.3 19.9 21.7 C-Luzon 22.7 22.4 22.5 23.7 22.8 22.7 S-TagaIog 22.9 22.7 22.1 22.8 22.8 22.7 Bicol 22.5 22.1 21.6 21.8 21.0 21.9 W-Visayas 23.5 23.6 23.4 22.8 23.3 23.3 C-Visayas 22.9 22.8 23.5 22.7 22.4 22.9 E-Visayas 21.9 21.9 21.9 22.2 20.7 21.8 W-Mindanao 21.5 21.3 22.1 22.1 21.5 21.7 N-Mindanao 21.8 22.8 21.4 20.8 22.5 21.8 S-Mindanao 22.1 21.9 21.4 22.9 22.4 22.0 C-Mindanao 21.2 21.3 22.3 21.6 21.6 21.6 Education No education 19.8 21.5 20.9 20.2 23.1 20.9 Elementary 20.8 20.7 21.0 21.4 21.1 21.0 High school 22.4 22.1 22.4 22.7 23.1 22.4 College or higher 26.9 26.5 25.9 26.4 26.9 26.6 Total 23.1 22.9 22.4 22.9 22.6 22.8 Note: The medians for the 15-19 cohort and for the 20-24 cohort could not be determined because half the women have not yet had a birth, aMedians were not calculated for these cohorts because less than 50 percent of women in the age group x to x+4 have had a birth by age x. 35 Filipino women in the urban areas are 1.8 years older than their rural counterparts when they first enter motherhood. Regional variation is not as distinct, but four regions (llocos, Western and Central Visayas, and the Cordillera Administrative Region) have median ages at first birth exceeding that of the country as a whole. Sharp educational differentials, however, are observed. Women with higher education exhibit a median age at first birth 5.7 years more than that of the unschooled women. The direct correlation between the median age at first birth and education indicates the postponement of marriage and eventual first birth among women who stay longer in school. 3.8 Teenage Ferti l i ty As noted earlier, early childbearing, and in particular births occurring before age 20, affects a small segment of the population. However, this does not necessarily mean that the insignificant level of teenage childbearing and motherhood does not pose social and health threats to society. Table 3.10 present data on fertility among teenagers age 15-19 at the time of the survey. Of the total women in these ages, only 7 percent have begun childbearing, five percent are already mothers and one percent being pregnant for the first time at the time of survey. Table 3.10 Te~a/~e pregnancy and motherhood Percentage of teenagers 15-19 who are mothers or pregnant with their first child, by seleeled background charaOzrisdes, Philippines 1993 Percentage who are: Percentage who have Pregnant ba/~un Number Background with rLrst child- of characteristic Mothers child bear ing teenagers Ag~ 15 0.4 0.1 0.5 662 16 0.6 0.7 1.3 681 17 2.9 0.7 3.6 650 18 8.3 2.0 10.3 600 19 16.1 2.9 19.0 565 Residence Urban 4.1 0.8 4.8 1868 Rural 7.0 1.8 8.9 1290 Region Metro. Manila 3.7 0.7 4.4 595 Cordillera Admin. 3.8 1.0 4.8 54 Iloeos 5.3 1.9 7.2 179 Cagayan Valley 7.3 1.8 9.2 77 C-Luzon 3.7 1.0 4.7 339 S-Tagnlog 6.0 0.9 6.9 444 aicol 3.4 2.1 5.5 138 W-Visayas 5.4 1.1 6.5 263 C-Visayas 7.7 2.3 9.9 214 E-Visayas 7.7 0.0 7.7 147 W-Mindanao 9.7 2.8 12.5 136 N-Mindanao 5.5 0.9 6.5 173 S-Mmdanao 5.2 1.1 6.3 245 C-Mindemao 4.4 1.0 5.4 154 Edu~thin No education 15.2 0.0 15.2 36 Elementary 11.7 1.8 13.5 566 High school 4.3 1.2 5.5 2039 CoLIegn or higher 1.3 0.4 l.g 517 Total 5.3 1.2 6.5 3158 36 Differences between subgroups of these women are evident. As expected, the proportion of women who have begun childbearing increases linearly with age, from less than one percent among those age 15 years to 19 percent among those age 19 years. Rural teenagers are almost twice as likely (9 percent) to experience teenage pregnancy as their urban counterparts (5 percent) (see Figure 3.4). Consistent with the urban-rural differentials, regional variations show that the less urbanized regions of Western Mindanao, Central Visayas, and Cagayan Valley all share higher proportions of teenage fertility relative to other regions of the country. This is particularly true for Western Mindanao where cultural factors impinging on women's roles and status could partially explain the highest proportion of teenagers with early childbearing ( 13 percent). Compare this to that in Metropolitan Manila which has the lowest proportinn of teenagers having begun childbearing (4 percent). One could infer from the data that teenagers in urban areas where educational facilities are concentrated, particularly in Metropolitan Manila, have other alternatives in life than early childbearing. Another interpretation is that teenagers in urban areas and more urbanized regions and those in school have greater access to information and could therefore be more knowledgeable on matters of safe sex. The preventive effect of education on early childbearing is borne out by the data. There is a gradual decrease in the proportions having begun childbearing from 15 percent among women who had never been to school to 2 percent among those with higher education. Percent Figure 3.4 Percentage of Teenagers Who Have Begun Childbearing Total Urban Rural No Elemen- High Colleg~ Education tan/ Sohool or Higher RES IDENCE EDUCATION 1993 N DS 37 3.9 Children Born To Teenagers A major concern about teenage pregnancy is its impact on the overall health and well-being of the mother and the child as women of reproductive age under 20 years old are considered at high risk of pregnancy-related illness and death. Table 3.11 shows that three of four teenagers who have started childbearing have one child, and the remaining 20 percent have two or more children. In both instances, the contribution of older teenagers to teenage motherhood is much more substantial than that of the younger teenagers. The overall level of teenage pregnancy in the country is low but this does not necessarily imply that efforts at curbing the incidence of pregnancy among adolescents should be decelerated. It should be borne in mind that as of 1990, about 5.5 percent of the country's total population--some 3.3 mill ion are girls aged 15-19. Table 3.11 Children bern to teenagers Percent distribution of teenagers 15-19 by number of children ever born (CEB), according to age, Philippines 1993 Age 0 1 2+ Number of Mean children ever born number Number of of Total CEB teenagers 15 99.6 0.4 0.0 100.0 0.00 662 16 99.4 0.6 0.0 100.0 0.01 681 17 97.1 2.7 0.3 100.0 0.03 650 18 91.7 7.6 0.8 100.0 0.09 600 19 83.9 10.7 5.4 100.0 0.22 565 Total 94.7 4.1 1.2 100.0 0.07 3158 38 CHAPTER 4 FAMILY PLANNING 4.1 Knowledge of Family Planning Methods and Their Sources Lack of knowledge of family planning methods and their sources is obviously a major obstacle to the use of contraception. As in other DHS surveys, information about knowledge of family planning methods and of the places where they can be obtained was generated by asking the respondent to name the ways or method that a couple can use to delay or avoid a pregnancy. If the respondent did not spontaneously mention a particular method, the interviewer described that method and asked the respondent if she recognized it. There were nine methods (pill, IUD, injection, diaphragm--together with foam and jelly--condom, female sterilization, male sterilization, natural family planning/rhythm method/period abstinence and withdrawal) described in the questiormaire. Other methods not provided in the questionnaire but mentioned spontaneously by the respondent were also recorded. For all methods mentioned or recognized, the respondent was asked if she knew where a person could obtain the method or, in the case of natural family planning, advice on how to use natural family planning. In this report, the term natural family planning is used for rhythm and periodic abstinence. Virtually all currently married women as well as all women know of one or more family planning method or a modem method (97 percent and 96 percent, respectively) (Figure 4.1 and Table 4.1). This high level of general contraceptive awareness has been observed in previous surveys, including the 1983 and 1988 National Demographic Surveys and 1986 Contraceptive Prevalence Survey (e.g., Concepci6n, 1991). Knowledge of traditional methods is only slightly less common than that of modem methods. Figure 4.1 Knowledge of Contraception Currently Married Women 15-49 Pill IUD Injection Diaphragm/Foam/Jelly Condom Female Sterilization Male Sterilization Natural Family Planning Withdrawal Note: Natural family planning refers to periodic abstinence or rhythm. ~ 9 6 54 92 . . . - 8 9 20 40 60 80 1 O0 Percent 1993 N DS 39 Table 4.1 Knowledge of contraceptive methods and source for methods Percentage of all women and currently married women who know specific contraceptive methods and who know a source (for information or services), by specific methods, Philippines 1993 Know method Know a source Currently Currently Contraceptive All married All married method women women women women Any method 95.9 97.2 88.8 93.3 Modern method 95.7 96.9 88.8 93.3 Pill 94.3 96.0 85.0 90.8 IUD 85.4 90.9 73.8 82.1 Injection 47.6 53.5 38.1 43.6 Diaphragm/foam/jelly 30.0 31.0 22.9 24.0 Condom 91.8 93.7 81.3 86.5 Female sterilization 87.4 92.2 75.4 82.9 Male sterilization 74.4 81.7 62.7 71.0 Any traditional method 85.1 92.5 NA NA Natural family planning 79.3 86.4 NA NA Withdrawal 77.5 88.7 NA NA Other traditional methods 6.2 8.1 NA NA Number of women 15029 8961 15029 8961 NA = Not applicable The more widely known modem methods are the pill, condom, female and male sterilization, and IUD. It is important to note that the low knowledge of injection is likely related to the fact that the method has not been cleared for widespread distribution (World Bank, 1991). The least known modem methods include the diaphragm together with foam and jelly and injections. Four of 5 women and slightly less than 90 percent of married women are aware of natural family planning and withdrawal. Not all who claim to know a family planning method know where they can obtain it; however, the gap between knowledge of contraceptive methods and knowledge of their sources among married women is very small. Over 90 percent know a source for the pill, 80 percent for the IUD, condom and female sterilization, and 70 percent for male sterilization. It is not surprising that less than 50 percent of women know a place where one can obtain injections and less than 25 percent of women know the source for diaphragm, foam and jelly because they are not well known contraceptive methods. Knowledge of any method, modem methods and sources for modem methods does not vary greatly by age, with the exception of the youngest age group, showing a lower level than older counterparts (Table 4.2). There is also little difference in levels of knowledge by urban-rural residence, where the urban level is higher by only 3 percentage points than the rural level. 40 Table 4.2 Knowledge of modem contraceptive methods and source for methods Percentage of currently married women who know at least one modem contraceptive method and who know a source (for information or services), by selected background characteristics, Philippines 1993 Know a Know Know source for Number Background any a modem modem of characteristic method method 1 method women Age 15-19 89.6 89.3 83.6 234 20-24 97.3 97.1 91.7 1174 25-29 96.9 96.7 94.5 1763 30-34 97.8 97.7 94.4 1838 35-39 96.9 96.7 93.3 1652 40-44 98.0 97.7 94.2 1358 45-49 97.1 97.0 92.2 942 Res|dence Urban 98.6 98.6 95.1 4638 Rural 95.6 95.2 91.4 4323 Region Metro. Manila 99.9 99.9 97.5 1272 Cordillera Admin. 99.3 99.3 98.6 148 Iincos 98.8 98.8 97.6 503 Cagayan Valley 98.1 97.9 94.2 340 C-Luzon 99.8 99.8 97.5 977 S-Tagalog 98.4 98.2 96.8 1218 Bicol 99.0 98.8 95.2 553 W-Visayas 99.1 99.1 97.7 706 C-Visayas 99.7 99.6 95.9 701 E-Visayas 95.8 95.4 81.6 403 W-Mindanan 80.3 79.2 67.7 485 N-Mindanan 99.8 99.8 94.6 506 S-Mindanac 97.3 96.5 92.3 677 C-Mindanao 84.6 83.9 81.1 471 Education No education 49.5 46.7 36.0 239 Elementary 96.9 96.7 91.9 3564 High school 99.3 99.2 96.4 3072 College or higher 99.8 99.8 97.7 2085 Missing 100.0 100.0 100.0 1.0 Total 97.2 96.9 93.3 8961 qncludes pill, 1UD, injection, vaginal methods (foaming tablets/diap~agm/ foam/jelly), condom, female sterilization, and male sterillzafion. 41 When it comes to regional variations, only Western Mindanao and Central Mindanao deviate from the practically universal knowledge of any method and any modem method. It is in the level of knowledge of a place to obtain a modem method that large regional differentials exist. Women in the Cordillera Administrative Region, Ilocos, Central Luzon and Western Visayas show the highest levels of knowledge of a source for a modem method (at least 97 percent); Eastem Visayas, Western Mindanao and Central Mindanao show the lowest levels (82, 68 and 81 percent, respectively). Excluding women with no education, there are no substantial differentials in the proportion knowing at least one contraceptive method and source for a modem method by women's education. Women with no education are much less likely to know about methods or their sources. 4.2 Ever Use of Family Planning Methods For each method mentioned spontaneously or recognized, the respondent was asked if she had ever used it. While the information is available for all women and married women, the analysis primarily focuses on the latter who are at the greatest risk of pregnancy (Table 4.3). Around 61 percent of married women have ever used a family planning method; 45 percent have used a modem method and 35 percent have ever used a traditional method. The most popular modem method is the pill (30 percent) followed by female sterilization (12 percent), the condom (10 percent) and the IUD (8 percent). The remaining modem methods have small proportions of ever users. Among the traditional methods, withdrawal is the most popular (23 percent), followed by natural family planning methods (19 percent). Table 4.3 Ever use of contraception Among all women and currently married women, the percentage who have ever used a contraceptive method, by specific method and age, philippines 1993 Modem methods Traditional methods Dia- Natural Any phragm/ Female Male Any family Number Any modem In~ec- foam/ Con- sterili- steri- trad. plan- With- of Age method method Pill IUD taoa jelly dora zailon lization method ning drawal Other women ALL WOMEN 15-19 1.9 1.2 0.9 0.2 0.0 0.0 0. I 0.0 0.0 1.0 0.4 0.7 0. I 3158 20-24 21.9 14.0 11.1 2.5 0.1 0.0 1.7 0.4 0.0 12.0 5.2 8.7 0.8 2649 25-29 46.0 33.0 25.8 5.3 0.6 0.2 4.6 4.0 0.1 25.4 13.0 17.7 1.6 2430 30-34 57.5 42.5 29.5 7.8 1.4 0.3 9.4 10.2 0.7 32.7 18.9 21.8 1.8 2196 35-39 62.9 47.7 29.4 7.7 1.6 1.0 12.7 16.9 0.5 37.7 22.5 25.4 2.0 1889 40-44 59.5 43.8 25.1 7.9 1.5 1.0 11.4 18.6 0.4 33.0 20.0 21.1 1.7 1571 4549 49.7 37.8 21.1 7.5 1.0 0.6 10.3 14.3 0.7 26.6 14.8 16.9 1.6 1137 Total 38.0 27.7 18.6 4.8 0,8 0.3 6.0 7.3 0.3 21.4 11.9 14.4 1.2 15029 CURRENTLY MARRIED WOMEN 15-19 25.1 16.1 12.2 3.1 0.0 0.0 1.3 0.0 0.0 I3.4 5.1 10.1 1.4 234 20-24 48.3 31.1 24.7 5.7 0.3 0.0 3.7 0.8 0.0 26.4 11.5 19.0 1.8 1174 25-29 62.4 44.8 34.9 7.2 0.8 0.2 6.2 5.4 0.2 34.6 17.8 24.0 2.2 1763 30-34 66.6 49.4 34.4 9.0 1.5 0.4 10.8 12.0 0.8 38.0 22.0 25.3 2.0 1838 35-39 68.9 52.1 31.7 8.5 1.6 0.9 13.7 18.6 0.6 41.8 25.4 28.0 2.3 1652 40-44 64.6 47.7 27.2 8.6 1.6 1.0 12.6 20.5 0.4 35.9 21.8 22.9 1.9 1358 45~19 54.5 41.4 23.0 7.7 1.2 0.5 11.6 16.1 0.8 29.6 16.3 18.9 1.8 942 Total 61.1 44.6 29.9 7.8 1.2 0.5 9.6 11.9 0.5 34.7 19.4 23.3 2.0 8961 42 In general, the level of ever used increases with age up to age 35-39, and then declines thereafter. However, the pattem varies for specific modem methods; pill ever-used peaks at age 25-34, IUD at age 30- 34, and female sterilization at age 40-44. 4.3 Current Use of Family Planning Methods The level ofcurrcnt use of contraception is the most widely used and valuable measure of the success of the Philippine Family Planning Program (PFPP). As with ever use, the information on current use is available for all women and currently married women but the analysis focuses on the latter (Table 4.4). Thus, contraceptive prevalence is defined as the proportion of married women age 15-49 years who were using some method of family planning at the survey date. Table 4.4 Current use of contraception by age Percent dJs~ibution of all women and currently marr ied women by contraceptive method currently used, according to age, Phil ippines 1993 Age Modern methods Traditional methods Any Dta- Feanale Male Any Natural Not Any modem phragnd steri- stefi- tradi- family With- Other cur- Number meth- meth- Injc¢- foam/ Con- liza- llzl- don- plan- draw- meth- reaatly of od od Pill ILID fion jeUy dora don tlon al nlng al od~ using Total womc/z ALL WOMEN 15-19 1.3 0.7 0.5 0.2 0.0 0.0 0.0 0.0 0.0 0.6 0.1 0.4 0.1 98.7 100.0 3158 20-24 14.2 8.4 5.9 1.8 0.0 0.0 0.3 0.4 0.0 5.8 2.2 3.4 0.2 85.8 100.0 2649 25-29 28.4 17.1 9.7 2.4 0.0 0.0 1.0 4.0 0.0 11.4 5.1 5.8 0.4 71.6 100.0 2430 30-34 38.6 24.6 9.2 3.1 0.1 0.0 1.4 10.2 0.5 14.0 7.6 6.3 0.2 61.4 100.0 2196 35-39 42.8 26.3 5.3 2.7 0,1 0.0 0.8 16.9 0.5 16,4 8.0 8.2 0.3 57.2 100.0 1889 40-44 38.3 24.2 3.0 1.7 0.0 0.0 0.6 18.6 0,3 14.0 7.6 6.2 0.2 61.7 100.0 1571 4549 23.6 17.1 0.5 1.3 0.0 O.0 0.3 14.3 0.7 6.5 3.0 3.2 0.2 76.4 1(10.0 1137 Total 24.2 15.1 5.1 1.8 0.0 0.0 0.6 %3 0.2 9.0 4.4 4.4 0.2 75.8 100.0 15029 CURRENTLY MARRIED WOMFAq 15-19 17.2 9.6 7.0 2.7 0.0 0.0 0.0 0.0 0.0 7.6 2.0 4.9 0.7 82.8 100.0 234 20-24 31.9 18.9 13.3 4.1 0.1 0.0 0.6 0.8 0.0 12.9 4.9 7.5 0.5 68.1 I00.0 1174 25-29 39.1 23.5 13.3 3.3 0.0 0.1 1.4 5.4 0.0 15.6 7.1 7.9 0.6 60.9 100.0 1763 30-34 45.8 29.0 10.9 3.8 0.1 0.0 1.6 12.0 0.6 16.7 9.0 7.5 0.2 54.2 100.0 1838 35-39 48.2 29.4 6.1 3.1 0.1 0.1 0.9 18.6 0.6 18.8 9.1 9.4 0.3 51.8 100.0 1652 40-44 43.1 27.0 3.5 1.9 0.0 0.0 0.7 20.5 0.4 16.2 8.8 7.1 0.3 56.9 100.0 1358 45-49 27.2 19.4 0.7 1.5 0.0 0.0 0.4 16.1 0.8 7.9 3.7 3.9 0.3 72.8 100.0 942 Total 40.0 24.9 8.5 3.0 0.1 0.0 1.0 11.9 0.4 15.1 7.3 7.4 0.4 60.0 100.0 8961 The contraceptive prevalence rate is 40 percent; 25 percent arc using modem methods and 15 percent traditional methods. Female sterilization ranks first (12 percent), the pill second (9 percent), withdrawal and natural family planning third (7 percent each), and IUD fourth (3 percent). The remaining methods have fewer users, each being used by one percent or less by married women (see Figure 4.2). 43 Figure 4.2 Use of Contraception Currently Married Women 15-49 Withdrawal 7% Other Methc Natural Family Planning 7% Female ¢~÷=rili7~fi~n 12% ndom 1% JD 3% Pill 9% Not Using 60% Note: Natural family planning refers to periodic abstinence or rhythm. 1993 N DS A review of the previous survey results in the past two decades reveals that the percentage using contraceptives at the time of interview among women 15-44 years increased from 15 percent in 1968 to 36 percent in 1988. The use of modem contraception increased steadily from 3 percent to 22 percent. The increase is mainly due to significant rise in the percentage of sterilized women from less than 1 percent in 1968 to 11 percent in 1988, making it the most prevalent method in the country. On the other hand, the use of traditional methods increased from 6 percent in 1973, reaching its peak at 22 percent in 1978 and subsequently declining to its level of 15 percent in 1993 (see Table 4.5 and Figure 4.3). An inverted-U pattern of prevalence by age was observed which is typical of patterns in most countries. A peak in use occurs at age 35-39 for any method, any modem method or any traditional method (Table 4.4). However, as with the data on ever use, the peak occurs in different age groups for specific modem methods. As expected, permanent methods such as female sterilization are popular among older women who are more likely to have completed their families and want to stop childbearing altogether. In contrast, the pill is popular among the younger women who are still in their early stages of family building, peaking with use at age 20-29 years. Current use of natural family planning is highest among married women age 30-39 years. Among women under age 30, withdrawal is the second most widely used method. 44 Table 4.5 Trends in contraceptive use Percentage of currently married women 15-44 using modem contraceptive methods mad traditional methods, Philippines, 1968-1993 Modern Traditional Survey methods methods Total 1968 National Demographic Survey 2.9 11.5 15.4 1973 National Demographic Survey 10.7 6.7 17.4 1978 Republic of the Philippines Fertility Su~ey 17.2 21.3 38.5 1983 National Demographic Survey 18.9 13.1 32.0 1988 National Demographic Survey 21.6 14.5 36.1 1993 National Demographic Survey x 24.9 15.1 40.0 Source: World Bank, 1991. Table 1.3 and 1993 NDS IBased on currently married women 15-49 Percent 80 4o 30 20 10 1968 NDS Figure 4.3 Trend in Contraceptive Use Philippines, 1968-1993 1973 NDS 1978 RPFS 1983 NDS 1988 NDS 1993 NDS IlModern Methods []Traditional Methods / With regard to specific methods, the most notable difference is observed for female sterilization, which tends to be urban biased (Table 4.6). Use of any contraceptive method is highest in Northern Mindanao, Central Visayas and Southern Mindanao (49, 46 and 46 percent, respectively), while Western Mindanao manifests the lowest use (29 percent). However, when current use of any modem method is examined, Cagayan Valley ranks first (32 percent), followed by Northern Mindanao and Central Luzon (31 percent). Bicol and Western Mindanao register the lowest level of current use of modem methods (16 and 45 Table 4.6 Current use of contraception by background characteristics Percent distribution of currently marr ied women by contlacepdve method cuffently used, according to selected background charactorisdcs, Phi l ippines 1993 Modem methods Traditional methods Any Dia- Fcraath Male Any Natural Not Any modem pbxngm/ stefi- stefi- tradi- farmly With- Othe~ cur- Number Background meth- mefn- Inj~> fman/ Con- ~za- llza- fton- plan- draw- mtth- rlmtly of characteristic od od Pill IUD tion jelly dora tion tion al nthg at ods using Total women Residence Urban 43.0 27.6 9.0 2.9 0.1 0.0 1.3 13.9 0.4 15.4 7.8 7.3 0.2 57.0 100.0 4638 Rural 36.8 21.9 8.0 3.2 0.1 0.0 0.6 9.6 0.3 14.9 6.8 7.5 0.5 63.2 100.0 4323 Region Metro. Manila 41.9 27.3 9.4 1.6 0.1 0.0 1.1 14.8 0.2 14.6 7.1 7.5 0.0 58.1 100.0 1272 Cordillera Admin. 38.6 23.1 3.4 2.1 0.0 0.0 1.7 15.9 0.0 15.5 7.6 7.9 0.0 61.4 100.0 148 llccos 38.8 21.9 6.8 0.9 0.0 0.2 1.2 12.8 0.0 16.9 5.5 10.9 0.5 61.2 100.0 503 Cagayan Valley 41.1 32.2 14.9 2.9 0.0 0.0 0.8 13.3 0.2 8.9 2.9 6.0 0.0 58.9 1GO.0 340 C-Luzon 43.8 30.9 9.4 1.1 0.1 0.0 1.3 19.1 0.0 12.8 3.2 9.6 0.0 56.2 100.0 977 S-Tagalog 35.2 22.6 5.8 3.4 0.0 0.0 0.9 12.5 0.0 I2.6 4.5 7.9 0.2 64.8 100.0 1218 Bicol 36.4 16.1 6.5 1.0 0.3 0.0 0.9 6.9 0.5 20.2 7.5 12.3 0.3 63.6 100.0 553 W-Visayas 39.7 23.4 9.7 1.6 0.0 0.0 1.0 9.9 1.3 16.3 10.1 6.0 0.1 60.3 100.0 706 C-Visayas 46.1 28.8 9.6 4.7 0.0 0.1 1.6 11.5 1.2 17.3 8.8 8.4 0.1 53.9 100.0 701 E-Visayas 35.9 18.2 6.0 1.8 0.0 0.0 0.2 10.2 0.0 17.8 9.8 6.6 1.4 64.1 100.0 403 W-Mindanao 28.5 16.7 8.7 1.7 0.0 0.0 0.2 5.9 0.2 11.8 7.3 3.3 t . l 71.5 100.0 485 N-Mindanao 49.3 31.3 12.3 9.1 0.2 0.0 1.4 8.2 0.2 18.0 13.2 4.3 0.5 50.7 100.0 506 S-Mindanao 45.9 27.1 8.5 5.5 0.0 0.0 1.2 11.0 0.9 18.8 11.3 6.6 0.9 54.1 100.0 677 C-Mindanao 32.5 20.4 6.7 7.3 0.0 0.0 0.0 6,2 0.2 12.1 8.4 2.9 0.8 67.5 I(30.0 471 FMucailon No education 10.8 7.2 1.6 1.4 0.0 0.0 0.0 3.8 0.4 3.6 2.1 1.1 0.3 89.2 100.0 239 Elementary 34.5 21.5 7.0 2.6 0.0 0.0 0.4 11.1 0.4 13.0 5.2 7.3 0.4 65.5 100.0 3564 High school 43.8 27.6 10,1 3.5 0.1 0.0 1.2 12.3 0.4 16.1 7.6 8.1 0.5 56.2 100.0 3072 College or higher 47A 28.5 9.4 3,3 0.l 0.0 1.9 13.5 0.2 18.6 11.1 7.4 0.1 52.9 1000 2085 Number of children None 1.9 0.6 0.6 0.0 0.0 0.0 0.0 0.0 0.0 1.3 0.7 0.6 0.0 98.1 100.0 558 1 26.7 13.9 9.7 2.5 0.0 0.0 1.0 0.7 0.1 12.7 5.9 6.5 0.4 73.3 1(30.0 1319 2 44.0 25.4 13.1 4.3 0.1 0.1 1.4 6.3 0.2 18.5 9.9 8.0 0.6 56.0 100.0 1745 3 51.5 35.5 10.I 4.0 0.0 0.1 1.2 19.5 0.6 16.1 7.7 8.0 0.4 48.5 100.0 1657 4+ 43.4 27.4 6.3 2.7 0.1 0.0 0.9 16.9 0.5 16.0 7.5 8.2 0.3 56.6 100.0 3682 Total 40.0 24.9 8.5 3.0 0.1 0.0 1.0 11.9 0.4 15.1 7.3 7.4 0.4 60.0 1000 8961 17 percent, respectively). The ranking changes with the current use of any traditional method with Bicol showing the highest level (20 percent) and Cagayan Valley the lowest (9 percent). The top ranking regions when pill use is considered are Cagayan Valley (15 percent) and Northem Mindanao (12 percent), and for female sterilization are Central Luzon (19 percent), Cordillera Administrative Region (16 percent) and Metropolitan Manila (15 percent). The higher the educational attainment, the higher the current use of any method, any modem method and any traditional method. This pattern holds true with specific methods such as female sterilization, condom, and natural family planning. For pill and IUD, the pattern is one of increasing current use with education up to secondary education with a slight decline among those with college education. 46 Contraceptive use of any method, any modem method and female sterilization also increases with the number of children a woman has, up to three children, then declines thereafter. An earlier peak at two children is observed for the pill, IUD, condom, natural family planning and withdrawal. 4.4 Number of Children at First Use of Family Planning In many cultures, family planning is used only when couples have already had as many children as they want. However, as the concept of family planning gains acceptance, the motivation to use family planning may either be to space births or to limit family size. Table 4.7 shows the percent distribution of ever-married women by the number of living children at the time of first use by the respondent's age at the time of interview. The results indicate that Filipino women are adopting family planning fairly early in the family building process although only 2 percent of ever-users began using immediately after marriage or before the first birth. Overall, one in five women began using family planning after they had the first child and one in four started using after they had two children. Table 4.7 Number of children at first use of contraception Percent distribution of ever-married women by number of living children at the time of first use of contraception, according to current age, Philippines 1993 Number of living children at time Never of first use of contraception Number Current used of age contraception 0 1 2 3 4+ Missing Total women 15-19 76.0 6.0 15.0 2.6 0.4 0.0 0.0 100.0 245 20-24 52.2 4.7 26.6 13.1 2.7 0.8 0.0 100.0 1203 25-29 38.7 3.5 26.2 17.2 9.5 4.9 0.0 100.0 1820 30-34 34.9 1.6 23.0 17.3 12.1 11.2 0.0 100.0 1929 35-39 32.7 1.6 19.4 14.7 12.2 19.2 0.1 100.0 1763 40~IA 37.1 1.3 13.1 14.6 12.4 21.3 0.2 100.0 1487 45-49 47.0 0.7 8.9 9.7 12.5 21.3 0.0 100.0 1065 Total 40.2 2.3 20.1 14.6 10.2 12.6 0.1 100.0 9511 The timing of first contraceptive use in terms of the number of living children varies among the different age cohorts ofwomen. A particularly striking difference is observed between women age 20-24 and 45-49 years. About half of the women in both age groups of women have ever used a method. Of those half, slightly less than half of those age 45-49 started after having four children while among those age 20-24, slightly more than half started when they had only one child. 4.5 Problems with Current Method Identifying problems with the use of specific methods has practical implications for future educational and publicity campaigns. Therefore, the 1993 NDS included a question for all current users as to whether they had experienced any problems with the method they were using and if so, what the main problem was. The results are shown in Table 4.8. Ninety percent or more of current users of the pill, IUD, condom, female sterilization, natural family planning and withdrawal reported having no problems with the method they were currently using. Of those who have had problems with their methods, side effects were generally cited as the most common problem, however, for condom users, the most common problem is that it is inconvenient. It should be mentioned that this question which asks about problems with current method may not have elicit a full reporting of problems. Women who had serious problems are likely to have discontinued the method. 47 Table 4.8 Problems with current method of contraception Percent distribution of contraceptive users by the main problem with current method, according to specific methods, Philippines 1993 Natural Female Male family Con- sterili- sterili- plan- With- Main problem Pill IUD dom zation zation ning drawal Other No problem 89.4 93.6 87,5 91.2 (83.6) 97.0 89.4 (97.7) Husband disapproves 0.2 0.2 0.0 0.1 (0.0) 0.4 0.4 (0.0) Side effects 5.9 4,1 1.0 5.9 (5.3) 0.8 3.7 (2.3) Health concerns 2.7 1.6 1.0 2.6 (0.0) 0.4 3.4 (0.0) Access/availability 0.l 0,0 0.0 0.0 (0.0) 0.0 0.0 (0,0) Cost 0.2 0.0 0.0 0.0 (0.0) 0.0 0.1 (0,0) Inconvenient to use 0,6 0.5 9.4 0.0 (0.0) 0.6 1,7 (0.0) Sterilized/want children 0.0 0.0 0.0 0.1 (2.8) 0,0 0.0 (0.0) Other 0.1 0.0 0.0 0.1 (5.6) 0.3 0.5 (0.0) Missing 0.8 0.0 1.1 0.1 (2.7) 0A 0.8 (0.0) Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women t 764 273 90 1104 34 658 669 33 ITotal includes 5 users of injection and 2 users of vaginal methods. ( ) Figures in parentheses are based on 25-49 cases 4.6 Knowledge of Fertile Period An elementary knowledge of reproductive physiology is useful for successful practice of coitus- associated methods, such as withdrawal, condom and vaginal methods. Such knowledge is particularly critical in the practice of natural family planning. In the 1993 NDS, women were asked during which days of a wom- an's menstrual cycle does a woman have the greatest chance of becoming pregnant. A fifth of all women in- terviewed said they did not know when they are fertile during their ovulatory cycle (Table 4.9). In contrast, only 6 percent of those who have used natural family planning did not know when a woman is most likely to get pregnant. Only 24 percent of all women and 34 per- cent of ever-users of natural family planning gave the "correct" response, that a woman's fertile period occurs in the middle of her cycle. Thirty percent of all women and 38 percent of ever-users of natural family planning said that a woman is most likely to conceive right after her period has ended. Much smaller proportions report- ed the least safe period as that right after a woman's period begins. A sizable proportion of all women and ever users of natural family planning (23 percent and 18 Table 4.9 Knowledge of fertile period Percent distribution of all women and of women who have ever used natural family planning by knowledge of the fertile period during the ovulatory cycle, Philippines 1993 Ever users of natural Perceived All family fertile period women planning During menstrual period 0.8 0.8 Right after period has ended 30.4 37.9 In the middle of the cycle 23.5 33.7 Just before period begins 2.3 2.8 Other 0.1 0.6 No particular time 22.6 17.8 Don't know 20.1 6.3 Missing 0.2 0.1 Total percent 100.0 100.0 Number of women 15029 1790 48 percent, respectively) reported no particular time. These proportions indicate the need to further educate the potential and actual users of natural family planning on the ovulatory process. 4.7 Timing of Sterilization In the Philippines where female sterilization is the most prevalent method, information about the trend in age at adoption of sterilization is very useful. To minimize problems of censoring, the median age at the time of operation is calculated for women sterilized at less than 40 years of age. Data shown in Table 4.10 indicate that 7 in 10 women who are sterilized had their operation at age 25-34, and 12 percent are sterilized before reaching their 25th birthday. There is evidence that, over time, women are having their sterilization operation at older ages; the median age at sterilization is 29.9 for women sterilized 8-9 years ago, and 30.9 for women who had the operation less than 2 years ago. Table 4.10 Timing of sterilization Percent distribution of sterilized women by age at the time of sterilization, according to the number of years since the operation, Philippines 1993 Age at time of sterilization Number Years since of Median operation <25 25-29 30-34 35-39 40-44 45-49 Total women age" <2 5.1 37.2 29.1 23.2 5.4 0.0 100.0 127 30,9 2-3 10.0 26.7 36.2 18.9 7.6 0.5 100.0 t59 30.7 4-5 10.0 39.6 24.1 20.7 5.6 0.0 100.0 137 29.8 6-7 17.3 33.6 30,5 16.0 2.7 0.0 100.0 152 29.8 8-9 13.2 36.7 32.6 15.9 1.5 0.0 100.0 153 29.9 10+ 12.5 47.3 32.9 7.2 0.0 0.0 100.0 376 b Total 11.8 38.9 31.5 14.8 3.0 0.1 100.0 1104 29.7 "Median age was calculated only for women less than 40 years of age to avoid problems of censoring t~Not calculated due to censoring 4.8 Source of Supply of Modern Contraceptive Methods Currently Used Information on sources of modem contraceptives currently used is useful for family planning program managers and implementors. The public sector (Table 4.11) emerges as the main source for a large majority of current users (71 percent) of modem contraceptives. In fact, almost three-quarters of users of the pill, IUD and female sterilization obtained their methods from government sources, as do over half of condom and male sterilization users. While the g°vemment h°spitals are the main s°urces °f the permanent meth°ds' barangay health stations or health centers are the main sources for the pill, IUD and condom. Pharmacies are an important source of pills and condoms. Aside from the type of source, information on the length of time needed to reach the source from home was obtained for women who are currently using a modem contraceptive method. Nonusers were also asked if they knew a place to obtain a method and, if so, where and how long it takes to get there. Table 4.12 shows the relevant information by urban-rural residence for three types of women: current users of modem contraceptives, nonusers of modem contraceptives and all women knowing a method. Among current users 49 Table4.11 Source of supply for modern contraceptive methods Percent distribution of current users of modem contraceptive methods by most recent source of supply, according to specific methods, Philippines 1993 Female Male Con- stefili- sterili- All So~ce of supply Pill IUD dom zation zadon methods Pubne seclor 73.4 78.8 55,6 70.4 (56.6) 71,4 Government hospital 2,7 17.7 4.0 59.2 (41.4) 32.6 Barangay health station 53.9 30,7 34.9 3.3 (12,4) 25.0 Barangay supply office 2.6 2.4 2.2 0.4 (0.0) 1.5 Puerleulture center 14.2 28.0 14,5 7.5 (2.8) 12.4 Medical private 23.4 19.5 40.6 28.5 (29.7) 26,3 Private hospital/clinic 3.6 12.8 3.8 26.8 (21.0) 16.4 pharmacy 17,4 0.0 36.0 0.0 (0.0) 7.3 Private doctor 2.4 6.7 0.8 1.7 (8.7) 2,6 Other private 2.2 0.6 2.7 0,8 (5.5) 1.4 Store 0.2 0,0 1.9 0.0 (0.0) 0,2 Church 0.0 0.0 0.0 0.8 (5,5) 0.5 Friends/~elatives 2.0 0,6 0,8 0.0 (0.0) 0,8 Other 0.4 0.7 0.0 0,3 (0.0) 0.4 Don't know 0.0 0,0 0.0 0.0 (5.5) 0.1 Missing 0.7 0.4 1.1 0.0 (2.7) 0.4 Total percent 100.0 100.0 100.0 100.0 100.0 100.0 Number of women I 764 273 90 1 I04 34 2272 ITotal includes 5 users of injection and 2 users of diaphragm/foam/jelly, ( ) Figures in parentheses ave based on 25-49 cases Table 4.12 Time to source of supply for modern contraceptive methods Percent distribution of women who are currently using a modem contraceptive method, of women who are not using a modern method, mad of women who know a method, by time to reach a source of supply, according to urban-rural residence, Philippines 1993 Women who are currently using a modem method Women who are not using a modem method Women who know a contraceptive method Minutes to source Urban Rural Total Urban Rural Total Urban Rural Total Other private sector 1,9 2,8 2,3 2,6 2,6 2.6 2,5 2.7 2.6 0-14 30.7 25.5 28.5 42.3 33.9 38.6 41.5 34.3 38.5 15-29 18.0 16.9 17.5 15.3 15.7 15.5 16.1 16.8 16.4 30-59 27,3 25.9 26.7 9.2 15.8 12.1 12.3 18.2 14.8 60+ 20.8 27.7 23.7 3.4 9.7 6.1 6.2 12,8 9.0 Don't know time 0.6 0.2 0.4 0.4 0.1 0.3 0.4 0,1 0.3 Don't know source 0.0 0.0 0.0 26,3 21.7 24.3 20,3 14,3 17.8 Not stated 0.8 1.0 0.9 0.6 0.5 0.6 0.6 0.6 0.6 Total percentage 100,0 100.0 100,0 100,0 100,0 100,0 100,0 100,0 100.0 Median time to source 25.8 30.3 30.1 10.5 15.4 10.8 10.8 15.7 15.1 Number of women 1319 953 2272 7182 5575 12757 8261 6148 14408 50 of modem contraceptives, the median time to reach a source is 30 minutes. The same length of time holds true for rural users, while urban users need about 26 minutes. Among nonusers of modem contraceptives, the median time is about 11 minutes in urban areas and about 15 minutes in rural areas. While it appears that women who are not using a modem contraception are closer to a known source than users of modem contraceptive method, note however, that about one in four nonusers did not know a source, which may be a cause for nonuse. Among all women who know a method, the median time is about 15 minutes; rural women state an average of 16 minutes, 5 minutes longer than the average travel time of urban women. In the 1993 NDS, users of modem contraceptive methods were asked if they had obtained the method they were currently using from the same place as previously. Questions on the first source of service and the reason for switching sources were asked to women who reported using a different source. This information is important in the evaluation of family plarming programs, particularly those related to the provision of methods and services. These data are not presented in this report due to the small number of women (88) who reported a change in source for the same method in the last segment of use. 4.9 Contraceptive Discontinuation Rates Population program managers are greatly interested in fostering improvements in the quality of contraceptive practice. One means of assessing the quality of contraceptive practice is to look at the contraceptive discontinuation rates which represent the proportion of users who discontinued the use of a method within 12 months after the start of use (for a technical discussion on the methodology of calculating this measure, see Macro International, 1992). Table 4.13 shows the contraceptive discontinuation rates due to various reasons for selected contraceptive methods. The results show that overall, one in three users discontinues during the first year of use. Discontinuation rates are highest for the condom (59 percent), followed by withdrawal (41 percen0 and the pill (40 percent). IUD has the lowest discontinuation rate--22 percent (see Figure 4.4). Withdrawal, natural family planning and condoms show high failure rates; one of five withdrawal users and around one in seven users of the condom and natural family planning becomes pregnant within a year of starting the method. Side effects/health reasons are cited as the main causes for discontinuing use of the pill. Table 4.13 First-year discontinuation rates for contraception Proportion of contraceptive users who discontinued use of a method by 12 months after beginning the method, due to method failure, desire to become pregnant, or other reason, according to specific methods, Philippines 1993 Reason for discontinuing contraceptive method Side Desire effects/ All Method to become Health other All Method failure pregnant concerns reasons reasons Pill 5.1 6.6 13.9 14.4 40.1 IUD 2.5 2.1 7.6 10.2 22.4 Condom 15.1 5.7 3.9 34.5 59.2 Natural family planning 15.6 4.8 1.0 9.8 31.3 Withdrawal 20.6 3.7 3.5 12.9 40.7 All methods 11.6 4.6 6.4 12.8 35.4 Note: Figures are based on life-table calculations. 51 Percent Figure 4.4 Contraceptive Discontinuation Rates for First Year of Use 60 40 20 0 Pill IUD Condom Natural Family Withdrawal Planning Note: Natural family planning refers to to periodic abstinence or rhythm. 1993 N DS "Other reasons" is an important category for the pill, IUD and condom. They include method-related reasons such as desire for a more effective method, inaccessibility or inconvenience, and the method costs too much and attitudinal, such as disapproval of the respondent's husband, or fatalistic feeling on the part of the respondent. Table 4.14 presents reasons for discontinuation among ever users who have discontinued use of a method during the five years preceding the survey. Considering all methods, accidental pregnancy stands out as the most important reason of stopping use. Desire for pregnancy and side effects rank second and third, respectively. Manipulable program variables, such as access/availability and cost of methods, are minor reasons for discontinuing use of any method. Looking at specific methods with the number of respondents in question greater than 50 women, the most common reason for discontinuing use the pill and IUD is side effects, while method failure is reported by users of condom, natural family planning and IUD. Method failure accounts for about half of the discontinuations of traditional methods. 4.10 Intentions for Future Family Planning Use among Nonusers Intention to use contraception in the future provides a forecast of potential demand for services, and acts as a convenient summary indicator of disposition towards contraception among current nonusers. Intention not to use contraception in the future is useful in identifying "hard core" targets for program managers and implementors. Among currently married nonusers, 64 percent do not intend to use a family planning method in the future (Table 4.15). Three in ten nonusers indicated their intent to use a contraceptive method in the future; 80 percent of these women said they were going to use it within the next 12 months. The past experience of nonusers also is taken into account in looking at future intentions in Table 4.15. Overall, 7 in 10 nonusers are never users. The intent to use a contraceptive in the next 12 months is more common among previous users than never users. 52 Table 4.14 Reasons for discontinuation of contraception Percent distribution of discontinuation of contraceptive methods in the five years preceding the survey by main reason for discontinuation, according to specific methods, Phil ippines 1993 Modem method Traditional method discontinued discontinued Natural Reason for Injec- Con- family With- discontinuation Pill IUD don dom planning drawal Other Total Became pregnant 14.5 9.0 (5.7) 26.1 47.5 52.6 40.6 34.0 To become pregnant 20.9 17.3 (5.3) 16.7 21.0 14.1 11.0 18.1 Husband disapproved 2.1 2.4 (0.0) 11.6 3.4 4.8 0.0 3.6 Side effects 24.3 24.5 (20.6) 2.9 1.6 4.4 6.0 11.9 Health concerns 6.3 7.5 (6.5) 2.8 1.4 1.2 1.9 3.5 Access/availability 2.0 2.2 (0.(3) 3.2 0.3 0.0 0.0 1.1 More effective method 1.1 2.8 (14.6) 4.7 4.1 3.0 1.0 2.7 ]namvenimt to use 2.0 8.8 (3.0) 17.7 2.1 3.0 7.5 3.5 lrtfrequent sex 7.8 1.1 (0.0) 1.3 3.7 2.8 6,0 4.6 Cost 0.6 0.0 (12.0) 0.6 0.0 0.0 0.0 0.4 Fatalistic 0.0 0.0 (0.0) 0.0 0.1 0.1 0.0 0.1 Menopause 0.2 1.4 (0.0 0.6 0.4 0.0 1.7 0.3 Marital dissolution 0.4 0.0 (0.0) 0.5 0.3 0.2 0.0 0.3 Other 2.3 3.1 (3.6) 0.9 0.9 0.9 3.0 1.6 Don't know 0.0 0.0 (0.0) 0.0 0.0 0.0 1.9 0.0 Missing 15.5 20.0 (28.8) 10.5 13.1 12.9 19.4 14.4 Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women I 1196 153 25 169 708 1036 53 3354 lincludcs users o f diaphragm/foam/j elly, female sterilization, male stenlizatlotl. ( ) Figures in parentheses are based on 25-49 cases. 53 Table 4.15 Future use of contraception Percent distribution of currently married women who are not using a contraceptive method by past experience with contraception and intention to use in the future, according to number of living children, Philippines 1993 Past experience with contraception and future intentions Number of living children I 0 1 2 3 4+ Total Never used contraception Intends to use in next 12 months 2.6 21,2 15.3 13.4 8,9 12,5 Intends to use later 10.0 6.5 3,4 1,4 1.4 3.2 Unsure as to timing 0.7 0.8 0.6 0,7 0.4 0.5 Unsure as to intention 4.1 5.9 2.6 2.3 1.6 2.8 Does not intend to use 77.7 48.9 39.9 38.6 44.0 45.6 Missing 0.3 0.0 0,0 0.1 0,0 0,0 Previously used contraception Intends to use in next 12 months 0.5 3.6 15,2 15.2 15.3 12.2 Intends to use later 0.2 2.3 2,8 3.7 2.0 2.3 Unsure as to timing 0,0 0.2 0.5 0.4 0.3 0.3 Unsure as to intention 0,0 0.5 1.2 1,8 1.2 1.1 Does not intend to use 3.9 10.0 17.6 21.1 23.4 18,3 Missing 0,0 0.2 1.0 1.3 1.5 1.0 Total percent 100.0 100.0 100.0 100.0 100.0 100.0 All currently married nonusers Intends to use in next 12 months 3.1 24,8 30,5 28.6 24.2 24,7 Intends to use later 10.3 8.7 6.1 5,1 3,4 5.6 Unsure as to timing 0.7 1.0 1,I 1,1 0.7 0.9 Unsure as to intention 4.1 6.4 3,8 4.1 2.8 3,9 Does not intend to use 81.6 58.9 57.5 59,7 67.4 63.8 Missing 0,3 0.2 1.0 1.4 1.5 1.1 Total percent 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 373 927 1007 876 2196 5379 llnclodes current pregnancy More than one fifth of married nonusers who say they do not intend to use family planning cited side effects as the main mason for not using a method. A similar percentage say that they want more children (Table 4.16). Other often cited reasons are "older age, difficulty in becoming pregnant, infrequent sex and husband away" (19 percent), "menopausal and had hysterectomy" (11 percent), and health concerns (10 percent). Small proportions (less than 5 percent) of nonusers are opposed to family planning or cited religion as a reason for not using contraception. Women under age 30 are twice as likely as older women not to use family planning because they want children. Side effects and health concerns are reported more often by women under 30 than older women as the reason for not using contraception. 54 Table 4.16 Reasons for not using contraception Percent distribution of currently married women who are not using a contraceptive method and who do not intend to use in the future by main reason for not using, according to age, Philippines 1993 Age Reason for not using contraception 15-29 3049 Total Wants children 32.2 15.6 20.1 Lack of knowledge 9.4 4.7 6.0 Opposed to family planning 3.0 3.3 3.2 Religion 5.6 4.5 4.8 Costs too much 0.6 0.4 0.4 Hard to get methods 0.4 0.4 0.4 Side effects 27.4 19.5 21.6 Inconvenient 2.2 2.1 2.1 Health concerns 11.3 9.5 10.0 Fatalistic 0.3 0.5 0.4 Old/difficult to get pregnant/ infrequent sex/husband away 5.4 23.5 18.6 Menopausal/had hysterectomy 0.4 14.6 10.7 Not married 0.4 0.2 0.3 Other 0.9 0.9 0.9 Don't know 0.4 0.4 0.4 Missing 0.2 0.1 0.1 Total 100.0 100.0 100.0 Number 929 2505 3433 Presented in Table 4.17 is the distribution of married nonusers who intend to use in the future by their preferred method. Half of nonusers who intend to use family planning in the future prefer to use the pill, 14 percent want to use natural family planning and 13 percent, female sterilization. It is interesting to note that the intent to use female sterilization is twice as common among nonusers planning to adopt in the next 12 months as among those who plan to use later. In contrast, a larger percentage of women who intend to use contraception later preferred to use the pill and natural family planning than those who wanted to use within the next 12 months. 55 Table 4.17 Preferred method of contraception for future use Percent distribution of currently married women who are not using a contraceptive method but who intend to use in the future by preferred method, according to whether they intend to use in the next 12 months or later, Philippines 1993 Intend to use In next After Unsure Preferred method 12 12 as to of contraception , months months timing Total Pill 45.3 48.1 43.9 45.7 IUD 10.5 7.6 11.3 9.9 Injection 1.5 1.1 2.4 1.4 Diaphragm/foam/jelly 0.0 0.5 0.0 0.1 Condom 2.8 2.2 2.8 2.6 Female sterilization 14.0 7.7 8.1 12.7 Male sterilization 0.1 0.0 0.0 0.1 Natural family planning 13.8 16.8 11.5 14.2 Withdrawal 5.9 8.7 7.6 6.4 Other 1.2 0.3 2.0 1.1 Missing 4.9 7.1 10.4 5.7 Total percent 100.0 100.0 100.0 100.0 Number of women t 1330 300 47 1683 1Includes 6 cases with missing information on timing of future use 4.11 Family Planning Messages on Radio and Television In the Philippine Family Planning Program, the Department of Health and Commission on Population are working hand in hand with other govemment and private agencies in implementing the Information, Education, Communication and Motivation (IECM) component. For example, given the high level of awareness about family planning, the focus of the Department of Health's efforts in IECM are (Department of Health, 1990): . 2. . 4. correcting misinformation about the Program emanating from various sources; reiterating and specifying the health bcnefits of family planning and the link of family planning services with other health services; providing the informational basis for expanded choice; and supporting any selection among legally and medically accepted choices with necessary information (as part of the service to assist that choice). One of the channels of IECM relates to the mass media which includes radio and television. About half of respondents in the 1993 NDS reported that they had not heard or seen a family planning message on either the radio or television during the one month prior to interview (Table 4.18). Of those who had, more than half heard messages on both the radio and television, one in three heard a message on the radio only, and one in six heard from the television only. Women in urban areas are more likely to have heard a message from a television or both television and radio while women in rural areas, heard the message from only the radio. 56 Table 4.18 Family planning messages on radio and television Percent distribution of all women by whether they have heard a family planning message on radio or on television in the month preceding the survey, according to selected background characteristics, Philippines 1993 Heard family planning message on radio or on television Number Background Radio Television of characteristic Neither only only Both Missing Total women Residence Urban 44.6 12.5 11.7 31.0 0.2 100.0 8501 Rural 55.9 21.4 3.1 19.2 0.3 100.0 6528 Region Metro. Manila 38.8 6.2 22.3 32.7 0.0 100.0 2733 Cordillera Admin. 15.2 43.6 1.1 40.2 0.0 100.0 241 llocos 46.6 7.0 4.9 41.5 0.0 I00.0 832 Cagayan Valley 51.1 36.1 1.5 11.0 0.3 100.0 486 C-Luzon 28.9 20.1 7.8 43.2 0.0 100.0 1599 S-Tagalog 50.1 15.0 9.3 25.5 0.1 100.0 2025 Bicol 61.0 23.2 4.2 11.3 0.2 100.0 805 W-Visay~s 64.0 15.5 1.4 19.1 0.0 100.0 1216 C-Visayas 58.5 17.3 5.1 18.7 0.5 100.0 1121 E-Visayas 57.6 20.9 2.1 18.6 0.7 100.0 645 W-Mindanao 59.0 22.8 2.1 15.6 0.5 100.0 729 N-Mindanao 61.1 16.4 2.2 20.1 0.2 t00.0 794 S-Mindanao 56.7 15.1 4.7 22.5 1.0 100.0 1095 C-Mindanao 56.8 23.4 2.4 17.1 0.2 100.0 707 Education No education 85.9 6.6 1.7 5.3 0.5 t00.0 320 Elementary 59.5 20.4 4.0 15.8 0.3 100.0 4690 High school 48.9 16.8 8.5 25.6 0.2 100.0 5967 College or higher 36,0 11.9 12.2 39.6 0.3 100.0 4049 Total I 49.5 16.4 8.0 25.9 0.2 100.0 15029 tlncledes 3 women with missing information on level of education The role of mass media as a channel for communicating family planning to the public varies by region. It is generally more important in Luzon than in other island groups; while only 15 percent of women in Cordillera Administrative Region said that they had not heard family planning messages on radio or television, in Visayas and Mindanao this proportion is more than 56 percent. Surprisingly, being the seat of the government, the level of family planning communication through radio and television in Metropolitan Manila is not the highest. With radio only as the source of family planning messages, Cordillera again tops the list, Cagayan Valley ranks second, and Bicol, Westem Mindanao and Central Mindanao together ranking third. The higher the education, the higher the proportion stating they have heard family planning messages from radio and television. Over half of women with some college education had heard a family planning message on the radio in the month before the survey, compared to only 12 percent of uneducated women. To determine the level of acceptance for family planning information dissemination among Filipino women, NDS asked the women respondents whether they consider it acceptable to provide family planning information over the radio or television. The results show that most of the women respondents consider it acceptable to air family planning messages over the radio or television (86 percent). There is very little 57 variation by women's current age. Urban women are somewhat more likely to accept family planning messages on radio or television than rural women. Women living in Metropolitan Manila, Southern Tagalog and Northern Mindanao are more likely to accept family planning messages over radio or television (92 percent or higher) in contrast to their counterparts residing in Western Mindanao and Central Mindanao (63 and 68 percent, respectively). Again, more educated women are more likely to accept family planning messages on radio or television (Table 4.19). Table 4.19 Acceptability of the use of mass media for disseminating family planning messages Percentage of women who believe that it is acceptable to have messages about family planning on radio or television, by selected background characteristics, Philippines 1993 Not Background Accept- accept- Don't know/ characteristic able able missing Total Number Age 15-19 80.8 5.6 13.7 100.0 3158 20-24 87.4 4.9 7.7 100.0 2649 25-29 88.1 5.4 6.5 100.0 2430 30-34 88.4 5.2 6.3 100.0 2196 35-39 87.3 6.1 6.6 100.0 1889 40-44 86.4 6.9 6.7 100.0 1571 45-49 85.9 6.4 7.7 100.0 1137 Residence Urban 88.5 4.6 6.9 100.0 8501 Rural 82.8 7.0 10.2 100.0 6528 Region Metro. M a,rtila 92.5 3.7 3.9 100.0 2733 Cordillera Admin. 85.4 2.1 12.5 100.0 241 Ilocos 80.5 6.6 12.9 100.0 832 Cagayar~ Valley 76.5 1.3 22.2 100.0 486 C-Luzon 88.3 3.5 8.2 100.0 1599 S-Tagalog 92.8 2.2 4.9 100.0 2025 Bicol 86.6 4.6 8.8 100.0 805 W-Visayas 82.8 6.3 10.9 100.0 1216 C-Visayas 89.6 5.3 5.1 100.0 1121 E-Visayas 86.4 5.1 8.5 I00.0 645 W-Mindanao 62.8 21.7 15.6 100.0 729 N-Mirtdanao 95.1 2.8 2.1 100.0 794 S-Mindanao 82.9 7.7 9.4 100.0 1095 C-Mindanao 67.7 15.5 16.9 100.0 707 Education No education 32.5 30.9 36.6 100.0 320 Elementary 82.2 7.1 10.7 100.0 4690 High school 87.1 4.6 8.2 100.0 5967 College or higher 93.1 3.5 3.4 100.0 4049 Total I 86.0 5.7 8.3 100.0 15029 lIncludes 3 women with missing iaformatlon on level of education 58 CHAPTER 5 OTHER PROXIMATE DETERMINANTS OF FERTILITY Addressed in this chapter are the principal factors, other than contraception, which affect a woman's risk of becoming pregnant: nuptiality and sexual intercourse, postpartum amenorrhea and abstinence from sexual relations, and secondary infertility. Marriage is a primary indicator of the exposure of women to the risk of pregnancy and, therefore, is important for the understanding of fertility. Populations in which age at marriage is low tend 10 be populations with early childbearing and high fertility. Trends in the age at which women marry as well as in the proportions remaining single can help explain trends in fertility. Included also in this chapter is information on more direct measures of the beginning of exposure to pregnancy and the level of exposure: age at first sexual intercourse and the frequency of intercourse. Measures of several other proximate determinants of fertility which, like marriage and sexual intercourse, influence exposure to risk are also presented. These are the durations of postpartum amenorrhea and postpartum abstinence, and secondary infertility. 5.1 Current Marital Status Table 5.1 shows the marital status of women at the time of the survey by age. Overall, 37 percent of women have never married, 54 percent are married, 5 percent are living together with a partner, and about 4 percent are not living with a husband or a partner. Table 5.1 Current marital status Percent distribution of women by current marital status, according to age, Philippines 1993 Marital status Number Never Living Not living of Age married Married together Widowed Divorced together Total women 15-19 92.2 4.7 2.7 0.0 0.0 0.3 100.0 3158 20-24 54.6 38.4 6.0 0.3 0.0 0.8 100.0 2649 25-29 25.1 66.3 6.3 0.7 0.1 1.6 100.0 2430 30-34 12.2 77.9 5.8 1.4 0.3 2.5 100.0 2196 35-39 6.7 81.6 5.9 2.7 0.2 2.9 100.0 1889 40J,4 5.3 81.0 5.4 5.1 0.6 2.5 100.0 1571 45-49 6.3 77.3 5.6 7.6 0.6 2.6 100.0 1137 Total 36.7 54.4 5.2 1.8 0.2 1.6 100.0 15029 The proportion never married decreases rapidly from 92 percent among teenagers to 55 percent among women in their early twenties to 25 percent among women in their late twenties. The proportions in both formal and informal unions start well below 10 percent among teenagers, increasing rapidly to 44 percent among women 20-24 years of age, and 73 percent among women 25°29 years. This proportion reaches its peak at 88 percent among women 35-39 years and slightly declines thereafter more as a result of marital dissolution (primarily through widowhood) than by nonmarriage. 59 5.2 Marital Exposure Table 5.2 is intended to show variations in exposure to marriage for a recent period by age and background characteristics of all women. The table is calculated using information collected in the calendar and shows the percentage of months in the five years prior to the survey spent married. Since the table is based on all women, never-married woman are included in the denominator by adding 60 months for each. The percentage of months spent in married state incorporates the effects of age at first marriage, marital dissolution, and remarriage. Table 5.2 Marital exposure Percentage of months spent in marital union in the five years preceding the sta'vey, by age and selected background characteristics, Philippines 1993 Age at time of survey Background characterisfc 15-19 20-24 25-29 30-34 35-39 40~14 45-,19 Total Residence Urban 2.0 24.2 58.2 76.4 83.7 87.2 79.7 49.7 Rural 4.0 38.4 72.7 86.6 90.6 87.5 88.9 60.8 Region Me~a'o. Matfda 2.1 17.0 46.3 66.3 78.4 85.6 68.0 41.3 Cordillera Admin. 1.7 28.3 69.7 88.2 94.6 86.3 90.0 57.7 llocos 2.9 27.6 65.1 80.3 85.5 84.4 86.1 54.3 Cagayan Valley 3.5 37.4 75.9 86.4 89.3 91.1 83.7 63.0 C-Luzon 1.8 37.5 68.8 85.5 85.5 83.4 85.4 55.9 S-Tagalog 3.0 27.0 65.7 79.2 90.0 89.3 88.3 54.7 Bicol 2.3 39.8 72.2 84.8 91.2 86.1 89.9 63.3 W-Visayaz 3.3 27.2 61.9 83.1 84.0 87.2 87.5 54.3 C-Visayas 3.5 33.1 65.2 78.9 86.1 87.2 85.6 57.9 E-Visayas 3.8 34.0 66.6 87.4 92.0 86.6 82.8 56.9 W-Mindanao 5.3 37.3 73.4 88.1 88.5 90.0 84.5 62.3 N-Mindanao 2.8 38.4 71.1 88.1 90.2 88.1 87.4 58.4 S-Mindanao 2.9 36.6 73.7 84.6 90.8 89.6 88.4 56.9 C-Mindanao 2.5 42.3 76.9 90.0 91.5 92.5 91.4 62.3 EducaHoB No education 5.2 53.9 82.5 82.8 91.6 87.8 87.2 72.6 Elementary 7.3 49.0 79.6 87.9 89.5 88.4 86.3 72.6 High school 2.1 35.5 69.7 82.9 87.8 87.3 81.8 45.5 College or higher 0.6 12.3 45.6 70.8 80.9 85.2 78.8 45.4 Total 2.8 30.1 64.3 80.9 87.0 87.3 84.0 54.5 The percentage of months spent married, as expected, increases with age, reaching a peak of 87 percent at ages 35-39, with a plateau of 87 percent at ages 40-44, and declining only slightly to 84 percent at ages 45-49 years. Undoubtedly, this pattern reflects the pace of entry into marriage among young women as well as the increasing incidence of widowhood among women aged 40 to 49 and the substantial proportion of older women living apart from their husbands. The most revealing aspect of the data in Table 5.2 is the low level of marital exposure among Philippine women. Only 55 percent of the 5 years preceding the survey was spent in marital exposure. The low level of marital exposure for those below age 25 arises from the fact that 55 percent are still single. 60 There are wide variations in marital exposure by level of education. In general, women with at most a primary education spent 73 percent of the last 5 years in marriage while those with secondary or higher education spent only 45 percent in marital union. This pattern most likely reflects the higher age at marriage among the more educated women. Regional variations in marital exposure depict larger than average marital exposure in less developed regions (Cagayan, Bicol, Westem Mindanao and Central Mindanao) with the most developed region (Metropolitan Manila) depicting the lowest marital exposure of 41 percent. The rest of the regions hover around the national marital exposure figure of 55 percent. The larger than average marital exposure values observed in the less developed regions reflects the effects of early age at marriage and of marital dissolution, while the low value for the country's primer region arises from the effects of older age at marriage and marital dissolution, particularly those not living with their husbands. In general, women in urban areas show slightly lower than average marital exposure of 50 percent while rural women show slightly higher than average marital exposure of 61 percent. 5.3 Age at FirstMarriage Table 5.3 presents the percentage of women who first married at selected ages and the median age at first marriage, according to current age. The table clearly shows an increase in age at marriage across cohorts. Among women aged 35 or older, approximately 40 percent were married by age 20, while 37 percent of women age 30-34 and only 29 percent of women aged 20-24 did so. The median age at first marriage increased only slightly from 21.3 years among women 45-49 years to 22.0 years among women 25- 29 years. This reflects a long-standing late age at marriage among Filipino women, evidenced by the fact that around one in three women 25-49 was still single at age 25. Table 5.3 Age at first marriage Percentage of women who were first married by exact age 15, 18, 20, 22, and 25, and median age at first marriage, according to current age, Philippines 1993 Percentage of women who were first married by exact age: Current age 15 18 20 22 Percentage Median who had Number age at never of F~st 25 married women marriage 15-19 0,7 NA NA NA NA 92.2 3158 a 20-24 1.9 14.2 29.3 NA NA 54.6 2649 a 25-29 2.4 16.7 34.0 49.8 66.9 25.1 2430 22.0 30-34 2.4 18.3 36.6 52.6 69.0 12.2 2196 21.7 35-39 2.9 20.1 39.0 54.5 73.5 6.7 1889 21.4 40~14 3.3 20.9 38.3 53.7 72.3 5.3 1571 21.5 45-49 4.2 22.7 40.4 55.3 72.3 6.3 i137 21.3 20-~9 2.7 18.1 35.4 50.0 64.8 21.9 11871 b 25-49 2.9 19.2 37.2 52.8 70,3 12.6 9222 21.6 NA = Not applicable aOmitted because less than 50 percent of the women in the age group x to x+4 were first married by age x t'Not calculated due to censoring 61 5.4 Median Age at First Marriage Urban women marry at a somewhat later age than rural women; the median age at first marriage for urban women is 22.3 years while that for rural women is 20.7 years. Sizeable differences in age at marriage exist by regions (Table 5.4). The median age at first marriage in Metropolitan Manila is 24 years. There is no distinct pattern in age at first marriage by island groups; however, the less developed areas show lower median values (ranging from 20.4 to 21.4 years) than other areas. There is a positive relationship between age at first marriage and educational attainment. The median value for women with no education is 19 years while those who reached high school show a median value of 21 years. Table 5.4 Median age at first marriage Median age at first marriage among women age 25-49 years, by current age and selected background characteristics, Philippines 1993 Current age Women Background age characteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 22.7 22.3 22.1 22.1 22.2 22.3 Rural 20.9 20.7 20,6 20.7 20,3 20.7 Region Metro. Manila a 25.0 22.6 23.3 22.8 24.0 Cordillera Admin, (22.4) 22.1 23.1 (21.2) (21.8) 22.3 Ilocos 22.8 21.8 22,3 22,1 21.5 22.2 Cagayan Valley 20,7 20.4 20.0 20.6 (19.6) 20,4 C-Luzon 20.9 21.4 21.6 22.6 21.2 21.5 S-Tagalog 21.8 21.3 20.9 21.4 21.7 21.4 Bicol 21.3 21.0 20.5 20.4 19.9 20.8 W-Visayas 22.2 22.6 22.4 22.0 22.1 22.3 C-Visayas 22. l 21.8 22.0 21.3 20.2 21.7 E-Visayas 21.1 21.3 20.7 21.1 19.7 20.9 W-Mindanao 20.6 20.0 20.7 20.3 20.6 20.4 N-Mindanao 20.9 21.3 19.9 18.9 21.1 20.6 S-Mindanao 20,9 20.5 20.5 21.6 21.2 20.9 C-Mindanao 20. l 20.2 21.0 20.0 20.7 20.4 Education No education 18.3 19.0 19.2 18.8 20,2 18.9 Elementary 19.7 19.4 19,5 19.8 19.8 19.6 High school 21,0 20,8 21.4 21.2 21.6 21.1 College or higher a 25.2 24.8 25.0 25.8 a Total 21.8 21.5 21.3 21.4 21,1 21.4 Note: Medians are not shown for women 20-24 because less than 50 percent have married by age 20 in almost all subgroups shown in the table. aOmitted because less than 50 percent of the women in the age group were first married by age 25. ( ) Figures in parentheses are based on 25-49 cases 62 5.5 Age at First Sexual Intercourse Like the age at first marriage, the age at first sexual intercourse is a proxy measure for the beginning of a woman's exposure to the risk of pregnancy. Table 5.5 presents information on age at first sex for all women. Overall, half of the women aged 25-49 started to be sexually active at age 21.5 years. Only 3 percent of the women aged 25-49 years had their first intercourse by age 15 and 38 percent by age 20. By age 25, 7 in 10 women have had sexual intercourse. The table shows that the onset of sexual activity has not changed remarkably over time. Table 5.5 Age at fLrst sexual intercourse Percentage of women who had first sexual intercourse by exact age 15, 18, 20, 22, and 25, and median age at f'trst intercourse, according to current age, Philippines 1993 Current age 15 18 20 22 Percentage of women who had Percentage Median first intercourse by exact age: who Number age at never had of f'tr st 25 intercourse women intercourse 15-19 0.8 NA NA NA NA 91.9 3158 a 20-24 2.0 14.7 30.3 NA NA 53.4 2649 a 25-29 2.5 17.9 35.3 50.8 67.4 24.4 2430 21.9 30-34 2.4 19.1 37.8 53.5 70.1 11.3 2196 21.5 35-39 3.2 21.4 41.0 56.0 74.4 6.4 1889 21.1 4044 3.3 21.1 38.8 54.6 72.8 5.1 1571 21.4 45-49 4.5 23.0 41.5 56.4 73.0 5.9 1137 21.1 20-49 2.8 18.9 36.6 51.1 65.6 21.3 11871 a 25~19 3.0 20.1 38.4 53.8 71.1 12.0 9222 21.5 NA = Not applicable aOmitted because less than 50 percent of the women in the age group x to x+4 bad had intercourse by age x. Comparing the information in Table 5.5 with the information on age at first marriage in Table 5.4, it is clear that the majority of Filipino women have first sexual intercourse when they marry; there is only a one month difference between the median ages at first intercourse (21.5) and first marriage among women aged 25-49 (21.6 year). Differentials in the median age at first intercourse also parallel those observed in the median age at first marriage (see Table 5.6). 5.6 Recent Sexual Activity In the absence of contraception, the probability of pregnancy is related to the participation in sexual intercourse. Thus, information on intercourse is important for refinement of the measurement of exposure to pregnancy. An indicator of the percentage of women who are abstaining from sex in any given month, due to such factors as a recent birth, spousal separation, illness, etc. is given by the percent who were not sexually active in the last four weeks. There were several questions in the 1993 NDS on the topic of recent sexual activity. All women were asked how long ago they had last had sexual intercourse, how many times they had sex in the last four weeks, and how many times they usually have sex in a month. 63 Table 5.6 Median age at first intercourse Median age at first sexual intercourse among women age 25-49 years, by current age and selected background characteristics, Philippines 1993 Current age Women Background age characteristic 25-29 30-34 35-39 40-44 45~19 2549 Residence Urbaaa 22.8 22,5 22,0 22,0 22,t 22,3 Rural 20.8 20.6 20.4 20.7 20.2 20.6 Region Metro. Manila 24.8 24.6 22.4 23.1 22.7 23.7 Cordillera Admin. (22.2) (21.8) (22.9) * * 22.1 llocos 22.8 21.8 22.2 22.2 20.6 22.2 Cagayan Valley 20.7 20.4 20.2 20.8 19.4 20.4 C-Luzon 20.9 21.4 21.4 22.2 21.1 21.4 S-Tagalog 21.9 21.3 20.9 21.3 22.0 21.4 Bicol 21.3 21.1 20.4 20.5 19.8 20.8 W-Visayas 22.2 22.5 22.2 21.6 21.9 22.1 C-Visayas 21.9 21.4 21.5 21.0 19.7 21.3 E-Visayas 20.8 21.0 20.8 21.1 19.7 20.7 W-Mindanao 20.7 19.9 20.5 20.5 20.5 20.4 N-Mindanao 20.8 21.2 19.9 18.9 20.8 20.5 S-Mindanao 20.6 20.2 20,1 21.6 21.1 20.6 C-Mindanao 19.9 20.3 20.8 20.0 20.5 20.3 Education No education (18.3) (19.1) (18.9) (18.8) (19.6) (18.8) Elementary 19.6 19.4 19.5 19.9 19.8 19.6 High school 21.0 20.8 21.1 21.3 21.6 21.1 College or higher a 25.2 24.6 24.9 25.8 a Total 21.9 21.5 21.1 21.4 21.1 21.5 Note: Medians were not shown for women 20-24 because less than 50 percent had had intercourse by age 20 in almost all subgroups shown in the table. 'Omitted because less than 50 percent of the women in age group x to x+4 had bad intercourse by age x. * Less than 25 u~aweighted eases ( ) Figures in parentheses are based on 25-49 unweighted cases. Table 5.7 is based on the question of time since last intercourse and allows an assessment of the overall level of sexual activity according to age, marital duration, and other background characteristics. In general, 77 percent of all women were sexually active in the month preceding the survey, 5 percent were postpartum abstaining, and 18 percent were not sexually active for reasons other than a recent birth (e.g., spousal separation, illness). The proportion postpartum abstaining declines as age and duration of marriage increase. At the same time, the proportion not sexually active for other reasons increases with increasing age and marriage duration. 64 Table 5.7 Recent sexual activity Percent distribution of women who have ever had sexual intercourse by sexual activity in the four weeks preceding the survey and the duration of abstinence by whether or not postpartum, according to selected background characteristics, Philippines 1993 Not sexually active in last 4 weeks Sexually Abstaining Abstaining active (postpartum) (not postpartum) Number Background in last of characteristic 4 weeks 0-1 years 2+ years 0-1 years 2+ years Missing Total women Age of mother 15-19 72.0 15.9 1.7 9.5 0.5 0.3 100.0 255 20-24 79.1 8.4 0.7 10.8 0.6 0.4 100.0 1233 25-29 79.7 5.5 0.5 11.7 2.6 0.0 100.0 1837 30-34 78.5 4.6 1.2 11.5 4.1 0.1 100.0 1948 35-39 77.7 3.4 0.7 12.7 5.3 0.1 100.0 1769 40-44 76.6 1.5 0.7 12.0 9.1 0.1 100.0 1490 45-49 69.2 0.3 0.2 16.6 13.3 0.5 100.0 1069 Duration of union 0-4 76.3 9.2 0.8 12.7 0.9 0.1 100.0 1858 5-9 79.4 4.7 1.0 11.7 3.0 0.1 100.0 2045 10-14 81.4 3.2 0.6 10.6 4.2 0.0 100.0 1851 15-19 79.1 3.1 0.3 11.1 6.1 0.2 100.0 1604 20-24 75.9 1.1 0.4 13.8 8.5 0.3 100.0 1217 25+ 69.3 0.4 0.5 16.1 13.5 0.2 100.0 937 Never in union 21.3 28.3 11.3 9.7 24.2 5.3 100.0 91 Residence Urban 73.5 4.3 0.9 14.7 6.4 0.2 100.0 5025 Rural 81.2 4.5 0.6 9.6 4.0 0.1 100.0 4577 Region Metro. Manila 66.7 5.3 0.7 17.5 9.5 0.3 100.0 1425 Cordillera Admin. 79.6 2.9 1.0 11.3 4.9 0.3 100.0 158 llocos 77.1 5.5 0.8 11.8 4.5 0.3 100.0 532 Cagayan Valley 85.1 4.2 0.2 6.2 4.0 0.4 100.0 356 C-Luzon 73.8 4.3 0.9 14.8 6.2 0.0 100.0 1038 S-Tagalog 73.6 5.2 0.6 15.3 5.3 0.0 100.0 1289 Bicol 79.7 6.6 0.5 9.7 3.1 0.5 100.0 588 W-Visayas 78.7 3.7 0.7 12.2 4.7 0.0 100.0 753 C-Visayas 79.6 4.4 0.9 10.3 4.3 0.5 100.0 765 E-Visayas 75.6 6.7 0.7 12.9 4.1 0.0 100.0 435 W-Mindmaao 85.5 2.5 1.0 6.9 3.9 0.1 100.0 514 N-Mindartao 86.4 2.1 0.9 7.7 3.0 0.0 100.0 540 S-Mindanao 82.0 2.9 1.0 10.4 3.6 0.1 100.0 715 C-Mindanao 83.8 2.1 0.6 7.7 5.6 0.2 100.0 494 Education No education 80.6 3.0 1.1 8.7 6.1 0.6 100.0 263 Elementary 79.2 4.3 0.6 10.5 5.2 0.2 100.0 3823 High school 76.1 4.9 0.8 13.4 4.5 0.2 100.0 3277 College or higher 74.6 3.8 0.9 14.0 6.4 0.1 100.0 2239 Current contraceptive No method 68.8 6.8 1.2 15.5 7.5 0.3 100.0 5971 Pill 95.0 0.2 0.0 4.6 0.1 0.0 100.0 764 IUD 94.9 0.0 0.0 4.3 0.8 0.0 100.0 273 Sterilization 82.8 0.7 0.1 11.5 4.8 0.1 100.0 1138 Periodic abstinence 94.0 0.9 0.0 5.0 0.1 0.0 100.0 658 Other 94.6 0.2 0.0 5.2 0.0 0.0 100.0 798 Total 77.1 4.4 0.8 12.3 5.3 0.2 100.0 9602 65 The percentage of women who were sexually active in the month preceding the sur- vey declines gradually with increasing level of education. More rural than urban women were sexually active in the month preceding the sur- vey. Women living in Metropolitan Manila showed the lowest proportion (67 percent) who were sexually active in the month before the survey. The comparatively large proportion ab- staining among Metropolitan Manila women was mainly due to factors other than a recent birth. The proportions sexually active among contraceptive users were far higher than for nonusers (95 percent compared to 69 percent), except for sterilization users, 16 percent of whom were abstaining for reasons other than a recent birth. 5.7 Postpartum Amenorrhea, Abstinence, and Insusceptibility Among women who are not using con- traception, exposure to the risk of pregnancy in the period following a birth is influenced by two factors: brcastfeeding and sexual absti- nence. Postpartum protection from conception can be prolonged by breastfceding, which can lengthen the time to onset of ovulation, and by delaying the resumption of sexual relations. Table 5.8 Postpartum amenorrhea~ abstinence and insusceptibility Percentage of births whose mothers are postpartum arnenorrheic. abstaining and insusceptible, by number of months since birth, and median and mean durations, Philippines 1993 Number Months Amenor- Insus- of since birth rbeie Abstaining ceptible births < 2 94.0 86.7 97.6 196 2-3 68.4 47.2 77.6 293 4-5 56.0 15.5 61.0 329 6-7 44.5 l 1.2 50.0 326 8-9 31.7 7.0 36.3 323 10-11 26.5 5.8 30.8 272 12-13 18.5 4.0 21.4 289 14-15 14.4 3.8 17.3 288 16-17 6.5 5.2 11.4 314 18-19 2.7 3.7 6.3 332 20-21 1.2 2.8 3.3 301 22-23 2.2 2.4 4.3 265 24-25 0.5 2.8 3.4 285 26-27 0.6 1.5 2.1 274 28-29 0.8 1.1 1.9 337 30-31 0.0 0.7 0.7 321 32-33 0.3 1.1 1.4 317 34-35 0.0 2.2 2.2 293 Total 19.2 9.9 22.6 5356 Median 5.5 2.3 6.4 NA Mean 7.7 4.4 8.8 NA Prevalence/ Incidence mean 6.8 3.5 8.0 NA Note: Means and medians are based on the current-status proportions in each two-month age interval (smoothed) NA = Not applicable Estimation of the mean durations was done using the current status proportions. The preva- lence/incidence (P/I) mean is borrowed from epidemiology, and is provided to enable intemational com- parison. Table 5.8 shows the percentage of births whose mothers are postpartum amenorrheic, abstaining, and postpartum insusceptible by the number of months since the birth, Women who are insusceptible are defined as those who are either amenorrheic or abstaining following a birth and, thus, are not exposed to the risk of pregnancy. The estimates shown in Table 5.8 are based on current status data, that is, they refer to the proportion of births occurring x months before the survey for which mothers are still amenorrheic or abstaining at the time of the survey. All live births occurring during the three years prior to the survey are included. To reduce fluctuations in the estimates, the births are grouped in two-month intervals. Among births 2 to 3 months prior to interview, 68 percent of the mothers are still amenorrheic. The proportion amenorrheic 6 to 7 months after the birth is 45 percent and 12 to 13 months after the birth, declined to 19 percent. The duration of postpartum abstinence is shorter than the duration of amenorrhea (see Figure 5.1). Forty-seven percent of mothers are still abstaining from sexual relations 2 to 3 months following a birth, but only 4 percent arc still abstaining after a year. Overall, half of all mothers are susceptible to the risk of pregnancy 6 months after a birth (not taking into account contraceptive use). 66 10(: 8C 60 40 20 0 Figure 5.1 Percentage of Births Whose Mothers Are Amenorrheic, Abstaining and Insusceptible Percent 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 Months since Birth 1993 NDS 5.8 Med ian Durat ion of Pos tpar tum Amenorrhea , Abstinence and Insuscept ib i l i ty Presented in Table 5.9 is the median duration of postpartum amenorrhea, abstinence, and insusceptibility by various background characteristics of women. As for Table 5.8, this table is based on current status data on all live births occurring in the three years prior to the survey. On average, women in the Philippines are amenorrheic for 5.5 months following a birth, abstain for 2.3 months, and are insusceptible to the risk of pregnancy for 6.4 months. The duration of postpartum amenorrhea is practically identical among women under 30 years of age and those 30 years or older. Urban women are amenorrheic for a shorter period of time than rural women perhaps due to their breastfeeding practices. As expected, the median duration of amenorrhea is shortest in Metropolitan Manila (3 months), average for the more developed regions (4-5 months) and longest for the less developed regions of the country (6-9 months). Education is inversely related with the duration of postpartum amenorrhea. Women with no education are amenorrheic for twice as long (9.8 months) as women with high school or higher education (4.8 months). Subgroup differences in the duration of abstinence tend to be less pronounced due to the brevity of this practice among Philippine couples. The most remarkable differences are observed among regions in Mindanao showing durations of less than 2 months compared to regions in Visayas or Luzon with abstinence duration of 2 to 3 months. In addition, women with no education showed a duration of abstinence of 1.5 months while for those with formal education, this is 0.5 month longer. 67 The combined effect of amenorrhea and abstinence is reflected in the median duration of insusceptibility shown in Table 5.9. Rural women are insusceptible for longer periods (7.9 months) than urban women (5.2 months); this difference is due largely to longer durations of postpartum amenorrhea among rural women. Education is inversely associated with duration of insusceptibility to the risk of pregnancy following a birth. Regional differences in the duration of insusceptibility generally replicate the differences in the duration of amenorrbea. Table 5.9 Median duration of postpartum insusceptibility by background characteristics Median number of months of postpartum araenorrhea, postpartum abstinence, and postpartum insusceptibility, by selected background characteristics, Philippines 1993 Postpartum Number Background Postpartum Postpartum insuscep- of characteristic amenorrhea abstinence tibility births Age <30 5.4 2.2 6.2 2982 30+ 5.7 2.3 6.7 2373 Residence Urban 4.3 2.3 5.2 2618 Rural 7.0 2.2 7.9 2738 Region Metro. Manila 3.0 2.2 4.1 680 Cordillera Admin. 6.7 1.8 7.1 104 llocos 6.8 2.2 7.7 300 Cagayan Valley 6,2 2.5 7.0 190 C-Luzon 5.3 2.6 5.9 542 S-Tagalog 5.7 3.3 6.5 675 Bicol 8.9 2.1 9.7 416 W-Visayas 7.7 2.3 8.5 432 C-Visayas 5.6 2.2 6.3 428 E-Visayas 5.9 3.0 6.5 269 W-Mindanao 5.9 1.7 6.8 292 N-Mindanao 4.0 2.0 4.1 332 S-Mindanao 6.2 1.8 6.2 406 C-Mindanao 6.8 1.7 7.5 292 Education No education 9.8 1.5 10.6 140 Elementary 8.2 2.3 8.8 2154 High school 4.8 2.4 5.7 1935 College or higher 3.3 2.1 4.7 1 t 26 Total 5.5 2,3 6.4 5356 Note: Medians are based on current status. 68 5.10 Termination of Exposure to Pregnancy The onset of infecundity with increasing age reduces the proportion of women who are exposed to the risk of pregnancy. Three measures of declining exposure to pregnancy, menopause, terminal infertility and long-term abstinence, are shown in Table 5.10. The percentage of currently married women who are not currently pregnant and not postpartum amcnorrheic but whose last menstrual period occurred six or more months prior to the survey or who report that they are menopausal is used as an indicator of secondary sterility. The data show that the percentage rises rapidly with age, particularly after age 44. By age 48, 42 percent of women are menopausal. A woman falls into the terminal infertility category if she was continuously married, did not give birth, and did not use any contraceptive method during the five-year period preceding the survey and she is not currently pregnant. Overall, 56 percent of women 30 years and older have reached terminal fertility. Table 5.10 shows the expected pattem of increasing proportions with age, from 28 percent among women 30-34 to 93 percent for women in the end of their childbearing ages. Long-term abstinence is another indicatorofterminal abstinence--the percentage of currently married women who did not have sexual intercourse in the three years prior to the survey. Although long-term abstinence is an important factor in the termination of exposure in some countries, especially in sub-Saharan Africa, it is not significant in the Philippines, where only 3 percent of women are terminally abstaining in the oldest age group. Table 5.10 Indicators of termination of exposure Indicators of menopause, terminal infertility, and long-term abstinence for currently married women 30-49 years of age, by age, Philippines Terminal Long-term Menopause I infertility 2 abstinence 3 Age Percent Number Percent Number Percent Number 30-34 1.4 1399 27.8 580 0.5 1838 35-39 2.0 1394 46.3 620 1.1 1652 40-41 3.7 533 54.9 276 0.9 593 42-43 7.1 504 60.5 262 1.6 537 44-45 13.1 440 74.1 265 2.6 449 46-47 27.2 385 82.9 240 2.2 388 48-49 42.1 333 92.7 247 2.9 333 Total 8.1 4987 55.5 2490 1.2 5791 tpereentage of non-pregnant, non-uanenorrheic currently married women whose last menstrual period occurred six or more months preceding the survey or who report that they are menopausal. 2Percentage of women continuously married, not using contraception in the five years preceding the survey, who did not have a birth during the period, and who are not ~pregnmat. ercentage of currently married women who did not have intercourse in the three years preceding the survey. 69 CHAPTER 6 FERTILITY PREFERENCES The Philippine Family Planning Program (PFPP) aims to assure the availability of reliable information and services necessary for families to manage the risks and outcomes of reproduction according to their health needs and fertility aspirations. It is anchored on a basic constitutional provision which recognizes the right of couples to choose for themselves the size of family they would like to raise. Addressed in this chapter are questions which allow an assessment of the need for contraception, whether for birth spacing or for birth limitation, and the extent of unwanted fertility. The respondents were asked questions whether they wanted more children. If so, how long they would prefer to wait before the next child; and if they could start anew, how many children in all they would want. Since the general objective of the Philippine Family Planning Program is to reduce the level of unmet needs for family planning particularly among high risk families, it is important to understand the extent of unmet need in the country, whether for spacing or limitation. Two other issues are examined: the extent to which unwanted and mistimed pregnancies occur and the effect of such pregnancies on the fertility rates. Interpretation of data on fertility preferences has always been the subject of controversy. Survey questions on this topic have been criticized on the grounds that a) answers are misleading because they may reflect unformed, ephemeral views, which are held with weak intensity and little conviction and b) they do not take into account the effect of social pressures, or the attitude of the other family members, particularly the husband, who may exert a major influence on reproductive decisions. The first objection has greater force in societies where the use of contraceptives is limited and the idea of conscious reproductive choice may still be unfamiliar or unknown. Thus, preference data from these settings should be interpreted with caution. This objection probably has little relevance in the Philippines where there is almost universal level of family planning knowledge and a moderated level of family planning use. The second objection is correct in principle. It is only now that the program realizes the importance of the husband with regard to fertility decisions. The inclusion of women who are currently pregnant complicates the measurement of views on future childbearing. For these women, the questions on the desire for more children is rephrased to refer to desire for another child, after the one that they are expecting. To take into account the way in which the preference variable is defined for pregnant women, the results are classified by number of living children, including the current pregnancy as equivalent to a living child. In addition, the question on preferred waigng time before the next birth is rephrased for pregnant women to make clear that the information wanted is the preferred waiting time after the birth of the child the respondent is expecting. The interpretation of the results should be treated with caution since desire for more children for these pregnant women might change given the high infant mortality experienced by the country. Women who have been sterilized for contraceptive purposes also require special analytic treatment. The general strategy presented in this chapter is to classify them as wanting no more children. 71 6.1 Desire for More Children Table 6.1 shows the percent distribution of married women by desire for children according to number of living children. It allows the examination of the potential need for contraceptive services, for spacing as well as for limiting births. The table indicates that 51 percent of all married women do not want any more children, almost one fifth want to delay their next birth for two or more years, and 12 percent have been sterilized. These figures suggest that 7 out of 10 married women are potentially in need of family planning services. Only 9 percent want another child within two years, while almost 6 percent are undecided about their fertility preferences (Figure 6.1). The table also shows that among married women, the desire to limit childbearing increases, and the desire to delay the next birth decreases with the number of living children. The proportion of women who want to limit their childbearing increases dramatically after having one child. For example, among women with one living child, 14 percent want no more children and 56 percent want to delay the next child after two years; among women with 3 children, 55 percent want no more children while 12 percent want to have their next child later. Table 6.1 Fertility preferences by number of living children Percent distribution of currently married women by desire for more children, according to number of living children, Philippines 1993 Number of living children I Desire for children 0 l 2 3 4 5 6+ Total Have another soon 2 67.5 20.8 8.2 4.7 2.4 1.3 0.9 9.0 Have another later 3 14.5 55.7 30.9 11.7 6.2 4.9 2.0 18.7 Have another, undecided when 1.3 0.3 0.6 0.1 0.1 0.1 0.2 0.3 Undecided 2.4 5.6 8.8 6.2 4.8 4.8 3.8 5.7 Wants no more 1.2 13.5 42.4 55.4 60.9 66.7 79.2 50.6 Sterilized 0.0 0.8 6.4 19.2 23.1 19.6 9.8 12.2 Declared infecund 12.4 2.5 2,4 2.4 2.5 2.1 3.9 3.1 Missing 0.7 0.7 0.2 0.3 0.1 0.4 0.3 0.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 384 1279 1774 1730 1313 966 1516 8961 llrteludes current pregnancy 2Wants next birth within 2 years ~Vants to delay next birth for 2 or more years Table 6.2 shows the distribution of married women by desire for children, according to age. The table shows that almost 54 percent of women age 15-19 want to delay having their next child by two or more years. This proportion diminishes with age, and the proportion wanting to limit increases. At age 35-39, only 7 percent of women want to have another child after 2 years, while 3 in 5 do not want any more children. It is interesting to note that at least 3 out of 10 women 20-35 years old stated that they do not want to have more children. 72 Figure 6.1 Fertility Preferences Currently Married Women 15-49 Want no more child r~-n F;1 °~, Undecided 6% Want a child soon 9% Sterilizea l~V/o Want a child Infeeund 3% later 19% Note: "Undecided" includes women who want another child but are undecided when, 1993 NDS Table 6.2 Fertility preferences by age Percent distribution of currently married women by desire for more children, according to age, Philippines 1993 Desire for Age of woman children 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Have another soon I 19.0 9,8 10.6 10.6 8,9 6.1 4.1 9.0 Have artother later 2 53.7 48.8 30.7 15.4 7.2 2.1 1.0 18.7 Have another, undecided when 0.0 0.4 0.6 0.4 0,3 0.0 0,1 0.3 Undecided 7.8 8.3 8,3 7.1 4.7 2.1 1.2 5.7 Wants no more 17.8 30.6 43.4 52.6 57.5 64.6 60.6 50.6 Sterilized 0.0 0,8 5.4 12.6 19.2 20.8 16.9 12.2 Declared in.fecund 1,0 0.7 0.8 1.1 1.9 4.2 15.2 3.1 Missing 0.6 0.6 0.1 0.2 0.4 0.2 0,8 0.3 Total 100,0 100,0 100.0 100.0 100,0 100.0 100.0 100.0 Number 234 1174 I763 I838 I652 1358 942 8961 tWants next birth within 2 years 2Wants m delay next birth for 2 or more years 73 Table 6.3 shows the percentage distribution of the married women who want no more children according to parity, and by selected background characteristics. This table provides information about group variation in the potential demand for family planning. It is interesting to note that there is almost no difference in the desire to limit childbearing between urban and rural women (62 percent in urban areas and 64 percent in rural areas) (see Figure 6.2). Considering the differentials by region of residence, Eastem Visayas has the largest proportion of women who wanted no more children (71 percent), while Central Mindanao shows the lowest percentage of 52 percent). Desire to limit childbearing among married women varies with education. In general, except for the comparatively small number of women with no education, there is an inverse relationship between educational level and the proportion of women wanting no more children. This is likely due to the concentration of more highly educated women at lower parities. At parity two and above, the expected positive relationship between education and the desire to limit childbearing is generally observed. Table 6.3 Desire to l imit/stop) childbearing Percentage of married women who want no more children, by number of living children and selected background characteristics, Philippines 1993 Number of living children I Background characteristic 0 1 2 3 4 5 6+ Total Residence Urban 1.0 15.7 50.8 76.3 86.6 88.7 90.1 62.2 Rural 1.6 12.5 46.2 72.6 81.2 84.1 88.2 63.5 Region Metro. Manila 0.0 15.8 57.5 82.9 91.9 92.9 86.7 59.9 Cordillera Admin. * * (27.8) (71.4) (65.5) * * (57.9) llocos * 8.0 42.2 70.5 74.7 83.1 84.5 58.3 Cagayan Valley * (4.5) 43.6 78.6 75.0 (67.3) (84.3) 56.6 C-Luzon (0.0) 8.1 38.1 72.4 87.8 89.0 85.8 59.8 S-Tagalog (0.0) 14.7 52.4 79.3 90.6 96.6 93.5 67.4 Bicol * 12.3 39.3 78.1 81.5 89.2 91.8 67.9 W-Visayas (0.0) 13.6 51.5 74.8 92.0 88.0 94.9 67.1 C-Visayas (0.0) 23.5 59.0 77.4 86.0 84.7 94.8 67.1 E-Visayas * (25.4) 42.5 80.6 89.5 (91.5) 92.7 70.5 W-Mindanao * 15.6 38.3 45.2 67.7 72.9 79.8 52.3 N-Mindanao * 16.0 50.0 73.6 84.4 93.6 91.0 67.2 S-Mindanao (2.6) 13.4 55.9 76.5 84.0 79.7 87.2 63.6 C-Mindanao * 12.3 45.0 56.3 63.4 67.1 79.7 55.1 Education No education * * (25.0) (40.9) (56.2) * 75.3 47.6 Elementary 2.2 18.3 48.8 70.8 82.4 85.3 88.7 70.6 High school 0.5 12.5 48.4 77.1 86.2 91.8 91.6 60.6 College or higher 1.5 13.1 51.0 78.8 87.8 84.9 90.9 54.5 Total 1.2 14.3 48.8 74.6 84.0 86.4 88.9 62.8 Note: Women who have been sterilized are considered to want no more 1Includes current pregnancy * Less than 25 unweighted cases ( ) Figures in parentheses are based on 25-49 unweighted cases. children. 74 Figure 6.2 Percentage of Currently Married Women Who Want No More Children by Residence and Education Years 80 60 40 20 71 Total Urban Rural No Elemen- High College Education tary School or Higher RESIDENCE EDUCATION 1993 N OS 6.2 Demand for Family Planning Unmet need is defined as the percentage of currently married women who do not use any method of family planning and do not want any more children or intend to space their next birth. Specifically, women with an unmet need for spacing include pregnant women whose pregnancy was mistimed, amenorrheic women whose last birth was mistimed, and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want to wait two or more years for their next birth. Unmet need for limiting purposes refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and women who are not using any method of family planning but who want no more children. These indicators are used to evaluate the extent to which family planning programs are meeting the demand for services. Table 6.4 shows the combined information on the desire for children and the intention to use contraception to explore the level of potential demand for family planning among married women. Demand for family planning is defined as the sum of contraceptive prevalence (including currently pregnant or amenorrheic women whose pregnancy or last birth was the result of a contraceptive failure) and unmet need. Overall, the total demand for family planning is 69 percent; around two thirds of that demand is for limiting births. The demand for family planning for limiting purposes peaks among women age 35-44. Total demand varies little by urban-rural residence. By region, it is highest in Eastem Visayas, Northern Mindanao and Southern Mindanao. Variation across educational groups is small except for a much lower level of demand among the small number of women with no education. 75 Table 6.4 Need for family planning services Percentage of currently married women with unmet need for family planning, met need for family planning, and the total demand for family planning services, by selected background characteristics, Philippines 1993 Met need for Unmet need for family planning Total demand for Percentage fiunily planning l (currently using) 2 fanfily planning 3 of demand Number Background For For For For For For saris- of characteristic spacing lirniting Tote/ spacing lln'fifng Total spacing limiting Total fled women Age 15-19 27.1 4.4 31.5 12.5 4.7 17.2 41.6 9.5 51,1 38.4 234 20-24 28.2 7.0 35.2 20.2 11.7 31.9 51.9 18.7 70.6 50.2 1174 25-29 19.7 12.6 32.3 15.7 23.5 39.1 37.8 36.7 74.5 56.7 1763 30-34 12.2 15.6 27.9 9.9 35.9 45.8 24.5 52.4 76.9 63.7 1838 35-39 6.4 17.1 23.6 3.9 44.3 48.2 11.4 62.3 73.8 68.1 1652 40-44 2.6 19.5 22.2 1.3 41.8 43.1 4.0 62.2 66.2 66.5 1358 45-49 0.5 8.9 9.5 0.3 26.9 27.2 0.9 35.9 36.8 74.2 942 Residence Urban 11.4 12.1 23.5 9.3 33.6 43.0 22,4 46.3 68.7 65.8 4638 Rural 13.6 15.6 29.1 8.7 28.1 36.8 23.9 44.4 68.3 57.4 4323 Region Metro. Manila 12.1 12.2 24.3 9.0 32.9 41.9 23.1 45.7 68.7 64.6 1272 Cordillera Admin. 15.2 12.1 27.2 9.0 29.7 38.6 25.5 41.7 67,2 59.5 148 llocos 14.2 14.4 28.5 9.9 28,9 38.8 26.8 44.6 71.5 60,0 503 Cagayan Valhiy 12.7 11.6 24.3 12.0 29.0 41.1 25.7 40.9 66.6 63.6 340 C-Luzon 12.4 11.1 23.4 10.4 33.4 43.8 24.4 44.8 69.2 66.2 977 S-Tagalog 9.4 15.9 25.3 6.7 28.5 35.2 17.9 44.8 62.7 59.6 1218 Bieol 12.5 19.6 32.1 8.9 27.4 36.4 23.0 48.5 71.5 55.2 553 W-Visayas 13.4 13.7 27.1 8.4 31.3 39.7 22,7 45.9 68.6 60.4 706 C-Visayas 10.4 11.4 21.8 9,3 36.8 46.1 22.1 48.8 70.9 69.2 701 E-Visayas 13.2 23.4 36.5 7.2 28.7 35.9 22.0 53.3 75,2 51.5 403 W-Mindanao 18.3 13.2 31.5 7.9 20.5 28.5 26.9 34.0 60.9 48.3 485 N-Mindanao 12.6 11.2 23.8 11.2 38.1 49.3 26.5 49.8 76.2 68.8 506 S-Mindanao 12.2 12.1 24.3 10.2 35.7 45.9 23.9 48.3 72.2 66.4 677 C-Mindanao 13.1 14.2 27.2 8.4 24.0 32.5 22.8 38.5 61.3 55.6 471 EducaUon No educa6on 18.4 15.2 33.6 1.4 9.2 10.6 20.5 24.4 44.9 25.2 234 Elementary 11.6 18.1 29.8 5.6 28.8 34.5 18.5 47.7 66.3 55.1 3564 High school 13.5 12.1 25.6 10.9 32.9 43.8 26.4 45.5 71.9 64.5 3072 College or higher 11.5 8.8 20.3 13.0 34.2 47.1 26.6 43.5 70.I 71.1 2085 Total 12.4 13.8 26.2 9.0 31.0 40.0 23.1 45.4 68.5 61.8 8961 tUnrret need for spacing includes pregnant women whose pregnancy was mistimed, amenorrbeic women whose last birth was ndstlmed, and women who arc neither pregnant nor arrenorrheic and who are not using any rf~thod of farrdl y planning and say they want to walt 2 or ~ years for their next birth. Aiso included in unmct need for spacing are women who are unsure whether they want another child or who want another child but are unsure when to have the birth. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amcnorrbeic women whose last child was unwanted and women who are neither pregnant nor amcnorrhelc and who arc not using any method of family planning and who want no more children. 2Using for spacing is defined as women who an: using some method of family planning and say they want to have another child or arc undecided whether to have another. Using for limiting is defined as women who me using and who want no more children. Note that the specific methods used are not taken into account here. 3Pregnant and amenorrheic women whose pregnancy was the result of a contraceptive failure me not included in the category of unrnet need, but are included in total demand for contraception. 76 Since only two thirds of the total demand for family planning is satisfied, there is a need for the Family Planning Program to intensify efforts to address unmet need and the backlog in the demand for family planning services. Unsatisfied demand or unmet need is 26 percent: 12 percent for spacing births and 14 percent for limiting childbearing. Total unmet need decreases with age. It is higher among rural women, among women who have no education orelementary education, and among women in Bicol, Eastern Visayas, and Western Mindanao than among other women. 6.3 Ideal Number of Children This section focuses on the respondent's ideal number of children, implicitly taking into account the number of children she already has. In ascertaining the total ideal number of children, the respondent is required to perform the more difficult task of considering abstractly and independent of her actual family size, the number of children she would choose if she could start again. As shown in Table 6.5, the ideal number of children is 3.2 among all women and 3.5 among all married women, regardless of actual number of surviving children. Almost two thirds of the women in the Philippines who express a numeric preference would like to have 3 or less children, while more than one third expressed more than three as their ideal number of children. It is interesting to note that 12 percent of women want to have 5 or more children, while more than one quarter want only two. Table 6.5 Ideal number of children Percent distribution of all women by ideal number of children and mean ideal number of children for all women and for currently married women, according to number of living children, Philippines 1993 Number of living children t Ideal number of children None 1 2 3 4 5 6+ Total 0 1.0 0.2 0.0 0.0 0.0 0.2 0.1 0.5 l 3.1 8.7 2.3 1.1 0.8 0.9 0.9 2.7 2 37.8 39.3 42.8 10.8 13.2 8.9 6,8 27.8 3 35.7 35.1 30.5 58.7 16.3 28.3 23.3 34.1 4 16.1 12.6 18.9 20.3 56.9 17.5 26.0 21.5 5 2.8 2.0 2.6 5.1 7.2 32.7 11.2 6.3 6+ 1.4 1.4 2.4 3.3 4.9 10.1 28.5 5.5 Non-numeric response 2.0 0.5 0.4 0.7 0.8 1.5 3.2 1.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 5864 1489 1888 1801 1385 1007 1594 15029 All women, mean ideal 2.8 2.6 2.9 3.3 3.8 4.1 4.6 3.2 All women 5745 1481 1881 1789 1373 992 1543 14805 Currently married women, mean ideal 2.9 2.7 2.9 3.3 3.8 4.1 4.6 3.5 Currently married women 380 1272 1766 1717 1302 953 1470 8861 Note: The means exclude women who gave non-numeric responses. llncludes current pregnancy There is an indication of a correlation between actual and ideal number of children. Women who want larger families tend to achieve larger families. It is also possible that women with larger families have larger ideal sizes because of attitudes that they acquired 20 or 30 years ago. For example, the mean ideal number of children of women with one living child is 2.6, while women who have 6 or more children expressed an ideal number 0f4.6. Women may adjust upwards their ideal size of family as the actual number of children increases. Preference for a three-child family is expressed by 59 percent of women with three living children, and about 57 percent of women with four children expressed their preference for 4.0 as their ideal number. 77 Despite the likelihood that some rationalization occurs, it is common to find that respondents state ideal sizes lower than their actual number of living children. This can be taken as an indicator of surplus or unwanted fertility. At four and higher number of living children, the proportion of women stating ideal family size smaller than their actual become sizable. In fact, among women with five or more children, more than 50 percent say that if they were to start again they want fewer children. Presented in Table 6.6 is the ideal number of children by age and by background characteristics of all women. The table shows that younger and better educated women are more likely to have lower long-term fertility goals. There is only a small difference in the ideal number of children among women in the rural and urban areas. Women in Central Mindanao desired more than four children compared to less than three for women in Metropolitan Manila, while the ideal numbers for other regions were all between 3 and 4 children. Table 6.6 Mean ideal number of children by background characteristics Mean ideal number of children for all women, by age and selected background characteristics, Philippines 1993 Age of woman Background characteristic 15-19 20-24 25-29 30-34 35-39 4044 45-49 Total Residence Urban 2.7 2.8 3.0 3.1 3.4 3.6 3.8 3.1 Rural 2.9 3.0 3.2 3.6 3.7 4.0 4.1 3.4 Region Metro. Manila 2.7 2.8 2.8 2.9 3.2 3.4 3.5 2.9 Cordillera Admin. (3.2) (3.3) (3.5) (4.1) (4.4) * * 3.8 llocos 3.1 2.9 3.0 3.6 3.8 3.7 4.3 3.4 Cagayan Valley 2.6 2.9 3.1 3.3 3.7 4.0 3.9 3.2 C-Luzon 2.9 3.1 3.3 3.4 3.8 4.1 4.1 3.4 S-Tagalog 2.7 2.8 3.1 3.1 3.6 3.6 3.8 3.1 Bicol 3.0 2.9 3.2 3.5 3.5 3.7 3.8 3.3 W-Visayas 2.8 2.8 3.1 3.3 3.4 3.7 3.7 3.2 C-Visayas 2.6 2.8 2.8 3.1 3.3 3.8 3.7 3.1 E-Visayas 2.6 2.8 3.1 3.3 3.3 3.7 (3.8) 3.1 W-Mindanao 2.9 3.0 3.4 4.0 4.1 4.6 4.8 3.7 N-Mindanao 2.6 2.8 3.1 3.2 3.5 3.7 (3.7) 3.1 S-Mindanao 2.7 2.8 3.0 3.2 3.4 3,6 4.0 3.1 C-Mindanao 3.4 3.7 4.0 4.5 4,6 4.7 5.3 4.2 Education No education (3.8) (3.7) (4.5) (4.6) 5.2 (5.1) (5.3) 4.6 Elementary 2.8 3.1 3.3 3.6 3.8 4.0 4.1 3.6 High school 2.8 2.8 3.0 3.3 3.4 3.7 3.8 3.0 College or higher 2.8 2.9 2.9 3.0 3.2 3.3 3,5 3.0 Total 2.8 2.9 3.1 3.3 3.6 3.8 4.0 3.2 * Less than 25 unweighted cases ( ) Figures in parentheses are based on 25-49 unweighted cases. 78 6.4 Unplanned and Unwanted Fertility Women were asked questions for each child born in the preceding f ive years and any current pregnancy, to determine whether the particular pregnancy was planned, unplanned but wanted at a later time or not wanted at all. Answers to these questions form a powerful indicator of the degree to which couples successfully control child beating. In addition, the data can be used to gauge the effect on period fertility of the prevention of unwanted births. Table 6.7 shows the distribution of births in the five years preceding the survey by fertility planning status, according to birth order and mothers' age at birth. Fifty six percent of all births were wanted at the time of conception, 28 percent were wanted but at a later time and 16 percent were unwanted. The proportion of births which were wanted at the t imeof conception is highest among the first birth (79 percent) and among mothers under age 20 at the time of birth (67 percent). Mistimed pregnancies are highest for second and third child. The proportion of unwanted births increases as mothers get older and have had larger number of children; it is highest among the fourth births and above (30 percent) and among mothers age 40-44 years (48.3 percent). The wanted fertility rate is defined as the level of fertility that theoretically would result i f all unwanted births are prevented. The total fertility rate provides another indicator of fertility aspirations and may be interpreted as the number of wanted births that a woman would bear by age 50. Table 6.7 Fertility planning status Percent distribution of births in the five years preceding the su:wey by fertility planning status, according to birth order mad mother's age, Philippines 1993 Planning status of birth Birth order Wanted Number and mother's Wanted Wanted no of age then later more Missing Total births Birth order 1 79.1 18.4 2.3 0.3 100.0 2190 2 58.7 35.9 5.1 0.3 100.0 1961 3 54.9 32.7 11.9 0.6 100.0 1605 4+ 41.9 27.6 30.0 0.5 100.0 4061 Age at birth <20 67.3 29.5 3.3 0.0 100.0 783 20-24 62.6 31.0 5.8 0.6 100.0 2651 25-29 57.0 30.2 12.4 0.4 100.0 2758 30-34 50.8 27.2 21.6 0.4 100.0 1985 35-39 45.1 21.4 32.8 0.6 100.0 1188 40-44 34.9 16.6 48.3 0.2 100.0 420 45-49 (39.8) (12.7) (45.1) (2.3) 100.0 33 Total 55.7 28.0 15.9 0.4 100.0 9817 Note: Birth order includes current pregnancy. ( ) Figures in parentheses are based on 25-49 unweighted cases. 79 Table 6.g Wanted fer tilit)' r ares Total wanted fertility rates and total fertility rates for the three years preceding the survey, by selected background characteristics, Philippines 1993 Total wanted Total Background fertility fertility characteristic rate rate Residence Urban 2.6 3.5 Rural 3.3 4.8 Region Metro. Manila 2.2 2.8 Cordillera Admin. 3.9 5.0 llocos 3.2 4.3 Cagayan Valley 3.2 4.2 C-Luzon 3.1 3.9 S-Tagalog 2.7 3.9 Bicol 3.5 5.9 W-Visayas 2.8 4.2 C-Visayas 2.9 4.4 E-Visayas 3.1 4.9 W-Mindanao 3.4 4.5 N-Mindanao 2.9 4.8 S-Mindanao 2.9 4.2 C-Mindanao 3.7 4.8 Education No education 4.0 4.9 Elementary 3.7 5.5 High school 2.9 3.9 College or higher 2.4 2.g Total 2.9 4.1 Note: Rates are based on births to women 15-49 in the period 1-36 months preceding the survey. The total fertility rates ate the same as those presented in Table 3.2. Table 6.8 shows the total wanted fertility rates and total fertility rates for the three years preceding the survey by place of residence and level of education. The comparison makes clear that women will bear 1.2 children more than they desire if they continue to re- produce at current levels over time. This difference is an indication of the number of births that a woman needs to avoid over her reproductive life in order to at- tain her fertility aspiration. The table also shows that regardless of the place of residence, region of resi- dence, and level of education, the wanted number of births is lower than the actual number of births. It is interesting to note, however, that women in rural areas have 1.5 children more than their desired fertility, while among urban women the difference is less than one child, indicating that urban women are more suc- cessful in achieving their fertility goal. Considering the gap between wanted and actu- al fertility among the regions, Bicol has the highest difference of 2.4 births while Metropolitan Manila has the lowest at 0.6 births. Metropolitan Manila has the lowest wanted fertility of 2.2 births as well as the gap between wanted and actual fertility. College-educated women seem to be most successful in achieving their fertility goal, with less than one or less child gap be- tween desired and actual fertility. On the other hand, women with elementary education have the largest gap of 1.8 children. 80 CHAPTER 7 INFANT AND CHILD MORTALITY 7.1 Background Reported in this chapter is information on levels, trends, and differentials in neonatal, posmeonatal, infant and child mortality. This information is relevant both to the demographic assessment of the population and health policies and programs. Estimates of infant and child mortality may be used as inputs into population projections, particularly if the level of adult mortality is known from another source or can be inferred with reasonable confidence. Information on mortality of children also serves the needs of agencies providing health services by identifying sectors of the population which are at high mortality risk. In this report, infant and child mortality are measured using the following rates: Neonatal mortality (NN): the probability of dying within the first month of life; Posmeonatal mortality (PNN): the probability of dying after the first month of life but before age one year, Infant mortality Qqo): the probability of dying between birth and age one year, Child mortality (4q~): the probability of dying between exact age one and age five; Under-five mortality (sqo): the probability of dying between birth and exact age five. The mortality rates presented in this chapter are computed from information derived from the questions asked in the pregnancy history section of the 1993 National Demographic Survey (NDS) individual woman's questionnaire. Data collection proceeded as follows: first, each woman was asked about the number of sons and daughters living with her in the same household as well as those who are living elsewhere, and the number who had died. At this point, the respondent was also asked about the number of pregnancies which did not result in a live birth. Next, the respondent was asked to give information on each of the pregnancies she had experienced. For each pregnancy, she was asked whether the pregnancy ended in a live birth or not. The name, sex, date of birth, age at last binhday, whether the birth was an outcome of a single or multiple births and survival status were recorded for all live births. If the child had died, the woman was asked the age at death. If the child is still living, information about his/her age at last birthday and whether the child lived with his/her mother was obtained. For pregnancies that did not result in a live birth, the respondent was asked if she or someone else did something to end the pregnancy, and how old the pregnancy was at the time of loss. The information on births (still living and now dead) is used to directly estimate mortality rates, It should be noted here that the reliability of these mortality estimates depends upon full recall about children who have died, the absence of significant differential of birth dates between surviving and dead children, and accurate reporting of ages at death. It should be said, however, that birth history data provide information that make detailed analyses of mortality possible. A closer look at the pattern of reporting of ages at death (Table C.6 in Appendix C and Figure 7,1) reveals some evidence of heaping of deaths. For the five years preceding the survey, a significantly high percentage of deaths was reported to occur to infants age 12 months, and to a lesser extent age 8 and 9 81 months. However, the extent of heaping is much less than that observed in the DHS data for Indonesia and Nigeria (Central Bureau of Statistics, 1992; Federal Office of Statistics, 1992). With regard to the issues of recall and misplacement of birth dates, the 1993 NDS data are found to contain slight biases (see Appendix C). While reporting of age at death appear to be reasonable, no definitive conclusions could be made about the birth history data as a whole. Figure 7.1 Deaths among Children under Two Years for Three 5-year Periods Preceding the Survey Number of Deaths 20O 15( 1 0O < 1 2 3 4 5 6 7 8 9 tO 11 12 13 14 15 16 17 18 19 20 21 ~r~ 7~ Age at Death (Months) i Years prior to survey i I "°'0-4 (1987-gl) -}-5-9 (1982-86) "~ 10-14 (1977-81) 1993 NDS A task force on child and maternal mortality rates created by the National Statistical Coordination Board to review and assess the latest mortality estimates obtained from surveys and to recommend the most reasonable mortality levels is currently undertaking a thorough assessment of the results of the 1993 NDS. Therefore, the observed levels and changes in mortality in this report should be considered preliminary. In order to analyze trends in mortality, direct estimates based on the 1983 and 1988 NDS, the 1986 Contraceptive Prevalence Survey (CPS) and the Republic of the Philippines Fertility Survey (RPFS) are also presented in this chapter as well as estimates from the Vital Registration System (VRS). Data from the maternity histories collected in previous surveys cited earlier provided direct estimates of infant mortality at various periods preceding each survey. The estimates from the vital registration system were calculated using the ratio of registered infant deaths to births expressed in terms of 1,000 live births. Comparing the point estimates of infant mortality from various sources during the same periods provides some insights as to the levels and trends on infant mortality. 7.2 Levels and Trends in Infant and Child Mortality Table 7.1 presents various mortality estimates for children under five based on the 1993 NDS. Infant mortality during the five-year period prior to the survey was 34 deaths per 1,000 live births, while the 82 neonatal mortality rate was 18 deaths per 1,000 live births. The probability of dying between birth and the fifth birthday was 54 per 1,000 live births. The data indicate that the under-five mortality rate declined from 79 in the period 10 to 14 years prior to the survey to 54 in the most recent five-year period. While the data in the various measures of mortality showed a declining trend, a slightly saw-tooth pattern is observed with child mortality. Table 7.1 Infant and child mortality Infant and child mortality rates by five-year periods preceding the survey, Philippines 1993 Years Neonatal Posmeonatal Infant Child Under-five preceding mortality mortality mortality mortality mortality survey (NN) (PNN) (lqo) (aql) (5%) 0-4 17.7 15.9 33.6 21.3 54.2 5-9 18.6 24.9 43.5 31.5 73.6 10-14 24.9 26.4 51.3 28.8 78.6 Table 7.2 and Figure 7.2 show direct measures of infant mortality from various sources. During the 20-year period, infant mortality continued to decline though at varying paces. Prior to 1980, the IMR based on the VRS was generally higher than those directly measured from the four national demographic surveys, with the exception of the 1978 RPFS which tumed out to be higher than the VRS in 1976. The 1978 RPFS, the 1983 and 1988 NDS rounds and the 1986 CPS yielded more or less comparable stable estimates of IMR for the periods 1971 to 1985. The pattern observed with the vital registration as a source is reversed for the periods since 1980 in which the rates are much lower than those estimated from the national surveys. Point estimates for 1980 appear to be similar from all sources. There were, however, wide divergence for the preceding and succeeding periods. To illustrate, a wide difference is noticeable from the results of the 1988 NDS and the 1993 NDS. The trend in the 1993 follows the pattern of the VRS showing a dramatic decline in the estimates. These varying pattern of changes from various sources imply that a more detailed assessment of the estimates of child mortality is necessary before arriving at a definitive conclusion. Table 7.2 Trend in infant mortality rate Infant mortality rates from various sources, Philippines 1970-90 Vital Approximate 1993 1988 1983 1978 Regisgation midpoint NDS NDS NDS RPFS System 1990 33.6 - 24.3 1985 43.5 52.0 38.0 1980 51.3 51.0 47.0 - 45.1 1975 53.0 50.0 59.0 56.9 1970 50.0 56.0 62.0 Source: Final Report of the Task Force on Infant Mortality Rate, NCSB, December 1992, and 1993 NDS. 83 70 60 40 30 20 Figure 7.2 Trends in Infant Mortality Philippines, 1971-90 Deaths per 1,000 Births 0 ¢ I I t I I 1971 1978 1980 1985 1990 7.3 Infant and Child Mortality Differentials by Socioeconomic Characteristics Socioeconomic factors are important determinants of the levels of infant and child mortality. In the NDS, several socioeconomic factors have been collected, such as, place of residence and education of parents. Health beliefs and practices as well as accessibility or availability of health care services have also been collected. This section deals with the relationship between the childhood mortality measures and some of these variables. Table 7.3 shows mortality measures by selected socioeconomic background characteristics of the mother for the ten-year period preceding the survey. In general, mortality in the urban areas is lower than in the rural areas. Table 7.3 indicates that mortality rates (except in the neonatal period) for children of mothers with no education or elementary education are much higher than those with a high school or especially college education (see Figure 7.3). This supports the findings of previous studies which showed that children bom to better educated mothers have higher probability of surviving their early years. In reviewing Philippines studies in this area, using various statistical techniques and mortality indicators, (Costello, n.d.) concluded that there is an inverse relationship between matemal education and infant mortality. 84 Meanwhile, mortality among infants/children whose mother had no antenatal care or medical assistance at the time of delivery is much higher than for those who had either or both antenatal care and medical assistance. This observation reinforces the findings of local studies which showed that accessibility and availability of health services/facilities can be linked empirically to reduced rates of infant mortality. For instance, it was found out that access to midwife, hospital, primary health care center or pharmacy is linked inversely with neonatal mortality rates, and that access to a health worker and hospital has a similar impact on posmeonatal mortality rates (Engracia, 1983). Similarly, it was observed that access to modem medical practitioners can be linked to lower infant mortality rates (Madigan, 1985). Table 7.3 Infant and child mortality by socioeconomic characteristics Infant and child mortality rates for the ten-year period preceding the survey, by selected background characteristics, Philippines 1993 Neonatal Posmeonatal Infant Child Under-five Background mortality mortality mortality mortality mortality characteristic (NN) (PNN) (;q0) Gq0 (sqo) Residence Urban 15,8 16.1 31.9 21.5 52.7 Rural 20,3 24,0 44,3 30.5 73.4 Region Metro. Manila 15.0 12.1 27.1 20.5 47, l Cordillera Admin. 11,0 12.0 23.0 26.1 48.5 Ilocos 21.6 24,9 46.5 20,7 66.2 Cagayan Valley 20.5 21.3 41.8 19.5 60,5 C-Luzon 13,9 8,3 22,2 13.7 35.5 S-Tagalog 19,1 14.6 33.7 24.4 57.3 Bicol 17.4 22.6 40.0 35,5 74,0 W-Visayas 22,9 22,6 45.5 20.9 65.5 C-Visayas 22,1 11.8 33.8 21.4 54.5 E-Visayas 27.7 33.7 61.4 38.4 97.5 W-Mindanao 13.8 38.0 51.8 34.8 84,8 N-Mindanao 14,5 22,6 37.1 26.4 62.5 S -Mindanao 16.7 26.4 43.1 38,0 79,4 C-Mindanao 17.9 31.2 49.1 39,3 86.5 Education No education 18,1 58,6 76,7 81.4 151,8 Elementary 19,9 26,7 46.6 35.5 80.4 High school 15.9 13.7 29.6 16.9 46.0 College or higher 18.0 9.6 27.6 8.3 35,7 Medical maternity care No antenatal/delivery care 26.8 35.8 62.6 Either antenatal or delivery 16.0 16.8 32.8 Both antenatal & delivery 15.9 8,5 24.3 Total 18.2 20.2 38.4 Note: Month of interview excluded from analysis. ( ) Based on 250-499 eases * Less than 250 cases (17.9) (50.2) (6.0) (30.2) 26.2 63.5 85 Figure 7.3 Infant Mortality by Background Characteristics Deaths per 1,000 Births 1 O0 80 60 40 20 0 Urban Rural RESIDENCE Note; Figures are for the lO-year period preceding the survey, No Elemen- High College Education tary School or Higher EDUCATION 1993 N DS 7.4 In fant and Chi ld Mortality Differentials by Demographic and Health-re lated Character ist ics Table 7.4 shows mortality by selected demographic characteristics, which have been shown to influence the survival chances of children. In general, mortality is higher for males than for females. One of the variables known to have an effect on infant mortality is the mother's age at the time of delivery. The level of infant and under-five mortality is higher among children whose mothers were less than age 20 at the time of delivery, decreases among mothers age 20-29 and increases among mothers age 40-49. The pattem is similar for child mortality which is extremely high among children whose mothers are less than 20 at the time of delivery. However, neither neonatal or postneonatal mortality shows a definite pattem of variation with mother's age. Mortality according to the length of the previous birth interval indicate the usual pattern of high mortality among children born less than two years after the previous birth. This is true for all mortality rates. The rates decline as the interval between birth increases except for neonatal mortality. Children who were judged by their mothers to be "average or larger" at birth generally have lower mortality levels than children judged to be "very small" or "very small" at birth. Before reaching age 1, the mortality risks for very small infants is four times higher than those whose birth size are average or larger. The same is tree for children under-five; mortality rates are 4 times higher for very small children than for children whose birth size are average or larger. 86 Table 7.4 Infant and chiM mortality by demographic characteristics Infant and child mortality rates for the ten-year period preceding the stnwey, by selected demographic characteristics, Philippines 1993 Neonatal Posmeonatal Infant Child Under-five Demographic mortality mortality mortality mortality mortality characteristic (NN) (PNN) (lqo) (4ql) (~o) Sex of child Male 19.8 23.7 43.5 27.6 69.9 Female 16.4 16.5 32.9 24.7 56.8 Age of mother at birth < 20 18.9 22.7 41.6 40.5 80.4 20-29 16.1 18.0 34.1 24.9 58.1 30-39 20.4 23.6 44.0 23.3 66.3 40-49 (30.2) 18.8 49.0 * * Birth order 1 18.1 10.0 28.1 17.9 45.5 2-3 13.9 17.3 31.2 24.3 54.8 4-6 21.5 26.3 47.8 29.6 75.9 7+ 23.0 33.0 55.9 39.8 93.5 Previous birth Interval < 2 yrs 20.6 33.5 54.0 38.3 90.3 2-3 yrs 15.0 18.0 33.0 25.0 57.2 4 yrs + 19.3 13.9 33.2 15.1 47.8 Size at birth 1 Very small (76.7) (23.1) (99.8) * * Small 28.4 23.9 52.3 * * Average or larger 11.6 13.1 24.7 13.8 38.1 IRates for the five-year period preceding the survey * Less than 250 cases ( ) Figures in parentheses are based on less than 500 eases (exposed persons). 7.5 High-Risk Fertility Behavior The distribution of women and children according to categories of increased risk of infant and child mortality as a result of fertility behavior of the mother is shown in Table 7.5. Children at elevated risk include those born to mothers who are too young or too old when they give birth, children of too high parity, and children born after a too short interval. The table also presents the relative risk of mortality for children born in the last five years by comparing the proportion dead in each high-risk category with the proportion dead among children who are not in any high risk category. This information is useful for designing and monitoring programs both to avoid high-risk behavior and to cope with the elevated risks. Of the total number of children bom in the five years preceding the survey, 3 in 5 (62 percent) are in one or more elevated risk categories. A high birth order and short birth interval were the most common high-risk factors. More than 40 percent of all births at elevated risk also had been subject to multiple risk characteristics. Under the single risk category, 2 percent were bom to mothers younger than 18, 2 percent were bom to mothers older than 34 years old, 14 percent were born after an interval of less than 24 months and 19 percent of births were of birth orders greater than 3. Meanwhile, under the multiple high risk category, 11 percent were bern to mothers who are over 34 years of age and with birth order greater than 3, and 11 percent were born after an interval of less than 24 months and with birth order greater than 3. 87 Table 7.5 High-risk fertility behavior Percent distribution of children born in the five years preceding the survey who are at elevated risk of mortality, and the percent distribution of currently married women at risk of conceiving a child with an elevated risk of mortality, by category of increased risk, Philippines 1993 Births in last 5 years Percentage preceding the survey of currently Risk Percentage Risk married category of births ratio women a Not In any risk category 37.6 1.00 31.1 b Single risk categories Mother's age < 18 2.3 1.67 0.2 Mother's age > 34 1.7 1.17 7.5 Birth interval < 24 13.5 1.32 9.3 Birth order > 3 19.0 1.50 12.1 Subtotal 36.5 1.43 29.1 Multiple risk categories Age <18 & birth interval <24 c Age >34 & birth interval<24 Age >34 & birth order>3 Age >34 & birth interval <24 & birth order >3 Birth interval <24 & birth order >3 Subtotal In any risk category Total Number 0.2 * 0.1 0.4 (1.05) 0.5 11.2 2.15 26.4 3.2 3.47 4.1 10.9 2.52 8.8 25.9 2.44 39.8 62.4 1.85 68.9 100.0 NA 100.0 8803 NA 8961 Note: Risk ratio is the ratio of the proportion dead of births in a specific risk category to the proportion dead of births not in any risk category. NA = Not applicable aWomen were assigned to risk categories according to the status they would have at the birth of a child, if the child were conceived at the time of the survey: age less than 17 years and 3 months, age older than 34 years and 2 months, latest birth less than 15 months ago, and latest birth of order 3 or higher. blncludes sterilized women elrtcludes the combined categories age <18 and birth order >3. * Less than 100 cases ( ) Figures in parentheses are risk ratios based on fewer than 200 cases. 88 The risk ratios shown in the second column of Table 7.5 illustrate the relationship between the risk factors and mortality levels. The risk ratios for children in the single risk categories are generally lower than risk ratios for children in multiple high-risk categories. Those who fall into only one elevated risk category have a risk ratio of 1.43, while children who are in multiple high risk category have a risk ratio of 2.44. The highest risk ratios for those in single high risk categories are observed for children with mothers who are less than 18 years of age (1.67). As for children who are in the elevated multiple risk, the highest ratio is observed for those with mothers who are older than 34 with birth intervals of less than 24 months and with birth orders greater than 3 (3.47). High risk ratios also are observed for those with birth orders greater than 3 combined with either mothers who are less than 24 (2.52) or those who are more than 34 (2.15) years of age. The distribution of currently married women according to category of potential risk if they were to conceive at the time of the survey is also presented. The results indicated that 29 percent of married women have the potential for giving birth to a child in one elevated risk category, and 40 percent have a risk of having a child in multiple high risk categories. In summary, the aforementioned findings indicate that the majority of births in the last five years are at an elevated mortality risk. Moreover, two thirds of married women had the potential for giving birth to a child at elevated risk at the time of the survey. It clearly implies that significant reduction in infant and child mortality can be achieved by changing the patterns of childbearing. 89 CHAPTER 8 MATERNAL AND CHILD HEALTH Presented in this chapter are three areas of importance to maternal and child health: matemal care and delivery assistance, vaccinations, and common childhood diseases and treatment. Combined with information on neonatal and infant mortality, this information is useful in identifying subgroups of women who are in need of maternity care and in planning for improvements of services. 8.1 Antenatal Care In the 1993 National Demographic Survey (NDS), the respondents were asked whether they had seen anyone for antenatal care during the pregnancy preceding each live birth in the preceding five years. The interviewer was instructed to record all responses if more than one source of antenatal care was mentioned for the same pregnancy. However, for the purposes of this tabulation, only the provider with the highest qualifications is considered when there is more than one response. Table 8.1 shows that the overall level of antenatal care among Filipino women is relatively high. Nine of 10 children born in the five years preceding the survey were to mothers who received antenatal care; mothers of almost half of these children saw a trained nurse or midwife, 4 in 10 saw a physician, and the rest received care from a birth attendant. Births to mothers age 20-34, lower order births and births to urban mothers, better-educated mothers, and mothers living in Central Luzon and Metropolitan Manila were more likely to receive medical attention during pregnancy than were other births in the five years prior to the survey. While more than half of children in the urban areas are bom to mothers who received antenatal care from a physician, in the rural areas nurses and midwives are more likely to be the antenatal care provider. The disparity in antenatal service provider is also present when the regions are considered. In Metropolitan Manila and Central Luzon, the most common antenatal care provider is a physician. In all other regions, mothers were most likely to consult a nurse or midwife. Birth attendants are an important source for antenatal care in Mindanao (especially West and Central Mindanao) and, to a lesser extent in Visayas. There is a very strong association between mother's level of education and type of antenatal care used. Children born to mothers who had secondary education are four times more likely to consult a physician for antenatal care compared to mothers who had no education. For mothers with higher education, the chance for using a doctor for antenatal care is even higher, almost seven times higher than the level of mothers who had no formal schooling. The matemal care program in the Philippines recommends that every pregnant woman have at least 3 antenatal care visits during her pregnancy, 1 visit in each of the three trimesters. Information about the visits made by pregnant women is presented in Table 8.2 and Figure 8.1. The findings indicate that for the majority of the births in the five years prior to the survey, mothers made the recommended number of visits. For more than half of births, mothers made 4 or more antenatal visits, and one in three had 2 or 3 visits. The median number of visits was 4.5. Table 8.2 also presents the distribution of births occurring in the past five years according to the timing of the first antenatal visit. For three in four births, the first antenatal visit was made in the first 5 months of gestation; in fact, the median number of months pregnant at the time of the first visit was 4.3 months. It should be noted that one in seven births had their first antenatal care in the second trimester, while a small percentage was first examined in the third trimester. 91 Table 8.1 Antenatal care Percent distribution of live births in the five years preceding the survey, by source of antenatal care during pregnancy, according to selected background characteristics, Philippines 1993 Antenatal care provider 1 Trained Traditional Number Background nurse/ birth No one/ of characteristic Doctor midwife attendant Missing Total births Mother's age at birth <20 34.5 45.9 11.9 7.7 100.0 731 20-34 39.7 44.7 8.6 7.0 100.0 6618 35+ 33.6 45.1 10.2 11.1 100.0 1454 Birth order 1 53.4 35.7 5.8 5.1 100.0 1995 2-3 42.0 44.2 7.9 6.0 100.0 3181 4-5 31.7 50.1 9.9 8.3 100.0 1857 6+ 21.2 50.8 14.3 13.7 100.0 1769 Residence Urban 53.9 34.4 5.7 6.1 100.0 4269 Rural 23.5 54.7 12.4 9.5 100.0 4533 Region Metro. Manila 81.3 9.9 2.1 6.7 100.0 1086 Cordillera Admin. 32.2 55.5 3.5 8.9 100.0 173 lincos 33.7 52.7 4.4 9.2 100.0 489 Cagayan Valley 25.2 58.4 2.7 13.8 100.0 317 C-Luzon 56.4 37.0 2.8 3.8 100.0 905 S-Tagalog 36.7 46.9 5.5 10.9 100.0 1069 Bicol 19.7 53.4 15.3 11.6 100.0 669 W-Visayas 30.3 52.3 7.9 9.4 100.0 738 C-Visayas 36.5 51.1 9.5 2.9 100.0 722 E-Visayas 33.5 45.7 11.4 9.4 100.0 437 W-Mindanao 16.7 50.8 29.4 3.1 100.0 491 N-Mindanao 24.3 61.6 8.6 5.5 100.0 550 S-Mindanao 26.9 51.8 12.1 9.1 100.0 666 C-Mindanao 24.4 44.9 22.0 8.7 100.0 491 Mother's education No education 10.7 22.8 41.3 25.1 100.0 244 Elementary 19.5 54.6 14.5 11.4 100.0 3637 High school 42.7 46.5 5.1 5.7 100.0 3114 College or higher 72.0 25.4 0.8 1.8 100.0 1808 All births 38.3 44.8 9,1 7.8 100.0 8803 Note: Figures axe for births in the period 1-59 months preceding the survey. tlf the respondent mentioned more than one provider, only the most qualified provider is considered. 92 Table 8.2 Number of antenatal cam visits and stage of pregnancy Percent dishibution of live births in the last 5 years by number of antenatal care (ANC) visits, and by the stage of pregnancy at the time of the first visit, Philippines 1993 Antenatal visits/ Stage of pregnancy Aii at first visit births Number of ANC visits 0 7.7 1 6.5 2-3 32.6 4+ 52.1 Don't know, missing 1.0 Total I00.0 Median no. of visits 4.5 Number of months pregnant at the time of first ANC visit No antenatal care 7.7 Less than 6 months 74.4 6-7 months 14.3 8+ months 2.9 Don't know, missing 0.7 Total 100.0 Median number of months pregnant at first visit 4.3 Number of live births 8803 Note: Figures are for births in the period 1-59 months preceding the survey. Figure 8.1 Number of Antenatal Care Visits and Stage of Pregnancy at First Visit No Visits 8% 1 Visit 7%~ 4+ Visits 52% 2-3 Visits 33% Number of Antenatal Care Visits 8+ Months 3% 6-7 Months 15% Less than 5 Months 82% Stage of Pregnancy at First Visit Note: Births 1-59 months before the survey. 1993 NDS 93 8.2 Tetanus Immunization of Pregnant Women In many countries, neonatal tetanus is a major cause of neonatal mortality. The mammal care program recommends that women receive at least two tetanus toxoid injections during the first pregnancy. Booster injections are given 6 months later, and in order to confer lifetime immunity, two more doses are given. Information on the number of tetanus toxoid injections received by pregnant women was collected in the 1993 bIDS. For mothers with antenatal car~s, inf9.rr~.afion was obtained from the card. Table 8.3 shows that for 8,803 births in the five years preceding the survey, slightly more than half of their mothers Table 8.3 Tetanus toxoid vaccination Percent distlibution of live births in the five years preceding the survey, by number of tetanus toxoid injections given to the mother during pregnmacy and whether the respondent received an antenatal card, according to selected background characteristics, Philippines 1993 Number of tetanus toxoid injections Percentage Two given Number Background One doses Don't know/ antenatal of characteristic None dose or more Missing Total card births Mother's age at birth < 20 32.9 22.0 45.1 0.0 100.0 50.3 731 20-34 34.6 22.2 42.8 0.4 100.0 53.2 6618 35+ 39.0 22.1 38.1 0.8 100.0 47.6 1454 Birth order 1 32.0 19.5 48.3 0.1 100.0 58.3 1995 2-3 33.3 23.6 42.7 0.4 100.0 54.1 3181 4-5 33.8 23.8 41.7 0.7 100.0 51.4 1857 6+ 43.7 21.0 35.0 0.4 100.0 42.0 1769 Residence Urban 36.4 21.4 41.7 0.5 100.0 61.2 4269 Rural 34.1 22.9 42.7 0.3 100.0 43.4 4533 Region Metro. Manila 44.1 21.5 34.1 0.3 100.0 65.6 1086 Cordillera Admin. 23.3 38.9 37.8 0.0 100.0 61.4 173 Ilocos 38.3 25.7 35.1 0.9 100.0 61.3 489 Cagayan Valley 28.3 22.9 48.8 0.0 100.0 22.3 317 C-Luzon 36.1 19.1 44.5 0.4 100.0 60.7 905 S-Tagalog 37.0 16.0 46.6 0.4 100.0 47.9 1069 Bicol 35.8 19.4 44.1 0.7 100.0 44.8 669 W-Visayas 29.8 18.9 51.1 0.3 100.0 44.9 738 C-Visayas 30.3 31.1 38.1 0.5 100.0 53.5 722 E-Visayas 33.5 21.5 44.8 0.2 100.0 35.9 437 W-Mindanao 36.5 17.9 45.4 0.2 100.0 52.0 491 N-Mindanao 25.5 35.8 38.7 0.0 100.0 72.0 550 S-Mindanao 33.8 23.2 42.0 1.0 100.0 44.7 666 C-Mindanao 43.2 17.1 39.4 0.3 100.0 42.0 491 Mother's education No education 73.3 10.2 16.4 0.0 100.0 15.3 244 Elementary 39.4 21.1 39.3 0.2 100.0 41.6 3637 High school 28.3 24.8 46.5 0.4 100.0 57.8 3114 College or higher 33.6 21.6 44.1 0.8 100.0 68.0 1808 All births 35.2 22.2 42.2 0.4 100.0 52.0 8803 Note: Figures are for births in the period 1-59 months preceding the survey. 94 received an antenatal card during pregnancy. Women who live in Metropolitan Manila, Cordillera Administrative Region, llocos, Central Luzon, and Northern Mindanao are more likely to have a card. It is worth noting that Cagayan Valley is the only region not only in Luzon island, but also in the country for which the antenatal card coverage level is less than 25 percent. For women who did not receive a card, information on tetanus toxoid injections was based on the respondent's recall. The mothers of I in 3 births in the five years prior to the survey did not receive a tetanus injection, for I in 5 births the mothers received one dose, and for 2 in 5 births the mothers received two or more doses. Tetanus toxoid coverage varies only slightly by mother's age, birth order and urban-rural residence. By contrast, coverage differs significantly according to region and women's education. Coverage levels are lower in Metropolitan Manila and Central Mindanao than in other regions. Less educated mothers are much less likely to have had a tetanus injection than other mothers. 8.3 Delivery Assistance Among births in the past five years, 28 percent were born in a health facility while the remaining 72 percent were delivered in the respondent's home or someone else's home. Table 8.4 demonstrates that there does not appear to be a strong relationship between mother's age and the children's place of delivery. Women who delivered in a health facility are more likely to have lower birth order babies, live in urban areas, have higher than college or higher education, and made 4 or more antenatal visits. It is interesting to note that the vast majority of births of order six or higher (88 percent) were delivered at home. This implies that a large proportion of high risk births did not receive medical attention during delivery. Delivery at a health facility most likely occurred in Metropolitan Manila (68 percent), and least likely in Cagayan Valley, Bicol, and Western Mindanao (11 percent). Presented in Table 8.5 is information on assistance at delivery. As with antenatal care, the interviewer was instructed to record all responses if more than one person assisted during delivery. However, for purposes of this analysis, only the most highly qualified attendant is considered if there is more than one response. Virtually all of the births in the past five years were delivered with some assistance; more than hal f by medical professionals. Medical assistance at delivery was more common among women with lower order births, those who live in urban areas, who have high school or higher educational level, and who had 4 or more antenatal visits. In Metropolitan Manila, almost 9 in 10 births were attended by a medical professional, while in Cagayan Valley, Bicol, Eastem Visayas, and all of the regions in Mindanao, less than 4 in 10 were assisted by a doctor or a nurse/midwife during delivery. 95 Table 8,4 Place of delivery Percent distribution of live births in the five years preceding the survey, by place of delivery, according to selected background characteristics, Philippines 1993 Place of delivery Other/ Number Background Health At Don't Know/ of characteristic facility home Missing Total births Mother 's age at birth < 20 25.5 74.5 0.0 100.0 731 20-34 29.5 70.2 0.2 100.0 6618 35+ 23.6 76.1 0.4 100.0 1454 Birth order 1 44.3 55.4 0.3 100.0 1995 2-3 30.8 68.9 0.4 100.0 3181 4-5 21.8 78.1 0.0 100.0 1857 6+ 12.1 87.6 0.4 100.0 1769 Residence Urban 43.5 56.2 0.4 100.0 4269 Rural 13.8 86.0 0.2 100.0 4533 Region Metro. Manila 68.3 30.7 0.9 100.0 1086 Cordillera Admin. 32.2 67.6 0.3 100.0 173 llocos 18.1 81.7 0.2 100.0 489 Cagayan Valley 10.7 89.3 0.0 100.0 317 C-Luzon 40.3 59.6 0.1 100.0 905 S-Tagalog 24.1 75.7 0.1 100.0 1069 Bicol 11.3 88.4 0.2 100.0 669 W-Visayas 26.2 73.6 0.1 100.0 738 C-Visayas 26.9 73.1 0.0 100.0 722 E-Visayas 19.9 79.9 0.2 100.0 437 W-Mindanao 11.2 88.5 0.3 100.0 491 N-Mindanao 19.1 80.6 0.2 100.0 550 S-Mindanao 23.1 76.7 0.3 100.0 666 C-Mindanao 15.6 84.4 0.0 100.0 491 Mother's education No education 3.9 96.1 0.0 100.0 244 Some primary 12.3 87.5 0.3 100.0 3637 Completed primary 29.3 70.5 0.2 100.0 3114 Some secondary 61.7 37.9 0.3 100.0 1808 Antenatal care visits None 7.7 92.0 0.3 100.0 676 1-3 visits 14.1 85.8 0.1 100.0 3444 4 or more visits 41.9 58.0 0.2 100.0 4590 Don't know/missing 26.4 62.4 11.2 100.0 92 Total 28.2 71.5 0.2 100.0 8803 Note: Figures are for births in the period 1-59 months preceding the survey. 96 Table 8.5 Assistance during delivery Percent distribution of live births in the five years preceding the survey by type of assistance during delivery, according to selected background characteristics, Philippines 1993 Attendant assisting during delivery I Trained Traditional Number Background nurse/ birth Relative/ Don't Know/ of characteristic Doctor Midwife attendant Other No One Missing Total births Mother's age at birth < 20 23.7 25.0 48.7 2.3 0.2 0.0 100.0 731 20-34 27.0 27.0 44.2 1.5 0.2 0.1 100.0 6618 35+ 22.4 27.1 48.4 1.9 0.2 0.1 100.0 1454 Birth order 1 41.8 24.6 32.5 0.9 0.0 0.1 100.0 1995 2-3 27.8 28.7 41.8 1.4 0.1 0.2 100.0 3181 4-5 20.0 26.3 51.6 1.9 0.2 0.0 100.0 1857 6+ 11.0 26.4 59.2 2.7 0.4 0.2 100.0 1769 Residence Urban 39.6 30.8 28.4 1.0 0.1 0.2 100.0 4269 Rural 13.1 23.0 61.2 2.3 0.3 0.1 100.0 4533 Region Metro. Manila 60.4 28.1 10.6 0.5 0.0 0.4 100.0 1086 Cordillera Admin. 31.9 20.4 21.8 24.5 1.2 0.3 100.0 173 llocos 19.0 45.9 34.6 0.4 0.0 0.2 100.0 489 Cagayan Valley 11.4 25.2 56.3 5.3 1.8 0.0 100.0 317 C-Luzon 39.0 41.6 19.4 0.0 0.0 0.0 100.0 905 S-Tagalog 21.9 33.0 44.5 0.5 0.0 0.1 100.0 1069 Bicol 10.5 19.8 68.7 0.8 0.0 0.1 100.0 669 W-Visayas 23.8 24.5 49.5 2.2 0.1 0.0 100.0 738 C-Visayas 25.2 26.0 48.4 0.4 0.0 0.0 100.0 722 E-Visayas 18.4 14.0 67.4 0.2 0.0 0.0 100.0 437 W-Mindanao 10.1 23.3 65.4 0.9 0.0 0.3 100.0 491 N-Mindanao 17.7 20.7 60.3 1.0 0.I 0.I 100.0 550 S-Mindanao 19.5 16.9 57.8 5.0 0.7 0.0 100.0 666 C-Mindanao 14.8 17.4 66.4 0.9 0.5 0.0 100.0 491 Mother's education No education 2.6 6.7 76.9 11.4 2.5 0.0 100.0 244 Elementary 10.6 23.9 63.0 2.1 0.2 0.2 100.0 3637 High school 26.7 32.8 39.4 1.0 0,0 0.1 100.0 3114 College or higher 58.8 25.2 15.4 0.6 0.1 0.0 100.0 1808 Antenatal care visits None 6.3 19.1 65.5 7.7 1.4 0.0 100.0 676 1-3 visits 12.7 25.2 60.6 1.4 0.1 0.0 100.0 3444 4 or more visits 38.8 29.6 30.7 0.9 0.0 0.0 100.0 4590 Don't know/Missing 26.4 6.7 52.5 3.3 0.0 11.2 100.0 92 Total 26.0 26.8 45.3 1.7 0.2 0.1 100.0 8803 Note: Figures axe for births in the period 1-59 months prior to the survey. 1If the respondent mentioned more than one attendant, only the most qualified atlendant is considered. 97 Table 8.6 and Figure 8.2 shows that about 1 in 16 births (6 percent) in the past five years were born by caesarean section. This constitutes 1 in 5 of all deliveries in a health facility. Less than two percent of births were bom prematurely. Information on the baby's birth weight was also obtained in the 1993 NDS. In addition, the mother was also asked for her own objective assessment of whether the baby's birth size was very large, larger than average, average, smaller than average, or very small. Among children bom in the 5 years prior to the survey, 36 percent were not weighed at birth. Of those who were weighed, 14 percent were reported by their mother to weigh less than what is considered as a normal birth weight (2,500 grams). According to the mother's report, 18 percent of births in the past 5 years were smaller than average or very small at birth. Table 8.6 Characteristics of delivery Percent dis~ibution of births in the five years preceding the survey by whether the delivery was by caesarean section, whether premature, and by birth weight and the mother's estimate of baby's size at birth, Philippines 1993 Characteristic Percent Caesarean Yes 5.9 No 91.8 Missing 2.4 Total 1(30.0 Premature birth Yes 1.6 No 98.1 Don't know/missing 0.2 Total 100.0 Birth weight Less than 2.5 kg. 8.7 2.5 kg. or more 50.3 Don't know/missing 5.5 Not weighed 35.5 Total 100.0 Size at birth Very large 2.5 Larger than average 17.4 Average 59.4 Smaller than average 13.9 Very small 4.2 Don't know/missing 2.5 Total 100.0 Number of births 8803 Note: Figures are for births in the period 1-59 months preceding the survey. 98 Figure 8.2 Delivery Characteristics of Births in the Five Years Preceding the Survey Percent 20 15 t0 5 o Caesarean Premature Weight Small** <2.5 kg* * Based on infants weighed at birth ** Identified by mother as 'very small"or "smaller than average" 1993 N DS 8.4 Immunization of Children To assist in the evaluation of the Expanded Program of Immunization (EPI), the 1993 NDS collected information on immunization coverage for all children bom in the five years prior to the survey. For each child, the mother was asked if she had a health card for the child, and, if so, the interviewer asked to see it. When a mother was able to show the health card to the interviewer, the dates of vaccinations were copied from the card to the questionnaire. If the child has never received a health card, or the mother was unable to show the card to the interviewer, the mother was asked whether the child had received vaccinations against specific diseases, namely, tuberculosis, measles, diphtheria, pertussis, tetanus and polio. Although data on vaccinations were obtained for children who died, the data presented in this report are restricted to children who were alive at the time of the survey. Shown in Table 8.7 is the overall vaccination coverage for children age 12-23 months according to the source of the data used for determining the coverage. Data were obtained from health cards for only about 1 in 3 children; for the remaining children the immunization coverage information is based on their mother's report. Overall, 72 percent of these children have received all of the vaccines. The coverage rate is highest for BCG and the first doses of DPT and polio (91 percent). The drop out rate Z measured by the difference in coverage between the first and third doses is 12 percent for DPT and 14 percent for polio. ~Drop out rate = (Dose 1 - Dose 3)/Dose 1 • 100 99 Table 8.7 Vaccinations by source of information percentage of children 12-23 months who had received specific vaccines at any time before the survey and the percentage vaccinated by 12 months of age, by whether the information was from a vaccination card or from the mother, Philippines 1993 Percentage of children who received: Percentage DPT Polio with Number Background a of characteristic BCG 1 2 3+ I 2 3+ Measles All t None card children Vaccinated at any time before the survey Vaccination card 34.7 34.9 34.7 33.1 34.8 34.5 33.0 32.2 31.1 0.0 35.1 611 Mother's report 56.5 56.2 53.2 46.8 56.1 51.6 45.1 49.3 40.4 6.8 64.9 1131 Either source 91.2 91.1 87.9 79.9 90.9 86.2 78.2 81.4 71.5 6.8 100.0 1742 Vaoelnaled by 12 months of age Either source 88.3 88.8 85.0 77.3 88.2 83.1 75.5 70.9 61.9 8.6 1742 Valid dates 93.5 96.0 92.9 84.3 95.2 91.5 82.5 77.9 69.4 2.3 611 Note: The DPT coverage rate for children without a written record is assumed to be the same as that for polio vaccine since mothers were specifically asked whether the child had received polio vaccine.For children whose information was based on the mother's report, the proportion of vaccinations given during the first year of life was assumed to be the stone as for children with a written accord of vaccination. IChildren who are fully vaccinated (i.e., those who have received BCG, measles and three doses of DPT and polio). Since the immunization series should be completed by the end of the first year of life, immunization coverage for the first 12 months is also reported in Table 8.7. Based on information obtained from the health cards and from mothers' report, 62 percent of children 12-23 months have been completely immunized during the first year of life. BCG and the first doses of DlYl" and polio have the highest levels, while coverage for the subsequent DPT and polio doses and measles is slightly lower. Differentials in immunization coverage among children 12-23 months by background characteristics are presented in Table 8.8 and Figure 8.3. The rates are based on both health cards and mother's report. Coverage varies only slightly by the sex of the child and type of residence; however, the rates have a strong negative association with birth order, and a very strong positive association with mother's education. Variation by region is greater on Luzon island than in Visayas or on Mindanao island. 100 Table 8.8 Vaccinations by background characterisfes percentage of children 12-23 months who had received specific vaccines by the time of the survey (according to the vaccination card or the mother's report) and the percentage with a vaccination card, by selected background characteristics, Philippines 1993 Percentage of children who received: Percentage DPT Polio with Number Background a of characteristic BCG 1 2 3+ 1 2 3+ Measles All I None card children Sex Male 91.5 90.9 87.7 79.9 91.0 86.3 77.9 81.4 71.0 6.4 34.8 899 Female 90.8 91.4 88.1 79.9 90.8 86.1 78.4 81.5 72.1 7.1 35.4 843 Birth order 1 96.2 96,8 93.0 86.6 95.6 92.0 84.8 86.5 77,5 3.0 41.8 378 2-3 93.6 93.6 90.9 83.9 92.8 88.8 81.2 84.2 74.4 5.2 36.3 640 4-5 89.2 88.3 85.0 74.6 89.4 83.7 74.1 78.2 68.5 8.2 30.9 387 6+ 83.1 83.5 79.8 70.9 83.6 77.4 69.4 74.3 62.9 12.2 30.2 337 Residence Urban 93.0 93.0 90.0 81.4 92.9 89.0 81.2 83.7 73.2 4.9 35.8 860 Rural 89.4 89.4 85.9 78.5 89.0 83.4 75.2 79.2 69.9 8.6 34.4 883 Region Metro. Manila 93.1 93.1 89.6 77.1 94.4 87.5 77.1 72.9 61.1 4.2 27.8 209 Cordillera Admin. 92.8 97.1 97.1 89.9 95.7 95.7 89.9 91.3 85.5 2.9 63.8 35 lloeos 93.8 94.7 90.3 79.6 93.8 83.2 68.1 81.4 59.3 4.4 23.9 97 Cagayan Valley 88.7 93.8 87.6 75.3 93.8 87.6 74.2 73.2 61.9 6.2 21.6 68 C-Luzon 94.4 93.7 93.0 81.0 92.3 89.4 76.1 85.9 71.8 4.9 31.0 163 S-Tagalog 94.1 93.5 90.5 83.4 92.3 87.6 83.4 84.6 77.5 5.3 24.9 226 Bicol 88.0 86.7 81.0 74.1 89.9 80.4 72.8 82.9 70.3 7.6 32.9 150 W-Visayas 89.8 90.6 87.5 82.8 89.8 88.3 82.0 80.5 74.2 7.8 60.9 129 C-Visayas 92.4 90.4 88.5 83.4 92.4 88.5 82.8 80.9 76.4 5.1 37.6 151 E-Visayas 92.6 92.6 89.4 83.0 91.5 89.4 81.9 85.1 75.5 6.4 34.0 76 W-Mindanao 82.9 82.9 81.4 75.2 82.2 78.3 72.9 76.0 69.8 17.1 40.3 99 N-Mindanao 95.6 96.4 89.8 79.6 92.7 87.6 78.8 91.2 75.9 2.9 39.4 109 S-Mindanao 91.7 91.0 88.9 84.7 91.7 90.3 83.3 86.8 79.9 5.6 50.7 131 C-Mindanao 80.2 80.2 76.3 71.8 77.1 74.0 71.0 71.8 67.2 18.3 26.7 98 Mother's education No education 51.2 51.2 48.0 46.1 51.2 48.0 46.1 48.2 43.0 46.8 20.4 47 Elementaay 88.4 88.7 83.8 75.0 88.4 82.5 73.7 76.9 67.6 8.5 35.1 696 High school 93.6 93.2 91.0 81.3 93.0 88.1 78.6 85.0 72.1 4.6 35.6 625 College or higher 97.4 97.3 95.4 90.8 97.0 94.6 89.7 88.2 81.5 2.0 36.1 374 All children 91.2 91.1 87.9 79.9 90.9 86.2 78.2 81.4 71.5 6.8 35.1 1742 Note: The DPT coverage rate for children without a written record is assumed to be the same as that for polio vaccine since mothers were specifically asked whether the child had received polio vaccine. IChfldren who are fully vaccinated (i.e., those who have received BCG, measles and three doses of DPT and polio). 101 1 O0 80 60 40 20 Percent Figure 8.3 Vaccination Coverage among Children 12-23 Months 2-3 4-5 6+ Urban Rural BIRTH ORDER RESIDENCE No Elemen- High COIIQge Education ta~ School or highor MOTHER'S EDUCATION 1993 N DS Shown in Table 8.9 is the trend in immunization coverage over a period of 4 years before the survey until the date of interview based on records in the health cards and mother's recall. Although the rate is still low, it is encouraging to note that health cards are more than twice as likely to be available for children 12-23 months than for children 48-59 months. At the same time, the immunization coverage has gradually increased. The percentage of children 1-4 years who have never received vaccination declined from 18 percent to less than 10 percent. 102 Table 8.9 Vaccinations in the first year of life Percentage of children one to four years of age for whom a vaccination card was shown to the interviewer and the percentage vaccinated for BCG, DPT, polio, and medics during the first year of life, by current age of the child, Philippines 1993 Vaccine Current age of child in months All children 12-59 12-13 24-35 36~.7 48°59 months Vaccination card shown to Interviewer 35.1 29.1 24.4 17.5 26.7 Percent vaccinated at 0-11 months a BCG 88.3 88.3 84.4 78.8 85.1 DPT I b 88.8 87.7 85.6 79.1 85.4 DPT 2 85.0 83.1 79.4 72.8 80.2 DPT 3 77.3 74.5 70.3 62.4 71.3 Polio 1 88.2 88.4 85.3 79.6 85.5 Polio 2 83.1 81.4 76.9 71.7 78.4 Polio 3 75.5 72.5 67.6 61.2 69.4 Measles 70.9 73.4 69.0 58.6 68.2 All vaccinations c 61.9 62.1 55.8 49.0 57.4 No vaccinations 8.6 9.7 11.9 18.0 11.9 Number of children 1742 1752 1712 1596 6802 alnformation was obtained either from a vaccination card or from the mother if there was no written record. For children whose information was based on the mother's report, the proportion of vaccinations given during the first year of life was assumed to ~,~ the same as that for children with a written vaccination record. he DPT coverage rate for children without a written record is assumed to be the same as that for polio vaccine, since mothers were specifically asked whether the child had received polio vaccine. cChildren who have received BCG, measles and three doses of DPT and polio vaccines. 8.5 Prevalence of Fever Various infectious diseases are accompanied by fever. In the Philippines, the most common diseases with fever are measles, respiratory infections, typhoid, and dengue. Information about the prevalence of fever among children under 5 was collected in the survey although the cause was not investigated. Provided in Table 8.10 is information on the presence of fever and its treatment. Overall, one in four children under 5 had fever in the two weeks prior to the survey. Variations in the percentage of children with fever are generally small across subgroups; the highest levels--30 percent or more--are found for children aged 6-23 months, and children of six or higher birth order. 103 Table g.lO Prevalence and treatment of fever Percentage of children under five years who had a fever during the two weeks preceding the survey, and the percentage of children with a fever who were treated with specific remedies, by selected background charactadsties, Philippines 1993 Among children with fever Percentage Percentage Percentage treated with: of taken to children a health Antibiotic None/ Number Background with facility or pill or Home Don't know/ of characteristic fever provider 1 syrup remedy Other Missing children Child's age < 6 months 18.2 54.1 34.5 10.5 65.3 12.8 751 6-11 months 36.5 48.3 42.6 11.0 61.3 12.4 905 12-23 months 32.3 43.6 38.9 13.8 63.9 11.3 1742 24-35 months 26.3 42.1 34.9 12.6 60.6 15.2 1752 36-47 months 22.3 38.9 36.3 12.7 63.6 12.2 1712 48-59 months 17.9 39.1 37.8 16.3 60.1 13.3 1596 Sex Male 25.7 42.1 38.4 12.0 63.4 12.4 4359 Female 25.4 44.5 37.0 14.1 61.2 13.1 4099 Birth ocder 1 22.7 47.9 37.9 10.2 66.9 10.5 1941 2-3 23.6 44.2 40.3 12.0 59.4 13.3 3083 4-5 28.3 40.3 35.0 13.4 64.7 12.8 1783 6+ 29.5 40.7 36.6 16.8 60.1 14.0 1651 Residence Urban 24.4 44.8 42.6 9.9 66.6 10.2 4135 Rural 26.6 4L9 33.5 15.8 58.6 15.1 4323 ResIon Metro. Manila 21.8 55.7 51.3 1.3 72.8 8.8 1052 Cordillera Admin. 17.0 44.6 37.5 12.5 64.3 14.3 168 Ilocos 23.8 55.4 49.2 6.9 64.6 13.0 470 Cagayan Valley 26.3 45.1 36.3 15.0 57.5 18.6 303 C-Luzon 19.2 42.6 48.6 6.8 71.6 8.8 884 S-Tagalog 25.4 29.3 37.4 8.1 65.2 10.1 1039 Bicol 36.3 38.7 32.5 16.0 65.0 10.7 634 W-Visayas 31.3 44.5 28.4 17.4 57.3 14.2 702 C-Visayas 18.6 42.2 23.7 10.4 57.0 24.5 696 E-Visayas 30.2 46.2 42.3 21.8 44.9 12.2 415 W-Mindanao 23.8 49.3 38.9 24.3 59.0 16.0 467 N-Mindanao 23.4 53.2 41.6 22.1 55.8 9.1 524 S-Mindanao 32.8 38.3 33.9 12.6 63.5 14.7 637 C-Mindanao 26.8 35.9 26.9 20.4 59.3 13.8 467 Mother's educallotl No education 22.0 20.2 21.2 24.5 43.2 37.4 215 Elementary 28.7 38.3 32.0 17.0 57.7 14.2 3456 High school 24.4 48.5 43.9 10.6 64.0 11.4 3027 College or higher 21.6 48.8 42.7 5.9 73.6 8.4 1760 All children 2 25.5 43.2 37.7 13.0 62.3 12.8 8458 ~ote: Figures are for children born in the period 1-59 months preceding the survey. Includes health post, health center, hospital, and private doctor. 21ncludes 34 children who were given antimalarial pill or syrup, and 14 children who were given an injection. Overall, 4 in 10 children with fever were taken to a health facility or provider. Young infants (less than 6 months) are more likely to be taken to a health facility for treatment when they have fever. Mother's education is also important in whether a child is taken to a health facility or not. The proportion of children taken to a health facility is highest among children bom to mothers with high school or higher education. 104 The types of treatment given to children with fever are also presented in Table 8.10. The most popular remedies for fever are antibiotics (38 percent) and other remedies (62 percent). 8.6 Acute Respiratory Infection Acute respiratory infection is still the leading cause of death among children under 5. The prevalence and treatment of this disease are investigated in Table 8.11. The 1993 NDS results show that 8.7 percent of children under 5 had cough with rapid breathing in the two weeks prior to the survey. Children 6 to 23 months, children of birth order 6 or higher, children in rural areas, and children bom to mothers with no education are slightly more likely to have been reported to have respiratory problems. Table 8.11 Prevalence and treatment of acute respiratory infection percentage of children under five years who were ill with a cough accompanied by rapid breathing during the two weeks preceding the sta'vcy, and the percentage of ill children who were treated with specific remedies, by selected background characteristics, Philippines 1993 Among children with cough and rapid breathing Percentage Percentage Percentage treated with: of children taken to with cough a health Antibiotic None/ Number Background and rapid facility or pill or Cough Home Don't know/ of characteristic breathing provider t syrup syrup remedy Other Missing children Child's age < 6 months 7.4 (56.5) * (45.3) * * * 751 6-11 months 10.7 56.0 52.8 55,3 * * * 905 12-23 months 11.0 55.0 45.3 51.4 (18.8) (21.5) * 1742 24-35 months 9.3 49.6 41.2 48.9 (16.1) (23.4) * 1752 36-47 months 7.1 47.2 39.3 48.9 (14.8) (25.5) * 1712 48-59 months 6.6 (44.8) 45.7 (38.8) (29.0) * * 1596 Sex Male 8.7 51.9 46.6 48.1 19.6 22.2 (11.2) 4359 Female 8.7 50.6 40.6 49.3 17.4 22.5 12.4 4099 Birth order 1 7.7 55.3 42.6 54.6 * (19.6) * 1941 2-3 8.8 52.0 42.9 48.5 20.4 24.2 (9.7) 3083 4-5 8.4 52.5 48.2 49.1 (16.4) (21.2) * 1783 6+ 10.0 45.4 41.6 43.1 (24.6) (22.7) * 1651 Residence Urban 7.4 55.8 48.6 56.5 15.0 20.8 * 4135 Rural 9.9 48.0 40.1 43.1 21.0 23.4 14.2 4323 M~her's education No education 9.8 * * * * * * 215 Elementary 9.9 47.1 39.1 42.0 20.9 22.0 14.6 3456 High school 8.5 54.9 47.2 48.4 19.5 22.8 (9.2) 3027 College or higher 6.5 60.5 51.8 71.0 * (24.5) * 1760 All children 2 8.7 51.3 43.6 48.7 18.5 22.3 11.8 8458 Note: PigtL~S are for children born in the period 1-59 months preceding the smwey. Includes health post, health center, hospital, and private doctor. 21ncludcs 7 children who were given an injection. ( ) Figures in parentheses arc based on 25-49 cases * Less than 25 cases 105 Among children who were ill with cough and rapid breathing, more than half were taken to a health facility. The percentage of children who were taken to a health facility varies insig- nificantly by various background char- acteristics except for mother's educa- tion. The types of treatment to chil- dren with cough are also presented in Table 8.11. The most popular treat- ments are cough syrup (49 percent) and antibiotic pill or syrup (44 percent). Little variation is again observed in the treatment by background characteristics of the children, except by mother's education, 8.7 Diarrheal Disease Mothers with children under 5 years of age were asked if their chil- dren had diarrhea at any time in the preceding two weeks prior to the inter- view and if they had diarrhea in the past 24 hours. Mothers are also asked about any action taken to treat their children, The 1993 NDS data indicate that 1 in 10 children under 5 was re- pored having diarrhea during the 2- week period before the survey, and less than 1 percent had bloody diarrhea in that period (Table 8.12). The preva- lence of diarrhea in the 24 hour before the survey is 3 percent. The prevalence of diarrhea generally varies only slightly by back- ground characteristics. For both the two-week and 24-hour periods preced- ing the survey, the most significant variation is by age and region. Preva- lence is somewhat higher for children 6-23 months than for younger or older children. Considering regional varia- tion, Table 8.12 shows that prevalence of diarrhea is higher in Bicol, llocos, and Cordillera Administrative Region than in other regions. Table 8.12 Prevalence of dianhea Percentage of children under five years who had diarrhea and diarrhea with blood in the two weeks p~ing the survey, and the percentage of children who had dlanhe, a in tha ~t tg 24 hours, by selected background characteristics. Philippines 1993 Diarrhea in the All preceding 2 we, eks I diarrhea in the Number Background All Diarrhea prec~in~ of charact~ristlc dlarrbea with blood 24 hours" children Child's age < 6 months 9.~ 0,5 2.9 751 6-11 months 17.0 1.2 6.0 905 12~23 months 15,6 1.1 S.4 1742 24-35 months 9,6 0.8 2,2 1752 36-47 months 6,6 0,4 1.7 1712 48459 moaths 4,9 0.4 0.8 1596 Sex Male 10.2 0.8 3.0 4359 Female 10.0 0.7 2.9 4099 Birth ocder 1 9,0 0,4 2.8 1941 2-3 9,3 0,9 2.8 3083 4-5 10,9 0,8 2.8 1753 6+ 12.1 0,6 3.7 1651 Residence Urban 9,7 0,7 2.7 4135 Rural 10.5 0,8 3.2 4323 Region Metro. Manila 7.5 0,4 2.3 1052 Cordillera Admin, ]3.6 0,6 7.9 168 llocos 13.6 0.5 5.7 470 Cagayan Valley 11.9 I),5 5.6 303 C-Luz.ott 6.5 ~3,3 2.l 884 S-Tagalog 11.8 0.6 3.3 1039 ~icol 15.4 1.5 4.8 634 W-Visayas 11 .g 0,6 2,2 702 C-Visayas 4.7 0,3 0.6 696 E-Visaya~ 10.7 1.2 1,9 415 W-Mindanao 9.4 t,0 5,0 467 N-Mindanao 10.0 0.8 3.0 524 S-Mindana~ 10,7 1.6 2.1 637 C-Mindanao 11,1 0.8 1.4 467 Mother's education No education 10.2 1,7 2.0 215 Elementary 11.4 0,9 3.5 3456 High school 9.6 0,6 3.0 3027 College or higher 8.6 0.6 1.9 1760 All children 10.1 0,7 3.0 8458 Note,. Figures are for children born in the p~dod 1-59 months preceding the survey. tlncludcs diarrhea in the past 24 hours 2Includes diarrhea with blood 106 Treatment with Oral Rehydration Therapy The level of knowledge of ORS (prepackaged oral rehydration salts) to treat diarrhea is shown in Table 8.13. In 1993 NDS, a mother is classified as knowing about ORS if she reported using ORS packets to treat one of her children for diarrhea in the two-week period prior to the survey, or if she has ever seen or heard of ORS packets. A large majority of mothers (85 percent) knew about ORS packets, and more than half have used ORS. There are significant variations in both the levels of ORS knowledge and ever use by age, region, and education; teenage mothers, mothers with no education are the least likely to know about or to have had experience in using ORS packets. The overall level of knowledge is almost twice as high among educated mothers as for mothers with no education. Table 8.13 Knowledge and use of ORS packets Percentage of mothers with births in the five years preceding the survey who know about and have ever used ORS packets, by selected background characteristics, Philippines 1993 Know Have ever Number Background about ORS used ORS of characteristic packets packets mothers Age 15-19 72.8 24.5 166 20-24 82.4 45.2 1046 25-29 85.8 56.1 1527 30-34 86.7 59.8 1362 35+ 83.8 58.0 1525 Residence Urban 84.3 53.0 2795 Rural 84.7 56.1 2831 Region Metro. Manila 73.7 45.1 747 Cordillera Admin. 96.9 78.6 98 Ilocos 84.2 57.1 311 Cagayan Valley 86.0 65.3 212 C-Luzon 84.2 55.6 590 S-Tagalog 80.6 46.0 708 Bicol 90.7 57.7 396 W-Visayas 94.6 60.6 468 C-Visayas 94.7 68.4 450 E-Visayas 92.2 59.4 269 W-Mindanao 76.4 52.4 308 N-Mindanao 92.9 60.5 349 S-Mindanao 80.1 46.4 421 C-Mindanao 74.3 46.3 300 Education No education 45.2 28.2 146 Elementary 85.1 57.6 2225 High school 85.9 56.4 2011 College or higher 85.8 49.3 1244 All mothers 84.5 54.6 5626 Note: Figures include mothers who have given ORS for diarrhea during the preceding two weeks, although they were not asked about knowledge of ORS packets. 107 Table 8.14 examines in detail the treatment approaches that were adopted for children who were reported to have experienced a diarrheal episode during the two-week period before the survey. Medical treatment was sought for 34 percent of children who had diarrhea in the two-week period prior to the survey (Table 8.14). The majority of children who had diarrhea were either treated with ORS packets (27 percent) or recommended home made solution such as sugar, salt and water, or rice water (am soup). While 1 in 5 of the children who had diarrhea were given increased fluids, it is interesting to note that 40 percent were given neither increased fluids nor ORT. Among children who were given other treatments, 39 percent received home remedies and 16 percent antibiotic. It is interesting to note that neither advice nor treatment was sought for 20 percent of children who had diarrhea. Table 8.14 Treatment of diarrhea Percentage of children under five years who had diarrhea in the two weeks preceding the survey who were taken for treatment to a health facility or provider, the percentage who received oral rehydration therapy (ORT), either a solution prepared from ORS packets or a recommended home fluids (RItF), the percentage who received increased fluids, the percentage who received neither ORT nor increased fluids, and the percentage receiving other treatments, according to selected background characteristics, Philippines 1993 Background characteristic Oral rehydration Percentage receiving therapy (ORT) Per- Percentage other treatments: Percentage eentage receiving Number taken to receiving neither No treat- of a health in- ORT nor Home ment/ children facility or ORS creased increased Anti- remedy/ORESOL/ with provider I packets R I IF fluids fluids bioties Other rice water diarrhea Age of child (months) <6 (34.9) * * * (49.9) * * * 70 6-11 41.1 (23.6) 39.4 (20.1) 40.5 (20.0) 32.7 (21.3) 154 12-23 33.4 31.0 38.9 22.2 36.3 (15.1) 38.0 18.6 272 24-35 33.0 (25.4) 32.7 (24.4) 44.3 (18.0) 41.9 (19.8) 169 36-47 31.5 (26.2) (36.5) * 45.2 * 47.2 * 112 48-59 * * (37.2) * (38.2) * (45.6) * 78 Sex of child Male 32.0 25.7 37.3 23.1 41.0 18.4 39.4 19.8 445 Female 35.9 28.8 35.1 19.6 41.2 14.1 39.1 19.2 410 Birth order 1 39.2 (23.5) 35.5 (19.1) 43.7 (19.0) 31.3 (25.6) 174 2-3 34.2 25.3 37.0 25.3 39.9 18.7 38.0 17.5 286 4-5 33.4 33.0 38.5 (19.0) 37.8 (15.7) 46.8 (14.9) I95 6+ 29.2 27.4 33.5 (20.1) 43.9 (11.3) 40.7 (21.6) 200 Residence Urban 36.2 26.0 35.5 21.3 42.2 20.6 36.2 20.7 403 Rural 31.8 28.2 36.9 21.5 40.1 12.6 42.0 18.5 452 Education No education * * * * * * * * 22 Elementary 29.6 25.6 32.4 23.2 43.2 12.6 39.9 20.9 393 I l igh school 33.2 28.6 41.3 17.1 39.4 (16.8) 38.7 19.6 289 College or higher 45.7 (29.0) 38.5 (27.0) 37.5 (26.6) 38.4 (14.5) 151 Total z 33.9 27.2 36.2 21.4 41.1 16.4 39.3 19.5 855 Note: Figmes are for children born in the period 1-59 months preceding the sttrvey. Oral rehydradon therapy (ORT) includes solution prepared from oral rehydration salts (ORS) and recommended home fluid (RIIF). e.g. sugar-salt-water solutaon. Increased fluids includes increased frequency of breastfeuding. llnciudes health post, health center, hospital, and private doctor. 2lncludes 5 children who were given an injection and 9 children with missing information on treatment. * Less than 25 cases ( ) Figttres in parentheses are based on 25-49 cases. 108 Table 8.15 and Figure 8.4 looks at the extent to which feeding practices were changed for children with diarrhea in the two-weeks prior to the survey. Among children who were breastfed, the majority either were given the usual amount or an increased amount of breast milk (7 percent), but 14 percent were given a reduced amount of breast milk. With regard to consumption of other fluids during children's diarrhea, mothers reported that they gave the same amount of fluids to 57 percent of children, and increased fluids for 21 percent. However, nearly one-fifth of children were given less fluids. Table 8.15 Feeffmg practices during diarrhea Percent distrlbufion of children under five years who had diarrhea in the two weeks preceding the survey by feeding practices during diarrhea, Philippines 1993 Feeding practices Percent Breasffeedlng frequency 1 Same as usual 75.7 Increased 6.9 Reduced 13.8 Stopped 1.3 Don't know/missing 2,4 Total 100,0 Number of children 676 Amount of fluids given Same as usual 57.3 More 20.9 Less 19.2 Don't know/missing 2.6 Total 100.0 Number of children with diarrhea z 855 1Applies only to childrela who are still breast fed. 2Children born in the period 1-59 months preceding the survey. Figure 8.4 Feeding Practices among Children Under Five with Diarrhea 100 80 60 40 20 0 76 14 Same as More Less Stop- DK/ Usual ped Missing FREQUENCY OF BREASTFEEDING 57 / / 21 19 I Same as More Less DK/ Usual Missing AMOUNT OF OTHER FLUIDS GIVEN 1993 NDS 109 CHAPTER 9 INFANT FEEDING AND SUPPLEMENTATION The importance of proper infant feeding cannot be overemphasized as it affects children's nutritional health and well being. Hence, the Philippines in urgent response to the 1981 Intemational Code of Marketing of Brcastmilk Substitute by the World Health Organization (WHO) advocated a strong campaign to encourage breastfeeding among nursing mothers instead of using breast milk substitute. Breastfeeding with all its healthful and economic advantages is the best form of feeding during the first six months of infancy. Supplementary foods introduced initially at four to six months of infancy greatly contribute to the nutritional needs of the growing child. Thus, proper and adequate infant feeding, starting at birth, is very important for physical and mental development of a child. 9.1 Prevalence of Breastfeeding and Supplementation Breastfeeding is not universal in the Philippines; 13 percent of children born in the preceding 5 years before the survey were not breastfed at all (see Table 9.1). The extent of breastfeeding does not vary by the sex of the child. Urban children were less likely to be given breast milk than rural children (82 percent compared to 92 percent). Observing regional variations, children in Metropolitan Manila are the least likely and children in Mindanao the most likely to be breastfed. Mother's education has a negative association with their children's chance to be given breast milk. While virtually all children of mothers who have no education were breasffed, only 78 percent of children whose mothers have higher education ever received breast milk. Exposure to medical assistance is also negatively associated with the children's likelihood of being put to the breast. Children who received assistance from a medical personnel at delivery and those who were born in a health facility were at least 10 percentage points less likely to be breast fed than those who were delivered by a traditional midwife or born at home. The first breast mill~, or colostrum, is beneficial to infants because it contains a high concentration of antibodies that protect children against certain infectious diseases. However, in some places, cultural norms dictate against giving infants colostmm. Results from 1993 NDS show that more than one-third of children born during the five years before the survey were given breast milk during the first hour after birth, and 61 percent were given breast milk during the first 24 hours. Differentials in the early initiation of breast milk appears to exhibit a pattern similar to that of prevalence; girls, rural infants, infants of mothers with no education, and those bom at home tend to be given breastmilk soon after birth. The percentage of children receiving colostmm in Luzon island, except in the Cordillera Administrative Region, tends to be lower than in other parts of the country. It is interesting to note that children in Metropolitan Manila, in addition to being the least likely to be given breast milk, were also among the least likely to be breastfed immediately after birth. For children born in the five years prior to the survey who were currently breastfed, mothers were asked if they bad given various types of liquids or solid foods to the child "yesterday' or "last night." Children who are exclusively breastfed are defined as receiving breast milk only, while full breastfeeding is 111 Table 9.1 Initial breastfeeding Percentage of children born in the five years preceding the survey who were ever breasffed, and the percentage of last-born children who started breastfeeding within one hour of birth and within one day of birth, by selected background characteristics, Philippines 1993 Among all children: Among last-born children, percent who started bre~ffeeding: Percent Number Within Within Number Background ever of 1 hour 1 day of characteristic breastfed children of birth of birth children Sex Male 86.7 4580 35.1 59.7 2936 Female 87.7 4279 36.1 62.3 2739 Residence Urban 82.3 4296 33.0 55,0 2819 Rural 91.8 4563 38.2 66.8 2856 Region Metro. Manila 75.5 1098 24.8 47.3 749 Cordillera Admin. 94.1 173 67.0 83.5 99 Ificos 84.4 490 28.2 57.5 311 Cagayan Valley 90.3 319 24.1 58.1 214 C-Luzon 82.5 912 29.4 47.6 594 S-Tagalog 86.7 1072 42.3 65.5 713 Bieol 92.7 674 12.8 60.0 400 W-Visayas 90.2 740 48.5 73.1 476 C-Visayas 87.3 725 41.4 63.9 458 E-Samar 87.8 442 51.3 66.9 269 W-Mindanao 95.0 497 38.1 63.9 310 N-Mindanao 89.6 553 28.7 59.3 352 S-Mindmaao 91.5 670 42.5 64.3 425 C-Mindanao 92.3 494 46.9 74.9 302 Mother's education No education 97.8 245 56.1 80.9 148 Elementary 92.2 3660 39.7 67.7 2245 High school 85.9 3141 33.7 60.2 2026 College or higher 77.9 1813 28.9 47.8 1255 Assistance at delivery Medically trained person 82.1 4677 31.8 54.2 3153 Traditional midwife 92.9 4009 39.6 68.9 2424 Other or none 94.8 162 57.9 81.9 95 Place of delivery Health facility At home 77.4 2503 28.2 46.9 1748 91.1 6333 38.9 67.2 3917 All children 87.2 8859 35.6 60.9 5675 Note: Table is based on all children bem in the five years preceding the survey, whether living or dead at the time of the interview. Excluded are children for whom auendance at delivery is missing or place of delivery is "other" or missing. defined as receiving breast milk and plain water only. The results shown in Table 9.2 indicate that, children in the Philippines are introduced to supplemental foods very early; among newborns under 2 months, one in six was not breastfed, and 31 percent were receiving supplementary foods. Only 4 in 10 newborns were exclusively breastfed. At age 4-5 months, the majority of infants were receiving supplementary foods; the percentage of children who were not breastfed increased to one in four children, while the percentage of children who were exclusively breastfed dropped to 13 percent. At age 6 months and older, virtually all infants have received foods other than breast milk (Figure 9. l). 112 Table 9,2 Breastfeeding status Percent distribution of living children by breasffeeding status, according to child's age in months, Philippines 1993 Percentage of living children who are: Breasffeeding and: Number Not Exclusively Plain of breast- breast- water Supple- living Age in months fed fed only ments Total children 0-1 15.9 42.7 10,7 30,7 100,0 194 2-3 18.6 26.4 10,3 44.7 100.0 292 4-5 24.5 13.2 11.2 51,1 100.0 319 6-7 30.6 1.8 3.4 64,2 100,0 316 8-9 38.8 1.1 2.7 57.4 100,0 321 10-11 40,1 1.4 2.7 55,8 100,0 269 12-13 41.3 1,3 1.2 56.2 100.0 274 14-15 45.4 0.3 0,3 53,9 100.0 282 16-I7 60.3 0,3 1.2 38.3 100,0 303 18-19 71.3 0.0 1,2 27,5 100.0 326 20-21 81.1 0.3 0,0 I8,6 100,0 294 22-23 82,6 0,0 0,3 17.1 100.0 264 24-25 91.3 0.3 0,3 8.1 100.0 275 26-27 89.0 0.0 0.0 11,0 100.0 262 28-29 90.6 0.3 0.3 8.8 100.0 327 30-31 93,9 0.2 0.6 5.3 100.0 312 32-33 96.2 0.0 0.8 3,1 100,0 299 34-35 96.7 0,0 0,0 3.3 100.0 277 Note: Breastfeeding status refers to preceding 24 hours, Children classified as breasOreeding and plain water only receive no supplements. 100% Figure 9.1 Distribution of Children by Breastfeeding (BF) Status According to Age 75% 50% 25% 0% 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 Age in Months 1993 N DS 113 Table 9.3 shows the type of supplements given to children under five. Among breastfeeding children age 2-3 months, 28 percent were given infant formula, 15 percent received milk other than breast milk, and 31 percent were given other liquids. Other liquids consisted of water, tea, rice water or fruit juice. By the time the infants are 4-5 months, the pattern of infant feeding has changed dramatically; 36 percent have been introduced to solid or mushy food. Infant formula and other milk seem to be popular among children up to almost three years old. Bottles with nipples arc usually used in conjunction with infant formula, but they are also used with other types of supplementary food. The use of a bottle is not generally recommended at early stages of infancy due to the risk of exposing the child to the harmful effects of inefficient and unhygienic preparation of the liquid, particularly in poor environmental and socioeconomic conditions. In particular, since it is difficult to thoroughly clean feeding bottles, their use is thought to place children at increased risk for developing diarrhea or other diseases. Among brcastfeeding newboros, 29 percent have already used a bottle with a nipple. The percentage of children who were given a bottle with a nipple increases until age 6-7 months, after which the percentage gradually declines. Table 9.3 Breastfeeding and supplementation by age Percentage of breastfeeding children who are receiving specific types of food supplementation, and the percentage who are using a bottle with a nipple, by age in months, Philippines 1993 Age in months Percentage of breastfeeding children who axe: Receiving supplement Using a bottle Number Infant Other Other Solid/ with a of formula milk liquid mushy nipple children 0-1 21.1 6.8 13.3 0.5 28.9 163 2-3 28.0 14.8 31.2 2.3 35.5 238 4-5 27.2 15.7 41.9 36.2 28.1 241 6-7 28.8 16.6 69.5 78.0 31.9 219 8-9 26.6 22.2 68.4 81.4 29.2 197 10-11 27.5 29.6 66.9 87.0 25.0 161 12-13 21.7 29.6 73.1 88.2 19.6 161 14-15 19.4 29.0 70.3 88.6 15.9 154 16-17 16.4 34.5 73.1 91.4 9.5 120 18-19 19.6 24.3 79.9 89.0 18.3 93 20-21 37.0 51.0 79.8 94.0 22.0 56 22-23 (23.7) (26.3) (81.3) (89.2) (6.6) 46 Note: Breastfeeding status refers to preceding 24 hours. Percents by type of supplement among breastfeeding children may sum to more than 100 percent, as children may have received more than one type of supplement. ( ) Figures in parentheses are based on 25 to 49 unweighted cases. 114 9.2 Duration of Breastfeeding The median duration and the frequency of breastfeeding according to selected background characteristics are presented in Table 9.4. The estimates of mean and median durations are based on current status data, that is, the proportions of children under 3 years of age who were being breastfed at the time of the survey, as opposed to the retrospective data on the length of breastfeeding of older children who are no longer breastfed. The prevalence/incidence mean is provided for the total population in order to allow for international comparison. Table 9.4 Median duration and frequency of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and full breastfeeding among children under 5 years of age, and the percentage of children under 6 months of age who were breastfed six or more times in the 24 hours preceding the interview, according to background characteristics, Philippines 1993 Children under 6 months Median duration in months 1 Number of Breastfed children 6+ times Any Exclusive Full under in Number Background breast- breast- breast- 5 years preceding of characteristic feeding feeding feeding 2 of age 24 hours children Residence Urban 9.0 0.5 0.6 2636 58.7 386 Rural 15.9 1.2 1.9 2757 84.4 419 Region Metro. Manila 1.2 0.5 0.5 683 34.1 128 Cordillera Admin. 16.9 2.2 2.4 105 * 15 Ilicos 13.8 1.8 2.2 301 (80.7) 49 Cagayan 17.3 1.5 2.1 192 (72.1) 30 C-Luzon 10.5 0.7 0.7 545 72.7 76 S-Tagalog 13.3 0.5 0.7 677 78,4 99 Bicol 15.8 2.2 2.5 419 90.8 62 W-Visayas 18.3 0.5 1.1 437 78.2 55 C-Visayas 11.7 0.7 2.0 433 75.8 63 E-Samar 16.5 2.1 2.5 269 (75.0) 42 W-Mindanao 15.9 0.6 0.7 295 90.8 50 N-Mindanao 14.1 0.5 0.6 334 (81.1) 42 S-Mindenao 14.1 0.5 0.7 410 (75.5) 48 C-Mindanao 16,6 0,7 0.7 294 (76.7) 45 Education No education 19.4 2.2 2.6 141 * 22 Elementary 16.7 1.6 2.4 2173 83.0 316 High school 13.8 0.5 0.6 1945 69.4 299 College or higher 5.4 0.4 0.5 1134 53.6 168 Assistance at delivery Medically trained 9.5 0.5 0.6 2911 63.2 444 Traditional midwife 15.7 1,4 2.3 2384 83.0 351 Sex of child Male 13.4 0.6 0.8 2800 71.0 416 Female 14.4 0.6 1.3 2593 73.2 389 Total 14.1 0.6 1.0 5393 72.1 805 Mean 13.7 2,3 3.1 86.9 NA NA Prevalence/Incidence 3 13.0 1.5 2.3 NA NA NA Note: Children for whom attendance at delivery is missing, "other," or "none" are excluded. NA = Not applicable IMedians and means are based on current status 2Either exclusive breastfeeding or breasffeeding and plain water only Sprevalence-ineidence mean * Less than 25 cases ( ) Figures in parentheses are based on 25-49 cases. 115 The median duration of breastfeeding is estimated at 14.1 months, only slightly shorter than in Thailand (14.5 months), but much shorter than in Indonesia (23.3 months). Children who live in rural areas are breastfed about 7 months longer than children in urban areas. Children whose mother had no education are breastfed 4 times as long as children whose mother have college or higher education (19.4 months compared to 5.4 months). Mothers assisted by traditional midwife at delivery are also shown to breastfeed longer than those attended by medically trained personnel at delivery. There is very little difference in duration of breastfeeding by the sex of the child; girls are slightly more likely to be given breast milk longer than boys. The duration of exclusive breastfeeding is very short in the Philippines. In fact, children are exclusively breastfed for only a little over half a month. The differentials of duration of exclusive and full breastfeeding resemble those of breastfeeding in general. The duration of postpartum amenorrhea is affected by both the length of time breastfeeding and the frequency of breastfeeding. The child's health and nutritional status are also affected by the frequency of breastfeeding. Frequent breastfeeding is fairly common in the Philippines; 7 in 10 children under 6 months were breastfed six times or more in the past 24 hours. The differentials in the frequency ofbreastfeeding are similar to those of breastfeeding prevalence, initiation, and supplement. 116 CHAPTER 10 MATERNAL MORTALITY 10.1 In t roduct ion Data were collected in the 1993 National Demographic Survey (NDS) which are suitable for estimating maternal mortality using either a direct or an indirect estimation technique and for providing estimates of adult male and female mortality. The data concem the survivorship of sisters and brothers of survey respondents. For each of a respondent's siblings, information was collected on current age or, if dead, age at death and the number of years ago the death occurred. For dead sisters, additional questions were asked to determine if the death was maternity related, i.e., did the death occur during pregnancy, during delivery or within six weeks following a delivery or pregnancy termination. The direct approach for estimation of maternal mortality uses data on the age of surviving sisters, the age at death of sisters who died, and the number of years ago the sisters died. For well-defined reference periods, the data are aggregated to determine the number of maternal deaths occurring in each reference period; matemal mortality rates are then directly estimated by dividing the number of deaths by the person- years of exposure. The result is the proportion of sisters who died of maternal causes among all sisters of respondents. This is an unbiased estimate of the probability of materoal death, provided that the mortality risk to all sisters is the same. In the indirect approach to estimate maternal mortality, the data requirements are less rigid than those in the direct approach. However, because the estimates derived using the indirect approach do not have a specific time reference period, it is less preferred. Thus, in this report, only direct estimates are given. 10.2 Data Collection The questions used in the 1993 NDS to collect information on adult mortality and matemal mortality are in Section 8 of the Individual Questionnaire (sce Appendix E). The respondent is first asked to give the number of children to whom her mother gave birth, followed by a question on the birth order of the respondent. The respondent is asked to list all of her brothers and sisters, that is, all of the children bom to her mother, starting with the first. After obtaining a complete list of the respondents' brothers and sisters, for each sibling the interviewer proceeded with the following questions: whether the sibling is still living or has already died; if living, his/her current age; if dead, how long ago the sibling died, and his/her age at the time of death. It was stressed during training that, while interviewers should be sensitive to the delicate nature of the data, every effort must be made to obtain answers to the questions. Interviewers were instructed that, when a respondent could not provide precise information on ages or the number of years ago the death occurred, approximate answers were acceptable. For deceased sisters, three questions were asked to determine ifa death was maternity related: "Was [NAME OF THE SISTER] pregnant when she died?" and if the answer was negative, the respondent was asked: "Did she die during childbirth?" and "Did she die within six weeks after a pregnancy termination or birth of a child?" 117 10.3 Assessment of Data Quality One gauge of the quality of data collected in the survey is the completeness with which information has been recorded. Table 10.1 shows the completeness of information on the siblings of the NDS respondents. Table 10.1 Data on siblings Number of siblings reported by survey respondents and completeness of the reported data on age, age at death, and years since death, weighted, Philippines 1993 Sibling status and completeness of reporting Sisters Brothers Total Number Percent Number Percent Number Percent All siblings 43269 100.0 44641 100.0 87909 100.0 Living 39684 91.7 39833 89.2 79517 90.5 Dead 3372 7.8 4761 10.7 8132 9.3 Status unknown 213 0.5 47 0.l 260 0.3 Living siblings 39684 100.0 39833 100.0 79517 100.0 Age reported 39566 99.7 39708 99.7 79274 99.7 Age missing 118 0.3 125 0.3 243 0.3 Dead siblings 3372 1130.0 4761 100.0 8132 100.0 Age at death and years- since-death reported 3233 95.9 4585 96.3 7818 96.1 Missing only age-at- death information 41 1.2 77 1.6 118 1.5 Missing only years-since death-information 43 1.3 33 0.7 77 0.9 Missing age-at-death and years-since-death information 54 1.6 65 1.4 119 1.5 Reporting of survivorship of siblings is almost complete in the NDS survey with less than 1 percent of the cases with missing information. Interestingly, information about the survival status of brothers is slightly more likely to be available than that of sisters. Information on the ages of siblings who are still alive is almost complete. In a few instances where the respondent could not recall her sibling's age, the age was imputed on the basis of the birth order of that sibling; as a result, less than 1 percent of the cases have missing information on age. Recall of information regarding dead siblings was also good; age at death and the number of years ago the death occurred were reported for 96 percent of the respondents' brothers and sisters. The Filipino tradition of visiting annually tombs of departed members of the family accounts for the high memory recall of this kind of information since tombstones usually bear the age and the year of death of deceased persons. Several tests were conducted on the completeness of the listing of siblings, and their characteristics. The following discussion is based on tables specially run to investigate the quality of data in this section. These tables are presented in Appendix C which discusses nonsampling errors found in the survey. One indicator of the superior quality of the data on which maternal mortality estimation will be based is shown by the distribution of year of birth of respondents vis-a-vis that of the siblings. The fact that the median year of birth of the respondent (1964) coincides with the median year of birth of her siblings indicates that them is no systematic omission of older siblings (Table C.7). 118 The evolution of the mean sibship size based on the listing of siblings lends further credence to the good quality of the Philippine data. The overall sibship size of 6.85, the high but stable sibship sizes observed until the mid-sixties and their subsequent monotonic decline reflects what is generally known to be the fertility trend in the country. Nevertheless, a slight omission in the reporting of older brothers seems to have occurred, as is evident from the low sex ratios among siblings born prior to the sixties. This brought down the overall sex ratio of the siblings to 104. While this may cause a slight bias in the estimation of adult mortality, estimates of maternal mortality remain unaffected because the omission occurred among male siblings (Table C.8). 10.4 Direct Estimates of Adult Mortality The information collected on the siblings through the above described data collection strategy permits the estima- tion not only of maternal mortality but also of adult mortality. Estimation of adult mortality in this case is straightforward. First, age specific death rates are computed by dividing the number of deaths in each age group by the total person months of exposure to the risk in that group during a speci- fied reference period. For females, an overall age-standard- ized adult mortality rate is then obtained by adjusting the age- specific rates by the current age distribution of the respond- ents, that is, by taking the sum of each age-specific mortality rate multiplied by the percentage of respondents in that age group. The underlying assumption in this instance is that the age distribution of the respondents is the same as that of her siblings. This procedure was also done for males, using the age distribution of the male population obtained from the household questionnaire. Age-specific mortality estimates for males and fe- males for the period 0-6 years before the survey, calculated from the survivorship data by direct procedures are shown in Table 10.2. The number of sibling deaths during the period in the age range 15-49 was fairly small, so that the individual rates are based on relatively few events and are subject to sampling variability. Table 10.2 also shows that the number of male deaths is almost twice as many as that for females (731 compared to 375). For both sexes, the pattern of mortali- ty rates is as expected; for all ages, males have higher mor- tality than females, and the rates rise according to age. Table 10.2 Estimates of age-specific adult mortality Direct age-speclfic mortality estimated based on the survivorship of siblings of survey respond- ents, by age and sex, Philippines 1987-1993 Age Exposure Estimated interval Deaths years rates MALES 15-19 65 38375 1.70 20-24 121 44882 2.70 25-29 113 42824 2.64 30-34 135 37170 3.64 35-39 134 27173 4.92 40-44 82 17301 4,71 45-49 81 10046 8.05 Total 731 217771 3.51 FEMALES 15-19 45 36907 1.23 20-24 67 44055 1.52 25-29 57 42412 1.34 30-34 63 36977 1.70 35-39 61 27849 2.21 40-44 49 17943 2.71 45-49 33 10587 3.10 Total 375 216759 1.79 10.5 Direct Estimates of Maternal Mortality Table 10.3 includes information necessary for the calculation ofmatemal mortality ratio. Two 7-year time periods are investigated, 1980-86 and 1987-93. These time periods are chosen to reduce the impact of heaping of reporting on 5-year intervals. For each time period, maternal deaths are found to be an extremely rare event; 53 in the more recent period, and 46 in the preceding seven years. Given the small number of cases, the age-specific pattern should be interpreted with caution. As such, the aggregate rate for 15-49 is preferred. Age-specific mortality rates are calculated by dividing the number of maternal deaths by years of exposure. To remove the effects of truncation due to the upper age boundary of eligibility for the survey (age 119 49), the overall rate for women 15-49 is standardized by the age distribution of the survey respondents. Based on this information, the maternal mortality rate for the 1980-86 period was found to be 0.280, and for the 1987-93 period 0.236 per 1,000 women. Table 10.3 Mammal mortality rates by age Direct maternal mortality estimate based on the survivorship of sisters, Philippines 198%93 and 1980-86 Age 1987-1993 1980 -1986 Mortality Mortality Maternal Exposure rates Fertility Maternal Exposure rates Fertility deaths years (000) rates deaths years (0CO) rates 15-19 2.34 36907 0.064 0.056 1.87 44724 0.042 0.066 20-24 13.42 44055 0.305 0.198 14.14 40910 0.346 0.227 25-29 13.50 42442 0.318 0.221 10.16 34235 0.297 0.248 30-34 8.60 36977 0.233 0.178 11.42 23871 0.487 0.207 35-39 8.09 27849 0.290 0.124 4.86 15041 0.323 0.150 40-44 2.69 17943 0.150 0.058 2.71 8354 0.325 0.090 45-49 4.44 10587 0.420 0.010 0.91 3836 0.237 0.016 Total 53.09 216760 0.245 4.224 46.06 170972 0.269 5.027 Total age-standardizad 0.236 0.280 Total age-standardized adjusted for "ever pregmmt" 0.273 0.327 General fertility rate 0.131 0.154 Mammal mortality ratio 181 182 Mammal mortality rado adjusted for "ever pregnant" 209 213 Since information on whether the female siblings of the respondents have ever been pregnant was missing for approximately 30 percent of the cases, these cases were distributed proportionately across age groups according to the distribution of women with a known response to the question whether they have ever been pregnant. A more detailed discussion of this adjustment is presented in Appendix C. The adjusted number of deaths for the two time periods increased to 53 for 1980-86 and 62 for 1987-93 (data not shown), and the maternal mortality rate increased to 0.327 and 0.273 for the same consecutive time periods. Matemal mortalit!¢ ratio is considered a more useful measure ofmatemal mortality because it reflects the risk experienced by women once pregnant rather than the combined risk of pregnancy and risk once pregnant. This ratio is calculated by dividing the age-standardized maternal mortality rate by the general fertility rate which has also been standardized by age. The resulting ratios are 213 deaths per 100,000 births for the 1980-86 period and 209 deaths per 100,000 births for the more recent period. A further analysis carried out by observing mortality ratios per 100,000 bMhs obtained by dividing the matemal mortality rate by the fertility rate for each of the age groups (not presented in table) show that the greatest mortality risks occur among women 35 and over. The risks are lowest for women 25-29 in 1980- 86 and 30-34 in 1987-1993. The low risks for teenage women should be used with caution due to the small number of women who started childbearing in their teens. 120 CHAPTER 11 LOCAL AVAILABILITY OF FAMILY PLANNING AND HEALTH SERVICES The information presented in this chapter comes from the Health Service Availability Questionnaire, which was administered at the community level (see Appendix E). Data collected in the questionnaire will provide information on the family planning and health environment available to women and children in the cluster samples. The relationship between availability of services and their use is also presented on the assumption that making services more accessible increases the likelihood of use. In this analysis, the availability of services is defined as the nearest facility providing services to the women in the clusters. It should be kept in mind that 1993 NDS covered an unbiased estimate of women of reproductive ages, not an unbiased sample of clusters or facilities. As such, the service availability sample is representative of the nearest facility to the sampled women, and does not represent all facilities in the country. In the 1993 National Demographic Survey (NDS), the community is the cluster sample, which corresponds to the lowest level of geographic administrative unit (barangay) or a segment of a barangay. The questionnaire was filled out using information obtained from knowledgeable residents. In most cases, this includes the barangay captain. This information is then assigned to each respondent. Information gathered include general information on the cluster setting, availability of public services, information on the types of family planning and health services available in the cluster, and information about stationary facilities providing family planning and health services. The survey also collected information on the distance between the community and the nearest of each type of facility. Accessibility, measured by time to the facility, was recorded if the most common mode of transport was public transportation. 11.1 Distance and Time to Nearest Family Planning Services Tables 11.1 and 11.2 show that the ma- jority of Filipino women live in close proximity to a health or family planning facility. Virtually all married women are within 5 kilometers of a health facility. As expected, urban women are more likely to have access to a health and fami- ly planning facility that rural women (Table 11.1). Table 11.2 shows that there are no nota- ble differences in the availability of health services across regions; throughout the country, at least 67 percent of women have a health fa- cility in the barangay or live within 1 kilometer from a health facility. Presented in Table 11.3 is the distribu- tion of married women 15-49 in the survey by the distance to the nearest facility offering vari- ous family planning services. The table shows TAle 11.1 Distan~ to nearest health or family planning ~v~es Percent distribution of currently married women 15-49 by distance to nearest health or family planning (FP) services/supplies, by area of residence, Philippines 1993 Residence Distance (kilometers) l Urban Rural Total Under l 89.1 71.8 80.7 1-4 8.2 18.5 13.2 5-9 0.3 6.1 3.1 10-14 1.6 1.3 1.5 15+ 0.2 1.6 0.8 Distance unknown 0.6 0.6 0.6 Total 100.0 100.0 I00.0 lDistance was obtained from the community-level service av ailability survey. that overall, distance and availability of family planning methods make no significant difference in whether a woman uses a contraception, or her choice of method. Except for small variations, for both family planning users and nonusers, and regardless of the method they are using, virtually all women have easy access to a family planning service. 121 Table 11.2 Distance to nearest health or family planning services Percent distribution of currently married women 15-49 by distance to newest family plazming services, by region, Philippines 1993 Cordiltrxa Admini- W- N- S- C- Distance MeUo stra- Cagayan C- S- W- C- E- Minda- Minda- Minda- Minda- (kilometers) I Total Manila tion llocos Valley Luzon Tagalog Bicol VisayasVisayasVisayas nao rmo nao rmo Under 1 80.7 88.4 80,7 66.7 70.1 81.9 77.2 83.7 86.3 78.6 81.8 71,7 80.6 91.0 75.0 1-4 13.2 9.5 19,3 33.3 24.9 10.8 14.6 14.4 8.9 12.6 11.4 18.3 5.4 7.9 11.1 5-9 3.1 0.0 0.0 0.0 5,0 4.0 6.4 0.0 4.9 2.9 1.8 7.8 0.0 1.1 7.8 10-14 1.5 0.0 0,0 0.0 0.0 3.3 1.9 0.0 0.0 4.7 0.0 0.0 6.1 0.0 2.9 15+ 0.8 0.0 0,0 0.0 0.0 0,0 0.0 1.9 0.0 1.2 0.0 2.2 7.9 0.0 1.8 Distance unknown 0.6 2.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.0 0.0 0.0 0.0 1.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 IDistance was obtained from the corra'mmity-level service availability soavey. Table 11.3 Distance to nearest family planning services by use of family planning Percent distribution of all currently married women 15-49 by distance to nearest family planning services, for nonusers of family planning and for users of family planning by type of method, Philippines 1993 Distance to Family planning users nearest facility All providing FP services married Non- Sterili- Clinical Supply Any and FP services women users zation methods methods method Distance (kilometers) 1 Under 1 80.7 79.9 79.8 79.8 81.6 82.0 1-4 13.2 13.2 15.4 15.9 14.0 13.2 5-9 3.1 3.6 2.2 0.8 2.7 2.3 10-14 1.5 1.5 1.5 1.5 1.1 1.4 15-29 0.3 0.4 0.2 0.0 0.3 0.3 30+ 0.5 0.6 0.4 1.4 0.2 0.5 Distance unknown 0.6 0.8 0.6 0.5 0.1 0.3 Total 100.0 100.0 100.0 100,0 100.0 100.0 Methods available Pill 89.8 88.5 92.6 95.1 93.5 91.9 IUD 59.3 58,3 63.4 61.9 63.5 61.0 Injection 29.8 29.2 30.3 36.2 33.9 30.7 Condom 86.3 84.8 91.7 92.6 89.1 88.7 Female sterifization 21.5 21.4 24.6 21.6 21.0 21.7 Male sterilization 17.5 17.1 19.5 20.3 18.3 18.1 Total 8961 5379 1097 278 853 3582 Note: Regional information may be subject to large sampling errors due to the small number of sampling points. aDistance was obtained from the community-level service availability survey. 122 The data concerning distance to the nearest health facility providing family planning services by type of facility are shown in Table 11.4. For the country as a whole, 81 percent of married women are within 1 ki lometer from a family planning facility, 13 percent arc I to 4 kilometers away from a facility. The median distance to the nearest facility is 0.6 kilometer. In general, hospitals arc slightly farther than other health facilities. As expected, urban women arc nearer to a family planning facility than women in rural areas. The median distance to a hospital for rural women is almost 4 kilometers. Nevertheless, more than 90 percent of rural women live within 5 kilometer of a family planning facility. Table 11.4 Distance to nearest family planning services by type of facility Percent distribution of currently married women age 15-49 by distance to nearest facility providing family planning (FP) services/supplies, according to type of facility, Philippines 1993 Rural health Distance to nearest unit/ facility providing Pueri- Barangay FP services Government culture health Private Private (in kilometers) t hospital center station hospital clinic Other Total Urban areas Under 1 66.9 88.8 96.2 69.1 100.0 1-4 25.5 8.1 3.2 20.7 0.0 5-14 6.0 2.0 0.0 10.2 0.0 15+ 1.6 0.0 0.0 0.0 0.0 Distance unknown 0.0 1.0 0.6 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Median distance 2 0.7 0.6 0.5 0.7 0.5 0.5 0.6 I00.0 89.1 0.0 8.2 0.0 1.9 0.0 0.2 0.0 0.6 Rural areas Under 1 22.2 36.5 86.5 81.7 I00.0 67.8 71.8 1-4 29.0 39.4 11.8 18.3 0.0 0.0 18.5 5-14 32.1 20.2 1.6 0.0 0.0 10.4 7.4 15+ 12.2 3.9 0.1 0.0 0.0 0.0 1.6 Distance unknown 4.4 0.0 0.0 0.0 0.0 21.8 0.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Median distance 2 3.8 2.2 0.6 0.6 0.5 0.6 0.7 Current ly marr ied women Under 1 53.0 68.1 90.7 70.3 100.0 80.1 80.7 1-4 26.6 20.5 8.1 20.5 0.0 0.0 13.2 5-14 14.1 9.2 0.9 9.2 0.0 6.5 4.6 15+ 4.9 1.6 0.1 0.0 0.0 0.0 0.9 Distance unknown 1.4 0.6 0.2 0.0 0.0 13.5 0.6 Total 10O.0 100.0 100.0 100.0 100.0 100.0 100.0 Median distance 2 0.9 0.7 0.5 0.7 0.5 0.5 0.6 1Distance was obtained from the community-level service availability survey. 2Based on women having access to a facility of a specific known type. 123 Informants for the service availability module of the 1993 National Demographic Survey (NDS) were also asked the estimated one-way travel time to reach the facilities discussed in the preceding section. This question applies only if the primary means of travel is public transportation; in sample clusters where most of the people go to the health facility on foot, ride their own vehicle or rented vehicle, time to reach the facility is not recorded. The result underscores the previous finding which suggests that distance as well as travel time to a family planning facility has little or no association with a woman's decision whether to use a contraception, and whether she is using contraception for limiting or spacing births. The median estimated travel time to a family planning facility is between 10 to 15 minutes. Data in Table 11.5 show the expected pattem; hospitals are more likely to be located farther than other facilities, and rural women are farther from a family planning service than urban women. Table 11.5 Time to nearest family planning services by type of facility Percent distribution of currently m~ried (rural) women age 15-49 by time to nearest facility providing family planning (FP) services/supplies, according to type of facility. Philippines 1993 Rural heaith Time to nearest unit/ facility providing Pueri- Barangay FP services Government culture health Private (in minutes) 1 hospital center station hospital Other Total Urban areas Under 15 16.2 13.5 4.0 23.5 0,0 9.4 15-29 11.0 4.0 2.5 4.9 0.0 4.0 30-59 4.9 1.8 0.0 0.0 0.0 1.1 60-119 6.0 0.0 0.0 10.2 0.0 1,3 120+ 0.0 0.0 0.0 1.3 0.0 0.I Time unknown 61.9 80.7 93.4 60.1 100.0 84.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Median time 2 15.3 5.8 10.7 10.8 10.6 Rural areas Under 15 17.9 17.8 6.6 0.0 0.0 9.5 15-29 15.8 20.2 1.1 18.3 0.0 6.1 30-59 4.6 4.7 0.7 0.0 0.0 1.8 60-119 10.0 2.6 0.0 0.0 10.4 1.3 120+ 10.5 1.3 0.0 0.0 0.0 0.9 Time unknown 41.1 53.5 91.6 81.7 89,6 80.5 Total 100,0 100.0 100,0 100.0 100.0 100.0 Median time 2 20.7 15.4 5.9 25.5 35.5 15.1 Currently married women Under 15 16.7 15.2 5.5 21.2 0.0 9.4 15-29 12.5 10.4 1.7 6.2 0.0 5.0 30-59 4.8 3.0 0.4 0.0 0.0 1.4 60-119 7.2 1.0 0,0 9.2 6.5 1.3 120+ 3.3 0.5 0,0 1.2 0.0 0.5 Time unknown 55.4 69.9 92.4 62.2 93.5 82,4 Total 100.0 100.0 100.0 100.0 100,0 100.0 Median time z 16.0 10.9 10,2 10.9 35,5 10.8 1Time was obtained from the community-level service availability survey. 2Based on women having access to a facility of a specific known type. 124 11.2 Distance to Nearest Maternal and Child Health Services During the interview with the respondents for the selected cluster, if the reported nearest health facility is a hospital, questions about services provided in the hospital were also asked. Overall, almost half of children 1-4 years live within 5 kilometers of a hospital and 61 percent are less than 10 kilometers away from a hospital. Unlike family planning services, distance to a health facility seems to have an impact on the use of services, particularly maternal and child health services (Fable 11.6). Mothers who received antenatal care from a doctor or a nurse, or trained midwife and were delivered by medical personnel or delivered in a health facility are more likely to live close to a hospital. The chance of a mother receiving either antenatal care or delivery assistance from medical personnel appears to be associated with the distance to the hospital. The likelihood of a child receiving a vaccination is reported in the last two columns of Table 11.6. Children who have received all recommended vaccinations are slightly more likely to live close to a hospital than those who are only partially immunized. Table 11.6 Distance to nearest maternal and child health services by type of care received Percent distribution of children under 5 by distance to nearest hospital providing maternal and child health services, according to antenatal care and delivery assistance received, Philippines 1993 Maternal care Vaccination coverage 2 Distance to nearest hospital providing All Neither All Some/no MCH services children ANC & ANC or ANC vaccina- vaccina- (in kilometers) l 0-4 years DA DA nor DA tions s tions Under 1 18.4 25.7 11.6 9.6 20.0 18.4 1-4 29.1 35.7 23.7 18.7 30.4 29.2 5-9 23.3 19.7 26.8 27.1 22.5 23.4 10-14 9.6 7.6 11.3 12.1 9.2 9.7 15-29 13.6 7.8 18.5 22.1 13.4 13.1 30+ 4.6 2.7 6.3 7.2 3.1 4.8 Distance unknown 1.5 0.8 1.7 3.2 1.5 1.4 Total 100.0 100.0 100.0 100.0 lO0.O 100.0 ANC = Antenatal care by doctor, nurse, or trained midwife DA = Delivery assistance by doctor, nurse, trained midwife, or delivered in a health facility. IDistance was obtained from the community-level service availability survey 2Figures are for children age 1-4 years 3Received BCG, measles, and three doses of DPT and polio vaccines before first birthday 125 REFERENCES Central Bureau of Statistics (CBS) [Indonesia]; National Family Planning Coordinating Board; Ministry of Health; and Macro International (MI). 1992. Indonesia Demographic and Health Survey 1991. Columbia, Maryland: CBS and MI. Chavoyan, N., P. Kamnuansilpa, and J. Knodel. 1988. Thailand Demographic and Health Survey 1987. Bangkok: Institute of Population Studies, Chulalongkom University and Institute for Resource Development/Westinghouse. Concepci6n, M.B. 1991. Fertility and Contraception in the Philippines: Glimpses from the 1986 Contraceptive Prevalence Survey. Manila: Population Institute, University of the Philippines. Costello, M.A. nd. Infant and Child Mortality Review in the Philippines: A Review and an Agenda. Research report series prepared for the Population and Development Planning and Research Project, National Economic Development Board. Manila. Department of Health [Philippines]. 1990. The Contribution of the Department of Health to the Philippine Family Planning Program. Manila. E1-Zanaty, F.H., H.A.A. Sayed, H.H.M. Zaky, and A.A. Way. 1993. EgyptDemographic andHealth Survey 1992. Calverton, Maryland: National Population Council and Macro International. Engracia, L.T. 1983. Infant and Child Mortality and Health Service in the Rural Philippines. Paper presented at the 6th National Population Welfare Congress, 17 November 1983 at the Philippine International Convention Center, Manila. Federal Office of Statistics (FOS) [Nigeria] and IRD/Macro Intemational Inc.(IRD). 1992. Nigeria Demographic and Health Survey 1990. Columbia, Maryland: FOS and IRD. Macro International Inc. 1992. Guidelines for the DHS II First Country Report: Working Draft. Columbia, Maryland. Madigan, F. C. 1985. Infant Mortality by Socioeconomic Variables, Philippines, 1983. Report No. 4 Series 1 for the 1983 National Demographic Survey. Cagayan de Oro City, Philippines: Research Institute for Mindanao Culture, Xavier University. National Institute of Population Studies (NIPS) and IRD/Macro International (IRD). 1992. Pakistan Demographic and Health Survey. Columbia, Maryland: NIPS and IRD. National Statistics Office [Philippines]. 1992. 1990 Census of Population and Housing. Report No. 3: Socioeconomic and Demographic Characteristics. Manila. World Bank. 1991. New Directions in the Philippines Family Planning Program. Report No. 9579-PH. Washington, DC. [World Fertility Survey] National Census and Statistics Office (NCSO); University of the Philippines Population Institute, Commission on Population; and National Economic and Development Authority. 1979. Republic of the Philippines Fertility Survey 1978: First Report. Manila: NCSO and World Fertility Survey. 127 APPENDIX A SAMPLE DESIGN APPENDIX A SAMPLE DESIGN The main objective of the 1993 National Demographic Survey (NDS) sample is to provide estimates with an acceptable precision for sociodemographics characteristics, like fertility, family planning, health and mortality variables and to allow analysis to be carried out for urban and rural areas separately, for 14 of the 15 regions in the country. Due to the recent formation of the 15th region, Autonomous Region in Muslim Mindanao (ARMM), the sample did not allow for a separate estimate for this region. The sample is nationally representative with a total size of about 15,000 women aged 15 to 49. The Integrated Survey of Households (ISH) was used as a frame. The ISH was developed in 1980, and was comprised of samples of primary sampling units (PSUs) systematically selected and with a probability proportional to size in each of the 14 regions. The PSUs were reselected in 1991, using the 1990 Population Census data on population size, but retaining the maximum number of PSUs selected in 1980. This sample is self-weighted in each of the 14 regions, but not at the national level. It was selected using a two-stage sample design; the first involved the selection ofbarangays, and the second, the selection of households in the sampled barangays. Barangays are the smallest political subdivisions. In general, the barangay corresponds to a census enumeration area. However, they vary widely in size, some covering more than 1,000 households. In the case when the barangay size was very large, it was segmented into several enumeration areas. To maximize the efficiency of the sample design, the sample was allocated to the regions using a method called "power allocation procedure." This method optimizes the precision by taking into account sampling errors found in previous demographic surveys, in particular the 1978 Republic of the Philippines Fertility Survey. For this purpose, the following characteristics were considered: mean number of children ever bom, proportion of women who want no more children, mean number of children desired, and proportion of married women who are using a family planning method. A total of 2100 PSUs were selected for ISH, 750 of which were selected for the 1993 NDS. Individual households were selected with a probability of selection inversely proportional to the barangay's size to maintain a fixed overall sampling fraction within each region. An average of 20 completed interviews was targeted in each PSU. The estimated probability of selection for each PSU in each region is calculated as follows: P~i=(b*Mi)/EMi where: b is the number of selected PSUs in a particular stratum M~ is the 1990 census population of the i-th PSU in the stratum EM, is the total stratum population. 131 The sample selection probability of households, Pz, follows that ~i*P2 i = f wherefis the overall sampling fraction for the corresponding region. In total, 750 PSUs and about 13,700 households were selected. The survey was well received by the respondents. Response rate for the household interview varies slightly by region (see Table A. 1). In some regions, all of the households in the sample were successfully interviewed. For the individual women's interview, Bicol women have the lowest overall response rate (93 percent). A total of 15,029 women aged 15-49 years were succesfully interviewed. The weighting factors to provide national estimates were calculated as the inverse of the overall sampling fractions, adjusted with the corresponding household and individual responses rates. Table A.2 shows the total number of selected PSUs per region and the final sampling weights for households and individual interviews: 132 Table A.I Sample implementation Percent distribution of households mad eligible women in the DHS sample by results of the interview, and household response rates, eligible women response rates, and overall response rates, according to region and urban-rural area, Philippines 1993 Region Metro. Cordillera Cagayan C- S- W- Result Manila Admin. llocos Valley Luzon Tagalog Bicol Visayas Selected households Completed (C) 92,5 87.3 98.1 98.9 94,7 92.6 96.3 96.2 ltousehold present but no competent respondent at home (HI>) 0,6 0.4 0,1 0.0 0.6 0.3 0.3 Refused (R) 0.g 0.2 0,1 0.0 0.3 0.1 0.1 0.1 Dwelling not found (DNF) 0.5 0.8 0.1 0.0 O, 1 0.2 0.0 Household absent (I IA) 0.5 2.1 0.3 0.0 0.2 2,0 1.9 0.5 Dwelling vacant/destroyed (DV) 0.8 2.3 0.4 0.0 1.6 0.3 0.1 0.1 Other (O) 4.2 6.8 0.8 L1 2.5 4.4 1.3 3.0 Total percent I00,0 I00.0 100.0 100.0 100.0 100,0 100.0 100.0 Number 1298 513 890 733 1183 1380 917 1127 Household response rate (HRR) l 98.0 98.5 99.7 100.0 98.9 99.3 99.5 99.8 Eligible women Completed (EWC) 98.8 96.9 98.6 98.3 98.5 98.6 92.7 98.9 Not at home (EWNII) 0.9 1.8 0,8 0.9 0.7 1,0 4.0 0.4 Postponed (EWP) 0.0 0.0 0,0 0.0 0.0 0,0 0.0 0.0 Refused (EWR) 0.2 0.0 0.1 0.0 0.0 0.0 l.O 0.0 Partly completed (EWPC) 0.0 0.0 0,0 0.0 0.0 0.0 O. 1 0.0 Incapacitated (EWI) 0.1 0.8 0.3 0.4 0.8 0.4 2.1 0.6 Other OEWO) 0.0 0.4 0.2 0.4 0.0 0.1 O.1 0.2 Total percent 100.0 100,0 100.0 100.0 100.0 100,0 100.0 100.0 Number 1904 488 981 701 1412 1538 916 1220 Eligible woman response rate (EWRR) 2 98.8 96.9 98,6 98.3 98.5 98.6 92.7 98.9 Overall resEonse rate (ORR) 3 96.8 95,4 98.2 98.3 97.5 97,9 92.3 98.7 Note: The household response rate is calculated for completed households as a proportion of completed, no com/~tent respondent, postponed, refused, and dwelling not found. The eligible woman response rate is calculated for completed interviews as a proportion of completed, not at home, postponed, refused, partially completed, incapacitated and "other." The overall response rate is the ~uroduct of the household and woman response rates. sing the number of households PAling into specific response ca,.egofies, the household response rate (I|RR) ~s calculated ~: C C+I IP+R+DNF 2Using the number of eligible women falling into specific response categories, the eligible woman response rate (EWRR) is calculated as: EWC EWC+EWNI I+EWP+EWR+EWC+EWI+EWO 3"Fhe overall response rate (ORR) is calculated as: ORR = IIRR * EWRR 133 Table A. 1 ----continued Percent dis~ibutinn of households and eligible women in the DHS sample by results of the interview, and household response rates, eligible women response rates, and overall response rates, according to region and urban-rural residence, Philippines 1993 Region Residence C- E- W- N- S- C- Result Visayas Visayas Mindanao Mindanao Mindanao Miedanao Urban Rural Total Selected households Completed (C) 96.0 93.5 Household present but no competent respondent at home (HP) 0.2 Refused 01) 0.2 Dwelling not found (DNF) 0.7 Household absent (HA) 1.1 Dwelling vacant/ desmayed (DV) 0.2 Other (O) 1.6 Total percent 100.0 Number 1(362 96.0 95.3 93.5 93.4 93.7 95.5 94.7 1.2 0.5 0.1 0.1 0.2 0.4 0.3 0.3 0.0 0.1 0.0 0.1 0.0 0.4 0.0 0.2 0.5 0.2 0.1 0.7 0.0 0.3 0.2 0.3 2.4 1.4 1.5 0.9 1.2 1.2 1.1 1.1 0.6 1.6 1.0 0.2 0.2 0.7 0.5 0.6 1.8 0.2 2.0 4.5 4.9 3.3 2.4 2.8 100.0 100.0 100.0 100.0 100.0 1130.0 100.0 100.0 867 886 93l 11360 881 6542 7186 13728 Household response rate 0tRR) I 98.9 98.3 99.2 99.8 99.1 99.8 98.9 99.5 99.2 Eligible women Completed (EWC) 98.6 97.1 97.1 98.3 98.5 98.7 98.2 97.9 98.0 Not at home (EWNtt) 0.5 1.8 1.5 0.9 0.9 0.7 1.1 1.1 1.1 Postponed (EWP) 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Refused (EWR) 0.5 0.1 0.1 0.0 0.2 0.3 0.2 0.1 0.2 Partly completed (EWPC) 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 Incapacitated (EWI) 0.4 0.8 0.7 0.7 0.4 0.2 0.5 0.7 0.6 Other (EWO) 0.0 0.0 0.5 0.0 0.0 0.0 0.1 0.1 0.1 Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 1182 826 973 1013 1223 955 8056 7276 15332 Eligible woman response rate (EWRR) 2 98.6 97.1 97.1 98.3 98.5 98.7 98.2 97.9 98.0 Ovecall response rate (ORR) s 97.5 95.4 96.3 98.1 97.6 98.5 97.1 97.3 97.2 Note: The household response rate is calculated for completed households as a proportion of completed, no competent respondent, postponed, refused, and dwelling not found. The eligible woman response rate is calculated for completed interviews as a prolmrfion of completed, not at home, postponed, refused, partially completed, incapacitated and "other." The overall response rate is the ~roduet of the household and woman response rates. Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as: C C +I IP+R+DNF hOsing the number of efigible women falling into specific response categories, the eligible woman response rate (EWRR) is calculated as: EWC EWC + EWNH + EWP + EWR + EWC + EWI + EWO 3The overall response rate (ORR) is calculated as: ORR = IIRR * EWRR 134 Table A.2 Dismbution of sample PSUs, households and women Number Region of PSUs Households Individual Metro. Manila 70 1.501267 1.452369 CAR 28 0.886659 0.860143 llocos 49 0.725397 0.705742 Cagayan Valley 40 1.184577 1.149854 C. Luzon 65 1.377194 1.336054 S. Tagalog 75 0.918937 0.948080 Bicol 50 1.042227 1.008199 W. Visayas 62 0.991550 0.962006 C. Visayas 58 0.816717 0.804357 E. Visayas 48 0.783337 0.771261 W. Mindanao 48 0.819593 0.797113 N. Mindanao 51 0.936176 0.908592 S. Mindanao 58 0.774537 0.750077 C. Mindanao 48 0.516750 0.509813 135 APPENDIX B EST IMATES OF SAMPLING ERRORS APPENDIX B ESTIMATES OF SAMPLING ERRORS The results from sample surveys are affected by two types of errors, nonsampling error and sampling error. Nonsampling error is due to mistakes made in carrying out field activities, such as failure to locate and interview the correct household, errors in the way the questions are asked, misunderstanding on the part of either the interviewer or the respondent, data entry errors, etc. Although efforts were made during the design and implementation of the 1993 NDS to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors, on the other hand, can be measured statistically. The sample of women selected in the 1993 NDS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each one would have yielded results that differed somewhat from the actual sample selected. The sampling error is a measure of the variability between all possible samples; although it is not known exactly, it can be estimated from the survey results. Sampling error is usually measured in terms of standard error of a particular statistic (mean, per- centage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which, apart from nonsampling errors, the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that same statistic as measured in 95 percent of all possible samples with the same design (and expected size) will fall within a range of plus or minus two times the standard error of that statistic. If the sample of women had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 1993 NDS sample was designed using stratification (region and urban/rural), clustering (barangay or a segment thereof) and stages of selection (barangay and household on the first and second stage, respectively). Consequently, it was necessary to utilize more complex formulas. The module on sampling errors in the ISSA package developed for the Demographic and Health Surveys program was used to assist in computing the sampling errors with the proper statistical methodology. This program treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance: 1- f mh 2 Zh 2.A Zh/ - - - var(r) ~ h.1 ~ ,.1 HI h in which zs -- ys - r .x~ , and z A = yh-r .xh where h mh Yhl represents the stratum which varies from 1 to H, is the total number of EAs selected in the h t~ stratum, is the sum of the values of variable y in EA i in the h th stratum, 139 x~ f is the sum of the number of cases (women) in EA i in the h ~ stratum, and is the overall sampling fraction, which is so small that CLUSTERS ignores it. In addition to the standard errors, the program computes the design effect (DEFT) for each estimate, which is defined as the ratio between the standard error using the given sample design and the standard error that would result i fa simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error due to the use of a more complex and less statistically efficient design. The ISSA program also computes the relative error and confidence limits for the estimates. For each variable, the type of statistic (mean or proportion) and the base population are given in Table B.1. Sampling errors are presented in Tables B.2.1-B.2.17 for variables considered to be of major interest. Results are presented for the whole country, divided into urban and rural areas, and for each of the 14 regions. For each variable, Tables B.2.1-B.2.17 present the value of the statistic (R), its standard error (SE), the number of unweighted (N) and weighted cases (WN), the design effect (DEFT), the relative standard error (SE/R), and the 95 percent confidence limits (R+2SE). More complex estimates like the total fertility rate, infant mortality rate or medians are calculated using the Jackknife replication procedure incorporated in this ISSA module. Results are presented only for the whole country, divided into urban and rural areas, but not for each of the 14 regions, because these estimates need to have a large sample size to provide accurate precision. The confidence limits have the following interpretation. For the proportion of married women currently using a contraceptive method (currently using any method), the overall average from the sample is 0.400 and its standard error is 0.006. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 0.400 + (2 x 0.006), which means that there is a high probability (95 percent) that the true proportion currently using is between 0.387 and 0.412. The relative standard error for most estimates for the country as a whole is small, except for estimates of very small proportions. The magnitude of the error increases as estimates for subpopulations such as geographical areas are considered. For the variable currently using any method, for instance, the relative standard error (as a percentage of the estimated proportion) for the whole country and for urban and rural areas is 1.5 percent, 2.1 percent, and 2.3 percent, respectively. 140 Table B.I List of selected variables for sampling errors~ Philippines 1993 Variable Type Description Base population Urban Proportion Urban resident All women With secondary education or higher Proportion Secondary or more All women Currently in union Proportion Ctm-ently in union All women Married before age 20 Proportion Married before age 20 All women 20-49 Had first sexual intercourse before 18 Proportion First sex before age 18 All women 20-49 Children ever born Mean Children ever born All women Children ever born to women over 40 Mean Children ever born Women 40-49 Children sin-riving Mean Children surviving All women Know any method Proporgon Know any modem method Proportion Know source for modern method Proportion Ever used any contraceptive method Proportion Currently using any method Propol'fion Currently using a modern method Proportion Currently using pill Proportion Currently using IUD Proportion Currently using condom Proportion Currently using female sterilization Proportion Currently using periodic abstinence Proportion Public source user Proportion Want no more children Proportion Want to delay next birth at least 2 years Proportion Ideal number of children Mean Mothers received tetanus injection Proportion Received medical care at birth Proportion Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS tJ~atment Received medical acatrr~nt Proportion Proportion Proportion Proportion Having henith card Proportion Received BCG vaccination Proportion Received DPT vaccination (3 doses) Proportion Received polio vaccination O doses) Proportion Received measles vaccination Proportion Fully immunized Proportion Knowing any method Knowing any modern method Knowing modem method source Ever use any method Using any method Using any modem method Using pills Using IUD Using condom Using female sterilization Using abstinence Public source user Desiring no more children Delay child at least 2 years Ideal number of children Received tetanus injection Medical attention at birth Diarrhea Iast 24 hours Diarrhea last 2 weeks Received ORS tJeatment Received medical tleatment Had health card Received BCG Received DPT O doses) Received POLIO (3 doses) Received measles Fully immunized Women in union Women in union Women in union Women in umon Women In union Women in umon Women in umon Women in union Women in union Women in union Women in union User modem method Women in union Women in union All women Births last 5 years Births last 5 years Children < 5 yem's Children < 5 years Diarrhea last 2 weeks Diarrhea last 2 weeks Chfld~n l~2.3months Chfld~n l~2.3months Children l~7.3months Children l~23 months Children 1~23 months Child~n l~23months 141 Table B.2.1 Sampling errors: Entire sample T Philippines 1993 Value Variable (R) Number of cases Standard Un- Weight- Design Relative error weighted ed effect error (SE) (N) (WN) (DEFT) (SE/R) Confidence limits R-2SE R+2SE Urban .566 .008 15029.0 15029.0 1.980 .014 .550 .582 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours tied diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .666 .006 15029.0 15629.0 1.622 .009 .654 .679 .596 .005 15029.0 15029.0 1.355 .009 .585 .607 .354 .006 11890.0 11871.3 1.419 .018 .342 .366 .189 .005 11890.0 11871.3 1.295 .025 .179 .198 2.300 4.950 2.127 .028 15029.0 15029.0 1.287 .012 .068 2741.0 2707.3 1.168 .014 .025 15029.0 15029.0 1.253 .012 2.244 2.356 4.814 5.087 2.078 2.177 .972 .003 9145.0 8961.3 1.808 .003 .965 .978 .969 .003 9145.0 8961.3 1.889 .004 .963 .976 .933 .005 9145.0 8961.3 1.794 .005 .924 .943 .611 .007 9145.0 8961.3 1.282 .011 .598 .625 .400 .006 9145.0 8961.3 1.198 .015 .387 .412 .249 .005 9145.0 8961.3 1.147 .021 .238 .259 .085 .003 9145.0 8961.3 1.103 .038 .079 .091 .030 .002 9145.0 8961.3 1.275 .075 .026 .035 .010 .001 9145.0 8961.3 1.113 .116 .008 .012 .119 .004 9145.0 8961.3 1.080 .031 .111 .126 .073 .003 9145.0 8961.3 1.096 .041 .067 .079 .717 .011 2251.0 2227.2 1.207 .016 .694 .740 .506 .187 3.226 .648 .528 .101 .030 .272 .339 .006 9145.0 8961.3 1.088 .011 .004 9145.0 8961.3 1.033 .023 .015 14764.0 14804.9 1.292 .005 .008 9137.0 8802.7 1.280 .013 .011 9137.0 8802.7 1.552 .020 .004 8767.0 8457.9 1.054 .037 .002 8767.0 8457.9 .952 .062 .016 907.0 855.2 .955 .058 .017 907.0 855.2 .975 .051 .012 1812.0 1742.3 1.053 .035 .007 1812.0 1742.3 1.080 .008 .011 1812.0 1742.3 1.107 .013 .011 1812.0 1742.3 1.086 .014 .010 1812.0 1742.3 1.107 .013 .012 1812.0 1742.3 1.125 .017 .351 .912 .799 .782 .814 .715 .494 .178 3.195 .631 .506 .094 .026 .240 .304 .327 .897 .778 .760 .794 .691 .517 .195 3.256 .664 .549 .109 .033 .303 .373 .375 .927 .820 .803 .835 .740 NA = Not applicable 142 Table B.2.2 Sampling errors: Urban sample I Philippines 1993 Number of cases Standard Value error Variable (R) (SE) Un- Weight- Design Relative Confidence limits wei g,hted ed effect error (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban 1.00ll .ll00 7908.0 8501.1 NA .000 1.000 1.000 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever borntowomen over40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceplave method Currently using any method Currendy using a modern method Currendy using pill Currently using IUD Currently using condom Currendy using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours llad diarrhea m last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .761 .007 7908.0 8501.1 1.555 .010 .746 .776 .546 .008 7908.0 8501.1 1.419 .015 .530 .561 .299 .008 6171.0 6633.5 1.449 .028 .282 .316 .152 .006 6171.0 6633,5 1.325 .040 .140 .164 1.937 4.343 1.813 .037 .089 .033 7908.0 8501.1 1.353 .019 1.863 2.011 1380.0 1453.1 1.156 .020 4.165 4.521 7908.0 8501.1 1.316 .018 1.747 1.878 .986 .003 4415.0 4638.1 1.729 .003 .980 .992 .986 .003 4415.0 4638.1 1.703 .003 .979 .992 .951 .005 4415.0 4638.1 1.436 .005 .942 .961 .655 .009 4415.0 4638.1 1.233 .013 .638 .673 .430 .009 4415.0 4638.1 1.189 .021 ,412 .447 .276 .007 4415.0 4638.1 1.056 .026 .262 .290 .090 .005 4415.0 4638.1 1.092 .052 .081 .099 .029 .003 4415.0 4638.1 1.160 .102 .023 .034 .013 .002 4415.0 4638.1 1.140 .147 .009 .017 .139 .005 4415.0 4638.1 .998 .037 .129 .150 .078 .005 4415.0 4638.1 ,1.134 .059 .069 .087 .653 .016 1207.0 1280.5 1.163 .024 .621 .685 .478 .008 4415.0 4638.1 1.063 .017 .462 .494 .183 .006 4415.0 4638.1 1.090 .035 .170 .196 3.095 .019 7789.0 8397.4 1.242 .006 3.058 3.133 .636 .010 4130.0 4269.5 1.102 .017 .615 .657 .704 .015 4130.0 4269.5 1.585 .021 .675 .734 .097 .006 3997.0 4135.1 1.079 .057 .086 .109 .027 .003 3997.0 4135.1 1.041 .104 .021 .033 .260 .024 405.0 402.9 1.007 .094 .211 .308 .362 .027 405.0 402.9 1.001 .075 .308 .416 .358 .017 834.0 859.7 1.017 .049 .323 .393 .930 .010 834.0 859.7 1.134 .011 .909 .950 .814 .015 834.0 859.7 1.098 .019 .783 .844 .812 .015 834.0 859.7 1.073 .018 .782 .841 .837 .016 834.0 859.7 1.218 .019 .805 .869 .732 .018 834.0 859.7 1.125 .024 .697 .768 NA = Not applicable 143 TaMe B.2.3 Sampling errors: Rural sample~ Philippines 1993 Value Variable (R) Standard error (SE) Number of cases Un- weighted (N) Weight- Design Relative Confidence limits ed effect error (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .000 .000 7121.0 6527.9 NA .000 .000 .000 With secondary education or higher Cunnenfly in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modem method Know source for modem method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth llad diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment llaving health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .543 .009 7121.0 6527.9 1.580 .017 .524 .562 .662 .006 7121.0 6527.9 1.062 .009 .650 .674 .423 .009 5719.0 5237.7 1.337 .021 .406 .441 .235 .007 5719.0 5237.7 1.252 .030 .221 .249 2.772 5.654 2.537 .039 7121.0 .101 1361.0 .034 7121.0 6527.9 1.141 .014 2.694 2.850 1254.3 1.193 .018 5.451 5.856 6527.9 1.099 .013 2.469 2.605 .956 .006 4730.0 4323.2 1.864 .006 .944 .967 .952 .006 4730.0 4323.2 1.981 .006 .940 .964 .914 .008 4730.0 4323.2 2.025 .009 .897 .930 .565 .009 4730.0 4323.2 1.314 .017 .546 .584 .368 .008 4730.0 4323.2 1.197 .023 .351 .385 .219 .008 4730.0 4323.2 1.253 .034 .204 .234 .080 .004 4730.0 4323.2 1.107 .055 .071 .088 .032 .004 4730.0 4323.2 1.388 .111 .025 .039 .006 .001 4730.0 4323.2 .967 .176 .004 .009 .096 .005 4730.0 4323.2 1.186 .053 .086 .107 .068 .004 4730.0 4323.2 1.025 .055 .061 .076 .802 .015 1044.0 946.7 1.238 .019 .772 .833 .535 .008 4730.0 4323.2 1.115 .015 .519 .551 .191 .005 4730.0 4323.2 .957 .029 .180 .202 3.396 .023 6975.0 6407.5 1.291 .007 3.350 3.443 .659 .013 5007.0 4533.3 1.462 .019 .634 .684 .361 .013 5007.0 4533.3 1.521 .037 .335 .388 .105 .005 4770.0 4322.8 1.035 .048 .095 .115 .032 .002 4770.0 4322.8 .880 .074 .027 .037 .282 .021 502.0 452.2 .922 .073 .241 .324 .318 .022 502.0 452.2 .944 .069 .274 .361 .344 .017 978.0 882.6 1.095 .049 .310 .378 .894 .010 978.0 882.6 1.046 .012 .873 .915 .785 .015 978.0 882.6 1.124 .019 .755 .814 .752 .016 978.0 882.6 1.109 .021 .721 .783 .792 .014 978.0 882.6 1.032 .017 .765 .820 .699 .017 978.0 882.6 1.141 .024 .665 .733 NA = Not applicable 144 Table B.2.4 Sampling errors: Metropolitan Manila sample r Philippines 1993 Standard Value error Variable (R) (SE) Number of cases Un- Weight- Design Relative weighted ed effect error (N) (WN) (DEFT) (SE/R) Confidence limits R-2SE R+2SE Urban 1.000 .000 1882.0 2733.4 NA .000 1.000 1,000 With secondary educafon or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever bern Children ever bern to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours tlad diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccina6on Fully immunized .851 .013 1882.0 2733.4 1,598 .015 .824 .877 .465 .018 1882.0 2733.4 1.532 .038 .430 .501 .230 .016 1472.0 2137.9 1,431 .068 .199 .262 .105 .010 1472.0 2137.9 1,208 .092 .085 .124 1.421 3,458 1.343 .059 .147 .054 1882.0 2733.4 1,317 271.0 393.6 1,036 1882.0 2733.4 1,280 .042 1.302 .042 3.164 .040 1.235 1,539 3,751 1,451 .999 .001 876.0 1272.3 .995 .001 .997 1.001 .999 .001 876.0 1272.3 .995 .001 .997 1.001 .975 .007 876.0 1272.3 1,299 .007 .961 .989 .679 .018 876.0 1272.3 1,122 .026 .644 .715 .419 .021 876.0 1272.3 1.270 .051 .377 .461 .273 .016 876.0 1272.3 1.050 .058 .241 .304 .094 .010 876,0 1272.3 1,064 .112 .073 .115 .016 .004 876.0 1272.3 .913 .242 .008 .024 .011 .004 876.0 1272.3 1,048 .330 .004 .019 .148 .012 876.0 1272.3 1.038 .084 .123 .173 .071 .008 876.0 1272.3 .980 .120 .054 .088 .527 .034 239.0 347.1 1,041 .064 .460 .595 .449 .016 876.0 1272.3 .977 .037 .416 .481 .180 .013 876.0 1272.3 1,007 .073 .154 .207 2,928 .029 1868.0 2713.0 1,045 .010 2.870 2,987 .559 .027 748.0 1086.4 1,180 .048 .506 .612 .885 .024 748.0 1086.4 1,696 .027 .837 .934 .075 .008 724.0 1051.5 .844 .110 .058 .091 .023 .005 724.0 1051.5 .910 .216 .013 .034 .24I .061 54.0 78.4 .998 .255 .118 .363 .444 .062 54.0 78.4 .908 .140 .320 .569 .278 .038 144.0 209.1 1,027 .138 .201 .354 .931 .023 144.0 209.1 1,103 .025 .884 .977 .771 .042 144.0 209.1 1.201 .055 .687 .855 .771 .041 144.0 209.1 1.158 .053 .690 .852 .729 .042 144.0 209.1 1.145 .058 .644 .814 .611 .044 144.0 209.1 1.090 .072 .523 .700 NA = Not applicable 145 Table B.2.5 Sampling errors: Cordillera Administrative Region sample, Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SF,/R.) R-2SE R+2SE Urban .522 .051 473.0 241.1 2.232 .098 .420 .625 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modern method Know source for modem method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth lied diarrhea in last 24 hours lied diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully inamunized .755 .022 473.0 241.1 1.123 .029 .710 .799 .613 .02g 473.0 241.1 1.270 .046 .556 .670 • 304 .034 368.0 187.6 1.416 .112 .236 .372 .174 .022 368.0 187.6 1.110 .126 .130 .218 2.442 .161 473.0 241.1 1.349 .066 2.120 2.763 4.444 .423 90.0 45.9 1.448 .095 3.598 5.291 2,290 .144 473.0 241.1 1.307 .063 2.062 2.577 • 993 .005 290.0 147.8 1.001 .005 .983 1.003 • 993 .005 290.0 147.8 1.001 .005 .983 1.003 • 986 .005 290.0 147.8 .740 .005 .976 .996 .586 .028 290.0 147.8 .978 .048 .530 .643 .386 .024 290.0 147.8 .843 .063 .338 .435 .231 .019 290.0 147.8 .749 .080 .194 .268 .034 .008 290.0 147.8 .744 .232 .019 .050 .021 .007 29~0 147.8 .859 .348 .006 .035 • 017 .011 29~0 147.8 1.374 .610 .004 .038 .159 .013 29~0 147.8 .616 .083 .132 .185 • 076 .011 29~0 147.8 .677 .139 .055 .097 .701 .072 67.0 34.2 1.286 .103 .557 .846 • 421 .025 290.0 147.8 .878 .061 .370 .472 • 248 .026 290.0 147.8 1.0'25 " .105 .196 .300 3.799 .092 437.0 222.8 1.275 ,024 3.615 3.982 .767 .038 339.0 172.8 1.335 . .049 .692 .842 • 522 .063 339.0 172.8 1.759 J]121 .396 .648 .136 .019 33~0 168.2 .941 .143 .097 .175 • 079 .017 33~0 168.2 .991 ,211 .046 .112 .467 .082 45.0 22.9 .969 .175 .303 ,630 • 422 .081 45.0 22.9 .965 ,193 .260 .585 .638 .067 69.0 35.2 1.149 .105 .504 .772 • 928 .022 69.0 35.2 .710 .024 .883 .972 • 899 .038 69.0 35.2 1.031 .042 .823 .974 • 899 .038 69.0 35.2 1.031 .042 .823 .974 .913 .034 69.0 35.2 1.012 .038 .844 .982 .855 .034 69.0 35.2 .799 .040 .787 .923 146 Table B.2.6 Sampling e, ,o~, ; Ilocos sample T Philippines 1993 Value Variable (R) N ~ of cases Standard Un- Weight- Design Relative Confidence limits errc~ weighted ed effect error (SE) (]~) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .285 .020 967.0 831.8 1.408 .072 .244 .326 With secondary education Qr higher Currently in union Married before age 20 Had first sexual in~'eourse befot¢ 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contzacepfive method Currently using any method Currently wing a modern method Currently using pill Currently using IUD Currcntiy using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no mm~ children Want to delay next birth at lea.st 2 y e~'s Ideal number of clfildren Mothers received mtanus injection Received medical car~ at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS ~'ealmcnt Received medical txeatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaeninafon (3 doses) Received measles vaccination Fully immunized .701 ,022 967.0 831.8 1,464 .031 .658 .744 .605 .020 967.0 831.8 1.243 .032 .566 .644 .302 .022 759.0 652.8 1.318 .073 .258 .346 .123 .014 759.0 652.8 1.173 .114 .095 .150 2.392 5.118 2.216 .113 .327 .101 967.0 831.8 1.295 .047 195.0 167.7 1.544 .064 967.0 831.8 1.256 .045 2.165 2.619 4.463 5.773 2,015 2.418 ,988 .006 585.0 503.2 1,366 .006 .976 1,000 .988 .006 585.0 503.2 1.366 .006 ,976 1,000 .219 .017 585.0 503.2 ,968 .076 .186 .252 .976 .007 585.0 503.2 1.120 .007 ,962 .990 .581 .022 585.0 503.2 1.060 .037 .538 .624 .388 .021 585.0 503.2 1.042 .054 .346 .430 .068 .012 585.0 503.2 1.187 .181 .044 .093 .009 .004 585.0 503.2 1.006 .448 .001 .016 .012 .004 585.0 503.2 .970 .365 .003 .021 .128 .013 585.0 503.2 .973 .105 ,101 .155 .055 .009 585.0 503.2 .932 .160 .037 .072 .711 .064 128.0 II0.I 1.600 .091 .582 .840 .017 .016 .070 .046 .041 .455 .210 3.383 585.0 503.2 .847 .038 585.0 503.2 .946 .076 963.0 828.3 1,555 .021 569.0 489.4 1.822 .074 569.0 489.4 1.588 .063 .617 .649 .420 .178 3.244 .525 .567 .490 .242 3.522 .709 .730 .136 .015 546.0 469.6 .903 .111 .105 .166 .057 .008 546.0 469,6 .797 .149 .040 .074 .351 .061 74.0 63.7 1.008 .172 .230 .473 .405 .082 74.0 63.7 1.274 .201 .242 .569 ,239 .048 113.0 97.2 1.205 .202 .142 .336 .938 .031 113.0 97.2 1.377 .033 .876 1.001 • 796 .030 113.0 97.2 .801 .038 .736 .857 .681 .050 113.0 97,2 1.135 .073 .582 .781 .814 .036 113.0 97.2 .978 .044 .743 .886 .593 .053 113.0 97.2 1.139 .089 .488 .698 147 Table B.2.7 Sampling errors: Cagayan Valley sample I Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .303 .026 689.0 486.3 1.486 .086 .251 .355 With secondary educataon or higher .599 Currently in union .700 Married before age 20 .436 Had first sexual intercourse before 18 .228 .030 689.0 486.3 1.621 .051 .539 .660 .015 689.0 486.3 .881 .022 .669 .730 .023 580.0 409.3 1.127 .053 .390 .483 .016 580.0 409.3 .921 .071 .195 .260 Children ever born 2.457 .105 689.0 486.3 1.128 .043 2.248 2.666 Children ever bern to women over 40 4.602 .320 123.0 86.8 1.326 .070 3.961 5.242 Children surviving 2.277 .086 689.0 486.3 1.015 .038 2.106 2.448 Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern m~thod Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at le~t 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth • 981 .007 482.0 340.2 1.195 .008 .967 .996 .979 .008 482.0 340.2 1.173 .008 .964 .995 • 942 .010 482.0 340.2 .892 .010 .923 .961 • 571 .028 482.0 340.2 1.234 .049 .515 .626 • 411 .030 482.0 340.2 1.360 .074 .350 .472 • 322 .031 482.0 340.2 1.445 .096 .260 .383 .149 .022 482.0 340.2 1.371 .149 .105 .194 • 029 .010 482.0 340.2 1.321 .348 .009 .049 .008 .004 482.0 340.2 1.002 .500 .000 .017 .133 .019 482.0 340.2 1.252 .146 .094 .172 • 029 .007 482.0 340.2 .958 .253 .014 .044 .742 .048 155.0 109.4 1.360 .065 .646 .838 .432 .019 482.0 340.2 .860 .045 .393 .470 • 210 .017 482.0 340.2 .942 .083 .175 .244 3.232 ,073 672.0 474.3 1.315 .023 3.086 3.378 .717 .031 449.0 316.9 1.142 .043 .656 .779 .365 .040 449.0 316.9 1.389 .108 .286 .444 .119 .017 429.0 302.8 .927 .139 .086 .152 .054 .013 429.0 302.8 1.040 .241 .028 .079 .275 .066 51.0 36.0 .925 .241 .142 .407 .412 .063 51.0 36.0 .771 .154 .285 .538 .216 .054 97.0 68.5 1.236 .248 .109 .324 .887 .032 97.0 68.5 .913 .036 .823 .950 .753 .046 97.0 68.5 1.049 ,061 .660 .845 .742 .043 97.0 68.5 .959 .058 .657 .828 .732 .054 97.0 68.5 1.170 .074 .624 .840 .619 .067 97.0 68.5 1.336 .108 .485 .753 }lad diarrhea m last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully irrmmnized 148 Table B.2.8 Sampling errors: Central Luzon sample t Philippines 1993 Number of eases Standard Un- Weight- Design Relative Confidence limi~ Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .575 .027 1391.0 1599.4 2.015 .046 .522 .629 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know arty modem method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Cun'ently using IUD Currently using condom Currently using female sterilization Currently uslr~g pododi¢ a, bstinetxce Public source user Want no more children Want to delay next birth at least 2 years Idea/number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination FuBy immunized .647 .019 1391.0 1599.4 1.461 .029 ,610 .684 .611 .013 1391.0 1599.4 1,001 .021 ,585 .637 ,370 ,020 1096,0 1260.2 1.364 ,054 ,330 .409 ,167 .015 1096.0 1260.2 1.343 .091 .137 .197 2.195 4,576 2.090 .084 1391.0 1599.4 1.284 .038 2.027 2.362 .163 264.0 303.6 ,937 .036 4.249 4.902 ,076 1391,0 1599.4 1.241 .036 1.937 2.242 .998 .002 850.0 977.4 .994 .002 .994 1.GO1 ,998 .002 850.0 977,4 .994 .002 ,994 1.001 .975 .005 850.0 977.4 .973 .005 .965 ,986 .629 .017 850.0 977.4 1.044 .028 .595 .664 .438 .015 850.0 977.4 .890 .035 .407 .468 .309 .013 850.0 977.4 .842 .043 ,283 .336 .094 .009 850.0 977.4 .944 .101 .075 ,113 .011 .004 850.0 977,4 1.090 ,361 .003 .018 ,013 .004 850.0 977.4 .932 .279 .006 .020 ,I91 .010 850.0 977.4 .767 .054 .170 .211 .032 .006 850,0 977.4 1,064 .202 .019 .045 .817 .023 263.0 302.4 .962 ,028 .772 .863 .407 ,017 850.0 977.4 ,995 .041 .374 .441 .201 ,013 850.0 977.4 .944 .065 .175 .227 3.407 .041 1389.0 1597,1 1.162 .012 3.326 3.489 .639 .023 787.0 904.9 1.109 .036 .593 .685 .806 .035 787.0 904.9 1.916 .043 ,736 .875 .065 .012 769.0 884,2 1.251 .186 .041 .089 ,021 .005 769.0 884,2 .928 ,229 .011 .030 .240 ,068 50.0 57.5 1.033 .282 ,105 .375 .260 ,066 50.0 57.5 ,982 .253 .128 .392 .310 .040 142.0 163.3 1,018 .130 .229 .390 .944 ,024 142,0 163.3 1.241 .025 .896 .992 .810 .030 142.0 163.3 .900 .037 .750 .869 .761 .037 142.0 163.3 1.029 .049 .687 .835 .859 .035 142.0 163.3 1.137 .040 .790 .928 ,718 .041 142.0 163.3 1.056 .057 .637 .800 149 Table B.2.9 Sampling errors: Southern Tagalog saraple~ Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .551 .026 1516.0 2025.5 2.034 .047 .499 .603 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever born Children ever bern to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at lent 2 years Ideal number of children Mothers received tetanus injection Received medic.a/care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment llaving health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received frazzles vaccination Fully immunized .675 .018 1516.0 2025.5 1.473 .026 .640 .711 • 602 .015 1516.0 2025.5 1.209 .025 .571 .632 .358 .017 1184.0 1581.9 1.248 .049 .323 .393 • 202 .013 1184.0 1581.9 1.100 .064 .176 .228 2.283 4.811 2.121 .063 1516.0 2025.5 .929 .027 2.157 2.409 • 181 285.0 38~8 1.052 .038 4.448 5.173 .056 1516.0 2025.5 .908 .026 2.009 2.233 .984 .007 91Z0 1218.5 1.609 .007 .970 .997 .982 .008 91ZO 1218.5 1.757 .008 .967 .998 .968 .009 912.0 1218.5 1.567 .009 .950 .986 .570 .021 912.0 1218.5 1.288 .037 .528 .612 .352 .017 912.0 1218.5 1.049 .047 .319 .385 .226 .017 91Z0 1218.5 1.215 .074 .192 .260 .058 .006 91Z0 1218.5 .823 .110 .045 .071 .034 .009 912.0 1218.5 1.557 .275 .015 .053 .009 .004 912.0 1218.5 1.232 .434 .001 .016 .125 .012 912.0 1218.5 1.073 .094 .101 .149 .045 .006 912.0 1218.5 .870 .133 .033 .057 .714 .035 206.0 275.2 1.116 .049 .643 .784 .549 .018 912.0 1218.5 1.110 .033 .513 .586 .158 .013 912.0 1218.5 1.090 .083 .132 .184 3.137 .040 1515.0 2024.1 1.342 .013 3.057 3.218 .630 .022 800.0 1068.8 1,026 .034 .587 .673 .549 .029 800.0 1068.8 1.276 .053 .491 .607 .118 .013 778.0 1039,5 1.033 .109 .092 .144 .033 .007 778.0 1039.5 .989 .197 .020 .047 .272 .044 92.0 122.9 .891 .163 .183 .360 .380 .050 92.0 122.9 ,915 .131 ,281 ,480 .249 .034 169.0 225.8 1.031 .139 .180 .317 .941 .020 169.0 225.8 1,009 .021 .901 .981 .834 .026 169.0 225.8 .875 .031 .783 .886 .834 .026 169.0 225.8 .883 .031 .782 .886 .846 .025 169.0 225.8 .869 .029 .796 .896 .775 .030 169.0 225.8 .906 .038 .716 .835 150 Table B.2.10 Sampling errors: Bicol sampl% Philippines 1993 Value Variable (R) Number of cases Standard Un- Weight- Design Relative Confidence limits error weighted ed effect error (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .280 .039 849.0 804.9 2.510 .138 .203 .358 With secondary education or higher .548 .032 849.0 804.9 1.883 .059 .483 .612 Currently in union .687 Married before age 20 .427 Had first sexual intercourse before 18 .228 .018 849.0 804.9 1.149 .027 .650 .723 .026 703.0 666.5 1.398 .061 .375 .479 .023 703.0 666.5 1.470 .102 .181 .274 Children ever born 3.190 .131 849.0 804.9 1.219 .041 2.928 3.451 Children ever born to women over 40 6.145 .257 173.0 164.0 1.082 .042 5.630 6.659 Children surviving 2.896 .115 849.0 804.9 1.201 .040 2.667 3.126 Know any method Know any modem method Know source for modem method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment .990 .005 583.0 552.7 1.199 .005 .980 .000 .988 .005 583.0 552.7 1.173 .005 .977 .999 .952 .008 583.0 552.7 .939 .009 .935 .969 .621 .021 583.0 552.7 1.042 .034 .579 .663 .364 .021 583.0 55Z7 1.072 .059 .32I .406 .161 .014 583.0 552.7 .912 .086 .133 .189 .065 .010 583.0 552.7 .982 .154 .045 .085 .010 .004 583.0 552.7 .941 .383 .002 .018 .009 .003 583.0 552.7 .833 .371 .002 .015 .069 .008 583.0 552.7 .796 .122 .052 .085 .075 .013 583.0 552.7 1.230 .178 .049 .102 .819 .049 94.0 89.1 1.235 .060 .721 .918 .605 .027 583.0 552.7 1.321 .044 .552 .659 .175 .019 583.0 552.7 1.200 .108 .137 .213 3.322 .050 829.0 786.0 1.123 .015 3.222 3.422 .642 .031 706.0 669.3 1.311 .048 .580 .703 .303 .031 706.0 669.3 1.431 .103 .241 .365 .154 .012 669.0 634.3 .836 .079 .130 .178 .048 .009 669.0 634.3 .982 .181 .031 .065 .291 .048 103.0 97.7 1.005 .164 .196 .387 .252 .047 103.0 97.7 1.042 .185 .159 .346 .329 .039 158.0 149.8 1.035 .118 .252 .407 .880 .024 158.0 149.8 .945 .028 .831 .929 .741 .042 158.0 149.8 1.190 .056 .657 .824 .728 .041 158.0 149.8 1.170 .057 .645 .811 .829 .026 158.0 149.8 .851 .031 .778 .880 .703 .045 158.0 149.8 1.226 .063 .613 .792 Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized 151 Table B.2.11 Sampling errors: Western Visayas sample, Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limks Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEF~I ') (SE~) R-2SE R+2SE Urban .483 .024 12(36.0 1215.9 1.684 .050 .435 .532 With secondary education or higher Currently in union Married before age 20 llad first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modern method Know source lot modern method Ever used any contraceptive method Currendy using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized ,666 .019 1206.0 1215.9 1,431 .029 .627 ,705 .580 .018 1206.0 1215.9 1.256 .031 .545 .616 .305 .019 945.0 952.7 1.256 .052 .267 .342 .166 .015 945.0 952.7 1.240 .090 .136 .196 2.334 5.168 2.167 .102 1206.0 1215.9 1.262 .044 2.131 2.537 .240 226.0 227.9 1.087 .046 4.688 5,649 .091 12~6.0 1215.9 1.231 .042 1.985 2.348 .991 .005 700.0 705.7 1.534 .005 .981 1.002 .991 .005 700.0 705.7 1.534 .005 .981 1.002 .977 .007 700.0 705.7 1.209 .007 .963 .991 .610 .020 700.0 705.7 1.088 .033 .570 .650 .397 .023 700.0 705.7 1.219 .057 .352 .442 .234 .018 700.0 705.7 1.130 .077 .198 .270 .097 .011 700.0 705.7 1.016 .117 .074 .120 .016 .004 700.0 705.7 .909 .272 .007 .024 .010 ,004 700.0 705.7 .977 .368 .003 .017 ,099 .016 700.0 705.7 1.389 .159 .067 .130 A0] .013 700.0 705,7 1.172 .132 ,075 ,128 .738 .054 164.0 165.3 1.581 .074 .629 .847 .560 .017 700.0 705.7 .928 .031 .525 .595 .154 .012 700.0 705.7 ~873 .077 .130 .178 3.155 .050 1170.0 1179.6 1.233 .016 3.054 3.255 .702 .026 732.0 738.0 1.239 .037 .650 .754 .482 .038 732.0 738.0 1.621 .078 .407 .558 .118 .013 696.0 701.7 .952 .109 .092 .143 .022 .006 696.0 701.7 1.113 .282 .009 .034 .293 .053 8Z0 82.7 .921 .182 .186 .399 .280 .059 82.0 82.7 1.049 .211 .162 .399 .609 .047 128.0 129.0 1.074 .077 .516 .703 .898 .024 128.0 129.0 .894 .027 .851 .946 .828 .043 128.0 129.0 1.235 .052 .743 .914 .820 .042 128.0 129.0 1.193 .051 .736 .904 .805 .038 128.0 129.0 1.041 .047 .729 .880 .742 .042 128.0 129.0 1.061 .057 ,658 .826 152 Table 11.2.12 Sampling errors: Central Visayas sample r philippines 1993 Number of cases Standard Un- Weight- Design Reiative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (gE~) R-2.SE R+2SE Urban .555 .031 1165.0 I120.7 2.118 .056 .4,94 .617 With secondary education or higher Currently in union Married before age 20 llad first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modem method Know source for modern method Ever used any contraceptive method Currentiy using any method Currendy using a modern method Currently using pill Currently using IUD Currently using condom Currently using fenude sterilization Cutrenlly using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth llad diarrhea in last 24 hours I lad diarrhea in last 2 weeks Received ORS treatment Received medical treatment llaving health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immuniT.ed. ,552 .022 1165.0 1120,7 1.519 ,040 .508 ,596 .626 .017 1165.0 1120.7 1.208 .027 .591 .660 .362 .020 943.0 907.2 1.276 .055 .322 .402 .224 .018 943.0 907.2 1.331 .081 .188 .260 2.454 5.043 2.287 .104 1165.0 1120.7 1.288 .042 2.247 2.661 .231 234.0 225.1 1.094 .046 4.582 5.504 .090 1165.0 1120.7 1.204 .039 2.107 2.466 .997 .002 729.0 701.3 .991 .002 .993 1.001 .996 .002 729.0 701.3 .984 .002 .991 1.001 .959 .009 729.0 701.3 1.172 .009 .942 .976 .697 .015 729.0 701.3 .895 .022 .666 .727 .461 .018 729.0 701.3 .966 .039 .425 .497 .288 .020 729.0 701.3 1.165 .068 .249 .327 .096 .012 729.0 701.3 1.089 .124 .072 .120 .047 .010 729.0 701.3 1.260 .211 .027 .066 .016 .004 729.0 701.3 .944 .270 .008 .025 .115 .014 729.0 701.3 1.154 .119 .088 .143 .088 ,010 729.0 701,3 +949 ,113 +068 ,108 .671 .034 210.0 202.0 1.047 .051 .603 .739 .543 .022 729.0 701.3 1.170 .040 .500 .586 .198 .014 729.0 701.3 .963 .072 .169 .226 3.051 .048 1156.0 1112.1 1.243 .016 2.954 3.148 .697 .025 75~0 721.5 1.139 .035 .648 .746 ,512 .043 750.0 721.5 1.814 .084 .426 .598 .047 .012 724.0 696.5 1.414 .266 .022 .072 .006 .003 724.0 696.5 1.001 .496 .000 .011 .235 .073 34.0 32.7 .965 .312 .089 .382 .412 .099 34.0 32.7 .996 .240 .214 .609 .376 .042 157.0 151.0 1.070 .112 .291 .460 .924 .021 157.0 151.0 .985 .023 .882 .965 .834 .027 157.0 151.0 .894 .032 .781 .888 .828 .025 157.0 151.0 .820 .030 .778 .878 .809 .029 157.0 151.0 .936 .036 .750 .868 .764 .035 157,0 151.0 1.035 +046 .694 .835 153 Table B.2.13 Sampling errors: Eastern Visayas sample r Philippines 1993 Number of cases Standard Un- Weight- Design Relaave Conlldence limits Value error weighted ed effecl error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .465 .022 802.0 645.1 1.234 .047 .422 .509 With secondary education or higher Currently in union Married before age 20 llad first sexual intercourse before 18 Children ever bona Children ever born to women over 40 Children surviving Know any method Know any modern method Know source for modem method Ever used any contraceptive method Cun-entiy using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth ltad diarrhea in last 24 hours I lad diarrhea in last 2 weeks Received ORS treatment Received medical treatment I laving health eaxd Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized ,607 ,024 802,0 645,1 1,374 ,039 ,560 ,655 .625 .022 802.0 645.1 1.266 .035 .581 .668 .423 .031 619.0 497.9 1.572 .074 .361 .486 .233 .027 619.0 497.9 1.598 .117 .178 .287 2.713 5.699 2.410 .096 802.0 645.1 .926 - .035 2.521 2.906 .288 156.0 125.5 1.127 .050 5.123 6.274 .086 802.0 645.1 .967- .036 2.239 2.582 .958 .009 501.0 403.0 1,010 .009 .940 .976 .954 .010 501.0 403.0 1.098 .011 .934 .975 .816 .031 501.0 403.0 1.769 .038 .755 .878 .543 .033 501.0 403.0 1.465 .060 .478 .608 .359 .029 501.0 403.0 1.334 .080 .302 .417 .182 .018 501.0 403.0 1.044 .099 .146 .218 .060 .012 501.0 403.0 1.094 .194 .037 .083 .018 .007 501.0 403.0 1.217 .402 .004 .032 .002 .002 501.0 403.0 .996 .996 .002 .006 .102 .014 501.0 403.0 1.012 .134 .074 .129 .098 .024 501.0 403.0 1.782 .242 .050 .145 .813 .019 91.0 73.2 .467 .024 .775 .852 .603 .021 501.0 403.0 .973 .035 .560 .645 .162 .014 501.0 403.0 .874 .089 .133 .190 3.096 .049 784.0 630.6 1.017 .016 2.998 3.194 .665 .033 543.0 436.8 1.245 .050 .598 .731 .324 .047 543.0 436.8 1.821 .145 .230 .418 .107 .016 516.0 415.0 1.075 .154 .074 .139 .019 .005 516.0 415.0 .879 .276 .009 .030 .436 .066 55.0 44.2 .879 .151 .305 .568 .418 .062 55.0 44.2 .809 .148 .295 .542 .340 .037 94.0 75.6 .766 .110 .266 .415 .926 .032 94.0 75.6 1.183 .035 .861 .990 .830 .034 94.0 75.6 .871 .041 .762 .897 .819 .035 94.0 75.6 .875 .042 .750 .889 .851 .038 94,0 75.6 1.037 .045 .775 .927 .755 ,039 94.0 75,6 .884 ,052 ,677 ,834 154 Table B.2.14 Sampling errors: Western Mindanao sample T Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .361 .034 945.0 728,8 2.176 .094 .293 .429 With secondary education or higher Currently in union Married before age 20 Had first sexual in~rcourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modem method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Cun'ently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours lied diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .506 .029 945.0 728.8 1.787 .057 .448 .564 .666 .021 945.0 728.8 1.368 .032 .624 .708 .449 .025 769.0 593.1 1.372 .055 .399 .498 .270 .019 769.0 593.1 1.157 .069 .233 .308 2.764 .106 945.0 728.8 1.148 .038 2.552 2.976 5.462 .293 182.0 140.4 1.247 .054 4.876 6.047 2.499 .090 945.0 728.8 1.093 .036 2.320 2.679 .803 .035 629.0 485.1 2.177 .043 .734 .872 .792 .037 629.0 485.1 2.305 .047 .717 .866 .677 .044 629.0 485.1 2.355 .065 .589 .765 .429 .031 629.0 485.1 1.545 .071 .368 .490 .285 .025 629.0 485.1 1.385 .088 .235 .334 .167 .022 629.0 485.1 1.485 .132 .123 .211 .087 .018 629.0 485.1 1.586 .205 .052 .123 .017 .007 629.0 485.1 1.273 .381 .004 .031 .002 .002 629.0 485.1 .979 .979 .002 .005 .059 .010 629.0 485.1 1.081 .173 .039 .079 .073 .010 629.0 485.1 .935 .133 .054 .093 .914 .025 105.0 81.0 .917 .028 .864 .965 .463 .027 629.0 485.1 1.363 .059 .408 .517 .231 .015 629.0 485.1 .900 .066 .200 .261 3.672 .092 922.0 711.1 1.406 .025 3.489 3.856 .635 .045 636.0 490.5 1.777 .071 .545 .726 .333 .038 636.0 490.5 1.581 .115 .256 .410 .094 .013 605.0 466.6 1.005 .134 .069 .119 .050 .007 605.0 466.6 .831 .150 .035 .064 .123 .056 57.0 44.0 1.264 .453 .012 .234 .193 .054 57.0 44.0 1.008 .279 .085 .301 .403 .056 129.0 99.5 1.300 .140 .290 .516 .829 .043 129.0 99.5 1.289 .052 .744 .915 .752 .071 129.0 99.5 1,849 .094 .611 .893 .729 .057 129.0 99.5 1.461 .079 .614 .843 .760 .055 129.0 99.5 1.452 .072 .650 .869 ,698 .065 129.0 99.5 1.606 .093 .567 .828 155 Table B.2.15 Sampling errors: Northern Mindanao sample~ Philippines 1993 Number of eases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE~) R-2SE R+2SE Urban .463 .045 996.0 793.9 2.852 .097 .373 .553 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever bern Children ever bern to women over 40 Children surviving Know any method Know any modem method Know source for modem method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Cumently using IUD Currently using condom Currendy using female sterilization Currendy using periodic abstinence Public source user Want no more children Want to delay next birth at le~t 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .638 .029 996.0 793.9 1.884 .045 .580 .695 .638 .020 996.0 793.9 1.304 .031 .598 .677 .434 .020 779.0 621.0 1.118 .046 .394 .474 .228 .016 779.0 621.0 1.033 .068 .197 .260 2.656 .153 996.0 793.9 1.661 .058 2.350 2.962 5.788 .261 165.0 131.5 1.074 .045 5.267 6.309 2.465 .127 996.0 793.9 1.509 .051 2.211 2.718 .998 .002 635.0 506.2 .971 .002 .995 1.001 .998 .002 635.0 506.2 .971 .002 .995 1.001 .946 .013 635.0 506.2 1.444 .014 .921 .972 .710 .026 635.0 506.2 1.426 .036 .659 .762 .493 .023 635.0 506.2 1.156 .047 .447 .539 .313 .025 635.0 506,2 1.361 .080 .263 .364 .123 .016 635.0 506.2 1.242 .132 .090 .155 .091 .012 635.0 506.2 1.075 .135 .067 .116 .014 .007 635.0 506.2 1.597 .529 .001 .029 .082 .013 635.0 506.2 1.150 .153 .057 .107 .132 .013 635.0 506.2 .959 .098 .106 .158 .784 .036 199.0 158.6 1.246 .046 .711 .857 .589 .024 635.0 506.2 1.211 .040 .542 .636 .197 .019 635.0 506.2 1.184 .095 .159 .234 3.099 .055 974.0 776.4 1.295 .018 2.989 3.208 .745 .023 690.0 550.0 1.154 .031 .699 .791 .384 .039 690.0 55~0 1.703 .103 .305 .463 .100 .019 657.0 523.7 1.433 .188 .063 .138 .030 .008 657.0 523.7 1.146 .273 .014 .047 .258 .049 66.0 52.6 .804 .190 .160 .356 .424 .063 66.0 52.6 .888 .148 .299 .550 .394 .039 137.0 109.2 .935 .100 .315 .473 .956 .017 137.0 109.2 .954 .017 .923 .990 .796 .038 137.0 109.2 1.105 .048 .719 .872 .788 .042 137.0 109.2 1.201 .053 .704 .872 .912 .022 137.0 109.2 .893 .024 .869 .956 .759 .041 137.0 109.2 1.121 .054 .677 .841 156 Table B.2.16 Sampling errors: Southern Mindanao sample~ Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .487 .021 1205.0 1094.9 1.452 .043 .445 .529 With secondary education or higher Currently in union Married before age 20 Had first sexual intercourse before 18 Children ever bern Children ever bern to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at le~t 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth Had diarrhea in last 24 hours Had diarrhea in last 2 weeks Received ORS treatment Received medical treatment tlaving health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .641 .025 1205.0 1094.9 1.773 .038 .592 .690 .618 .016 1205.0 1094.9 1.115 .025 .587 .649 .401 .027 935.0 849.5 1.703 .068 .346 .456 .234 .022 935.0 849.5 1.615 .096 .189 .279 2.432 5.428 2.211 • 107 1205.0 1094.9 1.339 .044 2.218 2.645 ,325 201.0 182.6 1.436 .060 4.779 6.077 .092 1205.0 1094.9 1.296 .042 2.026 2.395 • 973 .016 745.0 676.9 2.651 .016 .942 1.005 .965 .019 745.0 676.9 2.782 .019 .928 1.003 .923 .027 745.0 676.9 2.792 .029 .869 .978 • 681 .030 745.0 676.9 1.765 .044 .620 .741 .459 .026 745.0 676.9 1.446 .058 .406 .512 .271 .019 745.0 676.9 1.146 .069 .234 .308 • 085 .012 745.0 676.9 1.131 .136 .061 .108 .055 .010 745.0 676.9 1.208 .184 .035 .075 .012 .003 745.0 676.9 .810 .268 .006 .019 .110 .011 745.0 676.9 .982 .102 .088 .133 .113 .014 745.0 676.9 1.240 .128 .084 .142 .668 .038 202.0 183.5 1.151 .057 .592 .745 .517 .019 745.0 676.9 1.013 .036 .480 .554 .165 .015 745.0 676.9 1.112 .092 .135 .195 3.094 .053 1171.0 1064.0 1.380 .017 2.989 3.199 .662 .033 733.0 666.0 1.537 .050 .595 .728 • 364 .028 733.0 666.0 1.229 .077 .308 .420 • 107 .013 701.0 636.9 1.121 .125 .080 .134 .021 ,005 701,0 636.9 .884 .224 .012 .031 .187 .046 75.0 68.1 .953 .245 .095 .278 .293 .048 75.0 68.1 .865 .163 .198 .389 .507 .049 144.0 130.8 1.180 .097 .409 .605 • 917 .028 144.0 130.8 1.209 .030 .861 .972 • 847 .034 144,0 130.8 1.123 .040 .780 .915 • 833 .032 144.0 130.8 1.016 .038 .770 .896 .868 .031 144.0 130.8 1.111 .036 .805 .931 .799 .035 144.0 130.8 1.037 .043 .729 .868 157 Table B.2.17 Sampling errors: Central Mindanao sample T Philippines 1993 Number of cases Standard Un- Weight- Design Relative Confidence limits Value error weighted ed effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban .455 .035 943.0 707.3 2.133 .076 ,386 .524 With secondary education or higher Currently in union Married before age 20 llad first sexual intercourse before 18 Children ever born Children ever born to women over 40 Children surviving Know any method Know any modern method Know source for modern method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using condom Currently using female sterilization Currently using periodic abstinence Public source user Want no more children Want to delay next birth at least 2 years Ideal number of children Mothers received tetanus injection Received medical care at birth llad diarrhea in last 24 hours llad diarrhea in last 2 weeks Received ORS treatment Received medical treatment llaving health card Received BCG vaccination Received DPT vaccanafon (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized .557 .027 943.0 707.3 1.646 .048 .503 .610 .666 .015 943.0 707.3 .960 .022 .636 .695 .461 .018 738.0 553.6 .959 .038 .426 .496 .274 .015 738.0 553.6 .933 .056 .243 .304 2.936 .109 943.0 707.3 1.103 .037 2.718 3.154 6.085 .251 176.0 132.0 1.062 .041 5.584 6.586 2.654 .090 943.0 707.3 1.024 .034 2.474 2.834 .846 .027 628.0 471.0 1.888 .032 .791 .900 .839 .027 628.0 471.0 1.858 .032 .785 .894 .811 .028 628,0 471.0 1.759 .034 .755 .866 .473 .028 628.0 471.0 1.395 .059 .417 .529 .325 .024 628.0 471.0 1.307 .075 .276 .374 .204 .020 628.0 471.0 1.239 .098 .164 .244 .067 .010 628.0 471.0 .997 .149 .047 .087 .073 .017 628.0 471.0 1.613 .229 .040 .107 .000 .000 628.0 471.0 .000 .000 .(300 .000 .062 .012 628.0 471.0 1.240 .192 .038 .086 .084 .013 628.0 471.0 1.164 .153 .059 .110 .781 .046 128.0 96.0 1.251 .059 .689 .873 .487 .016 628.0 471.0 .822 .034 .454 .520 .234 .013 628.0 471.0 .777 .056 .208 .260 4.155 .125 914.0 685.6 1.691 .030 3.905 4.406 .568 .037 655.0 491.3 1.428 .065 .494 .642 .322 .055 655.0 491.3 2,248 .170 .213 .432 .111 .011 623.0 467.3 .796 .097 .089 .132 .014 .005 623.0 467.3 .934 .338 .005 .024 .232 .059 69.0 51.8 1.123 .254 .114 .350 .232 .058 69.0 51.8 1.104 .249 .116 .348 .267 .035 131.0 98.3 .912 .132 .197 .338 .802 .036 131.0 98.3 1.026 .045 .730 .873 .718 ,031 131.0 98.3 .775 .043 .657 .779 .710 .033 131.0 98.3 .834 .047 .644 .776 .718 .033 131.0 98,3 .829 .045 .652 .783 .672 .033 131.0 98.3 .814 .050 .605 .739 158 APPENDIX C QUALITY OF THE DATA: NONSAMPLING ERRORS APPENDIX C QUALITY OF THE DATA: NONSAMPLING ERRORS While Appendix B provides sampling errors for selected variables presented in the report, this appendix is presented to provide data users an initial overview of the data quality. For this purpose, misreporting of ages, respondent's recall problems and other problems encountered during data collection are investigated in Appendix C. Presented in Table C. 1 is the distilbution by single years of age o f the household population. Overall, slight heaping on ages ending with 0 and 5 is detected throughout all ages for both sexes. Errors are particularly notable in the age reporting of females at ages 15 and 49 years--the lower and upper limits of eligibility for individual interview. The age ratios at 15 for women is 0.92, while for men it is 1.02. At age 49, the ratios are 1.42 and 1.36 for women and men, respectively, demonstrating that heaping is detected for both sexes. In Table C.2, household weights are applied to the age distribution of women reported in the individual interview, to investigate if there is a bias in the age reporting in the individual woman's interview. The table shows the expected pattern of declining percentage as age increases, and that there is virtually no difference between the age distribution of women recorded in the household schedule and those interviewed with the individual questionnaire, indicating the absence of a bias. This table also shows that response rates vary slightly across the age of the respondents. Information on the completeness of reporting in connection with a set of important variables is provided in Table C.3. With the exception of information on child's size at birth, the percentage of cases with missing information is extraordinarily low, and information on dating of events seem to be complete. According to Table C.4, there is a slight heaping in the reported total number of births in 1990 and the number of children still living. Information on month and year of birth is available for virtually all children. Birth dates of dead children are less complete than for surviving children; nevertheless, this information is known for 95 percent of children, a much higher rate than that found in other DHS surveys, e.g., Malawi 88 percent and Indonesia less than 50 percent. The overall sex ratio at birth for all births is 107, while from year to year there are fluctuations without any indication of bias. Sex ratio for dead children is much higher than for surviving children, indicating higher mortality among male children. The calendar ratios show that there was a transference of births from 1988 to the earlier and later years. The ratio of birlhs in 1988 to the average of the two adjoining years is 0.95, while the ratios for 1987 and 1989 are 1.02 and 1.03, respectively. Compared to the ratio in other DHS surveys, the transference is not as serious (e.g., 0.92 in Peru; 0.90 in Indonesia and 0.77 in Nigeria). The percentage of early neonatal deaths (deaths within the first 7 days afterbirth) among all neonatal deaths (deaths within the first month of birth) increases as infant mortality decreases (Table C.5), The same can be deduced from the increasing proportion of neonatal among infant deaths shown in Table C.6, although the pattern is not as clear. It should also be noted that heaping at age 12 months which is detected in the more distant past (5 years or more prior to the survey) seems to have disappeared in the most recent period, demonstrating that reporting of age at death is improving. 161 Table C.I Household age distribution Single-year age distribution of the de jure household population by sex (weighted), Philippines 1993 Males Females Males Females Age Number Percent Number Percent Age Number Percent Number Percent <1 969 2.9 845 2.5 36 386 1.2 411 1.2 1 982 2.9 889 2.7 37 388 1.2 385 1.2 2 972 2.9 963 2.9 38 383 1.2 431 1.3 3 932 2.8 915 2.7 39 323 1.0 347 1.0 4 943 2.8 869 2.6 40 393 1.2 387 1.2 5 996 3.0 880 2.6 41 246 0.7 285 0.9 6 937 2.8 894 2.7 42 377 1.1 336 1.0 7 919 2.8 837 2.5 43 304 0.9 343 1.0 8 940 2.8 878 2.6 44 251 0.8 285 0.9 9 864 2.6 839 2.5 45 293 0.9 292 0.9 10 924 2.8 887 2.7 46 236 0.7 240 0.7 11 812 2.4 794 2.4 47 270 0.8 236 0.7 12 908 2.7 947 2.8 48 257 0.8 247 0.7 13 904 2.7 885 2.7 49 189 0.6 177 0.5 14 758 2.3 838 2.5 50 244 0.7 275 0.8 15 788 2.4 714 2.1 51 170 0.5 210 0.6 16 787 2.4 714 2.1 52 212 0.6 295 0.9 17 735 2.2 665 2.0 53 215 0.6 254 0.8 18 672 2.0 646 1.9 54 174 0.5 222 0.7 19 618 1.9 594 1.8 55 223 0.7 240 0.7 20 610 1.8 588 1.8 56 188 0.6 204 0.6 21 598 1.8 504 1.5 57 170 0.5 157 0.5 22 609 1.8 551 1.7 58 164 0.5 212 0.6 23 549 1.6 561 1.7 59 136 0.4 146 0.4 24 530 1.6 559 1.7 60 244 0.7 239 0.7 25 531 1.6 540 1.6 61 115 0.3 92 0.3 26 455 1.4 489 1.5 62 126 0.4 136 0.4 27 495 1.5 517 1.6 63 131 0.4 158 0.5 28 517 1.6 534 1.6 64 93 0.3 114 0.3 29 439 1.3 472 1.4 65 129 0.4 170 0.5 30 474 1.4 490 1.5 66 100 0.3 98 0.3 31 377 1.1 424 1.3 67 70 0.2 92 0.3 32 471 1.4 485 1.5 68 87 0.3 110 0.3 33 398 1.2 465 1.4 69 75 0.2 91 0.3 34 364 1.1 399 1.2 70+ 721 2.2 881 2.6 35 448 1.3 406 1.2 Don't know/ missing 9 0.0 13 0.0 Total 33319 100.0 33283 100.0 Note: The de jure population includes all usual residents. 162 Table C.2 Age distlibufion of eligible and interviewed women Percent distribution in five-year age groups of the de jure household population of women age 10-54 and of interviewed women age 15-49, and percentage of eligible women who were interviewed (weighted), Philippines 1993 Household population of women age 15-49 Interviewed women age 15-49 Percentage interviewed Age Number Percent Number Percent (weighted) 10-14 4351 NA NA NA NA 15-19 3333 21.2 3266 21.2 98.0 20-24 2762 17.6 2705 17.5 97.9 25-29 2552 16.2 2503 16.2 98.1 30-34 2262 14.4 2232 14.5 98.7 35-39 1979 12.6 1949 12.6 98.5 40-44 1636 10.4 1605 10.4 98.1 45-49 1192 7.6 1165 7.6 97.7 50-54 1255 NA NA NA 15-49 15717 NA 15425 NA 98.t Note: The de jure population includes all residents. NA = Not applicable Table C.3 Completeness of reporting Percentage of observations missing information for selected demographic and health questions (weighted), Philippines 1993 Percentage Number missing of Subject Reference group information cases Birth date Births in last 15 years Month only 0.8 24781 Month and year 0.1 24781 Age at death Deaths to births in lost 15 years 0.0 1651 Age/date at first union t Ever-married women 0.1 9511 Respondent's education All woman 0.3 15029 Child's size at birth Births in l~t 59 months 39.5 8859 Diarrhea in last 2 weeks Living children age 0-59 months 0.5 8512 IBoth year and age missing 163 Table C.4 Births by calendar year since birth Distribution of births by calendar years since birth for l iving (L), dead (D), and all (F) chi ldren, according to reporting completeness, sex ratio at birth, and ratio of births by calendar year, Phil ippines 1993 Percentage with Sex ratio Number of births complete birth date t at birth 2 Calendar ratio 3 Male Female Year L D T L D T L D T L D T L D T L D T 93 1764 80 1844 99.9 100.0 99.9 98.6 121.5 99.5 - - - 876 44 920 888 36 924 92 1640 74 1714 99.9 96.1 99.7 114.4 138.5 115.3 96.8 82.5 96.1 875 43 918 765 31 796 91 1625 99 1724 99.9 99.1 99.8 104.8 140.0 106.6 98.0 100.4 98.1 832 58 889 793 41 835 90 1677 123 1800 98.1 91.2 97.7 103.9 128.0 105.4 103.5 108.0 103.8 855 69 924 822 54 876 89 1615 129 1744 99.1 95.2 98.8 108.9 136.8 110.7 102.1 100.8 102.0 842 75 917 773 54 828 88 1489 133 1622 99.0 97.7 98.9 105.9 108.4 106.1 94.6 102.4 95.2 766 69 835 723 64 787 87 1532 131 1662 98.3 96.2 98.1 110.2 125.6 111.3 103.9 97.0 103.3 803 73 876 729 58 786 86 1460 136 1596 98.4 96,4 98.2 95,6 170.3 100.3 98.1 92.3 97.5 713 86 799 746 50 797 85 1445 165 1610 99.2 94.9 98.7 109.1 1208 110.2 103.0 129.9 105.2 754 90 844 691 75 766 84 1348 117 1465 98.1 94.9 978 99.7 113.9 1008 673 63 735 675 55 730 89-93 8322 505 8827 99.4 95.9 99.2 105.9 132.9 107,3 4280 288 4568 4042 217 4259 84-88 7273 682 7955 98.6 96.0 98.4 104.1 126.1 105.8 3709 380 4090 3564 302 3866 79-83 6062 580 6642 98.6 93.0 98.1 104.4 140.6 107.1 3096 339 3435 2966 241 3207 74-78 3830 396 4226 98.6 95.3 98.3 109.8 132.7 111.7 2004 226 2230 1826 170 1996 <74 2336 294 2629 98.7 95.2 98.3 98.4 125.6 101.1 1159 163 1322 1177 130 1307 All 27823 2457 30280 98.8 95.0 98.5 105.0 131.8 106.9 14248 1397 15645 13575 1060 14635 NA = Not applicable lBoth year and month of birth given 2 * (BJBI) 100, where B , and B! are the numbers of male and female births, respectively 3[2Bfl(B, t+B,+t)]* 100, where B, is the number of births in calendar year x 164 Table C.5 Reporting of age at death in days Distribution of reported deaths under 1 month of age by age at death in days and the percentage of neonatal deaths reported to occur at ages 0-6 days, for five-year periods of birth preceding the survey, Philippines 1993 Number of years preceding the survey Age at death Total (in days) 0-4 5-9 10-14 15-19 0-19 <1 34 44 48 24 150 1 38 31 44 28 142 2 19 9 8 7 43 3 5 17 19 11 52 4 8 5 8 3 25 5 11 5 7 7 30 6 2 6 2 1 I1 7 20 14 29 20 82 8 i 1 4 0 6 9 0 4 1 5 10 10 1 6 1 5 13 11 3 1 0 2 6 12 0 1 3 1 5 13 1 2 1 0 4 14 4 3 4 0 10 15 0 2 l 0 2 17 0 2 1 0 3 18 1 0 1 0 2 19 2 0 0 0 2 20 0 2 2 0 3 21 1 3 0 2 6 22 0 0 l 0 1 23 0 0 1 0 1 26 0 0 0 1 1 27 1 0 0 1 3 28 2 1 0 0 2 30 1 0 1 3 5 31+ 1 2 0 0 2 Total 0-30 155 157 185 122 620 Percent early neonatal t 75.2 75.0 73.5 67.2 73.1 1(0-6 days/0-30 days) * 100 165 Table C.6 Reporting of age at death in months Distribution of reported deaths under 2 years of age by age at death in months and the percentage of infant deaths reported to occur at ages under one month, for five-year periods of bkth preceding the survey, Philippines 1993 Number of yeats preceding the survey Age at death Total (in months) 0-4 5-9 10-14 15-19 0-19 <l a 155 159 186 124 624 I 25 22 31 14 91 2 11 28 28 13 8O 3 9 21 21 17 68 4 9 11 9 3 31 5 12 14 22 8 57 6 6 15 17 7 44 7 9 18 5 17 49 8 14 25 19 11 69 9 12 30 19 16 77 10 5 8 10 3 26 11 8 14 12 4 39 12 4 16 12 10 42 13 4 7 4 2 16 14 0 3 3 2 9 15 3 4 1 6 14 16 0 0 2 1 3 17 1 3 0 0 3 18 1 3 5 4 13 19 1 1 0 1 3 20 1 ! 1 1 3 2l 1 2 0 0 3 22 1 0 0 0 1 23 0 2 0 1 2 24+ 0 1 2 0 4 lyear 27 53 58 52 190 Total 0-11 275 363 377 238 1253 Percent neonatal b 56.3 43.8 49.2 52.2 49.8 alncludes deaths under 1 month reported in days b(Under 1 month/under 1 year) * 100 166 Table C.7 and C.8 are presented to show the superior quality of data used in the calculation of maternal mortality using the sisterhood method. Table C.7 shows that the distribution of respondents and their siblings by year of birth is very similar;, in fact, the median year of birth fails on the same year, 1964, indicating that there is no systematic omission and misreporting of date of birth. The evolution of the mean sibship size since 1940s is shown in Table C.8. Sibship size declines from over 7 per respondent in the 1950s to slightly more than 6 per respondents 20 years later. The decline in sibship size coincides with the fertility trend in the Philippines. Oflhe 88,607 siblings listed in the survey, sufficient information on sex, survivorship status, and age at death was available for 87,515 siblings, among who, 1,092 were females and have died at age 10 or over. Information on whether the sibling has ever been pregnant was missing for 331 women, or 30 percent of women with potential risks of matemal death. These women were distributed proportionately according to the composition of women with known information on ever pregnant and by age group. Table C.7 Percent distribution of respondents and siblings by year of birth, Philippines 1993 Year of birth Respondent Siblings Before 1945 2.0 7.5 1945-49 8.6 6.7 1950-54 11.2 10.4 1955-59 13.3 13.4 1960-64 15.0 15.3 1965-69 17.1 15.5 1970-74 17.8 13.1 1975 or later 15.0 18.1 Total 100.0 100.0 Lower range 1943 1913 Upper range 1978 1993 Median 1964 1964 Number of cases 15029 87887 Table C.8 Mean sibship size and sex ratio of births, Philippines 1993 Scx Mean ratio sibship at Year of birth size birth 1940s 7.1 101.1 1950-54 7.3 102.8 1955-59 7.4 102.9 1960-64 7.3 104.7 1965-69 6.8 104.2 1970-74 6.4 103.9 1975-77 6.1 105.5 Total 6.85 104.2 167 APPENDIX D PERSONS INVOLVED IN THE 1993 NATIONAL DEMOGRAPHIC SURVEY 1993 National Demographic Survey Project 1993 National Demographic Survey Project Steering Committee Technical Committee DR. JAIME GALVEZ TAN Undersecretary Department of Health MS. ERLINDA CAI~NES Assistant Director National Economic and Development Authority DR. ALEJANDRO HERRIN Professor School of Economics University of the Philippines DR. RODOLFO FLORENTINO Executive Director Food and Nutrition Research Institute DR. CORAZON RAYMUNDO Dean University of the Philippines Population Institute MS. CECILE JOAQUIN-YASAY Director Population Commission MR. TOMAS P. AFRICA Administrator National Statistics Office MS. LINA CASTRO National Statistical Coordination Board DR. AURORA E. PEREZ University of the Philippines Population Institute DR. JOSEPHINE CABIGON University of the Philippines Population Institute MS. GRACE VILLAVIEJA Food and Nutrition Research Institute MS. GRACE DINO Population Commission DR. DIVINA HEY-GONZALES Department of Health MS. MARITESS LOGARTO/LENI MAGALIT National Economic and Development Authority MS. NELIA R. MARQUEZ Deputy Administrator National Statistics Office DR. LUISA T. ENGRACIA Director, Household Survey Division National Statistics Office DR. ROMULO VIROLA Secretary General National Statistical Coordination Board National Statistics Office MS. ROSALINDA P. BAUTISTA MS. ELIZABETH GO MS. BENEDICTA YABUT MS. MINERVA ELOISA ESQUIVIAS MS. TITA TABIJE 171 1993 National Demographic Survey Staff Task Force Dra. Isabel Acquino Benedicta Yabut Edna Pineda Divina Graco Laluan Hazel Ricarte Josephine Quiambao Levitico Balajadia Marites Espinosa Lucita Flavier Tita Tabije Socrates Ramores Maribelle Baluyot Ma. Leah Magracia Minerva Eloosa Esquivias Estela de Guzman Jeremias Luis Dr. Aurora Perez Marichu Duka Field Workers Cordillera Administrative Region Region H - Cagayan Valley Team No. 1 Robert Tayawa (Team Supervisor) Eulalyn Dayoan (Field Editor) Michelle Acod Julieta Madiam Fatima Domondon Virginia Chokowen Yolanda Advincula Thelma Bentres Brigida BalutOc Region I - l locos Team No. 2 Jose Natividad (Team Supervisor) Rosalie Reyes (Field Editor) Yvonne Abenoja Jane Pamuspusan Mardy Barbosa Sonia Nicolas Guillermo Team No. 3 Carlito Caragan (Team Supervisor) Corina Roque (Field Edito0 Gloria Naraja Magdalena Taliao Sylvia de Guzman Belen Soriano Natalia Banta Team No. 4 Johnny Agustin (Team Supervisor) Cherita Ramos Angelina Callangan Merlita Abella Magdalena Aglibut Team No. 5 Tomas Domingo (Team Supervisor) Elenie Saddam (Field Editor) Rachel Anonas Dalife Cafelo Edna Casao Susana Guzman Region III - Central Luzon Team No. 6 Isidro Mariano (Team Supervisor) Cristina Lopez (Field Editor) Teodorica Puzon Agnes Borcena Remedios de Guzman Rowena Escoto Team No. 7 Rafael Gabriel (Team Supervisor) Elisa Rayo (Field Editor) Gracelyn Valmonte Merlyn Punzal Rosalinda P'lores Angelica Valeda 172 Team No. g Rey Fmdarina (Team Supervisor) Zenaida Noto (Field Editor) Perseveranda Rodriguez Cecilia Vega Liza Suarez Rosario Enriquez Region IV - Southern Tagalog Team No. 9 Carlito Tortes (Team Supervisor) Rosalinda Iranzo (Field Editor) Annelyn Agnila Vilma Glorios Cherrie Lagar Liza Valenfino Eriinda Caperina Region IV - Southern Luzon Team No. 10 Charlito Dapito (Team Supervisor) Baby Veronica Buhay-Mendoza (Field Editor) Maria Ramirez Norma Felia Elisa Alegria Mafia Asi Mafibel Panaligan Team No. 11 Emilio Salazar (Team Supervisor) Teresa Florin delos Reyes (Field Editor) Jocelyn Gerpacio Mafia Jesusa Garcia Norieta Grimaldo Team No. 12 Clemente Marapao (Team Supervisor) Marichu Heredero Sherly Valoroso Region V - Bicol Team No. 13 Celso Moral (Team Supervisor) Cynthia Balidoy (Field Editor) Alicia Rebosquillo Glena Lositano Erma Tuo Ligaya Ty Ligaya Docog Team No. 14 Salesio Orbon (Team Supervisor) Agnes Hemandez (Field Editor) Wilma Cristina Urquiza Ma. Soledad Cabanos Elma Macatangay Ma. Theresa Abriol Region VI - Western Visayas Team No. 15 Emesto Esmeralda (Team Supervisor) Lourdes Gonzales (Field Editor) Ma. Dulce Carpio Rocelyn Docto Salvacion Lemos Regina Sontat Mafilou Roxas Ma. Corazon Quijano Gloria Laurencio Team No. 16 Ildefonso Rollo (Team Supervisor) Helen Claur (Field Editor) Jasmin Baula Lucita Trajeras Lilita Vargas Mary Joy Tayo Merly Olis Myma Jamili Region VII - Central Visayas Team No. 17 Arcadio Regis (Team Supervisor) Priscilla Bautista (Field Editor) Epifania Hibaya Nimfa Aray Colita Montoya Jocelyn Vera Cruz Shired Miraflor Raelyn Grace Villasan Team No. 18 Rodrigo Puyot (Team Supervisor) Wenifreda Hayag (Held Editor) Fe Bascon Loma Chart Rossana Limbo Evelyn Casas Josephine Cachero Alicia Wong 173 Region VIII - Eastern Visayas Team No. 19 Romeo Layam (Team Supervisor) Lani Buerdon (Field Editor) Ma. Teresa Morante Ma. Rowena Capeda Jeannette Basibas Marissa Rosales Team No. 20 Custodio Saboran (Team Supervisor) Jocelyn Geraldo (Field Editor) Agnes Agner Dinah Santillan Panfila Salazar Emilinda Ricote Leonora Daga Region IX - Western Mindanao Team No. 21 Jalandoni Besas (Team Supervisor) Elnora Posadas (Field Editor) Vecky Otong Mei-mei Bisman Rose Bella Dolfinado Emma Ybanez Team No. 22 Isagani Templanza (Team Supervisor) Aida Tauto-an (Field Editor) Vilma Amoza Veneranda Bolicatin Susan Beliganio Myma Pabauya Grace Barrera Region X - Northern Mindanao Team No. 23 Eddie Nasol (Team Supervisor) Emma Sumalinog (Field Editor) Perlita Madjus Eva Cabotaje Donna Santander Elvie Blanco Adelina Indapan 174 Team No. 24 Julito Pilaf (Team Supervisor) Teresa Dayao (Field Editor) Isabel Piape Menchu Ojeda Loida Cabanlas Madelein Beja Carol Cantina Region XI - Southern M indanao Team No. 25 Rodulfo Estrella (Team Supervisor) Rhodora Grenien (Field Editor) Lily Eumague Leticia Baluran Judith Calida Charita Mahinay Cristita Madrista Mary Ann Lopez Team No. 26 Antonio Flores (Team Supervisor) Lydia Biala (Field Editor) Mary Sanie Alperto Dolores Berja Lilibeth Yntig Felipa Empleo Felicidad Orot Jenaliza Mundo Region XII - Central Mindanao Team No. 27 Lumangal Sahdulah (Team Supervisor) Ma. Liza Modequillo Amalia Bulan Sittie Hadjirasul Team No. 28 Edilberto Tabanay (Team Supervisor) Judema Angot (Field Editor) Bai Huddah Sandatu Nancy Paragas Jean Alang Felma Prudenciado Margie Mallo Shirley Trinidad Metropolitan Manila Team No. 29 Julius Estores (Team Supervisor) Cyd Cunanan (Field Editor) Priscilla Aguilar Agnes Mananes Elizabeth Quilban Cannelita Uranza Team No. 30 Yolanda Mantaring (Team Supervisor) Hilda Bagalihog (Field Editor) Glenda Hibaler Corazon Catapang Melissa Chart Nourin Dioneda Erlinda Quiling Adelfa Yeres Minerva Eloisa Esquivias (Over-all Supervisor) Ma. Leah C. Magracia Priscilla Bacus Estela de Guzman Maribelle Baluyot Edna Rapanot Josephine Quiambao" Teresita Tronco Gloria Velasco Gerry Labatorio Josefina Sevilla Velia Rendon Amalia Gonzales Elsie Ferrer Team No. 31 Naomi Guevarra (Team Supervisor) Belen Centena (Field Editor) Aida Bimanos Elnora Estalle Asuncion Falejo Luz Condes Data Entry and Processing Staff Wilma Sulit Alexis Pergis Myma Jenosa Arlene Anacion Cesar Cayaban Sonia Galope Geraldine Cadenas Carlito David Arleene Guillermo Marlyn Recupero Receipt and Control Amold Subierre Manual Processors Marcelina Parco Chedita Cueto Teodora Cortez Norma Abuan 175 APPENDIX E SURVEY QUESTIONNAIRES NDS FORM i Conf ident ia l i ty NSCB C learance Th is survey is author i zed by Commonwea l th Act No. 59 No .A0477-R011MS Al l in fo rmar t ion is s t r i c t ly conf ident ia l . Exp i res January 31, 1994 Repub l i c of the Ph i l iDDines NAT IONAL STAT IST ICAL O~F~CE 1993 NAT IONAL DEMOGRAPHIC SURVEY HOUSEHOLD SCHEDULE IDENTIF ICAT ION PROVINCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C ITY /MUNIC IPAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BARANGAY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CLUSTER NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . URBAN/RURAL (urban=l, rura l=2) . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSEHOLD CONTROL NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SAMPLE HOUSEHOLD SERIAL NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . ADDRESS I DATE INTERVIEWER'S NAME RESULT* NEXT VISIT: DATE T IME ii ::::::::::::::::::::::::::: ::::::::::::::::::::::::::: INTERVIEWER V IS ITS i 2 3 F INAL V IS IT * RESULT CODES: 1 COMPLETED NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT T IME OF V IS IT 3 ENT IRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD 4 POSTPONED 5 REFUSED 6 DWELL ING VACANT OR ADDRESS NOT A DWELL ING 7 DWELL ING DESTROYED 8 DWELL ING/HOUSEHOLD NOT FOUND 9 OTHER (SPECIFY) DAY MONTH YEAR NAME RESULT TOTAL NUMBER OF V IS ITS TOTAL IN HOUSEHOLD ~ - - TOTAL EL IG IBLE WOMEN L INE NO. OF RESP. TO HOUSE- HOLD SCHEDULE LANGUAGE OF QUEST IONNAIRE: C NAME DATE F IELD EDITED BY OFF ICE EDITED BY II KEYED BY KEYED BY VT- 179 HOL}~EHOLD ROSTER M~ ~ ~ld t{ka •Om~ In for l la t l~ about the people i~o US~laiLy l i ve in your household or ~11o are I t l y l t~ w i th yma nou, U~AL RESIOENTS AJ~O VISIT(~S RELATIQNeHIP F•*~4I Ly TO HEAD OF HOUSEHOLD* TYPE AND RELATIONSHIP RESIDENCE P ie••• g ive me the P4ae• = N~at i s the b~nat i s the Ooew Did I s o f the peraoccl 141o reLat iOnsh ip re la t ionsh ip (NAME) (NN4E) (NANE} ua~Lty L ive In your o f (MANE) to of (MARE) to usua l ly s leep ~ le hog=•hold and g~4sta the head of the head of L ive here or o f the hoe~ehoLd UhO the h(;~se- the f~ l i ty? hare? Last female? I teyad here L I lT n i~t# hold? n ight? • t&r t lng w i th the head ENTER F/LMILY o f the ho~eho ld . TYPE AND RELATIONSHIP CCOE* (1 ) I (2 ) I (3 ) I (4} I (B) (9 ) I (10) TYPE REL. YES NO YES NO N F 0, E • i _ _ = FT3 [-11T1. I I I ~ 1 ,o g | i i | m i I I I A~ Ho~ o ld i s (MANE) aa of h i s / her Last b i r thday? (11) IN YEARS FR M TICK HERE IF C,~T]MUATiON SHEET USED ~1 tOTAL NUHBER OF ELIGIBLE ~]4EN I [ [ JUS¢ to Nhe lu re that J have • CO~){ete l IST iNg , I have L i s ted - - peopLe. (5 ) Are there any o ther pera~such oseanatt ch i ld ren or tn fe~t• that we have not l i s ted? YES ~] ~ ENTER EACH NO ~' ] IN TABLE (6) Are there ~y o th•r peop le alto may not be members of your fEmi iy , such as domest ic servants , lodgers or YES ~] ~ ENTER EACH NO E~] f r lem~ ~e usuaL ly L ive here we have ~ot l i s ted? IN TABLE (7) DO you have any guests or te~qporary v i s i to rs s tGy lng YES ~ • ENTER EACH NO E~ hare, or anyor~e e l se who s ie~t here East n ight? ]N TABLE * COOER FCdR Q. ] RELATIONSHIP TO HEAD OF HOUSEHOLD/FAHILY: FAMILY TYPE: 01= HEAD 02 = U%FE OR HUSBARD O]= $oli ~ DAUGHTER ~= eGEI/DNJGHTER'IM-LAW 05• ~CHILD PARENT 07 m PARENT-IN-LAW BROIHER/SISTER OR 12= GRANDPARENT OR O = NO FAMILY NUCLEUS EROTHER/SIS~ER-IN-LAU GRANDPARENT-IN'LAW 1 • FIRST E/~41LY ~m UNCLE/AUNT OR UNCLE/ 13= ADOPTED/FOSTER CHILD ~ = SECi~4JD FMIILY AUNT'IN'LAW 14= NOT RELAted 3 = THIRD FANILY 10 m COUSIN/COIJSIN'IN'LAW 98; OK AND SO Fi~4iTH 11= NIECE/NEPHEW OR MIECE/NEPHEW'IN'LAW 180 AGED 6 YEARS O~ OLDER IF ATTEMDED ECHiX)L le (NAME)'s r4 tur l l mother s i l ve? HJrll (NAME) ewr been to school? I F YES, Idhat le the hi Ghmlt g rade/ynr campier ed?*" ( I ; ) YES NO DK 8 [DOCATIOM PAREXIAL SURVIVORSHIP AND RESIDEKCE FOR PERSONS LESS THAN 15 YEARS OLD * '~ IF AGED LESS THAN 25 YEARS Im (#~) I s t i L l in l cho~t? (12) (13) I YES KO ] [-i-] ' I , I I [--1--1 ' 1 E-- J -1 1 1 J-T-] ' ' [-[--] 1 1 j - j - ] 1 1 ] -~ 1 I ~ : 1 1 I t t CCOES FOR Q.12 GRADE/YEAR: IF ALIVE Is (NAk~E)~s natura l fa ther DOeS ( NAHE ) ' s &[ I re? mother l i ve in th i s household? IF YES: What i s her name? RECORD MOTHER'S LINE NUMBER (15) I (16) YES NO DK I I 1 2 8 I ELIGIBILITY i IF AL]VIE CIRCLE L%NE MIJ~4BER OF Does (NAJ4E)'S ~/Cil4l~N EL]- : fa ther L ive In GIBLE FOR th i s household? INDIVIDUAL IF YES: What iS INTERVIEW h is r~me? RECORD FATHER'S LINE NL,I~ER (17) _ (18) m 01 | ~-~ 0E 07 00= NO EDUCATICel 21" HIGH SCH~L YEAR 1 11a ELEI4ENTARY GRADE 1 22" H%GH SCHOOL YEAR 2 12g ELENIENTARY GRADE 2 23 = ½1GH SCHOOL YEAR 3 13= ELEMENTARY GRADE ) 31 = COLLEGE YEAR 1 14= ELEMENTARY GRAOE 4 32 = COLLEGE YEAR Z 15 = ELEMENTARY GRADE 5 33= COLLEGE YEAR 3 16 ELEMENTARY GRADE 6 34m COLLEGE YEAR 4 17n ELE~MTAJtY GRADE ? 35, COLLEGE YEAR 40 = COLLEGE GRADUATE e** TheSo oAkestio~l re fe r to the b io log ica l parents of the ch i ld . Record "DO" i f parent not member o f household, 181 SKIP NO" QUESTICedS AND FILTERS COUiNG CATEG~IES I To ' C(~W~4UNITY WATER SYSTEN I I 19 PLPED INTO RESIDENCE/YARD/PLOT . 11 ~21 blest I I the main source of water your household uses fo r hamdwaahlng 6nd d l sh~sh ing? PUBLIC TAP . . . . . . . . . . . . . . . . . . . . 12 TUBED/PIPED WELL/INPROVED DUG WELL PR[VATE ~ELL W/Q FAUCET WITHIN RESIDENCE/YARD/PLOT.,21 NOT W/IN RES/YARD/PLOT . . . . . . . 22 PRIVATE ;,i~LL W/ FAUCET . . . . . . . . 23 PUBLIC WELL . . . . . . . . . . . . . . . . . . . 2A ~EW DUG WELL . . . . . . . . . . . . . . . . . . . }1 DEVELOPED SPRIMG . . . . . . . . . . . . . . . . 41 RAIN~ATER . . . . . . . . . . . . . . . . . . . . . . $1 OTHER 71 ~21 .21 (SPECIFY) 20 N~ (q~l~l ~t ( I ke to 90 there~ get w i re r S MINUTES . . . . . . . . . . . . . . . . . uc l c~ beck? i i r i WITHIN PREMISES . . . . . . . . . . . . . . . 996 21 DCwms your ho~oLd got dr ink ing wBter YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ~23 f r~ th i s I~ I~rce? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 22 E lh l t IS the I~ ln source o f d r i f t ing water fo r ~ '~ '~r l Of your ho~ehoLd? E(~WMUMIT¥ WATER SYSTEN PIPED INTO RESIDENCE/YARD/PLOT . . . . . . . . . . I1 PUBLIC TAP . . . . . . . . . . . . . . . . . . . . 12 TUBED/PIPED WELL/IMPROVED DUG WELL PRIVATE &tELL U/O FAUCET WITHIN RE$1DENCE/YARD/PLOT.21 NOT W/IN RES/YARD/PLOT . . . . . . . 22 PR]VATE WELL W/ FAUCET . . . . . . . . 2S PUBLIC WELL . . . . . . . . . . . . . . . . . . . 26 OPEN DUG WELL . . . . . . . . . . . . . . . . . . . 31 DEVELOPED SPRING . . . . . . . . . . . . . . . . 41 RAIN UATER . . . . . . . . . . . . . . . . . . . . . . $ I OTHER 71 (SPECIFY) 23 I FLUSH TOILET (UATER SEALED) I,dlet k ind o f to i le t fac iHtydoes your household have? O~W FLUSH TOILET . . . . . . . . . . . . . . 11 SHARED FLUSH TOILET . . . . . . . . . . . 12 PIT TOILET/LATRINE 1RAD[T[O~AL PIT TOILET . . . . . . . . 21 VENTILATED iMPROVED PIT (VIP) LATRINE . . . . . . . . . . . . . . . 22 NO FACILITY/BUSH/F]ELD . . . . . . . . . . 31 OTHER 41 24 25 26 27 Doel your hoc~eh0Ld have: E lec t r i c i ty9 An a [ac t r i c /gBs rub le? A cetev l l l~? k re f r iger i to r? Now many ro~l in your ho~eho ld are used fo r s leep ing? ~ IW MATERIAL OF THE FLOOR, RECIteD OBSERVATIOM. Does ~y mmber o f y~Jr h~Jsehold o~: A b icyc le? A • torcycLe? A ¢8r? YES NO ELECTRICITY . . . . . . . . . . . . . . . . I 2 ELECTRIC/GAS RANGE . . . . . . . . . I 2 TELEVISION . . . . . . . . . . . . . . . . . I 2 REFRIGERATOR . . . . . . . . . . . . . . . I 2 NATURAL FLOOR EARTH/SAND . . . . . . . . . . . . . . . . . . . . 11 RUDIMENTARY FLOOR W[~O PLANKS . . . . . . . . . . . . . . . . . . . 21 PALM/BAMBOO . . . . . . . . . . . . . . . . . . . 22 FINISHED FLOOR PARQUET OR POLISHED ~ . . . . . . 31 VINYL OR ASPHALT STRIPS . . . . . . . 32 CERANIC TILES . . . . . . . . . . . . . . . . . 33 CEMENT . . . . . . . . . . . . . . . . . . . . . . . . MARBLE . . . . . . . . . . . . . . . . . . . . . . . . 3S OTHER 61 (SPECIFY) YES NO BICYCLE . . . . . . . . . . . . . . . . . . . . 1 2 MOTORCYCLE . . . . . . . . . . . . . . . . . | 2 CAR . . . . . . . . . . . . . . . . . . . . . . . . 1 2 182 Repub l i c of the Ph i l iDp iDes NDS FORM 2 NAT IONAL STAT IST ICS OFF ICE NSCB C learance No. Conf ident ia l i ty : 1993 NAT IONAL DEMOGRAPHIC SU~V~ Y INDIV IDUAL OUEST IONNAIRE Th is survey is author i zed by Commonwea l th Act No. 591. A l l in fo rmat ion is s t r i c t ly conf ident ia l . IDENT IF ICAT ION PROVINCE C ITY /MUNIC IPAL ITY BARA/~GAY CLUSTER NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . URBAN~RURAL (urban=l, rural=2) . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSEHOLD CONTROL NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SAMPLE HOUSEHOLD SERIAL NUMBER ADDRESS NAME AND L INE NUMBER OF EL IG IBLE WOMAN INTERVIEWER V IS ITS [ F INAL V IS IT DATE INTERVIEWER'S NAME RESULT* NEXT VIS IT : 1 DATE T IME 2 3 LI iiiiiiii~ii~i~iiiii!iiiiiii I I I : I I I I I I : I I I I : : I I I I I I I I I I l l l : l l l : l l l l : l l l l l : l l l l ; i l l DAY MONTH NAME r RESULT TOTAL NUMBER OF V IS ITS *RESULT CODES: i COMPLETED 2 NOT AT HOME 3 POSTPONED 4 REFUSED 7 OTHER 5 PARTLY COMPLETED 6 RESP. INCAPACITATED (SPECIFY) LANGUAGE OF QUEST IONNAIRE: ENGL ISH LANGUAGE USED IN INTERVIEW** RESPONDENT'S LOCAL LANGUAGE** WITH TP~KNSLATOR (NOT AT ALL=l ; SOMETIMES=2; ALL THE T IME=3) . . . . . . - ** LANGUAGE CODES: 1 TAGALOG 4 B ICOL 7 ENGL ISH 2 CEBUANO 5 H IL IGAYNON 8 OTHER 3 I LOCANO 6 WARAY NAME DATE F IELD EDITED BY OFF ICE EDITED BY II KEYED BY KEYED BY 183 SECTI~ 1. RESPONOENT~S BACKGROtJND NO. QUESTXONS AND FILTERS 101 RECOaD THE TINE. 102 F t r l t [ would L ike to I l k Io1~ quest J~J I about you ar'~ yoIJr h~q~Bhold. For n~l t o f the t ime unt i l you uere 12 ye l r l o ld , d id you L ive tn • c i ty , Ln • to~n, or in a ber r lo / ru r l l • re•? COO [NG CATEGORIES CITY . . . . . . . . . I TOWM . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 BARR ] O/RURAL AREA . . . . . . . . . . . . . . . 3 SKIP TO 103 Ln Nhst mo~th and year ~ere y~J born? I I I OK NONTH . . . . . . . . . . . . . . . . . . . . . . . 98 YEAR . ~ '~ OK yEAR . . . . . . . . . . . . . . . . . . . . . . . . 98 104 How o ld ~re you on yo~r Last b i r thday? AGE [N C~4pLETEO YEARS ~ I I COMPARE AND CO~RECT 103 AND/OR 104 IF INCONSISTEnt. 105 Kar l y~ lVe~ l t t ~ school? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2~109 106 IJhat LI the h ighest Level of school you attencled7 PRESCHOOL . . . . . . . . . . . . . . . . . . . . . . . 0 I ELEMENTARY . . . . . . . . . . . . . . . . . . . . . . 1 I HIGH SCHOOL . . . . . . . . . . . . . . . . . . . . . Z COLLEGE Oe HIGHER . . . . . . . . . . . . . . . 3 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B r '09 107 ~/hat { I the h ighest grade~year you completed at th l t LeveL? 109 Can you rel<J oral under l t lnd • Let te r or newspaper l i l t ty , u l th d i f f i cu l ty , or not a t atL? ORAO /YE'R . OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 sc.oo, I I OR HIGHER [~ ~,10 I I EASILY . . . . . . . . . . . . . . . . . . . . . . . . . . ' I I J l lH DI FF [EULTY . . . . . . . . . . . . . . . . . 2 NO1 AT ALL . . . . . . . . . . . . . . . . . . . . . . 3 ! - ( '1 I I , ,o Do ,ou .~.LLy r . .~ . ~, .s~, : , . r or r . , . z i~ • , ~°.~t , *ES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , t er ie • week? I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z ,1 , go y~ ~.~, tLy . . . , o tha r•~,o a, ~.~, . . . . . . k" I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' I I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 112 DO yo~J USu~(Ly aotch teLev is io~ at Least I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I ~0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 113 ~at I I y~Jr re t ig{on? RGtqAN CATHOLIC . . . . . . . . . . . . . . . . . . 1 PROTESTANT . . . . . . . . . . . . . . . . . . . . . . 2 [GLESIA N1KRISTO . . . . . . . . . . . . . . . ] AGLIPAY . . . . . . . . . . . . . . . . . . . . . . . . . 4 [SLAH . . . . . . . . . . . . . . . . . . . . . . . . . . . S OTHER 6 (SPECIFY) NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Z 184 SKIP NO. QUEST%I~;S AND FILTERS CODING CATEGORIES TO TAGALOG . . . . . . . . . . . . . . . . . . . . . . . . . 1 116 Nc~do you c lass i fy yourset f? Are you a TagaIog, CM~O, I toca~, ILo~goo m BicoLano e Waray, Kap4clpat~g~, Or k~lot? CfiEC[ Q.8 IN THE HOUIJEHOLD QUESIIOIINAIRE THE 1443MAN INTERVIEWED IS NOT A USUAL RESIDENT CERUANO . . . . . . . . . . . . . . . . . . . . . . . . . E [LOCANO . . . . . . . . . . . . . . . . . . . . . . . . . 3 ILC~4BGO . . . . . . . . . . . . . . . . . . . . . . . . . 6 8ICOLANO . . . . . . . . . . . . . . . . . . . . . . . . 5 WARAY . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 OTHER 7 (SPECIFY) THE W~4AN INTERVIEWED lS A USUAL RESIDENT ~201 I 116 J NO~ I MouLd l i ke to ask about the place in ~hich I you usualLy l i ve . DO you L,muaLly r ive in a c i ty , in a toun, or in a bar r io / ru raL area? I CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 J I TC~N . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 BARR [O/RURAL AREA . . . . . . . . . . . . . . . ] 117 I~at is the main source of ~ater your household uses fo r h ind~ishfng and dlshuashlno? CONiqUNITY MATER SYSTEM PIPED INTO RESIDENCE/YARD/PLOT . . . . . . . . . I1 ~119 PUBLIC TAP . . . . . . . . . . . . . . . . . . . . 12 TUBEO/PIPED ~ELL/IMPROVED OUG ~iELL PRIVATE ~LL W/O FAUCET ~ITHIN RESIDENCE/YARD/PLOT.21 r119 NOI W/IN RES/YARD/PLOT . . . . . . . 22 PRIVATE WELL W/ FAUCET . . . . . . . . 23 ~119 PUBLIC ~ELL . . . . . . . . . . . . . . . . . . . 24 OPEN DUG NELL . . . . . . . . . . . . . . . . . . . 31 DEVELOPED SPRING . . . . . . . . . . . . . . . . 61 RAINWATER . . . . . . . . . . . . . . . . . . . . . . . 51~119 OTHER 71 (SPECIFY) i 118 Ho~ tong does i t take to go there , get water, MINUTES . . . . . . . . . . . . . . . . . J i l l and come back? I I J I U[ININ PREMISES . . . . . . . . . . . . . . . 9~6 119 Ooel your household get d r lnk l~ l uater YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I - -~121 from th i s lamo source? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 120 What is the r~ in s~rce of d r in~lng Mater fo r members of your ha ,~otd? CC~4UMITY WATER SYSTEH PIPED INTO RESIOENCE/YARD/PLOT . . . . . . . . . 11 PUBLIC TAP . . . . . . . . . . . . . . . . . . . . 12 TUBED/PIPED WELL/IMPROVED DUG WELL PRIVATE NELL W/O FAUCET WITHIN RESIDENCE/YARD/PLOT.21 MOT M/IN RES/YARD/PLOT . . . . . . . 22 PRIVATE WELL W/ FAUCET . . . . . . . . 23 pUBLIC tJIELL . . . . . . . . . . . . . . . . . . . 2& OPEN DUG I~LL . . . . . . . . . . . . . . . . . . . 31 DEVELOPED SPRING . . . . . . . . . . . . . . . . 41 RAINWATER . . . . . . . . . . . . . . . . . . . . . . . 51 OIHER 71 (SPECIFY) 3 185 NO. O~JEST[ORS AND FILTERS 121 What k ind of to i ta t fac i t i ty does your household have? C~ING CATEGORIES FLUSH TOILET (MATER SEALED) ~N FLUSH TOILET . . . . . . . . . . . . . . 11 SHARED FLUSH TOILET . . . . . . . . . . . 12 SANITARY PIT/ANTIPOLO TYPE OWN TOILET . . . . . . . . . . . . . . . . . . . . 21 SHARED TOILET . . . . . . . . . . . . . . . . . 22 OPEN PRIVY . . . . . . . . . . . . . . . . . . . . . . 31 DROP TYPE/OVERHANG TYPE . . . . . . . . . 41 NO FACILITY/BUSH/FiELD . . . . . . . . . . Sl OTHER 61 (SPECIFY) 122 Does your househotd have: YES NO E lec t r i c i ty ' / ELECTRICITY . . . . . . . . . . . . . . . . 1 A 9as /eLect r i c range? A te tav(s lon? GAS/ELECtRIC RANGE . . . . . . . . . 1 2 A r t f r lgerator? TELEVISION . . . . . . . . . . . . . . . . . 1 2 REFRIGERATOR . . . . . . . . . . . . . . . I 2 123 HOW many rooms in your household are used For steeping~ I RO~S . . . . . . . . . . . . . . . . . . . . . . 124 CouLd you descr ibe the main mater ia l of the f toor o f your home? SKIP TO NATURAL FLOOR EARTH/SAND . . . . . . . . . . . . . . . . . . . . 11 RUDIMENTARY FLOOR PLANKS . . . . . . . . . . . . . . . . . . . 21 PALM/BAMBOO . . . . . . . . . . . . . . . . . . . 22 FINISHED FLOOR PARQUET OR POLISHED ~ . . . . . . 31 VINYL OR ASPHALT STRIPS . . . . . . . 32 CERAMIC TILES . . . . . . . . . . . . . . . . . 33 CEHENT . . . . . . . . . . . . . . . . . . . . . . . . 34 KARBLE . . . . . . . . . . . . . . . . . . . . . . . . 35 O~HER 41 (SPECIFY) 125 Does any member of your househo id own: A b icycte? A ~torcyc le? A car? YES NO I BICYCLE . . . . . . . . . . . . . . . . . . . . 1 2 MOTORCYCLE . . . . . . . . . . . . . . . . . 1 2 CAR . . . . . . . . . . . . . . . . . . . . . . . . I 2 186 NO. 201 SECTION 2. REPROOUCTION • JESIICidS AND FILTERS I lOW 1 ~J ld Like to ask about nat the b i r ths you have I hid@Jr lnQ your L i fe . Hive you ever given b i r th? I SKIP COOING CATEGORIES I 1o Y'~ . I m | NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ~206 2oz ,0 yo~hav, any ions or ~ter . to ~you hav. I yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I given b i r th who ore nov Living v t th you? I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ~204 203 HaM mare d Ions Live with yo4J? I SONS AT HOI4E . . . . . . . . . . . . . . . And hOUl amny daughters l i ve with you? I OAUGHTERS AT HOME . . . . . . . . . . IF IdC44E RECORO *00 ' . 204 DO you have any aa~s or daul~tera to ld~omyou have I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 g lvanb l r th who ore s t i l l a l ive but do ~t l i ve I u l th you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2----b206 205 Ho~mlnyso~s are a l i ve belt dan or l i ve with you? SONS ELSEWHERE . . . . . . . . . . . . . ~[~ I And how ~ daughters I re a l ive I~Jt do not Live Nith I yOU? DAUGHTERS ELSEWHERE . . . . . . . . IF NONE RECO(tD '00 ' . ZO6 HIve you ever gtvim b i r th to a boy or • g i r l who was YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I born a l i ve but to ter d{ed? IF NO, PROBE: Any I baby WhO cr l sd or Ihouid any sign of l i fe but NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2~208 only surv fv id a few hours or days? 207 In I L l , hOW many boys have died? BOYS DEAD . . . . . . . . . . . . . . . . . . ~-~ And hovlseny g i r l s have died? GIRLS OEAD . . . . . . . . . . . . . . . . . IF NONE RECORD lO0' 208 S~pregranc ies imddafor l fu l l term or as a | YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 s t i LLb i r th , Hove you h id ony pregml~:y that d id not I resu l t In I l i ve b i r th? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z ~210 2" I I , i l l , h~ many s~ch pr~ies have there been? PREGNANCY LOSS . . . . . . . . . . . . . I EUNAMS~dERS TO 20], 205, 207AND 20Q, A~O ENTER TOTAL. %F MaNE RECORD ' 00 ' . 211 212 CHECK 210: Just to make sure that I have th{s r ight , yc.J have had - - ch i ldren ~o are s t i l l l i v ing {203 and 205) ch i ldren who have died (207), and _ _ W ~ n c i e s which d ldP~t resul t in a LIVe b i r th (209). Is that correct? PROBE AND YES E~ NO ~ . CORRECT 201-210 AS NECESSARY V CHECK 210: PRECJ4AMCIES PREGNANCIES V .233 I 187 213 NOUB I l~OUld (Lke to t sLk to you about e l l of your pragPancies , khathar born a l i ve , barn dead or Lost before fuLL term, s ta r t ing v i th the f i r s t o¢~ yo~J had. REC(~D ALL THE PREGNANCIES. RECORD TWINS AND TRIPLETS ON SEPARATE LINES. 214 215 Th ink WSS ths t• back to s ing le or I the t im ~Lt ip te o f your pregnancy? ( f i r s t / next ) prs l lnarcy, "1 216 217 ~i the baby ber t O ld th l t baby eL iTe r born dQade Cry~ I~Ve~ or or LOSt be fore bce l th i ehen fuLL term? i t ue| born? $ ]NGLE. , . , I MULTIPLE.2 S INGLE. . . .1 MULTIPLE.2 S INGLE. , . ,1 MULTIPLE.2 BOSH AL IVE . . . . .1 YES . . . . . . . . 1 (SKIP TO 218)~ ] NO . . . . . . . . . 2 8~XqN DEAD . . . . . . 2 I LOST BEFORE 226 FULL TERN . . . . . (SKIP TO 22619 BORN ALIVE . . . . . 1 YES . . . . . . . . 1 (SKIP TO 218)3 NO . . . . . . . . . 2 EI~N DEAD . . . . . . 2 I v LOST BEFORE 226 FULL TERM . . . . . (SKIP TO 226)9 I~K)RN AL IVE . , . , .1 YES . . . . . . . . I (SKIP TO 218)3 NO . . . . . . . . . 2 .OeN BEAD . . . . . . 2 I V LOST BEFORE 226 FULL TERN . . . . . (SKIP TO 22619 218 k11at name eas g iven to that Ch i ld? (HAME) 219 I s (NAME) a bay or • g l r ( ? BOY . . . . . 1 GIRL . . , .2 220 221 In what wonth 1$ (NAME) and yaar uss I t i I l (NAME) barn? s i l va? pROBE: What Is h i s /her b i r thday? MONTH. . . .~] YES . . . . . . 1 YEAR . . . . . ~ NO . . . . . . . 2 I 225 ( NN4E ) BOY, . . , ,1 V~INTH . . . . I I I YES . . . . . . 1 G IRL , . , ,2 YEAR . . . . . ~ Me . . . . . . . E I 225 (NAI4E) BOY . . . . . 1 NONTH. . . . J J J l YES . . . . . . 1 G IRL* , . .2 YEAR . . . . . I l l NO . . . . . . . 2 I V 225 S INGLE. . . ,1 MULTIPLE.2 BORN AL IVE . . . . .1 YES . . . . . . . . 1 (SKIP TO 218)~ ] NO . . . . . . . . . 2 ~ N OEAD . . . . . . z r v LOST BEFOre 226 FULL TERM . . . . . (SKIP TO Z26)~ J (NAME) BOY . . . . . I MONTH . . . . J J J YES . . . . . . L G]RL . , , .E YEAR . . . . . [ ~ NO . . . . . . . 2 I v 2ZS 05J S INGLE. . , .1 MULTIPLE.2 BORN ALIVE . . . . . 1 YES . . . . . . . . I (SKIP TO Z18)~ ] NO . . . . . . . . . 2 BORN DEAD . . . . . . 2 I V LOST BEFORE 226 FULL TERM . . . . . (SKIP TO 226) I ( NAHE ) BOY . . . . . 1 MONTH . . . . J I J YES . . . . . . 1 G IRL . . . *2 YEAR . . . . . ~ ] NO . . . . . . . 2 I V 225 61 S INGLE. . . .1 MULTIPLE.,2 80RN AL IVE . . . . .1 YES . . . . . . . . ( (SKIP TO 218)3 NO . . . . . . . . . E eORH OE~ . . . . . . z I v LOST BEFORE 226 FULL TERN . . . . . (SKIP TO 226) I (HAHN) BOY . . . . . 1 MONTH . . . . J J J YES . . . . . . 1 G]RL . . . ,E YEAR . . . . . ~ 1 NO . . . . . . . 2 I v 225 7[ S INGLE ' ' ' ' 1 MULTIPLE,.2 BORN ALIVE . . . . . I YES . . . . . . . . 1 (SKtP TO 218)* ] NO . . . . . . . . . 2 .as . Oz~ . . . . . . z I V LOST BEFORE 226 FULL TERN . . . . . (SKXP I0 22611 (NAJ4E) BOY . . . . . 1 MQNT8 . . . . J l i YES . . . . . . 1 G IRL , , . ,2 YEAR . . . . . ~ NO . . . . . . . 2 L v 225 S INGLE, , , .1 NULTIPLE.E BORN AL IVE . . , . ,1 YES . . . . . . . . 1 (SKIP TO 218)~ ] NO . . . . . . . . . 2 QORN OEAO . . . . . . 2 I ¥ LOST BEFORE 2Z6 FULL TERM . . . . . (SKIP TO 226) I (NAME) BOY . . . . . 1 MONTH . . . . J J J YES . . . . . . ) G IRL . . . .2 YEAR . . . . . ~ NO . . . . . . . 2 v 225 6 188 IF lOIN ALIVE ~22 Hour oLd ~ls (iM/4E) i s of h is /her l i l t b~r th~ ¥E~I kflE IN yUJ | IN YE~S AGUE IN yEAJ~S AGE IN yEARI AGE IN AG~ IN yEARS IN yEARS AGE I# yEARS L LIVING: L BO~N ALIVE BLIT NO~DEA 225 HO~ o ld ~•S (NAME) when he/she died? IF "1 yR,", pROBE: HOW many I~ths o ld was (N~4E)? RECI~D DAYS IF LESS THAN 1 k~TN, MONTHS IF LESS THAN T~.IO YEARS, OTHERMISE, ENTER YEARS, I XF LC~T IF BORN DEAD ~ LOST BEFORE BEF(~E FULL TERN: FULL TE~J4: 223 224 IF LESS TITAN 15 YRS, OF AGE: Is (i~qE) L lv lne Ul th~h~d~t l u l th ~ he/she t in t IF 15-: GO TO NEXT PREGNANCY 226 : 227 in v~l t HOW mamy n~onth •r~ mo~ths d id year d id the pregnm~cy th i s L ist? pregnancy er~:~? RECORD IN CONPLETED NONTHS* ~THS ~ITHS MO~ITHS NONTHS M I FATHER . . . . . . . . . . . . . 1 YES . . . . . . . 1 MATERNAL RELAT]VE.,Z DAYS . . . . . . . . . . . . . 1 MONTH (GO TO 'EX~ i p I tE~CY) PATERNAL RELATIVE.] WStiINS . . . . . . . . . . . 2 yEAR ~40 . . . . . . . . Z f.Ck~(~E ELSE . . . . . . . 4 yEARS . . . . . . . . . . . . 3 (GO TO MEN1 PREGNAMC~ (GO TO flEXT pREGNANCY) • FATHER . . . . . . . . . . . . . 1 j YE$(c,~ . . . . . . . TO MEXTIT~ N ATERNAL RELATIVE"2 DAYS . . . . . . . . . . . . . 1 ~ MDNIH ~ P#EG;~MCy) PATERNAL RELATIVE.] 14ONrHS . . . . . . . . . . . 2 YEAR M• . . . . . . . . 2 SO~E~E ELSE . . . . . . . & YEARS . . . . . . . . . . . . 3 (GO TO NEXT PREGKANOI (GO I0 NEXT PREGHANCY) FATHER . . . . . . . . . . . . . 1 YES . . . . . . . 1 NATER~LAL RELATTVE.2 ~ DAYS . . . . . . . . . . . . . 1 KONIH (GO TO NEN~ PREGNANCY) PATERNAL RELATIVE,,] N~IHS . . . . . . . . . . . 2 YEAR NO . . . . . . . . 2 ~NEC~E ELSE . . . . . . . & YEARS . . . . . . . . . . . . 3 (GO 10 NEXT P/EC~JULCY) (GO 10 NEXt PREGNANCY) • FATNER . . . . . . . . . . . . . 1 • YES I i4ATERMAL RELATIVE''2 D A Y S ( G O . . . . . . . TO NEX~ . . . . . . . . . . . . . 1 ~ )4ONYH PREGI4AMCy) PATERNAL RELATIVE.] i4()~4THS . . . . . . . . . . . 2 YEAR KO . . . . . . . . 2 ~MEI~E ELSE . . . . . . . 4 (GO TO I YEARS . . . . . . . . . . . . 3 NEXT PREGk~,NCy ) I (GO TO NEXT PREGNAHCy) FATHER . . . . . . . . . . . . . 1 DAYS . . . . . . . . . . . . . 1 14OMTN (GO TO NEX~ PREGNANCy) PATERNAL RELATIVE*.3 NOMIHS . . . . . . . . . . . 2 yEAR ~ . . . . . . . . Z SO~E ELSE . . . . . . . I, yEARS . . . . . . . . . . . . 3 (GO TO NEXT PREGk/,ANCY) (GO TO NEXT PREGNANCY) • FATHER . . . . . . . . . . . . . 1" PREC~AMCy)~ PATERNAL RELATIVE.] K~]~TRS . . . . . . . . . . . 2 YEAR I• . . . . . . . . Z SC(4E(~E ELSE . . . . . . . 4 YEARS . . . . . . . . . . . . 3 (GO TO u NEXT PREC~ANCY) u (GO TO NEXT PREGNANCY) I FATHER . . . . . . . . . . . . . 1 YES(GO . . . . . . . TO NExTjl NATERNAL RELATIVE.2 DAYS . . . . . . . . . . . . . 1 ~ KO~T;t [ ~ PItEGHAMOy) PATERNAL RELATIVE,.] MONTHS . . . . . . . . . . . 2 YEAR NO . . . . . . . . 2 SOWN OI~E ELSE . . . . . . . ~; YEARS . . . . . . . . . . . . ] (GO TO NEXT PREG;tAMCY (GO TO NEXT PREGNANCY) m FATHER . . . . . . . . . . . . . I m YES . . . . . . . 1 i4ATERMAL RELATIVE.2 DAYS . . . . . . . . . . . . . 1 ~NIH (GO TO NEX~j pREGNANCY) PATERNAL RELATIVE.] MONTHS . . . . . . . . . . . 2 YEAR NO . . . . . . . . 2 ~4E~£ ELSE . . . . . . . 4 YEARS . . . . . . . . . . . . ] (GO TO NEX! PREGNANCY) (GO TO NEXT PREGNANCY) KO~FHS M 226 Did y~J or • ~oct op or S ~ i t s• do onytht nO to end th i s pr egrmncy? YES. . . I NO . . . . . . 2 YES. •, I ~t$ . . . . .1 NO . . . . . . 2 YES. . . . . I NO . . . . . . 2 YES. . . .1 NO . . . . . . 2 yES. . . . . 1 NO . . . . . . 2 NO . . . . . . 2 YES. • , . , 1 NO . . . . . . 2 189 214 ThiCK beck zo the t l~ o1 your ( f i r s t / next ) p r~4~cy . 215 Was th l t l s ing le or • mJ l t lpLe pregrar~y? 216 t~lll the baby borr a l i ve , born deed, or Lost before fu l l te r~? 217 Did that baby cry , move, or b reathe when {t ml l born? 218 What ~ was g iven tO that ch i ld? 219 Is (N/~4E) a boy or a 9brL? 220 In Iv/lot m~th a~dyear ~as (NN4E) born? PRO[IE: ~dlaz is h i s /her b i r thday? 221 Is (ROUTE) le f t ( a l i ve? S INGLE. . . .1 HULT%PLE.,2 S INGLE. . , .1 MULTIPLE.,2 ~N ALIVE. , . ,.11 I YES . . . . . . . . 1 (sKiP TO 218) I NO . . . . . . . . . B~N DEAD . . . . . . Z ] v L~T BEFORE 226 FULL TERM . . . . . (SKIP TO 226) BORN ALIVE . . . . . 1 YES . . . . . . . . I (SLIP TO 218)" ] NO . . . . . . . . . 2 e.oR. OeAo . . . . . . z I v L~T BEFORE 226 FULL TERN . . . . . ] l (SKXP TO 226)~ (NAME) (NAME) S INGLE. . , .1 BORN ALIVE . . . . . 1 (SKIP To 218)~] HULTIPLE,.2 II~liN DEAD . . . . . . 2 LOSl BEFORE FULL TERM . . . . . (SK[P TO 226) I YES . . . . . . . . 1 MO . . . . . . . . . 2 i v 226 (NAME) SINGLE. , . .1 B~tN ALIVE . . . . . 1 YES . . . . . . . . L (SKIP TO 218)~ ] MULTIPLE.2 MO . . . . . . . . . 2 BORN DEAD . . . . . . 2 t v LOST BEFORE 226 FULL TERM . . . . . (SKIP TO 22613 (NAME) S [NGLE. , . , I RGIiN ALZVE . . . . . 1 (SKIP TO 218)~ ] MULTIPLE.2 Ethan DEAD . . . . . . 2 LOST BEFORE FULL TERM . . . . . (SKIP TO 226)3 YES . . . . . . . . 1 NO . . . . . . . . . 2 I V 226 (NAME) YES . . . . . . 1 NO . . . . . . . ~ v Z25 80Y . . . . . 1 MC~TH.J J Jj YES . . . . . . I GIRL . . , .2 YEAR . . . . . [ ~ NO . . . . . . . 2 I V 225 80Y . . . . . 1 MONTH . . . . I l l YES . . . . . . 1 G IRL . . . ,2 YEAR . . . . . [ ~ NO . . . . . . . 2 v 225 BOY . . . . . 1 MONTH. . . . i i i YES . . . . . . 1 G IRL , , , .2 YEAR . . . . . [ ~ NO . . . . . . . Z V 225 BOY. . . , ,1 MONTH . . . . t l l YES . . . . . . 1 G IRL , , , ,2 YEAR . . . . . [ ~ NO . . . . . . . 2 I V 225 190 IF BG~N ALIVE AND STILL LIVING: 222 Ho~ o ld u~l ( i~) ms of h i s /her I ss t b l r thcMy? RECORD IN TEARS 223 tm (MA~E) t ry ing ~ l thyou? 224 IF LESS THAW 1~ YR$, OF AGE: g l th whom~oel he/she L ive? IF 15÷: GO TO NEXT PREGNANCY AGE IN YEARS AGE ZN YEARS AGE IN YEARS AGE IM yEARS AGE IN YEARS M m i 230 m i J FATHER . . . . . . . . . . . . . I YES . . . . . . . 1 MATERNAL RELAT ]VE.E (GO TO NEX~ PREGNANCy) PATERNAL RELATIVE.] NO . . . . . . . . 2 SOMEONE ELSE . . . . . . . 4 (CO TO NEXT PREGNANCY) FATHER . . . . . . . . . . . . . 1 YES . . . . . . . 1 ~TERNAL RELATIVE. ,2 (GO TO NEX~ PREGNANCY) PATERNAL RELATIVE.3 NO . . . . . . . . 2 SCICEON E ELSE . . . . . . . 4 (GO TO NEXT PREGNANCY) FATHER . . . . . . . . . . . . . 1 YES . . . . . . . 1 MATERNAL RELATIVE.,2 (CO TO NEX~ PREGNANCY) PATERNAL RELATIVE, ,3 NO . . . . . . . . 2 SOMEONE ELSE . . . . . . . 4 (GO TO NEXT PREGNANCY) FATHER . . . . . . . . . . . . . 1 YES . . . . . . . 1 MATERNAL RELATIVE.E (CO TO NEX;e] PREGVdLMCY ) PATERNAL RELATIVE.3 NO . . . . . . . . 2 SCI4EONE ELSE . . . . . . . 6 (GO TO NEXT PRECUANCT ) FATHER . . . . . . . . . . . . . I YES . . . . . . . I MATERNAL RELATIVE.2 (CO TO NEX~ PREGNANCY) PATERNAL RELATIVE.] NO . . . . . . . . 2 BONEOGN ELSE . . . . . . . 4 (GO TO NEXT PREGNANCY) m ~ BORN ALIVE BUT NO~ DEAD: 225 HO~ otd ~as (NAHE) uhen he/she died? IF Ul yR , " PROBE: HO~ many months o ld ~es (NAME)? RECORD DAYS IF LESS THAN 1 14CMTH t KONTH$ IF LESS THAN TkK) YEARS r OTHER~[SE, ENTER YEARS. DAYS . . . . . . . . . . . . . 1 J J J NOMTHS . . . . . . . . . . . 2 YEARS . . . . . . . . . . . . S (GO TO NEXT PREGNANCY) DAYS . . . . . . . . . . . . . 1 r l J K~NTNS . . . . . . . . . . . 2 YEARS . . . . . . . . . . . . 3 GO TO NEXT PREGNANCY DAYS . . . . . . . . . . . . . 1 I J J MONTHS . . . . . . . . . . . 2 YEARS . . . . . . . . . . . . 3 (GO TO NEXT PREGNANCY) DAYS . . . . . . . . . . . . . I I I I MONTHS . . . . . . . . . . . 2 YEARS . . . . . . . . . . . . 3 GO TO NEXT PREGNANCY) I %F LOST IF BORN DEAD OR LOST 6EFDQE BEFORE FULL TERM: FULL TERN: 226 227 In what Ho'd many mo~th erud months d id year d id the pregnancy th i i ~ ls t? pregnancy end? RECORD XN COMPLETED Md[~MTHS. +TH I[--1 MONTHS YEAR MONTH MONTHS YEAR N4JNTHE YEAR 228 DAYS . . . . . . . . . . . . . 1 J J l MONTHS . . . . . . . . . . . 2 YEARS . . . . . . . . . . . . 3 (GO TO NEXT PREGNANCY) mmmmiml lm~Jmmm NONTHS YEAR NONTHS YEAR Did you or ! a doctor or" s oF~o~e e lse do Bnyt h ing to end th (s pr ~ l~cy? YES . . . . . 1 NO . . . . . . 2 YES . . . . . 1 NO . . . . . . E YES. . . . . 1 NO . . . . . . 2 YES. . . . .1 NO . . . . . . 2 YES , . . . .1 NO . . . . . . 2 CQNPARE 210 WITH NUMBER OF PREGNAUCIES IN HISTORY ABOVE AND HARK: NUMBERS ~ NUM8ER S ARE [ -~ ARE SAME ~ DIFFERENT . (PROBE AND RECONCILE) v CHECK: FOR EACH B%RTH: YEAR OF BIRTH )S RECORDED IN 220. FOR EACH LIVXNG CHILD: CURRENT AGE IS RECORDED [N 222. FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED IN 2ES. FC~ EACH PREGNANCY LOSS: DURATION IS RECORDED IN 22?. FOR AGE AT DEATH 12 NC~THS: PROd~E TO DETERMINE EXACT NUNBER OF MONTHS IN 225. CHECK EZO AND ENTER THE NUMBER OF B%RTHB SZNCE JANUARY 1988. IF N(~ND, ENTER 0 AdO GO TO 212. L~ FOR EACH BIRTH SINCE JANUARY 1988 ENTER B IN MONTH OF BIRTH IN COLL~4N I OF CALENDAR AND P [N EACH OF THE 8 PRECEDING ML)MTHS. WRITE NAME TO THE LEFT OF THE "O"COOE. AT THE ~TTON OF THE CALENDAR, ENTER THE NAME AND B%RTH DATE OF THE LAST CHILD EORN PRIOR TO JANUARY 19~J5, IF APPLICABLE. 9 19] m NO. I QUESTIONS AND FILTERS 2]3 I Arm you pregz~nt i~ow? m I SKIP CODING CATEGORIES n TO YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I II IIIIIIIIIIIIIIIIIIIIIIIIII L , I 2~ I NO~ymonth= preonsnt are you? ~NTHS . . . . . . . . . . . . . . . . . . . . . I I I I ENTER "P= IN COLUMN I OF CALENDAR IN M(~4TH OF INTERVIE~ AND IN EACH PRECEDING it~NTH PREGNANT. Z3S At the= tlmm you bec~ pregnant , d id you *ant to become U l l U ~ W ~ t there, d id you ~a~t to wa i t unt i l l a te r , m 236 J CHECK 209: I I/ITH PREGNAIICY L0$$ E~ THEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 LATER . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . 3 NO PREGNANCY LOSS 239 240 CHECK Z16 AgeD 226 FOR DATE OF LAST PREGNANCY LOSS: LAST PREC41ANCY ENDED SINCE JANUARY 1988 L~ LAST PREGNANCY ENDED BEFORE JANUARY 1988 I I ASK FQR DATES AND DURAT%QNS OF ALL PREGNANCIES SINCE JANUARY 1988. uM ENTER T IM COLUMN I OF CALENDAR IN MONTH PREGNANCY TERH]NATED, AND #pm IN EACH PRECEDZNGMONTH PREGNANT. t~er~ d id your Last =e~nstr=[ per iod s ta r t? DAYS AGO . . . . . . . . . . . . . . . . . 1 WEEKS AGO . . . . . . . . . . . . . . . . 2 HONTHS AGO . . . . . . . . . . . . . . . 3 YEARS AGO . . . . . . . . . . . . . . . . A ]N MENOPAUSE . . . . . . . . . . . . . . . . . . ~'~)4 BEFORE LAST BIRTH . . . . . . . . . . . . . 995 NEVER MENSTRUATED . . . . . . . . . . . . . 9'96 Wi th in a w~nls menstrual cyc le , that t s f between the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 f i rm• day of I keoe~nll per iod ar¢l the f i r s t day of her next per iod , are there d~ys when she has a greater NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - - cherm• o f becoming pregnant? OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 241 Dur ing which days of • Wolean~s menstrua l cyc le does • u=mn have the gre l tes t chance of becoming pregnant ~ DURING HER PERIOD . . . . . . . . . . . . . . . 1 RIGHT AFTER HER PERICO HAS ENDED . . . . . . . . . . . . . . . . . . . . . . 2 IN THE H[ODLE OF THE CYCLE . . . . . . 3 JUST BEFORE NER PER]O0 BEGINS.4 OTHER 5 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 W / ~301 10 192 SECTION ~: CONTRACEPY[ON 301 MOW I wOuLd L ike to ta lk / )out f i l l y p taming - the var ious ways o r methods that • c~[ I can ~e to da l ly o r avo id • pa l ix l&n l :y . ~h lch u•y l or ~thods have you heard ebo~t? CIRCLE ~E 1 ]M ]OE FO~ EACH KIETNOD MENTIONED SPONTANEOUSLY. THEM RIOCEEO OOMN THE COLLINM, READ[MG THE MANE AND DESCR]PTIQM OF EACH HETHOt) NOT NENTIONED SPONTANEOUSLY. CIRCLE COOE. 2 I F HETHOD IS RECOGNIZED+ AMD CCOE ] IF MOT RECOGNIZED. O1[ P ILL toml~l¢ l t~ take I p i l l i v t ry day , )02 H ive you ev l r heard o f (METHOD)? READ DESCRIPTION OF EACH NETHOO. YES/SPONTANEOUS . . . . . . . . . . . . . 1 YES/PROBED . . . . . . . . . . . . . . . . . . NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 YES/SPOnTANEOUS . . . . . . . . . . . . . I " 1 IUD Women Clm h ive • Loop or COl t pL IK ; Id i r l l l d l l the u teru i YE$/PRO6ED . . . . . . . . . . . . . . . . . . 2 by • ~octor o r I hur l• . NO . . . . . . . . . . . . . . . . . . . . . . . . . . 3. v YES/SP~k~TANEOUS . . . . . . . . . . . . . _J [HJECTI~44S Wo¢ lnc lm h ive ml J~ J~l ) tLon by I doctor or f~r ie yES/pROBED . . . . . . . . . . . . . . . . . . 2 ~l lch I to~o l l th l l f r¢ i i pacomll~g pregnant fo r l iV l r l l !~of l tha. M• . . . . . . . . . . . . . . . . . . . . . . . . . . ~+m V YES/IPC44TAWE(~J$ . . . . . . . . . . . . . 1 ~J DZAPHP-~C=W+ FC~M+ JELLY, CRE/~4 can pr i ce • m~ge , sup- YES/PROBED . . . . . . . . . . . . . . . . . . E poa l to ry , d i lphre l l , j eLLy o r c r IB i n l ibe Mfore Lnt i r¢our l l NO . . . . . . . . . . . . . . . . . . . . . . . . . . ] v YES/SPOMTANE(~JS . . . . . . . . . . . . . I I~ ~.(~ND()N ~en Car l USe i r ~ r lhelth dur ing leX l l l l l I n te r - YES/PR~ED . . . . . . . . . . . . . . . . . . courae+ MO . . . . . . . . . . . . . . . . . . . . . . . . . . ] v YES/SPONYANEOUS . . . . . . . . . . . . . 1 ~6[ L%GATII~4, FEMALE STERIL IZAT IO I ¢ l~h lv l In oper i t$c~ to YES/PROeED . . . . . . . . . . . . . . . . . . I vo ld hovJr lg a{ ly l~ore ch i ld ren . MO . . . . . . . . . . . . . . . . . . . . . . . . . . YES/SPONTANEOUS . . . . . . . . . . . . . 1 VASECTOMY, NALE STERILIZATION 1441fl ¢~/~ h ive i~ ~r l t l~ l to YES/PRO~ED . . . . . . . . . . . . . . . . . . E Ivo Id h lv ino imymre ch i ld ren . NO . . . . . . . . . . . . . . . . . . . . . . . . . . ] ~1 NATURAL FMMILY PLANNIHG, RHYTKM, PERIC(~IC/d~STINENCE COUpl i l cen lvo ld h iv ing SeX~Bi i n t l r coura i on c t r t l i , days o f the month k411m the w0man i s more L ikeLy to beccml pregrmnt . v YES/SPONTANEOUS . . . . . . . . . . . . . I ~ITRORAIAL Men c lm be care fu l ~nd pu l l out be fore c l imax , yE$/PROeEO . . . . . . . . . . . . . . . . . . E Me . . . . . . . . . . . . . . . . . . . . . . . . . . . . v 01 Have you heard o f any o ther YES/SpONTANEOUS . . . . . . . . . . . . . I kq ly l o r l l thoda that wo41)on NO . . . . . . . . . . . . . . . . . . . . . . . . . . ] (0 o r ! t l l C l~ L ie to avo id pr egn ln~y? 1 (SPECIFY) (SPECIFY) (SPECIFY) v AT LEAST ONE "YES" (EVER USEO) [ - -~ v v YES/SPONTANEOUS . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES/PRO~ED . . . . . . . . . . . . . . . . . . 2 2 kO . . . . . . . . SKIP TO 309 303 Have you ever 30A Oo you kno~ uh l re used {METHOD)? I person cou ld go YES, SANE BARAMGAy . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES, AMOTHER EARAUGAy . . . . . . 2 HO . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . . . ] YES, SAJ4E BARANGAY . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES, ANOTHER EARAWGA¥ . . . . . . 2 NO . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . . . ~ . YES, SAAE BARANGAy . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES, ANOTHER BARAMGAy . . . . . . 2 NO . . . . . . . . . . . . . . . . 2 MO . . . . . . . . . . . . . . . . . . . . . . . . . 3 . yES I SAME BARAMGAy . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES, AMOTHER BARANGAY . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . . . ] yES a SAME BARANGAY . . . . . . . . . 1 YES . . . . . . . . . . . . . . . 1 YES, ANOTHER BARAMGAY . . . . . . 2 NO . . . . . . . . . . . . . . . . Z NO . . . . . . . . . . . . . . . . . . . . . . . . . 3 Have you ever had an YES, SANE EARAMGAy . . . . . . . . . 1 operet l¢~l to avoid hav ing any more YES+ ANOTHER BARANGAY . . . . . . 2 eh l td ren? NO . . . . . . . . . . . . . . . . . . . . . . . . . ] YES . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . E Have your par tner YES+ SAME DARANGAY . . . . . . . . . 1 ever had an i para - t ier1 tO avo id havtn YES+ ANOTHER 6ARANGAY . . . . . . 2 any more ch i ld ren? NO . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . 1 NO . . . . . . . . . . . . . . . . E DO you know where I person can obt•Ln I~ iCm ~ how to use r~atur• l fmi ty p t l~n in i? YES t SANE EARAMGAy . . . . . . . . . 1 YES+ ANOT½ER BARAMGAY . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . . . :3 [. H._ ,,p+.+l~ t +im)+.,,~. j p + m,l~ l[iH)~ ~ H met. ni~[[~ 1.iP;qd - p:ppqqtfl+[ifl,i, p m.fl++qllfliUflp+iifl qp~W ~O 2 IUII)U Ulh '+d fl)LUt fl)l[tllfl Jl "II++ Uiifl J[+Uifl Ullll++Imlli~ U dllt ~Llt ~ r++ rfl I I I F . . . . . . . . . . . . . . . . Ud,++Jl,lmJ,lllillliilt,,g~l,J~llllltilllUl~tt~mM~ . mu++um. .+. . . - . .~ . .+ . . . .+ .~.~- , i E.~+e. r ~mm1. i l hl+uLmH mh~++HU UJl I @III~ UIB'+Eml)ILtild3+ film m fl mli1+Ulh I + I,I r b H I ~ ) I r i:i,:t " i J7 .FL+ll))tii+l llig)Ulg~ m.liJrH Utllligilii+J.J IIII m] t. ~m.m.mm+ .~q.fl1~¢.~gHmm. U)ml i.l.~;i.:+)+.',tt.l+il.ljl+]ltil:JIL).'l.U J ,l)l ~ Ull:~lhi~ +~. +.~ )J" YES . . . . . . . . . . . . . . . + ][+1(i .t,+~):,l,(Lihl)] M MI I ) ) I )1 + I J)[i t t 1 ++3tlllfl]t + E ~ tel ) ~ r l+ L::l'll iq~l I IIFHliHI~p orrfl ld"~ I . ~ , , __ . ,u,lJ+llgl __. , , ,+l,g, l l~E~.,+it mo . . . . . . . 2 I.l./.l+.' .+."mlI J . I P+. .~+MI I I I . I I~++ " ""~'+ i .,,mlL:~lll+'~' I I INml l YE~; . . . . . . . . . . . . . . . 1 q:l"l":" I II1~1111 ~ mi l l +III+NI~I ~ ~o . . . . . . . . . . . . . . . . z Illil3',il,'~i, ll lill:l III1~ I '. + i+,il'.;::l+ll £4 I+ • Ul I I Ipl 'E' I" l~l I ' , ,,+ ~ >C+I p l~ ~ r rh¢ l r ld IH F~I - ,q l 193 NO. ~ QUESTIONS AND FILTERS 306 I Xeve you ever used anyth ing or t r ied in any ~ay to i I d4tay or avo id get t ing pragrumt? 308 309 SKiP COOING CATEGORIES ~ TO I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 .308 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ENTER "0" IN COLUJLM 1 OF CALENDAR IN EACH BLANK MONTH. I J-361 What have youused or do~? C~RECT 303-305 {AND 302 %E NECESSARY), What i s the f i r s t th ing you ever d id or method you ever ~ed to da l ly or avo id get t ing prcg~nt? PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 Ibo . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 iNJECTIONS . . . . . . . . . . . . . . . . . . . . . 03 OIAPNRAC~4/FOAM/JELLY/CREN4.OA CONDO4 . . . . . . . . . . . . . . . . . . . . . . . . . 05 L]GATION/FEM. STER . . . . . . . . . . . . . VASECTONY/14ALE STiR . . . . . . . . . . . . 07 NAIURAL FA/4[LY PLANNING . . . . . . . . 08 311 ~[IHDRAWAL . . . . . . . . . . . . . . . . . . . . . 09 OTHER iS PEC[FY ) I 310 t/hero d id y~ go to get th i s method the f i r s t t i re? (NAI4E OF FACILITY) PUBLIC SECTOR GOVERNMENT HOSPITAL . . . . . . . . . . . 11 BARA~GAY HEALTH STATION . . . . . . . 12 BARANCrAY SUPPLY/SERVICE POINT OFFICER . . . . . . . . . . . . . . 13 RNU/pUERICULIURE CENTER . . . . . . . 16 MEDICAL PRIVATE SECTOR PRIVATE HOSPITAL OR CL IN IC , . . .21 PHARMACY . . . . . . . . . . . . . . . . . . . . . . 2Z pRiVATE DOCTOR . . . . . . . . . . . . . . . . 23 OTHER pRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . 31 C½URCH . . . . . . . . . . . . . . . . . . . . . . . . 3Z FRIENDS/RELATIVES . . . . . . . . . . . . . 33 OTHER 41 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 311 HOW many L iv ing ch l id ren d id you have ot that t ime, NUMBER OF CHILDREN . . . . . . . . . I fw~n %F NONE, RECORO '00 j . 312 In ~hmt month end year d id you f i r s t s ta r t us ing MONTH . . . . . . . . . . . . . . . . . . . . . . F ~ th i s mthod? OK HONTH . . . . . . . . . . . . . . . . . . . . . . . 98 YEAR . . . . . . . . . . . . . . . . . . . . . . . OK YEAR . . . . . . . . . . . . . . . . . . . . . . . . 98 313 HO~ o ld were you a t that t irr~? AGE . . . . . . . . . . . . . . . . . . . . . . . . 31k CHECK 233: I ~*~ L ] 5 ] N O T PREGNANT PREGNANT | STERILIZED ~'~ STERILIZED ~3171 APe you cur rent ly do]rig something or us ing any r~thod to ¢ietay or avo id get t ing pregrmnt? '°1 I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 -~,353 12 194 NO. QUESTI041S AND FILTEAS 317 Which method are you (,ruing? 317A CIRCLE '06 ' FOR FEMALE STERILIZATIOn. SKIP COOING CATEGORIES TO PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 lUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 - - INJECT TOllS . . . . . . . . . . . . . . . . . . . . . 03 D I APHRAGN/FCk~M/JE LL Y/CREA,q,., , .~ ~327 CO~DON . . . . . . . . . . . . . . . . . . . . . . . . . 05 - - L )GAT IOM/FEM. STER . . . . . . . . . . . . . 06~ VASECTOMY/HALE. STER . . . . . . . . . . . 07 - - ~]24 NATURAL FAMILy PLANNING . . . . . . . . OJ~ .~2~ Id[ THDRAWAL . . . . . . . . . . . . . . . . . . . . . 09~ OTHER 10 .342 (SPEC]FY) YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L MO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 318 At the t l~ you f i r s t I t l r ted us ing the p i l l , d id you I ¢OCM~ULt I doctor or • nurse ? I 319 At the t lmyou Lost got p i l l s , d id you consu l t a doctor J YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I or a nut•e? I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 320 Hay I see the package of p i l l s you are us ing no~? RECORD NAME OF BRAND. I PACKAGE SEEN . . . . . . . . . . . . . . . . . . . . 1 I -3 22 BRAND H A ) r E I I I PACKAGE NOT SEEN . . . . . . . . . . . . . . . . 2 321 322 323 32/, 325 327 Do you ke~ the brand ~ o f the p la ts y~ ar t no~ u l ln l l ? RECORD NAME OF BRAND. DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 HO~ I~aCh does one packet /cyc le of p i l l s cost you? DR:I::::::::IT: Y What type o f t~tura l fmiLy p lann ing are you us ing : c , i e r~r , muc~, O i t l lngs , ovu la t ion , temperature , thermQGImterf or o ther method? IF RESPleNDENT D~ES MOT K#OW THE NAME, ASK HER TO DESCRIBE HOld SHE USES THE METHOD, AND CIRCLE APPROPRIATE CODE, CALENDAR . . . . . . . . . . . . . . . . . . . . . . . . L MUCUS, BILLINGS, OVULATION . . . . . . 2 L ~ 2 5 TEMPERATURE, THERP4~tETER . . . . . . . . 3 OTHER NETHO~ . . . . . . . . . . . . . . . . . . . . & in i lh i t ebonth and year was the s ta r l t l za t~o~ operet i~ performed? MONTH . . . . . . . . . . . . . . . . . . . . . . OK NONTH . . . . . . . . . . . . . . . . . . . . . . . 98 YEAR . . . . . . . . . . . . . . . . . . . . . . . [ ~ DK YEAR . . . . . . . . . . . . . . . . . . . . . . . . 98 Now mu£h d{d the s ter l L J za t io*~ operat ion cost you? PESO . . . . . . . . . . . . . . FREE . . . . . . . . . . . . . . . . . . . . . . . . DK . . . . . . . . . . . . . . . . . . . . . . . . . . 99998 ENTER STERILIZATION METHOO CCOE IN N(YATH OF INTERV[E~ IN COLUMN 1 OF CALENDAR AgO IH EACH 1401dTHOAOCTO OATE OF OPERATIGIdOR TO JANUARY 1988 IF OPERATION OCCURRED BEF~E 1988. CHECK 31T: Mi]~LM/PARTNER USlNGANOTHERNETHCO $TERILIZED [~ [~ J v v Where d id the Where d id you obta in i te r l L I za t (~ take (METHOD) tho les ( t ime? JLaCe? (NN4EOE FACILITY) PUgLIC SECTOR GOVERNMENT HOSPITAL . . . . . . . . . . . L1 BARA~C, Ay HEALTH STATION . . . . . . . 12 BARANGAY SUPPLY/SERVICE POINT OFFICER . . . . . . . . . . . . . . 1] RHU/PUERICULTURE CENTER . . . . . . . 14 MEDICAL PRIVATE SECTOR PRIVATE HOSPITAL OR CL IN IC . , . ,21 PHARMACy . . . . . . . . . . . . . . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . . . . . . . . 2 ] OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . 3 ~ CHURCH . . . . . . . . . . . . . . . . . . . . . . . . 32 FRIENDS/RELATIVES . . . . . . . . . . . . . 33 ~2 OTHER 41 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 I 195 ~x "0 . J QUESTIONS AND FLLTERS I 328 Note Long does i t take to t r i ve t from your hot~e to (¢dOURCE)? IF LESS THAN 2 HOURS, RECORD NINUIES. OTHERWISE, RECORD HOURS, SKIP COOING CATEC~¢IE8 I TO MINUTES . . . . . . . . . . . . . . . 1 ~ I HOURS . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . 9998 ]29 I s ~t l i l y or d i f f i cu l t to get there? EASY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I DIFFICULT . . . . . . . . . . . . . . . . . . . . . . . 2 I 330 Noud ld yOU t r lv l [ to (SOURCE) the Last t l~ you Men(? WALKED . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PERSONAL VEHICLE/CART . . . . . . . . . . . 2~832 HIRED VEHICLE/CART . . . . . . . . . . . . . . ] PUELIC TRANSPORTATION . . . . . . . . . . . 4 OTHER 8 (SPECIFY) I 331 | How much d id i t co l t you to t rave l to and from PESO . . . . . . . . . . . . , (SOURCE) on your L i l t v i s i t ? ~ ~-~ I FREE . . . . . . . . . . . . . . . . . . . . . . . . 99996 OK . . . . . . . . . . . . . . . . . . . . . . . . . . 99998 332 On which days o f the Week does th i s (SOURCE) prov ide fmL(y pIMInirIQ i t rv l¢ i l /S+l ie+? ENCIRCLE ALL THAT APPLY. HONDAY . . . . . . . . . . . . . . . . . . . . . . . . . . A TUESDAY . . . . . . . . . . . . . . . . . . . . . . . . . 8 ~EDNESDAY . . . . . . . . . . . . . . . . . . . . . . . C THURSDAY . . . . . . . . . . . . . . . . . . . . . . . . D FRIDAY . . . . . . . . . . . . . . . . . . . . . . . . . . E SATURDAy . . . . . . . . . . . . . . . . . . . . . . . . F SUNDAY . . . . . . . . . . . . . . . . . . . . . . . . . . G OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H ~ 8 ~ 333 Ar t the days when fami ly p tannmg serv ices /suppL ies are YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 | i v l l t lbLe I t (SOURCE) cc~venient fo r you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3~ I Are the hour i o f oper . t lon at (SOURCE) . . . . . . . . . t i YEs . 1 I fo r you? XO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ($CtJRCE) from the t im yo~J a r r ived unt i l the t ime MINUTES . . . . . . . . . . . . . . . 1 you Le f t? HOIJR S . . . . . . . . . . . . . . . . . 2 [F LESS THAN 2 HOURS, RECORD MINUTES. OTHERWISE, RECORD HOURS. OK . . . . . . . . . . . . . . . . . . . . . . . . . . . 9998 337 | On your l i s t V i s i t to (SOURCE) were you unable tO YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I | I obtmln your p rescr idad or p re fer red method because I i t uam no Longer In stock? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I ~n you V iS i t (SOURCE) fo r f~ iLy pl . . . . g . . . . . . . . / , I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I SuppLies, do yOU USUaLLy ccxubine the t r ip w i th o ther I I a~iaL , fmi iy or bus i rwss ac t iv i t ies? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 .340 l ip | IAltch o f these ac t iv i t ies i s usua l ly combined w i th I fuml ty p lann ing V iS i t ? ENCIRCLE ALL THAT APPLY. On yc~Jr Last v i i i ( to th i s p lace , how much d id you pay/donst e? CHECK 317/317A: IUDPER DEVICE [NJECTIOI4S PER INJECTION OIAGHRAOR/FOAM/OREAM PER PIECE OR TUBE PER PIECE OTHER (SPECIFY) V[SI1 FR IENDS~RELAT IVES . . . . . . . . . A MARKET ACTIVITIES . . . . . . . . . . . . . . . E UORK . . . . . . . . . . . . . . . . . . . . . . . . . . . . C HEALTH CARE FOR SELF OR OTHER FAJ41LY MEMBER . . . . . . . . . . . . D OTHER E (SPECIFY) PESO . . . . . . . . . . . . . . . . . . . . FREE . . . . . . . . . . . . . . . . . . . . . . . . . . 996 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998 14 196 NO. 342 QIJESTIONS AND FILIERS Whir i l th ! leain rea ion yon decided to use (CUItRENT RETHO0 FROM 317/317A) ra ther th in s0ee o ther le tha l o f fami ly p t lnn lng? ]43 Arl you h lv ing any pr®t== in us ing (CURRENT MEIHO0)? ¢KEOK 317A~0 317A: 345 ~7 CCOING CATEGORIES REC~qHENDAIION OF FANILy PLANNIWGWO~KER . . . . . . . . 01 RECONi4EWDATIONOF FRIEXD/RELATIV1E . . . . . . . . . . . . . . . 02 51DE EFFECIS OF OTHER NETHOOS.03 CONVENIENCE . . . . . . . . . . . . . . . . . . . . O/t ACCESS/AVAILABILITY . . . . . . . . . . . . 05 COST . . . . . . . . . . . . . . . . . . . . . . . . . . . 06 WANTED PERMANENT METHO0 . . . . . . . . 07 HUSBAND PREFERRED . . . . . . . . . . . . . . 08 WANTED NORE EFFECTIVE NETHO0.09 RELIGION . . . . . . . . . . . . . . . . . . . . . . . 10 OTHER 11 (SPECIFY) O~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 SKIP TO YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I ke l l t I I the ~ ln pro4)Lem? HUSBAND DISAPPROVES . . . . . . . . . . . . 01 SIDE EFFECTS . . . . . . . . . . . . . . . . . . . 02 HEALTH CONCERNS . . . . . . . . . . . . . . . . O~ ACCESS/AVAILABILiTY . . . . . . . . . . . . 04 COST . . . . . . . . . . . . . . . . . . . . . . . . . . . 05 INCONVENIENT TO USE . . . . . . . . . . . . 06 $TERIL)ZED, ~ANTS CHILDREN . . . . . . . . . . . . . . . . 07 OTHER (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 liq~+4AM/PAR T ME R [~ CURRENTLY USING [~ CURRENTLY E~ STERILIZED NATURAL FAMILY PLANNING, US[NB A 351 WITHDRAWAL a OTHER 351 MCOERN NEIHOD TRADITIONAL METHO0 V B I rce you begnt lus tng (CURRENT METNOD)(this t ime) , have I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 you l IWly l obtBir led J{ from {he SHale pLace7 I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ~351 tAly d id yOU StOp going to the p lace td~ere yceJ f i r s t Olat I |ned(CURRENTI4ETHOD)(this t ime)? COST . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 DISTANCE . . . . . . . . . . . . . . . . . . . . . . . . 2 POOR SERVICE . . . . . . . . . . . . . . . . . . . . 3 iNACCESSIBLE/UNAVAILABLE . . . . . . . . 4 CHANGE OF RESIDENCE . . . . . . . . . . . . . 5 RUMORED pOOR SERVICE/ INAVA]LABIL]TY OF SUPPLIES. . . . .6 OTHER 7 (SPECIFY) 348 Sere d id you go to get th i s method the f i r s t t l r~? (MANE OF FACILITY) IF NAME IS SANE AS IN Q.327, SKIP TO Q.351. PUBLIC SECTOR GOVERNMENT HOSPITAL . . . . . . . . . . . I1 BARANGAY HEALTH STAT[O~ . . . . . . . 12 8ARANGAY SUPPLY/SERViCE POINT OFFICER . . . . . . . . . . . . . . 13 RHU/PUERICULTURE CENTER . . . . . . . 14 MEDICAL PRIVATE SECTOR PRIVATE HOSPITAL OR CL IN IC . . . .21 PHARMACY . . . . . . . . . . . . . . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . . . . . . . . 23 OTHER PRIVATE SECTOR STO~E . . . . . . . . . . . . . . . . . . . . . . . . . 31 CHURCH . . . . . . . . . . . . . . . . . . . . . . . . 3~ FRIENDS/RELATIVES . . . . . . . . . . . . . 33 OTHER 41 3SI DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O 15 197 I~0. 349 ~JEST[~S AND FILTERS NOV tong ~oe= i t take to t rave l from yc*Jr home to IF LESS THAll Z NI3JRS, REC~MINUTES. OTHERVISE, RECORD HOURS* SKIP I CODING CATEGORIES TO I MINUTES . . . . . . . . . . . . . . . 1 ~RS . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . 9998 350 [ I I t easy or d i f f i c~t t to get there? CHECK 317~t~ 324: k(CNAMANO PARTNER MOT STERILIZED ~-~ EASY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 DIFF]CUL! . . . . . . . . . . . . . . . . . . . . . . . 2 STERILIZED BEFORE JANUARY 1988 STERILIZED SINCE JANUARY 19~ I ~370 I ~-353 352 353 ENTER iG'ETHOD CODE FROM 317 IN CURRENT ~TH IN COLUMN 1 OF CALENDAR. THEN DETERMINE WHIM SHE STARTED USING THIS METHCID THIS TIME. ENTER METHO0 COOE iN EACH ~TH OF USE. I LLUS1RAT I VE gUEST 1~4S: " When d id you s tar t us iN th i s method cc~ttr~uc~sty? " Hot~ tong have you beef', us ing th i s method contir~Jousty7 I ~ouid l i ke to ask =Dine qoest ic r l s abo~t 81L o f the (o ther ) petards In the Lest feu year= dur ing which you or your par t r~r used a method to avo id get t tng pregnant . USE CALENDAR TO PROBE FOfl EARLIER PERIODS OF USE AND NONUSE, STARTING ~ITN MOST RECENT USE, BaCK TO JANUARY 1988. USE IIA/I~S OF CHILDREN, DATES OF BIRTH, AND PERIGO$ OF PREGNANCY AS REFERENCE POINTS. ]M EACH MONTH, ENTER CCOE FOR METHOD Ok "O" FOR NONUSE IN COLUMN 1. IN COLUMN 2, ENTER ~ES FOR DISCONTINUATI(~d NEXt TO LASt ~TH OF USE. NUMBER OF CCOES ENTERED IN COLUMN 2 MU!;T BE THE SANE AS THE M~ER OF INTERRUPTIC¢4S OF CONTRACEPTIVE USE IN COLL,,MN 1 ASK WHY SHE STOPPED USING THE NETNQD. IF A PREGNANCY FOLLOS~EO, ASK UHETHER SHE BECAJq[ PREGNANT UNINTENTIOIdALLY UHILE USING THE NETHO0 OR DELIBERATELY STOPPED TO GET PREGitAI~T. ILLUSTRATIVE QUEST IOIdS: COL UKM 1: -When WaI the tes t t im you ~8td a method? Uhich r~ethod was the(? -kStet~ d id you a tar t u=lr lg that cry(hod? NOW tong a f te r the b t r th o f (NJ~4E)? -HOW tot41 d id you t~e the ~thOd thenT COLLIN~ 2: - I~y d id you s top us ing the (METHOD)? *Did yOU beCO~ pregnant ~ i le us ing fMETHO~), or dad you Stop to get pregnant , o r s top fo r s~lw other reason? I F DELIBERATELY STQ~PED TO BECOME PREGNANT, ASK: =HOW m~ly months d id i t take you to get pregm~nt a f te r you stopped us ing (METHO0)? AIdO ENTER =0 = IN EACH SUCH IONTN IN COLUMN 1. 16 xxiv 198 355 356 357 358 359 361 362 OUESTIONS AND FILTERS 88EC~ CALENOAR: NETH(~USED XN NOMTN OF dAi . 1988 SKIP CODING CATEGORIES I TO I NO NETHO0 USED I I %N NOKTH OF JAN. 1988 I iN thor you were ush lg (N~THOD) in Jaury 1988. Wh~t d id yo,a • t | r t uair41 (~ETHOD) that t i~e? THIS DATE SHOULD BE PR|OE TO JANUARY 1988. YEAR . . . . . . . . . . . . . . . . . . . . . . . L_ .~ I ] l ee that you ~r ! not id le ( i any ~ethod o f ¢ont r i cept i0~ in J l ial~lry 1988, Did you ever usa • ~thOd before that? CHECK 220: HAD B[RTH BEFORE J Ak~AR Y 1988 ¥ D id yOU ~e a ~ethod between the b i r th o f (~N4E OF LAST CH%LO BQ~N BEFORE JANUARY 1988) and J l~Uary 1988? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 J NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ~60 i NO 8IRTH BEFORE I I JANUARY 1958 -359 I m YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I l NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 r388 When d id you s top USinQ a method the fas t t i~ pr io r to J•rxdary 1988T CHECK 317: CURRENTLY USING r---1 NATURAL FAMILY PLANNING, L~ WlTHORAi~AL, OTHER v TRADITIONAL NETHOD (SKIP TO 366) HOT CURRENTLY (~ US]NG A ~.ETHO0 V Co yc*J Int~.nd to use a method to deLay or avo id pregnancy s t any t{me in the fu (ura? ~ERN NETHO0 I I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 L363 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I l OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ~366 What IS the main ree$~ly~Jdo not in tend to use a aethod? UANTS CHILDREN . . . . . . . . . . . . . . . . . 01 - LACK OF KNOWLEDGE . . . . . . . . . . . . . . 02 OPPOSED TO FAHILY PLANHIXG., , , ,03 COS( TOO MUCH . . . . . . . . . . . . . . . . . . 06 SIDE EFFECTS . . . . . . . . . . . . . . . . . . . 05 NEALIN CONCERNS . . . . . . . . . . . . . . . . 06 HARD 10 GEl NEIHOOS . . . . . . . . . . . . O? RELIGION . . . . . . . . . . . . . . . . . . . . . . . 08 FATALISTIC . . . . . . . . . . . . . . . . . . . . . 09 OLD/DIFFICULT TO GET PREGNANT/ INFREG~JENY SEX/HUSBAND AWAY. . . (0 MEnOPAUSE/HAD NYSIERECTi~4Y.,.I¶ INCO~VENJENT . . . . . . . . . . . . . . . . . . . 12 NO! MARRIED . . . . . . . . . . . . . , . . . . . . 1] 01HER 14 (SPECIFY) OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9&---- Oo you in tend to use • mmthod to de lay or avo id YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 p rc~z~y w i th in the ~ext 12 months? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 D[ . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 17 199 *366 SKIP 140. QUESTIO~IiSANO FILTERS CCOIHGCATEGORIES TO 364 ~enyouLa ie a n~thod , ~ ich n~thod~J td you pre fer tO USa? P ILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 tuo . . . . . . . . . . . . . . . . . . . . . . . . . . . . O? INJECTIONS . . . . . . . . . . . . . . . . . . . . . 03 OIAPNRAG/4/FOAM/JELLY/CREAN.O& CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . 05 FEMALE STERILIZATION . . . . . . . . . . . 06 HALE $1ERIL IZATIOH . . . . . . . . . . . . . 0? ~ATURAL EAN]Ly PLANNING . . . . . . . . 0 ~ WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . 09 OTHER 10 (SPECIFY) UMSURE . . . . . . . . . . . . . . . . . . . . . . . . . 98 - ,366 365 I~ere can yOU get (METH~O MENTIONED IN 36&)7 (NAME OF FACIL ITY) PUBLIC SECIOR I GOVERNNEKT HOSPITAL . . . . . . . . . . . 11 - - 8ARANGAY HEALTH STATIOX . . . . . . . 12 8ARANGAy SUPPLY/SERVICE POINT OFFICER . . . . . . . . . . . . . . 13 RHU/PUER[CULTURE CEXTER . . . . . . . 14 MEDICAL PRIVATE SECTOR PRIVATE HOSPIIAL OR CL IN IC . . . ,21 PHARHACY . . . . . . . . . . . . . . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . . . . . . . . 23 OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . 31 - CHURCH . . . . . . . . . . . . . . . . . . . . . . . . 32 - - FRIENDS/RELATiVES . . . . . . . . . . . . . 33 OTHER 41 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ~ .370 366 Do you knou o f a p tace k~here you can obta in YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I a method o f fmiLy p tann ing? I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ,370 367 Where i s tha~? (NAME OF FACIL ITY) PUBLIC SECTOR GOVERNNENT HOSPITAL . . . . . . . . . . . 11 8ARANGAY HEALTH STATIOn4 . . . . . . . 12 8ARANGAV SUPPLY/SERVICE POINT OFFICER . . . . . . . . . . . . . . (3 RHU/PUERtCULTURE CENTER . . . . . . . 14 HEOICAL PRIVATE SECIO~ PR[VAIE HOSPITAL OR CL IN IC . . . .21 PHARMACY . . . . . . . . . . . . . . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . . . . . . . . 23 OTHER PRIVAIE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . 31 CHURCH . . . . . . . . . . . . . . . . . . . . . . . . 32 - - FRIENDS/RELATIVES . . . . . . . . . . . . . 33 OTHER 41 (SPECIFY) D~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 .3?0 .~ I1~ tOflg does i t take to t ravet IIINUTES . . . . . . . . . . . . . . . 1 ~ I f rom your home to th i s p lace? I HOURS . . . . . . . . . . . . . . . . . Z IF LESS THAN 2 HOURS. RECORD MINUTES. OTHERWISE I RECORD HOURS. DK . . . . . . . . . . . . . . . . . . . . . . . . . . . 9998 369 [ , I t e , ,y o r d i f f i cu l t to get there? I EASY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I I DIFFICULT . . . . . . . . . . . . . . . . . . . . . . . 2 370 In the Loaf month , have you heard a ¢~essage | mbout fmi |y p tann lng on : YES NO I th l r~ io? RADIO . . . . . . . . . . . . . . . . . . . . . . 1 2 t I1[ I I v lo J QII? TELEVISION . . . . . . . . . . . . . . . . . 1 2 371 l= i t acceptab le o r not acceptab le to you fop fami ly ACCEPTABLE . . . . . . . . . . . . . . . . . . . . . . 1 | p (enn ing in fo rmt icq l to be prov ided on the rad io o r I te lev i s ion? NOT ACCEPTABLE . . . . . . . . . . . . . . . . . . 2 DR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 18 200 SECTION 4. NA]~RNA~ANDCHI~OHEALTH SUBSECTION 6A, PREGNANCY AND BREASTFEEDING 403 CHECK 2]0: ONE OR PI~E B]RIHS SINCE JAM, (9~ NO BIRTHS SINCE JAN. 1988 I I . (SKIP TO 465) I ENTER THE LINE k'UKBER, MAKE, AND ~IRVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1988 IN THE TABLE. ASK T)LE ~ST IOM$ ABOUT ALL OF TNESE 81RIH$. BEGIN l i~ IN THE LAST B IRTh . ( I F Tt(ERE ARE MORE THAN 3 B(RTNS, USE ADDITIC~AL FO~MS). NOW I ~utd t ihe to ask y~ some I~ore tN~stions abc~t the hearth of ate your ch i ldren born Jr1 the p4st t i re ye l r l . w i t ( ta lk ~bout ~e ch l (d at • t ime. LIKE NLINOEil LAST O.R. .E T-TO-LAST .IRTH N O/ CO;dD" FR(~" LASt BIRTH FROM Q. 210 NAME NAME N AND Q. 221 ALIVE ~ DEAD ~ ALIVE ~ DEAD ~ ALIVE ~ DEAD v / v v ~ v v ~mmm~J l v I lml l At the t l l~ y~ I~l~ame THEN . . . . . . . . . . . . . . . . . . . . . 1 THEN . . . . . . . . . . . . . . . . . . . . . 1 THEN . . . . . . . . . . . . . . . . . . . . . 1 youPregtuuntw~t ulthto ~C~(NAKE ), d id (SKIP . . . . . . . . . . . . . . . . . . TO 6DE)_ / (SKXP . . . . . . . . . . . . . . . . . . TO 4O5)~ / (SKIp(SKIP . . . . . . . . . . . . . . . . . . IoTO GO5).;O5)" Pregnant ~LIW, d id you LATER . . . . . . . . . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . . . . . . . . . ~nt tO ~Olr unt i l Later or d id you t~•~t ~o (more~ NO MORE 3~ NO MORE 3~ I NO MORE 3 ¢hJLdre~ i t •(L? (SKIP TO ~,0S)~ (SKIP TO /*O5)* 404 HOU = tonger ~ou(d you ~ ~ Like to here U~itod? MONTHS . . . . . . . . . . . . 1 MO~T HS . . . . . . . . . . . . 1 140~ ~'HS . . . . . . . . . . . . 1 YEARS . . . . . . . . . . . . . ~ YEARS . . . . . . . . . . . . . Z YEARS . . . . . . . . . . . . . OK . . . . . . . . . . . . . . . . . . . . . 998 OK . . . . . . . . . . . . . . . . . . . . . 99B OK . . . . . . . . . . . . . . . . . . . . . 998 4O5 When you v~re pregnant with (NAME), d id you see • nyone fo r preru~tal care fo r th i s pregnancy? IF YES, t*ql~mdid yoiasee? Anyone eL•e? REC(~D ALL PERSONS SEEN. HEALTH PROFESS %~qAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . O MIDWIFE . . . . . . . . . . . . . . . . . C ~THER PERSON TRAINED HILOT . . . . . . . . . . . O UNTRAINED HILOT . . . . . . . . . E ~THER F dEALTH PROFESSIONAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . B MIDWIFE . . . . . . . . . . . . . . . . . C 3THER PERSON TRAINED NILO! . . . . . . . . . . . D UNTRAINED HILOT . . . . . . . . . E ~THER F HEALTH PROFESSIONAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . B MIDWIFe . . . . . . . . . . . . . . . . . C DTHER PERSON TRAINED HILOT . . . . . . . . . . . 0 UNTRAINED NILOT . . . . . . . . . E OTHER F (SPECIFY) (SPECIFY) (SPECIFY) VO~ . . . . . . . . . . . . . . . . . . . . 6 VDOiCE . . . . . . . . . . . . . . . . . . . . ( ~O~2WE . . . . . . . . . . . . . . . . . . . . (SKIP TO 409)~ (SKIP TO 409)~ (SKIP TO &09). 4~ li ~'" YOU glv~ 'prtmata( card fo r YES . . . . . . . . . . . . . . . . . . . . . . 1 DKYES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 YES . . . . . . . . . . . . . . . . . . . . . . 1 ]m th i s pregnancy? NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 ko . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 GK . . . . . . . . . . . . . . . . . . . . . . . 8 k l re you Idlen you f i r s t MONTHS . . . . . . . . . . . . . . MO~THS . . . . . . . . . . . . . . NOHTHS . . . . . . . . . . . . . . SaN SOmeOne for • pret~atat check o1"1 th J l Prltg~41/~y? OK . . . . . . . . . . . . . . . . . . . . . . Q8 OK . . . . . . . . . . . . . . . . . . . . . . 98 OK . . . . . . . . . . . . . . . . . . . . . . 98 | d id you h&ve dur l r~ NO, OF VISITS . . . . . . . NO. OF VISITS . . . . . . . RO. OF VISITS . . . . . . . th i | pregnancy? OK . . . . . . . . . . . . . . . . . . . . . . 98 OK . . . . . . . . . . . . . . . . . . . . . . 98 bK . . . . . . . . . . . . . . . . . . . . . . 98 | t~hen y~ were Pregrwnt Y~S ~0 Ol' YES KO Oi~ YES NO OK •ith (NAME) ulere you given any of the fo l lowing: IRON TAB/CAP.1 2 8 IRON TAB/CAP. . , . I 2 8 IRON TAB/CAP.,1 2 8 %ron t~iet /c#q)sute? IODINE CAP . . . . . . . 1 2 0 IOOINE CAP . . . . . . . 1 2 8 ICIDINE CAp . . . . . . . 1 2 0 I och r~ Capeu i a? Tetanus toxo ld , an in jec t ion TETANUS TOXOID.1 2 ~ TETANUS TOXOID.,.1 28 TETANUS TOXOID.1 2 0 to p r ivet the ~ fro~ L - -~ L -~ c~'n~tsi~gett (~g tet~, , f ter thatbirth?fs~ (SKIP TO 41( SKIP ?0 411 (SKIP TO 411) ,,o 1oo,,., ,hi. Pr. , [] [] [Z] ho~ ma,*Jy t imes d id yOU get TINES . . . . . . . . . . . . . . . . . . TIMES . . . . . . . . . . . . . . . . . . TIMES . . . . . . . . . . . . . . . . . . Tetanun ToxoJd In ject ion? OK . . . . . . . . . . . . . . . . . . . . . . . 0 DK . . . . . . . . . . . . . . . . . . . . . . . 8 OK . . . . . . . . . . . . . . . . . . . . . . . O 19 201 &11 Whare d id yo*J O Iv l b i r th to (~4E)? LAST BIRTH M~4E NOME OVA4 HOME . . . . . . . . . . . . . . . 11 OTHER H~I4E . . . . . . . . . . . . . 12 PUBLIC SECTOR GVT. HOSP[TAL . . . . . . . . . . E1 GVT. HEALTH CENTER. . . . .Z~ GVT, HEALTH POET . . . . . . . 23 PRIVATE SECT~ PVT. HOSPXTAL/CL IMIC , , ,31 01HER 41 (SPECIFY) NEXT*TO-LAST GIRTH NAME NONE OWN H(~qE . . . . . . . . . . . . . . . 11 OTHER HONE . . . . . . . . . . . . . 12 PUBLIC SECTOR GVT. HOSPITAL . . . . . . . . . . ~ I GVT. HEALTH CENTER. . . . .22 GVT, HEALTH pOST . . . . . . . 2~ PR[VATE SECTOR PVT. HOSPI TAL /CL IN IC . . .31 (SPECIFy) SECOIdD-FR~I~-LAST BXRTH MANE HQ/4E OWN HOME . . . . . . . . . . . . . . . 11 OTHER HONE . . . . . . . . . . . . . IE PUBLIC SECTOR GVT. HOSPITAL . . . . . . . . . . E l GVT. HEALTH CENTER. . . . .22 GVT. HEALTH POST . . . . . . . 23 PRIVATE SECT~dl PVT. HOSP ITAL /CL IN IC , , .31 01HER &~ (SPECIFY) 412 ~qIo I I I I I tK I In tho d i [ Ivery o f (14N<t)? AJ~y~+IO e l la? PR~E FOR THE TYPE OF PERSON AND RECIteD ALL PERSl~4~S ASS iST ING. HEALTNPROFE~SIOMAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . B MIDWIFE . . . . . . . . . . . . . . . . . C OTHER PERSON TRAINED NILOT . . . . . . . . . . . D UNTRAINED HILOT . . . . . . . . . E RELATIVE . . . . . . . . . . . . . . . . F OTHER G HEALTH PROFESSIONAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . G MED~IFE . . . . . . . . . . . . . . . . . C OTHER PERSON TRAINED HILOT . . . . . . . . . . . O UNTRAINED H]LOr . . . . . . . . . E RELATIVE . . . . . . . . . . . . . . . . F OTHER G HEALTH PROFESSZ~IIAL D~TD+I . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . R MIDVX FE . . . . . . . . . . . . . . . . . C OTHER PERSON TRAINED BXLOT . . . . . . . . . . . O UNTRAINED HII .O+ . . . . . . . . . E RELATIVE . . . . . . . . . . . . . . . . F OTHER G (SPECXFY) (SPEC iFy) (SPECIFY) NO ONE . . . . . . . . . . . . . . . . . . . . H NO ONE . . . . . . . . . . . . . . . . . . . . H MOO+ME . . . . . . . . . . . . . . . . . . . . H &13 WaS (NAME) born on t fm 014 TXHE . . . . . . . . . . . . . . . . . . 1 ON T]HE . . . . . . . . . . . . . . . . . . 1 ON T[14E . . . . . . . . . . . . . . . . . . 1 o r p rmture ly? PRE+4ATURELY . . . . . . . . . . . . . . E PREMATURELY . . . . . . . . . . . . . . E PREN+~TURELY . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 OK . . . . . . . . . . . . . . . . . . . . . . . G DK . . . . . . . . . . . . . . . . . . . . . . . 8 414 ~aS (NMIE) de l ivered YES . . . . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . . . . . . . . I I YES . . . . . . . . . . . . . . . . . . . . . . I ~DyCle la r~a~ I IK ; t (m~ MO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . Z NO . . . . . . . . . . . . . . . . . . . . . . . E ~1¢~n (NAM4E) ~l l l bor~, ~as ha /sha : vaPy l i P |e+ Larger th in average , averaRe , miLer than lvaraGe + Or very l l i l L? VERY LARGE . . . . . . . . . . . . . . . I i LARGER THAN AVERAGE . . . . . . 2 AVERAGE . . . . . . . . . . . . . . . . . . 3 ! SMALLER THAN AVERAGE. . . . .4 VERY ,,~4ALL . . . . . . . . . . . . . . . VERY LARGE . . . . . . . . . . . . . . . 1 LARGER THAN AVERAGE . . . . . . Z AVERAGE . . . . . . . . . . . . . . . . . . 3 $~ALLER THAN AVERAGE. . . . .4 VERY SFiALL . . . . . . . . . . . . . . . 5 OK . . . . . . . . . . . . . . . . . . . . . . . 8 VERY LARGE . . . . . . . . . . . . . . . 1 LARGER THkN AVERAGE . . . . . . AVERAGE . . . . . . . . . . . . . . . . . . 3 SMALLER THAN AVERAGE. . . . .~ VERY SMALL . . . . . . . . . . . . . . . 5 OK . . . . . . . . . . . . . . . . . . . . . . . ~16 417 ~as (NAME) ~ lRh~ i t b i r th? I F YES, ho~mJch d id LNN4E) ~ igh? D id you le411myorm for pOi t l~t l [ check*NO a f te r the b i r th o f (LAST CHILD)2 XF YES+ t4homdld you see? Anyone eLse? YES, WEIGHT IN POUNDS AND OUNCES YEE, I~EIGHT UMKNC~N.+,9998 ROT NEIGHED . . . . . . . . . . . 9992 (EALTH PROFESSIONAL DOCTOR . . . . . . . . . . . . . . . . . . A NURSE . . . . . . . . . . . . . . . . . . . B NLD~/[FE . . . . . . . . . . . . . . . . . C DTHER PERS~ TRA] NED HILOT . . . . . . . . . . . O UNTRAINED HILOT . . . . . . . . . E 3TNER F YES, ~E]GHT iN AND POUNDS OUNCES YES, WEIGHT UNKNOWN. .9998 NOT WEIGHED . . . . . . . . . . . 9992 ,,,II,E, r ', ~ * II , , L,q ]JLE,.I P + u ~++!+ . . . . . . . ,m!u t+P~t*+ +*+ *++++~i++ + +*3+ELL *::+,t:++Fl ]h.hi.l +.+.hhhl.t. ii . +mhflm + . h. . .hh+ +I,,H., L , +f l ,+~' ++'].I r, , 'ILLhHILmH + +'~t+ +'~']i'+ ++ ji@+~ +++ ,, . . . . . . H, . , H+. . . ,+~ ,+L . , , . , . , . , . , ,h ,L . .+ ]fit~[p' ' ' , t+ 'h + tl+[+'l[,'+ ~,+'W,ME] . . . . . . . . . . . . . . . . . . . . . . . . . . . +~. , [ .+ I ]llmihl ]q +h]l + Lflll "]J'L %;IH qlfllLH ] .++HII %+.]llpdlrl. N hpl + ] ' t , ] tEll.+ ].:++'t+ . [ r [ + 13 '4 ] t + +. + 1# ++ 4t+ tt++jt'+++, t L++~++H]+ t t ++]~ I+,,+,+ - . i , . . , ; = + .p+.t+~ ++it+++ ~+ ~,+++t+:[:: + . +,+:t!+tt,+ ++ +dE+It+it tt +lhL+h. I, . q]flllHc+ll L ] " .J llFg+ 'J+PB]Jql"iPJ L: L:L *'+++ . . . . . . P "* tat h+~+¢ +~: +,+ +~+~t;+~ .L , , . . +++++,m. m,+ m. +, I+ ~Id YES, ME IGHT IN POUNDS AND OUNCES YES. ~JEEGHT UNKNOWn. , .9998 MOT WEIGHED . . . . . . . . . . . 999~ mml i mt , , i,qmmmmLm+ ,l~m, m+ t"J Hhl I ' ['[ ' ILl .,,,~ J,,ll~ 'J, '~,,h,lI,L .~l,l.h~,~ fil ,Lira.ll[,dl, I,~,,, I ]~tlgl~fiL T~U . IIM,llLmr,**~MJ[,IILILNII, u i~ ",I','!!I~*,LMU,IN II]IJlUIIIHB .11 Fd II II L m]l Lr Elllill~llll]ll L~LhHllllll~lll i I ,],~m, iL~llll~ll,fl .pNl~e,]larLl,],l [ -~ , L,/[llllgn:rl RECTO ALL PERSONS SEEN. (SPECIFY) G4~E . . . . . . . . . . . . . . . . . . . . C (SK IP TO 420L~ b i r th o f LLAST CHILD) d id you DAYS . .1 I1,',I, J I . k IiII,rL r ~ imJlkll [dll lrhld 1 , hI~JIEhlE~ ~Jhd]~' ~ rz[]~J~h~H~[udl] l it IIE~L~lllll[+lb+~ll~] .mrlrE, ,, , ,,,m Hp ,,m,,im,, + mmlm; l ,H ~,.,,,,, ~ ,. mmm. . ]~, m+lr, . . . . . . . . . . . I I " " I t I IIII', ' ', * I ll'*!Jl/ ' ' ~]*rt!!;l~["l IhLtL h+,' , , ,I +l,l~[lll,lll[~ ,,h~rLllL ]1~ 2O 202 419 420 421 422 ~h l t serv ices d id you rece ive dut i fu l your pos t rmt i l check-u RE~ ALE SERVICES RECEIVED* LAST BIRTH NAME CHECK'UP OE 6~.BY . . . . . . . . . A CHECK'UP OF MOTHER . . . . . . . B INSTRUCTIONS IREASTFEEDING/ F~I4ULA FEEDING . . . . . . . . C FANILY PLANNING ADVICE/ SERVICE . . . . . . . . . . . . . . . . D 3THEN E (SPECIFY) HIS your per iod re turned i l l ' e l the b{r th o f (NN4E)? ENTER '~X '~ IN COl.] OF CALENDAR IN MCITB AFTER BIRTH AND IN EACH 14C#TN TO CURRENT M~3MTH (OI TO CURRENT PREGNANCY) (SKIP TO 423) NEXT" TO" LA~| gIBTR NAiL I;dlll~,l~,l_ ,i,~1,.i ~,,r~III~FIIII,IFrlP~,,E~I~,IIt I:~IIFZ:]! '-'~'l.rh~'.'".=l~lr',lP=, =.:~n=~' LU. . . .~ .h l . IrE .),fl~ .].lrlhllH,hlhlll.==mdlhllhflhlflllllhlhlffdllil IlU'H'IUHlll]IIFpqqUUqlfflIIflfflIfllLIIIIII~IIIITLlill li:JiLIl!l!]ii[ihl]it[lllli[[llh]l[ll!lllL[Ell![HlilliFlilll II I IIIl*l~llllleqql~Lilllllhlhll~tl.l~lqillLiHIIILiilllHiifllmlll hl'lhl]~hll!fflllllrdllhUl,~qlfl]llhlllLLIIIIILIIIL~LIIIIl~ ~.llW~l]il~'i~]L:llhll[ll]l]![l15111ml~['llllIWil]][flll]F[mll! . lii"'"'"i[N ., ,,,, tills' i ] J . t lh~. . . I J . l . [ IH! l l l l , i l ,111 ~11 laLL~I la J i .~ml I~lllllllEElia u ~ll~lll]ll~dla J ,~l l l~l l l l ~ i lu ' f f l dl ~i hh}ldlllhHI i J i l l II ,.~.l.hdd.dlll.J.h.]l.dlt.lillLt,ht. . . . . . . . . 1 , , . , . . . . . . . . . ,, ,,I .,,,,, ~,,.~I~,&,[ . . x . . , . .u . . . , :~ . ;, I II111[:l,llll;:il~;~l[lll111111111FIlllllll=l~11[illllIIlflil]~llflll[lll~t I . , I . ih,ll, ['llll ,l i:~Jl;i:i ;~L !=ii!;itliili:i;!ii! ' ,:'ff,!ii'=~ i[Eii,~t~q"d~ll rtlmj Lr " '1'11 [ Ilill riiq] ']]]ffqmlffllll{H Hit"eft tli t 'aH I~CCa" a ILLflH,LllCa,Jr i alldlq]HII]Jfflq]~pChlF~ I I I I ~ ]", E ] I [ I )Jl,[i),, ~) I] ] [iiHff i]1 . . . . ,q , r SEC~'~RO~-LAIT | I I TN Nk~ [!!ll[!!i[l!!ill!! lU! ill|l!dill[ il] I I l~ ] I I I I I IB IItE lillffT~HII I III Bl,lrrllllllililllill l lllllllNl iNJili i Tii iiii glll,"~,~ll~',llllllllll!!ll~lll'~lllll~llll~l"%llfil~ !!li]]t!!!!!]¢i?!!!]li!!!i]!Wt,~!!!!!!]!!i!!!]~dfifi!!,~!!ii![!!!!!HH For hOt~ Iltirff I~ l th l a f te r the b i r th o f (NN4E) d id yOU not h ive I Per iod? ENTER "X # IN COL.3 OF CALENDAR FOR THE NUMBER OF SPECIFIED 14ONTHS ~]THOUT A PER[OD, STARTING IN THE MONTH AFTER BIRTH. I f LESS THAN ONE MONTH UITHOIJT A PERICO, ENTER "O** IN COL,] IN MONTH AFTER BIRTH. PREGNANT U%REe V (SKIP TO 4261 /*]4 I H ive y~.J ra l tml ( I i l x~t YES . . . . . . . . . . . . . . . . . . . . . . 1 ] r i lmt t f l l l l~ l the b i r th (SKIP TO 4E6)= " I of (~)? NO . . . . . . . . . . . . . . . . . . . . . . . 2 [SKIP TO 427) , ,,,,,,i ,11 ,,,r,,rt,,ll~L,J,~E~l~E,l~ PP,I] ~ , E,,It,E,,,, ,,,~=,q,U.,,,U,,H.I ~,, , ~,,~',,, -,_ Li,]~,,I,iI,, u i]] 'll r,]]l~,l r,., hll I*,l~'E,,~ll[lli]JJ["fllL~'.U,~dlll H. I . , ,~ ' , "H,H ' " 'H ' " , J L~[~I,=~ . ,,:J,IL~:: ' ]i-,!i!!l=ll~i~riUiil~ aa,q l J~ ff 426 I For hOW ~y~ths a f te r I the b i r th o f (NN4E) d id you r~t hmve lexu~ r l l l t l~? II~J~lll~lE.Jlrr.l~JL.mIJ~'.l~l~.l~JqEIIIq'l~Ll,lllJ~lllh',Jr' q~llt}ffllflLlfl!lllffi~hdldlff~lgfffllll~hih~fftWIIh,SH ~hqbJrlllllL~illlllFHI]ffmll~hPIlll[llm~=EIIl~.llll~l~fiHd ~[lllili[lllHHIIIIimllllllfillll INIfl!IIII~IllUI~IIIIIH . ,HI ~t . i II~ffWIlfflllUffff~[WINlUm~LiiUnt311N/t~Hlfllffll. III~fflII~HlllLIIIn~fflhlI;HI~IlfflI~LDIII~LIIIIIIII'EfflIIL~ IIIIIIlllEIIILlllllll[iillllllll~lllilllJllillll[lllllli[llllilllll[lllllg IIIlUllllJ]fflllltEIIIIliffP~llll]l~lllllla~lmll~lllH]llfflllllll~ ~II]IThlII~WUlIEIIIILIIII~fflIIIll III)l ~ I~m IIEI , I H,r~q,l,ml,lmUlmalt~Fl~FlPlll~FlUl,-mMal~,.Idlll ~iI;; I~%liiiii~l'~[iill%l%"][[[;hi~ihii~i~iiiiiillril;H ~Jff.hrffllllllffli]qlli]l~[~lliIFglll~illllffihi.Hl*[Lfflllliilfflll ENTER "X" IN COL.4 OF CALENDAR FOR THE NUMBER OF SPECIFIED NONTHS ~ITHOUT SEXUAL RELATIONS, STARTING IN THE MONTH AFTER BIRTH. IF LESS THAN O~E )40NTH MITHCUT SEXUAL RELATIONS, ENTER "0" [N COL.4 OF CALENDAR IN THE HONTH AFTER BIRTH. 4Z7 429 O ld yo~ evsr I YES . . . . . . . . . . . . . . . . . . . . . . 1 1 bcemstfeed (NA i l ) ? I (SKIP TO 43B) . I N O . . . . . _ _ ~ ENTER "N" IN COL.5 OF CALENDAR IN i40~TH AFTER BIRTH blhy d id yo~ not NOTNER iLL /~AK . . . . . . . . . Ol b reast feed ( I0~/~ )? CHILD i LL/WEAK . . . . . . . . . . OE CHILD DIED . . . . . . . . . . . . . . O] N ] PPLE/BREAST PROBLEM.Q4 INSUFFICIENT NILK . . . . . . . 05 MOTHER h~3RK 1NG . . . . . . . . . . D~ (HI t,D REFUSED . . . . . . . . . . . 07 OTHER (SPECIFY) (SKIP TO t~39). YES . . . . . . . . . . . . . . . . . . . . . . l l YES . . . . . . . . . . . . . . . . . . . . . . 1]1 YES . . . . . . . . . . . . . . . . . . . . . . I (SKIP TO 43B) . ] [SKIP 10 ~30)'* (SKIP TO 4~0) . ] NO . 2 NO . . . . . . . . . . . . . . . . . . . . . . . E NO . . . . . . . . . . . . . . . . . . . . . . . 2 NOIHER ILL/WEAK . . . . . . . . . 01 CHILD ILL/WEAK . . . . . . . . . . 02 CHILD DIED . . . . . . . . . . . . . . O] NIPPLE/BREAST PROBLEN.*D4 [NSUFFIC[EM[ N]LK . . . . . . . O~ MOTHER k~qKING . . . . . . . . . . Od CHILD REFUSED . . . . . . . . . . . 07 OTHER O~ (SPECIFY) (SKIP 10 ~39)~ MOTHER ILL/~EAK . . . . . . . . . OI CHILD ILL/~IEAK . . . . . . . . . . O~ CHILD DIED . . . . . . . . . . . . . . NIPPLE/GREAST pRGBLEH.O~ INSUFFICIENT N]LK . . . . . . . DE MOTHER WORKING . . . . . . . . . . 0~ CHILD REFUSED . . . . . . . . . . . 07 OTHER O& (SPECIFY) (SKIP TO 439)~ 430 HOW Ior ;gmfter b i r th d id yotJ f i r s t put (MN4[) to the brsa l t ? IE LESS THAN 1 HOUR, REC(~D '00 ' HOURS. IF LESS THAN 24 NCURS, RECC~D NO. OE HOURS. OTHERWISE. REC~D GAYS. IW4EBIkIELY . . . . . . . . . . . . DO0 HOURS . 1~ DAYS . . . . . . . . . . . . . . . 2 IMMEDIATELY . . . . . . . . . . . . DO0 HOURS . . . . . . . . . . . . . . 1 ~ DAYS . . . . . . . . . . . . . . . 2 iHNEDIATELY . . . . . . . . . . . . ODD HOURS . . . . . . . . . . . . . . 1 ~ BAYS . . . . . . . . . . . . . . . Z I (SKIP TO 437) I (SKIP TO 437) I . L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 , r,~ I , ' , '-- '"i ~'.~131t'[l]llllhll~II~?flPll[Jfll[li~PT h~l[[ 1IN DE~ ~ h'ulr ] ' ] ' t"~"'[d ' l lH='" l iI,ffhlltLhdfl.r .d L I ,h,d , , , h]hLli.hCmlS~lffNM~lffll hl, lL J r Hhd]h . I i I~ r= . ,= ImUil l f fq. lr[ l lF t"d]h! ' [ IL [ I ~ L i t I[/,]ll~, ':r'= ' 'h ' ;l!l[ll]ll]h :;111~ ],=,I:I[J,IJIIIiIIIi,.'[:.,IL.,]It[LI~r~I",~IL]]II,;,U 1141Lh= ~ r iI L .I]) h, ,,L ,, ~[d,Jltid']l. dill (SK IP T0~/417) I Jrlr~lk,", ' lr[I L;=., ' i--lklllp"lLt" ~N/ LI] I~J"U~"lUEIqq[=fi"~Fffhl n m~lqqlffiHI]lffll'l]nm)ffEIqlamll 'JJ P "]L~Jig=]ll[~ d U t l i+~ , ' ~ ~mq I' ~l~LUl H ~lll J't L"_~.~,a,,U~,Un"mPq~,~, , , 203 I 43Z IAre you s t l t i br l l s t - I feedlrv~ (kL~E)? i433 J ENTEII "X" IM COl.5 OF CALENDA~ ]M 14C4+TH ALTER AND IM EACH MO~TN TO CURRENT 140~TH breut fnd (11~) L~st n ight N]GHTT]I4E I~tk~ met ~ s,Jnriee? FEEDINGS HOt+ ~ t imes d id you NLMBER OF bc I I I t f l lK I ye l l t e rd ly DAYL % GBY dla~(~'~li the d ly t ({ l l~ , h~rs? IF AMS~R 10 MOT NIJI4ER[C, PROBE FOIR APPIIOX]MATE MUI48ER LAST BIRTH NANE NEXT'TO-LAST BIRTH I YE0 1 I I ~p]lH H, ~,T-[]lq H "e"' Lrl , , , . , Hk ~]fl'ff"qr"E~ff'ffgfl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~,,~,+ . , , I ) . , , a l i , I . . . . . . . . . +,,,+ . . . . . . . . . . . . . . +.l.,t,tl.~,++.~+t,+,,Irl + . . . . . . . . . . . . . . . . . . . . . . . hEl - m - . j Lhh.,r + ++ i +v + +n ~t~ 1 +Irll rhp+JId+,J++J., LK] f fmlhhH+mH+l i~ +m r |+ ++r , . llph ;H , . i ~mq ~[RTf l eft+++ t+ mffh]]ll+Effm , i Hld,++Lrqm,+dflKfflH h.+v r + ""dU'. +++''L'++ .Lt.C.j+~m.+ Hg+[[q.~ I+,+,, , .m , , , . . I F +,+. , , , r ,p , ,o ,+. , , h , _ -+, , f i lm p,;lff m+ffdpph +, ++l!ff;+h+tp;l , + .qflJF +llrLtC++ i d : + Fmll i + +. I I I iIHi+._ ++~,ihIU;+:+:'+:';Q;++;++dh.r+'+.,++ 6; , L mm+~+;, ++~.q,h, , , , ~t r , r , WNJ+ + ++p++,[plJ ii+ + .h r E h,+ ffd +I h++,+J~ t+,++++ ]+,Ir , + q++ p]%[ ' ] ' S I U, J+. , , ,mk, , ' ,,MdU,:,+,++mJ+t+l { ~ I lh :h 'm .:m++i]J,L,h+.mdflLm.Hrh+ m. lmHl W]+IL; mflHffmfllt,++ :+llltd+llFh r ,NqUl , I ff~h+ , J]11r ,,'1,1,[ilfl i + I ,] llm . . . . . . . . . +Ld . . . . . . . . . . . . +[ dL J J , J J t l ff,h , I hH W+. ap i ,r+, ,rM]Hff_; .Lh,hIMHll I.+-;~'; .m+m.J.=.' ' ++"H'h?'r+ . hdh.h+J I lff. m ii t , , + : ; +, ffEll]Jt, +,J ,+ LpN; I . l+d.flFqhfllt . J l fftqL,p]4qrllm, ,]lqq]+~ . +~. +++hl i lmK~l~dm I t~, ,++i lm SECOND - FRCI4" LAST 6%RT# NAME ,m , , . .~ . t .u E ,m l,+,, m,],, m, m,m m m, m, , , l , , , , ,~, ,h , J t T m h ,h , ~ l~.++.id.h+t.,++ m++t~l.t~i ~+l l lP~ i , , , jmt j , ' " ' , [ , , +h++ , m ,.hJhtg+++ffE f f~r .mJ l ldHm+l~l , l~ m.JmhiJff,liJJJmdJ~m ~l l J+]mHi I J~i l+ ~ g pc +]ffppH,.+ffffl + mh++t ~,.]+,ffPp +T~d.H1mmmC q di++ffii+l+ ff mlfl m d+~ h hii+llilH fl ff fi m H ~ m B fl H fflim dl ~LtJl[~Qihiflr+m#jrg~g+tdli~lt Pttt,l~tml~ttl I~ mlH, l~l l l ] E ru I J f l ] l lm lm~l~ ++[ttP+Ji+lli]lJ+llg" MIq+MIIIii]MEIi]iMfflI]]]JmlII + U.L.hlH WlihEtfld +h +] mllfllUmhi~iflfl]+t i +~ t~ ffq,]it,m,Lffm+r, ,+l+m,+]ffffp]fl~q,m4+t[m,lfl~+ ~ttt+ti]ttttlt',l+,lz~+'ttii~titllHJ+ttlll~ ~ll~+[iltllll~ ~ : m]~m,mm~ mal~mJ]J~mm~.m~m.qu~mmm J~ ll;tt~l]]lrJlJ,~;[lll:,] ;I;IJJ] Ii L~II3 M+m]gJ3tHi[]:li~ ~ ,9'.'ffhgfft, 9Hffff.~.F.,.flH ,mflJffH,9~ffml,99~ffm .h9 Ig'ffq,I ~, ,.~'tim19 ff m, ~, , m Jff m ,9~ ~Ip199~L~,IIIIn]94~ 435 436 417 At ~ny t im ye l te rd4y or Leer n l~t ~ JS (NN4E) g iven Iny o f th t to t ~ l~e? : PLa in ki l t er? SUQIp ~lt e r? I I IC I ~ l l t l r ( I l l ) ? Ju ice? Herba l tea? i l l by f o r l~ l l l ? F re l th i+ lk? Tinned or powdered mi lk? Other L iqu ids? ea~V I .~ l (d o r m~shV food~ CHECK &~5: F~ C~I LIQUID GIVEN YESTERDAY? For h~ ~ months d id you br l l i l t f l41( i (M/d~)? YES PLAIN MATER . . . . . . . . . . 1 SUGAR WATER . . . . . . . . . . 1 RICE WATER (A~) . . . . . . 1 JUICE . . . . . . . . . . . . . . . . 1 HERBAL TEA . . . . . . . . . . . 1 BABY FORMULA . . . . . . . . . I FRESH HILK . . . . . . . . . . . 1 T INNED/P~EREO MILK.1 OYHER L IQUIOS . . . . . . . . 1 SOL 10/NIJSH¥ FOOD . . . . . 1 "YES" TO I~qE O~ "MO" TO V (SK IP TO (SKIP TO 4411 It.L .r.h.J.~h. _ -E. pJm. ~ .~.~ jlIU~I~j,~,~III~IdlUIUglIIIMIIp~IIIUIM!I:!QHIII!MUIqll . ~ . ' ~!']JU[I Hm.m EH.mm. . . . . . . ,H . . m,~.m ,hh .Hr . . . i f . . . . . . ~.~1 IIII'U~ . . . . "1 . . . . . . I . . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LLII m. . .~ . .~ .qH P.Lhm. n .~.m ",;.~U;,I . . . . ,,i,J, hh'.,,~,,ill '~ t"i . . . . . , ~,."~"'",,, 'i~!'~iIl ~ ' ,,,,,+ II TM ~j~.~ ~.~. .+1.; 111~2', .mm, ~,1~,, ,,q,,hJ,,, ,,~,J . . . . . fill mH .+m.Hi . . . .ml f f .ml . .+ 440) I,;,I! ' t ' " -~ peril . . . . . . . ,~ ¢ - " r '` 1+111L . . . . . r[ ['a[,j~,j]T r' U ALL + r[ + i i i i J l, .1 .+.+ +.t . ] . . . lit h]1ff f f l ,]lffh]lff +L l f f th .h l l IL,Ehfllt h: Ii +;i d : l + ~ +h. : :h]fft, Urn. . i J l l f f . + Nhr r , ; lUdFu It,+J~ti ] L J , , +J,J+, . . . . . +H . . . . . . . . . . , , Qt]+ , , , l IN , .,s++ ,, , , E,,+,+, Jghlh [he,,++h, h,,tllziillUll!]]~ M P,] f M M PPlII.]~ IFIII'ilLEIII+ILPII El+ lflll+llt11+ililit~i"l it .m.t.+UJ] m +m.h.lm . i~ + lttlilllPllltlllllllt]IttllJtllllll]tl[lllltltlIllltltIUllllllllltlrlllttl EqPJffdlllff+lliiffffli~ffffA1+ImBiLmlm~immil+FfflmlHg ~dt~l ; l f i~f fmf lE t lMpml l f i f fu1+~f f r~f lH f f+~ L+.ldtttlliJ]llllli+JMl ~Jit]+ffm++3t.~lfiiJP+~IQ ~ff~ hIE,d]llml]Hlill+]JffliH+Wfl]]LmlBffmM++ffmBl1+m i l l lllffllllffmdlff"mffrmllfftmllffilflllJff"ll"ll+fflll"llffLffIEill m 1 I II P + t 1 + L.hJllm,lllll,lJlL IIil[IUIll]~IIII~IMIII fl ~fflli,JffmillmiliF[idl~ffllll~mlgh)bdg~mlillll~Uurlff ~p]Hff.lqffBK'pdpFrffil!U'ffEm]'ffhlm~ffffpBJ'rr[~ H' ilflllml ii iii ~r ql~ I I I I I rEI yS,]l,,r i;H"pHIiIpflffi,+];ff,]]~Mh]IIEIgii+JffEIUfl+LPlP +m u+.J+flffd+hr, I ;+ffhh+ILqEl+++TltllE++HpffL ff 1.+.+ ++ . + + HEE ' l+Hff ' t+ +,,,,,h+l,,,g,.,+,.,,+d,lJfl+IU+t,+,++,dhh,,+.dhl+ , J a i ;]lffhH+.lhlUL L IdZ+, Uffffhhh+.ff, r+ Hmtli~IH, . . ffr.llli,prqm-L,mq rifE. + . i m. , . ,+ , + ' , '+ , l",' fetid ,", '+' ,~+ ''][~,,,'r, lP'' +l+ .,,+ , , ' J , + d-hHtptl,ffE ,, pifl l.l]]+FJltlli]Jmm]lHffffffil+ ~+ , i L .p l '+ , Udlh]lffhlHff l I + lifl]ll+ I IHm+] l . ] ItJlqJlMpilpd+ + +- I[ , . . JHi]l~m~+ ++,. Jh,,g.,,,,mJ,,+, l , o mem,,mttm,,t , ,tt, N,~it+tlmj~m ,m,m,,,utmm,m m p: "fff l lHphl. ~+[mfljlPtBifffftll~ffm'+ flrqlU+~ . . . . . . h+, . +~. LJ,h.,++.,.~ IpmdlF, l i i l l+l . i lh l ; , f f q l lb .m,mr , , . , ] , ~ mfflhiHmlillm:hp.d+hiPlilffdqNmhJ:Itfflm+ll+Jli+Nd m l+itLh + hfl lttUi], i : , , l ~++ h Jhhm] I t . .h=. ]I ,]]l]Itq,,,- ,,,.+QI,+ +, t l+,q ++idHILffmiJEfflhtkm++milfllffml]+ffmlmmlHlJhtlliill mdl] f fpmlf f , : J r rdl dd] J r lhH lg : iq f f l i+ r~ I,,h,M,,_~,l,J,mlllhINh+/?~%ml+;J h,mmHJHIhdm ,m ,.,dd+Jm,~,,,~s]ll Ihlm,lllmfllLpdfllrm,uffml]rrff. Zh]H~lr.plm -.ff.NIrE.~ t.qlp]Hl~k.~d~.~.plfl]lTff.~.l T~ iLidlphlrH~l~lbdhHp~HIIi l~ffhfl.~:: " , , Htl'lJlll I I i,,i I llil4~LU!,' ffHh~d,mlIBtff~ IHffdP]cmd.dhlF~ h.dH~ ~ hmP ~ !III!!!!HIIM!]I hm)ml ~, I I ~ ] .'.r&ppmlllffllrrc'~d4J[W~llffh"lthc":hllffLr~.n ~ ENTER "X" IN COL+5 OF CALENDAR FOR THE NLI~¢BER OF SPECIFIED MONTHS OF BREASTFEEDIMG, STARTING %M THE MONTH AFTER BIRTH. IF BREASTEED LESS THAM OI+E HONTH, ENTER "O" IN COL.5 IN MONTH AFTER BIRTH. 4~ kl~y d id you stop bre l s t fe l .d [ng (MANE)? 439 J CHECK 221: CHIL0 ALIVE? I /~0 J Wee (~U4E) ever g lv lm I ~lter ~r In~ythlr~e~se tO dr ink or e l i (o ther th in b reutmi tk )? ~TBER ILL/~IEAK . . . . . . . . . 01 CHILD ILL/WlEAK . . . . . . . . . . 02 CBIUf l OIEO . . . . . . . . . . . . . . Q3 NIPPLE/BREAST pROBLEM.04 INSUFFICIENT MLLK . . . . . . . 05 MOTBER WORKING . . . . . . . . . . 06 CHILD REFUSED . . . . . . . . . . . O? MEANING AGE . . . . . . . . . . . . . 08 BECAME PREGNANt . . . . . . . . 09 STARTED USING COIIYRACEPT]ON . . . . . . . . . . 10 OTHER 11 (SPECIFY) I ALIVE + OE ! (SKIP TO 4411 I YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . Z (SKIP TO 444)4 NOTHER ILL/WEAK . . . . . . . . . 01 CHILD ILL/WEAK . . . . . . . . . . 02 CHILO OLEO . . . . . . . . . . . . . . 03 NIPPLE/BREAST PROBLEM.04 INSUFFICIENT MILK . . . . . . . 05 MOTHER WORKING . . . . . . . . . . 06 CHILD REFUSED . . . . . . . . . . . 07 WEANING AGE . . . . . . . . . . . . . 00 BECAME PREGNANT . . . . . . . . . 09 SIARTED USING CO~JTRACEPT]O+4 . . . . . . . . . . 1D OTHER 11 (SPECEFY) ALIVE ~ DEAD V (SKIP IO 441) YES . . . . . . . . . . . . . . . . . . . . . . 1 NO 2 . . . . . . i~ i~- i61~i ; - , 1 NOTHER ILL /WEAK . . . . . . . . . O( CH%LD ILL/WEAK . . . . . . . . . . 02 CHILO DIED . . . . . . . . . . . . . . 03 NIPPLE/BREAST PROBLEM.04 INSUFFICIENT MILK . . . . . . . 05 HOIHER WORKING . . . . . . . . . . 06 CHILD REFUSED . . . . . . . . . . . 07 WEANING AGE . . . . . . . . . . . . . OB BECAME PREGNANT . . . . . . . . . 09 STARTED USING CONTRACEPTIOW . . . . . . . . . . 10 OTHER 11 (SPECIFY) (SKIP TO 4411 I YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . ~ ] (SKIP TO 444)* ZZ 204 i~ ~,STBIR*N IN HEXT,OL,S*BIBTH Ih~,R.~BT.I.TH 441 443 HOW mete/ months old ~s (MANE) d~ee~ you stor ied giv ing the fo tL~ino o~ • r l l iu ter , b~ l l ? : Forguala or I I t k other that~ b l ' l l l l l t i i tk? PLain ~ter? Other tiffaids? Any so l id or aLa~y food? IF LESS TV, AN 1 ~TH, REC.~D '001 , D id (NANE) dr ink n~ything from • ~ot t le MIth • nipple yellterdlly or Lstt night? AGE INMONTHB . . . . . . . I [ I HOT GIVEN . . . . . . . . . . . . . . . 96 AGE IN MONTHS . . . . . . . [11 NOT G]VEN . . . . . . . . . . . . . . . 96 AGE IN ~THS . . . . . . . ~ AGE NOt GIVEN . . . . . . . . . . . . . . . 96 gOT AGE IN MO#ITHS . . . . . . . ~ AGE NOT GIVEN . . . . . . . . . . . . . . . 96 NOT ,.,Hs . ~IAGE .OT o lv . . . . . . . . . . . . . . . . O°Ho~ i l m m l iN V~4#IH$ . . . . . . . I I I GIVEN . . . . . . . . . . . . . . . 96 IN MONTHS . . . . . . . [ J J GIVEN . . . . . . . . . . . . . . . 96 GIVEN . . . . . . . . . . . . . . . 96 OEO~ (SKIP 4441 AGE IN 140~THS . . . . . . . i I i HOT GIVEN . . . . . . . . . . . . . . . 96 m AGE IN MONTNS . . . . . . . I J l NOT GXVEX . . . . . . . . . . . . . . . 96 AGE IN NOIITHS . . . . . . . I I I NOT GZVEN . . . . . . . . . . . . . . . 96 AGE 1N;4ONT~S . . . . . . . I l l NOT GIVEN . . . . . . . . . . . . . . . 96 ALIVE DEAD (SKIP TO 444 YES . . . . . . . . . . . . . . . . . . . . . . 1 [ YES . . . . . . . . . . . . . . . . . . . . . . 1 J YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 j HO . . . . . . . . . . . . . . . . . . . . . . . 2 [ NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . B OK . . . . . . . . . . . . . . . . . . . . . . . 8 DK . . . . . . . . . . . . . . . . . . . . . . . 8 GOB ACK TO 40B FOR NEXT BIRTH; (~, IF NOMORE BIRTHS, GO TO 445. NO. QUESTIONS AND FILTERS .S I CHECK 220: AHY BIRTH IN 1985, 1986, OR 19877 I ? YES NAKE OF LAST BIRTH PR%~ TO 198~: (NAME) l 666 I D(d you aver breestfeed (HA-I¢~)? I IF YES, hou many e~onths did you breastfe~d (N/d4E)? I YES, HU~BER OF NONTHS . . . . . . ~-~ NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 SKIP TO I ,669 I F°r b'r*h I M°N Soo As OT o, . . I 448 | For ho~mnny~cE$ after the birch of {NAKEI I did ye.J no(hove sexual relotic~s? ~TNS . . . . . . . . . . . . . . . . . . . . . [ ~ NOT RESLg4ED . . . . . . . . . . . . . . . . . . . . 96 CHECK 401: (~E Ot~ MORE BIRTHS ~ NO BIRTHS SINCE JAN, 1988 ~ SINCE JAN. 1988 I I V (SKIP TO 451) 501 205 23 4S1 452 ENTER THE LINE E4Ji4BER~ WN4E AND SUW~V]VAL STATUS OF EACH 6]RTN SINCE JANUARY 1988 IN TNE TABLE, ASK THE ~S1]0~$ ABOUT ALL Of THESE BIRTHS. BEGIN VITH THE LAST BIRTH. ( IF THERE ARE MORE THAN ] BIRTHS, USE ADDITIORAE FORMS)* LIME NUBBER FRON O. 214 FROM 0. 21B AWD Q. ZE1 Do you h ive • c l rd ~here are wr J t t~ ldot l~? IF YES: Nay ( lee Jr , p~ea•e? LAST BIRTH NEXT'TO'LAST BIRTH WANE NN4E ALIV, [~ BEAD E~ ALIVE E~ ] DEA,O [~ v ~ v v l v ¥E$, NOT SEEN . . . . . . . . . . . . 2 YES, NQT SEEN . . . . . . . . . . . . ($K[P TO 4~6)a (SKIP TO 456) . NO CARO . . . . . . . . . . . . . . . . . . ~ NO CARD . . . . . . . . . . . . . . . . . . SECOND" FRON-LAST BIRTH )THEE ALIVE [~ DEkO [~ v ~ v YES, SEEN . . . . . . . . . . . . . . . . 1 YES, NOT SEEN . . . . . . . . . . . . 2 (SKIP TO 456)~ l NO CARD . . . . . . . . . . . . . . . . . . ] , , , *E , . . . . . . . . . . . . . . . . . . . . . . '7 ' *ES . . . . . . . . . . . . . . . . . . . . . . *E , . . . . . . . . . . . . . . . . . . . . . . , ~I~C¢(P~t(O~ cerd fo r (SICIP 10 4~6)a ] ) NO (SKIP TO &56}* Z } (SKIP TO ~56:~ (m~E)? ~0 . . . . . . . . . . . . . . . . . . . . . . . z . . . . . . . . . . . . . . . . . . . . . . . #o . . . . . . . . . . . . . . . . . . . . . . . 2 j 45~, (1) COPY VACCIMAT]ONDATES FOR ! EACN VACCINE FROM THE CARD. (2) WRITE 144~ IN 'DAY' COLUI4N IF CARD Si41~S THAT A VACCINATION bIAS GIVEN, BUT NO OATE RBCORDED. 8C6 OPT 1 OPT 2 OPT 3 ~*LIO 1 POLIO 2 POLIO 3 NEASLEB DAY 140 YR DAY -o111 I I Bco ° ' I l l I °' °~111 I ~ ° '111 I o3 P' I I I PC i i P2 P3 i P3 I "EA I ;4E' i MO YR I I DaY V~ YR Bc°ll I ] D2 - I I i - ] I I PE I I I " ] I I "Al l I I .~55 Has (V~IE) rece ived ~y v lcc i rmt l~ that mr• not recorded on th l• ¢lrci? REC(~O IYES' ONLY IF RESPONDENT WENTII;~S BCG, DPT 1"3, POLIO 1"8 AND/OR NEASLEB VACCINE(S), YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 I (PROBE FOR VACCINATIONS~ (PROBE FOR VACCINATIOHS~ AND WRITE ~6.6 ~ IN THE AND WRITE 'fx~' lN THE C{~RESFOttOING DAY C~HESPOND[NG DAy COLUNN IN 454 AND GO COLUMN iN 454 AND GO TO 458) TO 458) NO . . . . . . . . . . . . . . . . . . . . . . . Ell NO . . . . . . . . . . . . . . . . . . . . . . . 1 OK . . . . . . . . . . . . . . . . . . . . . . . B DK . . . . . . . . . . . . . . . . . . . . . . . SKIP TO 498) ~ (SKIP 10 ~SB) 4 YES.* . . , . . . . . . . . . . . . . . . . . 1~ (PROBE FOR VACEliLAT[OHS AND ~JAITE 166' IN THE CORRESP(~CDIHG DAY .i- COkl~4N IN 454 AND GO TO 458) NO . . . . . . . . . . . . . . . . . . . . . . . BE . . . . . . . . . . . . . . . . . . . . . . . (SKIP TO 458) 456 Old (WANE) ever rece ive YES . . . . . . . . . . . . . . . . . . . . . . 1 I YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 any vacc i r~t Jo~l tO I ~raveclt h iWher from NO . . . . . . . . . . . . . . . . . . . . . . . ~]2 ~]2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 Bet t ingd i la l les? (SKIP TO 458)J (SKIP TO 458)* (SKIP TO 458)4 DK . . . . . . . . . . . . . . . . . . . . . . . 8 J OK . . . . . . . . . . . . . . . . . . . . . . . ~ OK . . . . . . . . . . . . . . . . . . . . . . . ' 457 P ia i sa taLL m i f (NAME) rece ived any o f the foLLowing viccJ l~•tio41v: A BEG v lcc i~t iO* l aga ins t tuber tu (o4 i | , that i$ r 8n in jec t ion (n the (e f t IhouL~r that caused • l eer? A BPT v~¢ inat ion mgal r~t d ip ther la , l :Gr tus l i l and t l t l k~ r that l i o Im in jec t ion in the th igh? IF YES: NOulmny t i r lml? PoL io v=cc i r~, that i s , d ro~i in the mouth? IF YES; NOW IIIIny t i lm l? kn in jec t ion iBa i~t mt lLH? YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DIE . . . . . . . . . . . . . . . . . . . . . . . B YES . . . . . . . . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 KIJI4BER OF TINES . . . . . . . . ~ J YES . . . . . . . . . . . . . . . . . . . . . . 1 WO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 NUMBER OF TINES . . . . . . . . [ ] YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DE . . . . . . . . . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . 1 WO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . B NUMBER OF T[~ES . . . . . . . . YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . B NUNBER OF T[HES . . . . . . . . [ ] YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . B YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 NI~IBER OF TINES . . . . . . . . [__J YES . . . . . . . . . . . . . . . . . . . . . . I WO . . . . . . . . . . . . . . . . . . . . . . . 2 O~ . . . . . . . . . . . . . . . . . . . . . . . B NUMBER OF TINES . . . . . . . . YES . . . . . . . . . . . . . . . . . . . . . . ( NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . , * , , , . . . . . . . . . . . B 24 206 LAST BIRTH J NEXT'TO-LAST BIRTH J NA~E SECOND'FR~-LAST BIRTH MANE +s~ E.ECK +;,: ,o ,,+07 +l ? +,+ o+p .++E+ OE+! +++ ++ CHILD ALIVlE? v v I I (SKIP (SKip TOY460) j! (SKIP TO 460) I 6~9 I GO BACK TO ESE FOE NEXT BIRTH; OR+ IF NO NC~E BIRTHS, SKIP TO 491, At I~y t Jmdur{~ e th• (a i r • i x ao~ths, d id (~UCE) rece ive any o f the fo(Lm+Ing: V i tmln A Ce~euLe? YES NO VITAMIN A CAPSULE.,.1 2 IODINE CAPSULE . . . . . . . 1 2 460 YES N( I YES BO I VIT~IN A CAPSULE.1 2 VITA~tI~ A C.AP~ULE.I IODINE CAPSULE . . . . . . . 1 2 IODINE CAPSULE . . . . . . . 1 2 IOdine cN~uLe? I ron dr~/sye~? IRON DROPS/SYRUP.1 2 IRON DR{~OS/SYRUP.1 2 IRON DR~$/RYRL"~. , . . . ( 2 4~1 gs l (IU~E) ever hod mis t•s? YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . 2 O~ . . . . . . . . . . . . . . . . . . . . . . . B OK . . . . . . . . . . . . . . . . . . . . . . . 8 DK . . . . . . . . . . . . . . . . . . . . . . ,~ ~Z Rim (NAFIE) ~ TIL w i th $EB . . . . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . . . . . . . . I I fever • t J~y ~t~e In th l l i l t veek l? NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . Z NO . . . . . . . . . . . . . . . . . . . . . . . 2 i DK . . . . . . . . . . . . . . . . . . . . . . . ~ DK . . . . . . . . . . . . . . . . . . . . . . . O DK . . . . . . . . . . . . . . . . . . . . . . . . ; YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 • C0¢~ i t ~y t l l l e In the L i s t ~ ~k•? ~0 . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . (SKIP TO ~67)~ (SKIP 10467)~ (SKIP TO 667)~ . . . . . . . . . . . . . . . . . . . . . . . OK. . . . . . . . . . . . . . . . . . . . . . O[ . . . . . . . . . . . . . . . . . . . . . . . iI •Hllcou~h(NAPJ~)in beenthe Lest(EL w i th ~KYES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 2& hr~Jri? NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 OK . . . . . . . . . . . . . . . . . . . . . . . B 665 I For ho~Llsted/didmM~y d~y~ (has the cough the cough OAYS . . . . . . . . . . . . . . . . i l l DAYS . . . . . . . . . . . . . . . . l l , DAYS . . . . . . . . . . . . . . . . I I I I ~••t )? ( i ( IF LESS 1NAJI 10Ay , RECORD IO0 ~ ~4~ ~hJn (IU~E) hod thw YES . . . . . . . . . . . . . . . . . . . . . . 1 467 ~en ( l tM~) the J[lr~ess ~ l th • cGugh, d id he/she breathe fas ter t f i•r l ~uJ t ( w i th Ihor~, r l~p(db l 'eaths? CHECK 462 ~ 46~: FEVER CL~ CCUGB? YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . 0 YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . B . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . , . . . . . . . . . . . . . . . . 0 4b~ W&S I~yth ing givqm to t re i t the fever /coup1? "YES" IN "HO" OR "DK" IN EITHER 462 AHD 463 ~62(1~ 463 ? . (SKIP 10472) YES . . . . . . . . . . . . . . . . . . . . . . 1 "YES,, IN "~0" OR '*OK'* ]N "YES" IN "MO # OE ~101 IN EITHER 462 AND 463 EITHER 662 ANO 663 462 OR 463 [] 462 OR 463 (SKIP 10 g72) (SKIP TO 4~) YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . ,1 ~o . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . Z (SKIP TO 470)~ OK . . . . . . . . . . . . . . . . ~ . . . . . . IDK . . . . . . . . . . . . . . . . . . . . . . . 8] (SKIP TO 470) 469 Hat was g iven to t reat the fever/cc~Jgh? /mythir~B e lse? REC~D ALL MENTH~EO. IHJECIlON . . . . . . . . . . . . . . . . A INJECTION . . . . . . . . . . . . . . . . A ANTIBIOTIC ANtIBIOTiC (PZLL ~ SYRUP) . . . . . . . . . O (PILL ~ SYRUP) . . . . . B ~TIIeALARIAL (PILL ~ SYRUP) . . . . . . . . . C C(~JGN SYRUP . . . . . . . . . . . . . . D OTHER P i l l ~ SYRUP . . . . . . E UNKNCBdN PILL ~ SYRUP.,.F HONE REMEDY/ HERBAL NEO(CINE . . . . . . . . . G OTHER H ANTIMALARIAL (PILL OR SYRUP) . . . . . . . . . C C(~JGH SYRUP . . . . . . . . . . . . . . O OTHER P i l l OR SYRUP . . . . . . E UNKNOWN PILL 0~ SyRUp,, . .F HOME REMEDY/ HERBAL MEDICINE . . . . . . . . . G 01HER H INJECT[~ . . . . . . . . . . . . . . . . k ANTIBIOTIC (P]LL I~ SYRUP) . . . . . . . . . O ANTIMALARIAL (PILL (~ SYRUPy . . . . . . . . . C COUGH SYRUP . . . . . . . . . . . . . . D OTHER P i l l ~R SYRCLP . . . . . . E UNKN~N PILL ~ SYRUP. . . f J HCt4E REMEDY/ HERBAL HEDICINE . . . . . . . . . G J OTHER H (SPECIFY) (SPECIFY) (SPECIFY) I YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 I 470 Oidtreat~.ntyou seekfor ~iCethe or (EK)P lO 672) . } NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SKIP lO 472)~ SKIP TO 472 4 j | fevmr lcO+ai t~? NO . . . . . . . . . . . . . . . . . . . . . . . 2} NO . . . . . . . . . . . . . . . . . . . . . . . 21 207 z~ A71 Uhere d id y~ seek K lV lCa or t reatment fo r the fever /cough? Anyt~ere e tae? RECORD ALL NENT[OREB. LAST BIRTH gAME PUBLIC SECT~ GVT. HOSP/CL IN IC /CHHC. . .A RURAL HEALTH UNIT(RHU) . .B BOY HEALTH STATION(BHS) .C MOBILE CL IN IC . . . . . . . . . . . O COI4HUH[YY HEALTH NORKER,E K£DI~L PRIVATE SECTOR PVT. HOSP]YAL JCL]N]C . . . , F PHARMACy . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H IN~I ]LE CL IN IC . . . . . . . . . . . I CUMNUN[TY HEALTH NORKER.3 OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . K HILOT/HERBOLAR[O . . . . . . . . L OTHER H (SPECIFY) NEXT'TO'LAST BIRTH NkME PUBLIC SECTOR GVT. HOSP/CL IN IC /CF IHC. . .A RURAL HEALTH UNIT(RHU) . .B BGY HEALTH STATIOR(SHS) .C MDB]LE CL IN IC . . . . . . . . . . . D COHMUNITY HEALTH ~ORKER.E REOICA~ PRI~ATE SEe?OR PVT. HOSP ITAL /CL IN IC . . . . F PHARHACY . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H HOB]LE CLIN%C . . . . . . . . . . . ! COF*qUNITY HEALTH N(~KER. J OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . K HILOT/HERBOLARIO . . . . . . . . L OIHER M (SPECIFY) SECONO'FROR'LAST 81RTN MANE >URLIC SECTOR GVT. HOSP/CL[MIC/CHHC. . .A RURAL HEALTH URIT (RRU) . .S BGY HEALTH $TATIOR(SHB) .C MOBILE CL IN IC . . . . . . . . . . . O CCI4~UNITY REALTH',JORKER.E ~OICk~ PBIVATE~IE~OR PVT. HOSP(TAL /CL IN]C . . . ,T PHARV;ACY . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H MOBILE CL[MIC . . . . . . . . . . . ] COi4k%iNlTY HEALTH k~tKER. J OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . K HILOT/HERBOLARIO . . . . . . . . L OTHER M (SPECIFY) 47'Z | Has (gAME) had d ia r rhea I I o tha ( sac tk~ ~eeks? YES . . . . . . . . . . . . . . . . . . . . . . 11 (SK IP 10 /*74)+ NO . . . . . . . . . . . . . . . . . . . . . . . 2 O~ . . . . . . . . . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . 1 1 (SK IP TO 474)a / NO . . . . . . . . . . . . . . . . . . . . . . . OK . . . . . . . . . . . . . . . . . . . . . . . GO BACK TO 452 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, SKIP TO 491 TES . . . . . . . . . . . . . . . . . . . . . . 11 (SE%P TO &7/*)~ HO . . . . . . . . . . . . . . . . . . . . . . . R DK . . . . . . . . . . . . . . . . . . . . . . . B "1 H ' - ) h'dt'rrHe" I YES . '1 YES . '1 YES . (I i n the l as t 24 hours? BO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . B DK . . . . . . . . . . . . . . . . . . . . . . . 8 OK . . . . . . . . . . . . . . . . . . . . . . . 8 dLar rhaa [ l l ted /d tU DAYS . . . . . . . . . . . . . . . . DAYS . . . . . . . . . . . . . . . . DAYS . . . . . . . . . . . . . . . . tha d¢ar rhea las t? I F LESS THAN 1 DAY, RECORD '00 ' . 476 I Was there any brood in the StOOlS? YES . . . . . . . . . . . . . . . . . . . . . . 1 ND . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . B YES He (SK IP TO 479) 478 I Dur ing (NAJ4E) ' I d ia r rhea , I d id you ~ l in ta ln the same NAINTAINED THE SAME . . . . . . 1 number o f b reaat feeds o r d id INCREASED . . . . . . . . . . . . . . . . 2 you J~reue or r ~ them or REDUCED . . . . . . . . . . . . . . . . . . 3 I o r d id you s too comolete lv? i STOPPED CORPLEYELY . . . . . . . YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . B (SK IP TO 479) , N ~llh ~ Idll iffll.IJ "~ Ilh~HiIllld I i l 'd~ ,11pi , HFH;qd hllH~ffl.lfflrlll ¢ f in i , . t , J l f f I~ r . ~.lqlFq]m - != = ' l ip I I . .~ i ~ Id ' 1 '11 i , iE~t~lffll,,HIi YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 OK . . . . . . . . . . . . . . . . . . . . . . . 8 (SK IP TO / .79) ifflff.,~ q i:] h= W Lii] q ffll}~lff fflEllfflffll~ D q[ lllllffll] ffl; ~ fi }!1 IIIIItll![l]ll]til]illtll]lPlli]Plll{ ~llffP]llllIIIItqllrql~l ~ mlhffl~mIilllllThdUffl=lit t Illlll g ~ fi~llI[l~l~ll] [IIIIEII [111~ Iqd l II I I~ ~111 ~ IIItll IJ h t ,,~,,lt,,iLlll][I Ill ~,~,l~Jll, ]11 g IJ,INl/,Llff;~, ,~ ] ii i[i lift ifflffllfflff.iEimlllHim]ff~ 11 llll] ffllff.u IIl!ff!fl]~fflIffFEIIEIlff[.lqffllll I ff!lfl!flHlffmff ~[FEI , ff F.~d RIJFFRp fill,It U hlrllJEH m~H~ffHLIWWh.q ~ I I~ ~"~ ll][:,l= ' ~1[=1111]ii i J ' [ ~ ~ LJItll,;ll;~ i H'L'=p h HI~PltEII~II]r; h L L,~J,I~ i ,,~ d~llllE=R n ! h ;=lift q EIJtlh h Jmz .Bdlt!d~hld v=~l 479 L (As ide f rom breastmi Ih ) , | DE . . . . . . . . . . . . . . . . . . . . . . . 8 DK . . . . . . . . . . . . . . . . . . . . . . . 8 ~a he /she g iven the sa*m SAME . . . . . . . . . . . . . . . . . . . . . 1 SANE . . . . . . . . . . . . . . . . . . . . . ) SANE . . . . . . . . . . . . . . . . . . . . . 1 amount to d r ink a t be fore ~ORE . . . . . . . . . . . . . . . . . . . . . Z ~£ . . . . . . . . . . . . . . . . . . . . . 2 t~.E . . . . . . . . . . . . . . . . . . . . . 2 the d ia r rhea , o r more, o r LESS . . . . . . . . . . . . . . . . . . . . . 3 LESS . . . . . . . . . . . . . . . . . . . . . 3 LESS . . . . . . . . . . . . . . . . . . . . . 3 tess? DE . . . . . . . . . . . . . . . . . . . . . . . 8 I . . i . . . . . . . . . . . . . . . . . . . . . . il /*80 Uas anyth ing g (v~ to t reat the d ia r rhea? NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SK IP TO 462)~ (SK IP TO 4B2)9 (SK IP TO / .82)~ OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OK DK . . . . . . . . . . . . . . . . . . . . . . . 481 t411at WaS RJVerl to t reat the dLar rhea? Anyth ing e l se? RECORO ALL MEKTIORED. FLUID FROI4 ORS PACKET. . . .A RICE WATER/"AH" . . . . . . . . . . B ANT IB IOT IC (P ILL OR SYRUP) . . . . . . . . . C OTHER P ILL OR SYRUP . . . . . . . . . . . . . . . . . . . D INJECTION . . . . . . . . . . . . . . . . E { I .V . ) INTRAVENOUS . . . . . . . F HONE REMEDY/ HERBAL MEDICINES . . . . . . . . G O~HER H FLUID FR~4 ORS PACKET. . . .A RICE WATER/"AN" . . . . . . . . . . S ANT IB IOT IC (P ILL OR SYRUP) . . . . . . . . . C OTHER P ILL DR SYRUP . . . . . . . . . . . . . . . . . . . 0 INJECTION . . . . . . . . . . . . . . . . E ( I .V . ) INTRAVENOUS . . . . . . . F HOHE REMEDY/ HERBAL MEDICINES . . . . . . . . O OTHER H FLUID FR~q ORS PACKET. . . .A RICE WATER/"AH" . . . . . . . . . . B ANT IB IOT IC (P ILL OR SYRUP) . . . . . . . . . C OTHER P ILL OR SYRUP . . . . . . . . . . . . . . . . . . . 0 %NJECT]OR . . . . . . . . . . . . . . . . E ( I .V . ) INTRAVENOUS . . . . . . . f HOME REMEDY/ HERBAL MEDICINES . . . . . . . . O OT~E9 H (SPECIFY) (SPECIFY) (SPECIFY) 482 D id you seek ~v lce o r (SK IP TO 48~) , 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . . . . . . . . 1 t reatment For the d ia r rhea? NO . . . . . . . . . . . . . . . . . . . . . . . 2 #0 . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SK IP TO 4~)~ 1 1 (SK IP TO 4~)4 26 208 485 Where d id you leek IK~iGa or t ra | tmlnt? ~ lere e lse? RECORD ALL NENTIORED. CHECK 481: ORS FLUID FRON PACKET MEHTIOREDT Was INANE) g iven ORESOL when I ha/she had the d iar rhea? For how mBny ~y i WaS (MANE) S Iven oRESOL? IF LESS THAN 1 DAY, RECORD +00' . LAST BIRTH N/diE PUBLIC SECTOR EVT. HOSP/CLINIC/CHHC.A RURAL HEALTH UMIT(RHUI. .B SET HEALTH STATION(BHS).C NC~]LE CLINIC . . . . . . . . . . . D COMI4UNITY HEALTH ~KER.E ~EDZCAL PRIVATE SECTOR PVT. HOSPITAL/CL~NIC.,.F PHARNACY . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H ~OBILE CLIM[C . . . . . . . . . . . I C[~I~4UNITY HEALTH WORKER.J 3THER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . K HILOT/HERBOLARIO . . . . . . . . L OTHER M (SPECIFY) NEXT'TO'LAST BIRTH NANE PUBLIC SECTOR GVT. HOSP/CLIHIC/CHHC.A RURAL HEALTH UMIT(RHU).B BEY HEALTH STATION(BHS).C NOBILE CLINIC . . . . . . . . . . . D CONMUNITY HEALTH I~RKER.E MEDICAL PRIVATE SECTOR PVT. HOSPITAL/CLIMJC.F PHARMACY . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H HOB]LE CLINIC . . . . . . . . . . . ] COI4HUNI1Y HEALTH WORKER.J OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . K H[LOT/HERBOLARIO . . . . . . . . L OTHER M (SPECIFY) BECOZdD-FROR-LAST BIRTH MANE PUBLIC SECTOR GVT. HGSP/CLIHIC/CHHC.A RURAL HEALTH UNIT(RHU).B BEY HEALTH BTATIORIBH$).C 140(IILE CLINIC . . . . . . . . . . . D COMNUNITY HEALTH WORKER.E ~EDICAL PRIVATE SECTOR PVT. HOSPITAL/CLIHIC, , , .F PHARHACY . . . . . . . . . . . . . . . . G PRIVATE DOCTOR . . . . . . . . . . H ~4)6[LE CLINIC . . . . . . . . . . . I COI@UJMITY HEALTH ~KER. J OTHER PRIVATE SECTOR SIORE . . . . . . . . . . . . . . . . . . . K HILOT/HERBOLARiO . . . . . . . . L OTHER H (SPECIFY) NO, YES, NO, YES, NO, YES, I ORS FLUID ORS FLUID ORS FLUID ORS FLUID ORS FLUID ORS FLUID HOT NENTIONED MENTIONED NOT NENTIOHED HENTIOHED MOT MENTIONED NEHT]ONED ~EB . . . . . . . . . . . . . . . . . . . . . . , Y . . . . . . . . . . . . . . . . . . . . . . . I ,EE . . . . . . . . . . . . . . . . . . . . . . ( (SKIP TO 4B7), / (SKIP 10 LeT)~ / ISKIP TO '871, OK . . . . . . . . . . . . . . . . . . . . . . . ~ DK . . . . . . . . . . . . . . . . . . . . . . . ~J OK . . . . . . . . . . . . . . . . . . . . . . . 4,87 CHECK 481 : RICE IdATER/UA~I = MENTIC~ED? I w . (NAME) given r ice water/ I uai~' llherl he / Ihe h~KI the d ia r rhea? O.S . . . . . . . . . . . . . . . . D ,YS . . . . . . . . . . . . . . . . DA. . . . . . . . . . . . . . . . . DE . . . . . . . . . . . . . . . . . . . . . . 98 OK . . . . . . . . . . . . . . . . . . . . . . 90 DK . . . . . . . . . . . . . . . . . . . . . . 98 NO, RICE YES. RICE NO, RICE YES, RICE NO, RICE YES, RICE WATER/"AI4" WATER/"AH" UATER/'AN" WATER/"AM" MAEER/UAM" VATER/UAN" NOT MENTIONED NENTIONED HOT HENTIONED NENTIOMED HOT MENTIONED V;ENT%ONED I g YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 I NO . . . . . . . . . . . . . . . . . . . . . . . ~]Z NO . . . . . . . . . . . . . . . . . . . . . . . 2] NO . . . . . . . . . . . . . . . . . . . . . . . 2 (E~IP TO 490) , / (SKIP TO 490)~ 8j (SKIP TO 490)J OK . . . . . . . . . . . . . . . . . . . . . . . 8 J DK . . . . . . . . . . . . . . . . . . . . . . . DE . . . . . . . . . . . . . . . . . . . . . . . 489 For how l~ny days was (NAME) Divert r i ce water/"BIM'? IF LESS THAN T DAY, RECORD 'DO'* DAYS . . . . . . . . . . . . . . . . OK . . . . . . . . . . . . . . . . . . . . . . 98 DAYS . . . . . . . . . . . . . . . . BK . . . . . . . . . . . . . . . . . . . . . . 98 ) BACK TO 452 FOR NEXT BIRTH; OR, IF NO KORE BIRTHS, GO TO 491 DAYS . . . . . . . . . . . . . . . . DK . . . . . . . . . . . . . . . . . . . . . . 9B 27 209 NO. SKIP QUEST[O~dS AND FILTERS CODINGCATEGO~IE$ TO CHECK 681 AND 685 (ALL COLUMNS): J I ORS FLUID r . ~ FROM PACKET ~ ~-69~ GIVEN TO ORS FLUID FR(~4 | ANY CHILD PACKEr NOT GIVEN I TO ANY CHILD OR 481 AND 685 NOT ASKED 692 J Have you ever heard o f a spec ia l p roduct ca t ted I QeESOL which you can gee fo r the t reatment o f d ia r rhea? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ~ ~694 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 493 I Have you . . . . seen 8 packet L ike th i s be fore? I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 SHOE/ RACKET, NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 L&98 696 Have you ever p repared a io tu t ion N i th one o f these YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I J packet l fo r yourse l f o r lo t ions e[=e to t reat d ia r rhea? I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 .497 SNOB PACKET. I 69§ I The ( l l~ t i res you prepared the ORESOL so lu t ion , d id | ~HDLE PACKET AT ONCE . . . . . . . . . . . . 1 I I y~me ehe ~hote packet I t once or on ly par t o f t I the packet? PART OF PACKET . . . . . . . . . . . . . . . . . . 2 ~&97 696 H~ ~h uater d id you ~e to prepare OAESOL the (s i t t ime you mode i t ? 112 LITER . . . . . . . . . . . . . . . . . . . . . . 0 t 1 LITER . . . . . . . . . . . . . . . . . . . . . . . . 02 1 1/2 L[TERS . . . . . . . . . . . . . . . . . . . 03 2 LITERS . . . . . . . . . . . . . . . . . . . . . . . 06 FOLLOWED PACKAGE INSTRUCTIONS.05 OTHE~ 06 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 697 1 498 699 IWhere can you get the O~ESOL packet? PROBE: Anywhere e l se? RECI:~D ALL PLACES NENTIONED. CHECK 481 AND 488 (ALL COLUMNS): RiCE ~ATER/"AH" RICE EIATER/ NOT GIVEN TO ANY CHILD "N4" GIVEN OR ]O ANY CH1LD 68) BnCI6~NOT ASKED Where d id you learn to p repare the recomm~ndad h~ f tu id made f rom r i ce uater g |ven to (NAHE) ~hen he /she had d ia r rhea? PUBLIC SECTOR GVT. HOSPITAL/CLINIC/CHHC . . . . . . A RURAL HEALTH UNIT (RHU) . . . . . . . . H BGY HEALTH STATION (HHSI . . . . . . . C NOBILE CLINIC . . . . . . . . . . . . . . . . . . P C(~4~]Ty HEALTH WORKER . . . . . . . . MEDICAL PRIVATE SECTOR PVT. HOSPITAL/CLINIC . . . . . . . . . . . f PHARNACY . . . . . . . . . . . . . . . . . . . . . . . C PRI~A~E DOCTOR . . . . . . . . . . . . . . . . . H NOBILE CLINIC . . . . . . . . . . . . . . . . . . [ COHMUNITY HEALTH WORKER . . . . . . . . J OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . . K HILOT/HERDOLARIO . . . . . . . . . . . . . . . L OTHER M (SPECIFY) PUBLIC SECTOR GVT. EOSP[TAL/CLINIG/CHHC . . . . . 11 RURAL HEALTH UNIT (RHUI . . . . . . . 12 BGY HEALTH STATION (DHS) . . . . . . 13 MOBILE CL[N]C . . . . . . . . . . . . . . . . . 14 EOt4NUN]TY HEALTH NIORKER . . . . . . . 15 HEDICAL PRIVATE SECTOR PVT, HOSPITAL/CLINIC . . . . . . . . . . E l PHARMACY . . . . . . . . . . . . . . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . . . . . . . . 23 MOBILE CLINIC . . . . . . . . . . . . . . . . . 24 COCHUN]TY HEALTH ~ORKER . . . . . . . 25 OTHER PRIVATE SECTOR STORE . . . . . . . . . . . . . . . . . . . . . . . . . 31 HILOT/HERBOLARIO . . . . . . . . . . . . . . 32 OTHER 33 (SPECIFY) -501 28 210 NO I 501 I SECTION 5, NUPT[ALITY QUESTIONS AND FILTERS N|v l y~ ever been mmrried or Lived u i th • man? SKIP I CODING CATEGORIES I TO IYES . ' 1 .~ NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ENTER #O u iN COLLil4N 6 OF CALENDAR IN MONTH OF INTERVIEW, AND IN EACH NONTN B#,~ TO JA~t~I.JAEY 1988. 503 I I F NEVER BEEN MARRIED DR LIVED ~]TH A MAN: I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ~518 I Have ~ ever had sex~l intercourse? I | NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ~523 504 Are yc~J now Ix l r r iedor Hy ing wi th • man, or ere you no* I MARRIED . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 ~idok~d, d ivorced, or no longnr l i v tn g together? I | LIVING TOGETHER . . . . . . . . . . . . . . . . . 2 I WIDOUED . . . . . . . . . . . . . . . . . . . . . . . . . DIVORCED . . . . . . . . . . . . . . . . . . . . . . . . 5D7 NO LONGER LIVING TOGETHER . . . . . . . 5 505 ~| stayir~lll your eLseldheraThusband/partner l i v ing wi th y . . . . . . . i s he I| STAYINGLIVING WITHELSEWHEREHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 l~507 EOG I - - - - *ourh° - - L " I *Nc NT'Y . I OVERSEAS . . . . . . . . . . . . . . . . . . . . . . . . z so7 .eve you ba~ .~*r ied or Lived u i th = ~n only once, I ONCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I or MOre tha~l o¢1ce? I I MORE THAN ONCE . . . . . . . . . . . . . . . . . . 2 I 509 NOW o ld were you when yc~a s tar ted L iv ing u i th him? I AGE . . . . . . . . . . . . . . . . . . . . . . . . I I J I DK AGE . . . . . . . . . . . . . . . . . . . . . . . . . 98 510 CHECK 507: MARRIED OR LIVED r~ SKIP TO HARRIED OR LIVED Ul IH WITH A NAN ~LY ~ ' • 513 A MAN MORE THAN ONCE i ONCE 511 In wh|t mo~th and year d id y~J s ta r t l i v ing ~ i th your cur rent / taut hu~b,md/F~rtner? MONTH . . . . . . . . . . . . . . . . . . . . . . ~- -~ DK MONTH . . . . . . . . . . . . . . . . . . . . . . . 98 YEAR . . . . . . . . . . . . . . . . . . . . . . . ~ OK YEAR . . . . . . . . . . . . . . . . . . . . . . . . 9a I 512 HOU o ld were you when you s tar ted L iv ing with him? AGE . . . . . . . . . . . . . . . . . . . . . . . . I { { { I OK AGE . . . . . . . . . . . . . . . . . . . . . . . . . 98 513 N~ o ld uas your cur rent /Las t husband/partner ~hen you s tar ted L iv ing wi th him? CHECK 508 AND 509: YEAR AND AGE YES GIVEN? ~- - I,OE . rl-- i DK AGE . . . . . . . . . . . . . . . . . . . . . . . . . 98 No ] ~] L516 29 211 MO. 515 516 qUESTIONS AND FILTERS CODING CATEGORIES CHECK ~SIBTENCY OF 508 A~ 309: YEAR OF BIRTH (103) [ ~ PLUS + AGJE AT MARRIAGE (509) CALI~dLATEO YEAR OF MARRIAGE IF YEAR OF BIRTH UMKHO~N, CALCULATE TEAR OF BIRTH CURRENT YEAR MINUS CURRENT AGE (104) CALCULAIED ~-~ YEAR OF BIRTH tO THE CALCULATED YEAR OF MARRIAGE WITHIN ONE YEAR OF THE REPORTED YEAR OF MARRIAGE (508)? YES NO ~ ~PROSE AND CORRECT 508 AND 309. DETERN]NE V~ONTHS KARRIED OR IN UNIOR SINCE JANUARY 1988. ENTER "X" IN COll~4M 6 OF CALENDAR FOR EACH NQNTH ~dP.RR[EO OR IN UNION, AND ENTER "0" FOR EACH NONTH NOT MARRIED/NOT IN UNION+ SLICE JANUARY 1988, FOR ~l~l[M MOT CURRENTLY IN UMIOM OR UITN MORE THAN ONE UNION: PRORE FO(~ DATE COUPLE STOPPED LIV[NG TOGETHER OR DATE WIDO~ED, AND FOR START%NG DATE OF ANY SUB,T~EGUE N T UN[OR, SKIP I TO I 517 Out ing the t I+t four reeks , how may days +ere you and I DAIS . . . . . . . . . . . . . . . . . . . . . . . I [ I y~r h,~r tmr Ip41rt? I I I I 5 ,8 I Nou we need some deta i l s about your sexual ac t iv i ty in I order to get a bet ter uhderstarldlng of fami ly plaming I~ ftrtltlty. He4+ mm~ny t imes d id yOU h ive sext.ml In tercourse Ln the TIMES . . . . . . . . . . . . . . . . . . . . . . Lmst fOUr weeks? I f i . . . . . ,,y+v+ I T I+ . . . . . . . . . . . . . . . . . . . . . . 520 k lh~ ~IS the Last t ime ym had sex~l intercourse? DAys AGO . . . . . . . . . . . . . . . . . 1 ~EEKS AGO . . . . . . . . . . . . . . . . 2 MONTHS AGO . . . . . . . . . . . . . . . 3 YEARS AGO . . . . . . . . . . . . . . . . 4 BEFORE LAST BIRTH . . . . . . . . . . . . . 996 521 I Bc~ old Mere you when you f i r s t had sexual i rttercourse? AGE . . . . . . . . . . . . . . . . . . . . . . . ~ ] I FIRST TIME WHEN HARRIED . . . . . . . . 96 3E2 Bow o ld were you in years and rr~nth$ ~hen you had your AGE IN YEARS . . . . . . . . . . . . . . . I I I i f i r s t menstrual ~r iod7 L I I 52.1 PRESENCE OF OTHERS AT THIS POINT. AND MONTHS . . . . . . . . . . . . . . . . . I J l YES NO CHILDREN UNDER 10 . . . . . . . . . . 1 2 HUSBAND . . . . . . . . . . . . . . . . . . . . 1 2 OTHER MALES . . . . . . . . . . . . . . . . 1 2 OTHER FEMALES . . . . . . . . . . . . . . I 2 3o 212 NO. SECTION 6. FERTILITY PREFERENCES ~4JESTIO~S AND FILTERS CHECK ]F7: AND PARTNER t~AN OR PARTNER NOT STERILIZED E~ [~ STERILIZED SKIP CCOING CATEGORIES TO ~607 603 CHECK 5OR: CURRENTLY HARRIED NOT NARRIED/ ~1 LIVING NOT LIVING TOI'~TNER [~ TOGETHER CHECK 233: NOT PREGNANT OR UNSURE [~ NOW [ have a~quest iona ItJ~zout the future. ~k~uLd you t|ke to have (a/another) ch i ld or uoutd yo4Jprefer not to PREGNANT [~ i V Nou ] have some questions about the future. After the ch i ld you are expecting, uoutd you l i ke to have another ch i ld Or have any (more) chi ldren? uoutd you prefer not to have any more chi ldren? .61Z I NAVE A (ANOTHER) CHILD . . . . . . . . . . 1 I l SAYS SHE CAN+T GET PREGNANT . . . . . ] 610 604 CHECK 233: ROT PREGNANT OR UNSURE [~ / i v Nou (ongwoutd you l i ke to ~lt from no~ pefore the b i r th of (a/another) chi ld? 605 I CNECJC 221 AND 2]3: HAS LIVING CHILD(REN) YES OR PRECdIANT? V 606 CHECK 213: NOT PREC44ART OR UNSURE [~ / NOW otd~outd you ( i ke your ~est ch i ld to be ~en your next ch i ld is born? PREGNANT HOW l¢~g mould you Like to Wait af ter the b i r th of the ch i td you are expecting before the b i r th of another chi ld? NO F] PREGNANT E~ Hou old woutd you t ike the ch i ld you are expecting to be when your next chJtd is born? MONTHS . . . . . . . . . . . . . . . . . . . 1 I1~'~ YEARS . . . . . . . . . . . . . . . . . . . . 2 SOC~¢/NOqa . . . . . . . . . . . . . . . . . . . . . . 994 SAYS SHE CANIT GET PREGMANT.995-- OT~ER 996 (SPECIFY) OK . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998 ~610 ~610 I I ACE OF CHILD ::::::::::::::::::::::::::::: I "1 I Y+ . '1 over again, do you th ink (you/your husbar~l) woutd make the Sm doc is i~ to have an o~eretion not to have NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z any more chi ldren? I Do yo4J regret that (ycxJ/yc~Jr husba~) had the operation I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I not to have any (more) chi ldren? I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 -610 31 213 NO. QUESTIONS AND FILTERS 609 Why do you regret it? CODING CATEGORIES RESPONDENT t~ANFS A~OYHER CHILD.I PARTNER WANTS AMOTHER CH[LD . . . . . 2 SiDE EFFECTS . . . . . . . . . . . . . . . . . . . . ] OTHER REASQ#~ 4 (SPEC%FY) SKIP TO I 610 | Have you and your husband/partner ever discussed YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I the ~ r of chiidrtn~ you wo~id Like to have? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 611 I Do you think your h~band/pertner uants the sa~ I SA/qE NURSER . . . . . . . . . . . . . . . . . . . . . t I number of children that you cant, or does he want mor_._~e I or fgHgf then uhet yo~ uant? NORE CHILDREN . . . . . . . . . . . . . . . . . . . 2 FEWER CHILDREN . . . . . . . . . . . . . . . . . . ] DK . D 612 C~ON 221: HAS LIVIMG CHILO(REM) (~ / I f you could go beck to the t im you did not have any children and could choose NO LIVING CHILD(REN)[~ I V If you could choose exactly the number of children to have in exQctly the r~mber of children your ~hole I ife, how to have in your whole Life, many would that be? ho~ mmny would that be? RELIED SINGLE NUMBER ON OTHER ANSWER. NUNBER . . . . . . . . . . . . . . . . . . . . . OTHER ANSWER 96 (SPECIFY) I 61] | Hat do you think is the best number of months or I yearl between the b i r th of one chi ld sad the b ir th of the next child? I MON]HS . . . . . . . . . . . . . . . . . . . 1 ~ J YEARS . 2 OFHER 996 (SPECIFY) ch, LOr.o, . L Y'' o . . 2'1 615 I Whirl do you expect to Live? I RESPONDENT~S HOUSE . . . . . . . . . . . . . . 1 I CHILD(REM)+S HOUSE . . . . . . . . . . . . . . 2 OTHER ] (SPECIFY) 616 0o yo4J expect to recefve f inancial or material support from your chi ldren/relat ives ~en you get old? YES . | NO . 2 DEPENDS ON CHILDREN . . . . . . . . . . . . . ) OTHER 4 (SPECIFY) 32 214 NO. 701 702 7. HUSBAND=S BACKGROUND, RESIDENCE ABp I~AN=~ bPQRK DUESTIONS AND FILTERS I COOING CATEGORIES CHECK 501: EVER It~RR1ED NEVER HARRIED/ 03 LIVED ~ NEVER LIVED TOGETHER TOGETHER [~ ! v ASK O/~[$TLCMS ABOUT CL~RENT Ca NOST RECENT HUSBAND/PARTNER. Did your (Lest) husband/l~rtner ever attend schoot? i YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 SKIP I TO I ~TOT I I ~7O5 703 14her Is/mbs the highest Level of schoot he attended? PRESCHOOL . . . . . . . . . . . . . . . . . . . . . . . 0 ELEMENTARY . . . . . . . . . . . . . . . . . . . . . . 1 HIGH SCHOOL . . . . . . . . . . . . . . . . . . . . . Z COLLEGE OR HIGHER . . . . . . . . . . . . . . . 3 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 7DS I I I . . 705 k~mt kind of uork does (did) your (Lest) husbend/~artner msinLy do? 706 707 CHECK 705: ~IORKS (W(~KED) [~ DOES LDID) F-1 IN A FAJU4 NOT ~*~RK ' , 7_ IN A FARM ¥ (Does/did) your husband/partner work r~inLy on his own L~d or family Land, or (does/did) he rent Land. or (does/did) he work ~n someone etse's land? H[S/FAJ~ILY LAND . . . . . . . . . . . . . . . . . 1 RENTED LAND . . . . . . . . . . . . . . . . . . . . . 2 SOMEONE ELSE~S LAND . . . . . . . . . . . . . 3 I 708 Rave yo~ Lived Ln thLs baranoay since January 19887 YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 =-710 I BEGIN IN THE 140NTH OF INTERVIEI~ AND CONTINUE WITH ALL PRECEDING MONTHS BACK TO JAN. 1903. R711 33 215 BK]P NO. ~ESTIOMS AND FILTERS J CODING CATEGORIES TO 710 In uhat moc~th and year did you move to th is barangay? ENTER (IN COL.? OF CALENDAR) "X" IM THE kK~TH AND YEAR OF THE k~)VE, AND IN THE SUBSEQUENT 14O~TR$ ENTER THE APPROPRIATE CODE ("1" CITY, "2" TO~N, "3 I' BARRIO/RURAL AREA). CO~ITIklUE PROBING FOR OTHER BARANGAYS OF RESIDENCE AND RECORD ROVES AND TYPES ACCORDINGLY. ILLUSTRATIVE OUESTIO~S • lahere Did you l i ve be fore . . . . . ? " In Hat month ind year did you ar r ive there? " IS that place in • c i ty , • torn, or in • bor r io / ru ra l area? 711 REFER TO PLACE OF RESIDENCE IN JANUARY 1988: ~/hefl d id you move to (PLACE OF RESIDENCE IN JAk~ARY 1988)? TII4E SHOULD BE PRIOR TO JANUARY 1988 I LIVED THERE SINCE BIRTH . . . . . . . . 96 r71] YEAR . . . . . . . . . . . . . . . . . . . . . . . ~ '~ Dl( YEAR . . . . . . . . . . . . . . . . . . . . . . . . 98 ?lZ ~OS the place you moved from a C i ty , a to~n, or a her r |o / rura l area? I CiTY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 [ ~*ARR I O/R'~A~. AREA . . . . . . . . . . . . . . . 3 713 1 ~JLd like to ask you some questions about Working. Aaidm f r~ yo~Jr own housework, are you cur rent ly working? I YES 1 J ,717 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 J I I 71S I AS yOU kt~e~ some Roman take up jobs for k~hich they I J are paid in cash or kind. Others seLL things~ have a ] I l l a l | IxzlJness or i~ork o~ the f i lmi ly farm or tn the f l i [y bIJ~Ji~ess. Are you cur rent ly doing any of these things or any other WOrk? I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 r? l ? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 715 I Have you ever worked since January 1988? ! YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . ,717 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ENTER #0" IN COLUI4M 8 OF CALENDAR IN EACH leONTH FROM JANUARY 1988 TO CURRENT h~TH. I ~721 ! I 717 I ~Jalit tS (WAS) your (most recent) occupation1? I I That Is, what kind of work do (d id) you do? I 718 USE CALENDAR TO PROBE FO~ ALL PERIOOS OF ~JORK. STARTING kJ[TN CURRENT OR HOST RECENT NK~RK~ BACK TO JANUARY 1988. ENTER CLYDE FOR NO bK)R[ OR FOR TYPE OF ~RK IN COLUMN 8. I L LUSTP~,i' IVE QUESTIONS I~ d id th is job begin (and when did i t end)? Mhat d id you do before that? Hc~ long did y~a ~ork at that time? Were you self-empLoyed or an employee? Were you paid for th i s uork? Did you ~ork at home or a~sy from home? 216 ;'20 l see that y~ were ~rk i~ In January 1988, Mhend ld you s tar t that Job? MONTH . . . . . . . . . . . . . . . . . . . . . . DK NOt4 t N . . . . . . . . . . . . . . . . . . . . . . . 98 723 YEAR . . . . . . . . . . . . . . . . . . . . . . . DID YEAR . . . . . . . . . . . . . . . . . . . . . .9~ I STARTING DATE SHOULD BE PRIQ~ TO JANUARY 19845 721 I I l ee that you kmre not work ing in Jar~sry 1988. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( I I | D(d yO~J ev l r work pr io r to Ja~.mry 1988? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2~7"~ 722 723 724 725 726 when d id your La l t Job pr io r to J a~ry 1988 end? ENO DATE SHOULD BE PRIC~ TO JANUARy 1988 HONTN . . . . . . . . . . . . . . . . . . . . . . DK NO441N . . . . . . . . . . . . . . . . . . . . . . . 98 YEAR . . . . . . . . . . . . . . . . . . . . . . . [~ OK YEAR . . . . . . . . . . . . . . . . . . . . . . . . 08 CHECK 2201223: WITH A CHILD BO~N SINCE YES NO JAM, 19M AMP LIVING EL UITH DESPONDENT L--J CHECK 71]AND 714: YES CURRENTLY ~,I(~K]NG? vE ~ I~ i te you are work ing , ck) you usua l ly hove (#AJ4E OF YOUNGEST CHILD AT ROME) w i th you, iomet lmes have h im/her w i th you, or ~yqf h ive h lm/hor w i th you? NO R I USUALLY . . . . . . . . . . . . . . . . . . . . . . . . . 1 SCd4ETINE$ . . . . . . . . . . . . . . . . . . . . . . . 2 NEVER . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 kq~o um~aLty takes care o f (MANE OF YOUNGEST CHILD AT NCI4E) l,,~iie yo, J are work i r~? HUSBAND/PARTNER . . . . . . . . . . . . . . . . OI OLDER CHILD(REN) . . . . . . . . . . . . . . . 02 ELDERLY RELATIVES . . . . . . . . . . . . . . 03 OTHER RELAT[VES . . . . . . . . . . . . . . . . 04 NEIGHBORS/FRIENDS . . . . . . . . . . . . . . 05 SERVAHTS/HLRED HELP . . . . . . . . . . . . 06 CHILD IS IN SCHOOL . . . . . . . . . . . . . 07 ]NST[]UIIONAL CHILDCARE . . . . . . . . OG OIHER 09 (SPECIFY) ,72T I I .727 I ~727 727 ODes ~y o ther famJ(y member ~ed to be cared for? IF YES: ~o are they? RECORD ALL MENTIONED. OTHER yOkING CHILDREN . . . . . . . . . . . . A ELDERLY PARENTS OF RESPONDENT.,,B ELDERLY PARENTS OF HUSBAND . . . . . . C OTHER ELDERLY RELATIVES . . . . . . . . . D OTffER .E (SPECIFY) NO ONE . . . . . . . . . . . . . . . . . . . . . . . . . . F 35 217 SECTION 8. H~T~RMAL 14O~TALITY 80t | Nov I WO~id t i ka to ask y~ s~ ~est i~ abe~t your b ro thers and s i s te rs , that I s , e l i o f the ch i td ren bern to your o~n mother, NL~BER OF BIRTHS TO J J ~ I tnc lud(ng t~n~e ~o ere t ry ( r ig v ( th y~, those t lv le '~ eLseuhere. C/~N MOTHER . . . . . . . . . . . . . . . . . . . •nd those who have d ied . Hou many ¢h( tdren d id your mother g ive b i r th to , in t rud ing yo~raet f? ~02 CllECK ~1: ~ v E ~ ONLY ONE HIRT½ (RESPONDENT ONLy) [~ .SKip TO 81~ ~03 J HOW ee~ny a f these b i r ths d id yOUr mother have before you ~ere I born? NLI~eBE R OF I I pRECED ] NG BIRTHS . . . . . . . . . . . . . [1) (2] [3) |4) [5] PLease Give sw the nA~s o f s i t your b ro thers ~ s i s te rs bern to your o~rt Bother ) s t i r t l r~ w i th the e ldes t . 805 I s (MANE) I Le or fe ru le? MALE . . . . . . . 1 MALE . . . . . . . 1 ~LE . . . . . . . 1 MALE . . . . . . . 1 KALE . . . . . . . 1 FEMALE. . . .2 FEMALE. . . .2 FEMALE. . . .Z FEMALE. . . .2 FEMALE. . . .Z 606 I t (NAME) s t i l t s i l va? YES . . . . . . . . 1 YES . . . . . . . . 1 yES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 SKLP TO SO8, SKiP TO ODe,- sk ip to sos , sK,,',u'o,,,,,. SKLP TO =a,~l °~ . . . . . . . . . ° ' . . . . . . . . . °~ . . . . . . . . . °= ~ ' ;~ ~ i~ Go ,o oo to 1s, To °= 807 HOw o ld I s (MANE) as o f h i s /her t ss tb t r t~y? FI I FTq ?-F1 GO TO [21 GO TO (3) GO TO [4) GO TO [51 GO TO (h) 808 .OU many year . .go d id (NAME) d ie? F I { IF HALE OR IF MALE OR IF MALE OR IF HALE OR IF MALE OR DIED BEFORE 10 DIED BEFORE 10 DIED BEFORE 10 DIED BEFORE 1( )lED BEF~E 10 YEARS OF AGE YEARS OF AGE yEARS OF AGE YEARS OF AGE YEARS OF AGE GO TO [2] GO TO (33 GO TO (4) GO TO [S] GO TO [6) 810 Hal (NAME) ever be~n pregn~t? YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 NO . . . . . . . . . 2 NO . . . . . . . . . 2] NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 ~0 TO [21<] GO YO (3)~ GO WO [41~] GO TO [s ly ] GO TO [61<] 811 UaS (MANE) pregn~t ~hen she d i~? YES . . . . . . . . ~ YES . . . . . . . . 1] yES . . . . . . . . ,]1 YES . . . . . . . . ,11 YES . . . . . . . . 1 ' l SKIP 10 814< SKIP TO 814< ~KIP TO 814<~ SKIP TO 814<~ KIP TO 814< ~ No . . . . . . . . . 2 NO . . . . . . . . . 2 No . . . . . . . . . z HO . . . . . . . . . 2 NO . . . . . . . . . z 812 Did (NAME) d ie dur ing ch l tdb i r th? YES . . . . . . . . ~ YES . . . . . . . . I~ YES . . . . . . . . ,~1 YES . . . . . . . . 1~ YES . . . . . . . . 1 '1 SKIP "ro B15< SKIP 10 B15< SglP 10 81S~ SKIP TO BlSx SKIP TO B15<~ NO . . . . . . . . . Z NO . . . . . . . . . E NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 L iS t th i rd d id (NAME) d ie? (DayS DY,.1 i f cOO, ~ths I f <12, a tse years ) . NO.2 qO.2 NO.2 NO.2 NO.,2 YR.3 YR.3 fR . .3 YR.3 YR. .3 816 VSS the death re t i red to pregnancy or YES . . . . . . . . .11 YES . . . . . . . . ,11 YES . . . . . . . . 1] YES . . . . . . . . .11 YES . . . . . . . . .,~1 ¢~mpLicat(ocu| of p r ~ y o¢ ~KIP TO ~6< ~ ~KLP TO 816< ~ ~IP TO 6t6~- - SKiP 10 816 <~ SKiP TO ~t6 ~-J det ivery? NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 OK . . . . . . . . . 8 OK . . . . . . . . . 8 DK . . . . . . . . . 6 O~ . . . . . . . . . 8 OK . . . . . . . . . 8 815 CHECK ~ ANO 809: I I I I YES . . . . . . . . 1 ~ES . . . . . . . . I YES . . . . . . . . 1 ~/ES . . . . . . . . 1 ~ES . . . . . . . . 1 DEATH IN THE PAST 20 YEARS AND AGE AT ~ ~ DEATH BETWEEN 15 AND 50 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . Z NO . . . . . . . . . 2 NO . . . . . . . . . 2 b i r tN to be fore that pregnancy? 8ROTNER/S[STER LSKIP TO B18 GO IIACK TO 804* FOR NEXT BROTHER/SISTER; OR [F NO iqoRE 36 218 [6] I [7] I [8] I [8] r [103 I 604 P(aase g ive me the names o f a l l vour I Give Be names o f e l [ your I brothers and s i s ]e re born to your ova~ ! mother , s t i r ] in8 Mi th the e ldes t , i le (RARE) ro le or f~ le? 8~6 I s (RAI~) s t l ] t t r iTe? How o ld ]1 ( I~NE) SO7 l i l ac ] b i r thday? ms of h i s /her g~ I~ny ye i re los d id iNANE] d ie? HOed o ld ~s (NAME) uh(m she/he d ied? 810 Bss (MANE) ever been pregnant? )tALE . . . . . . . I FEK4LE . . . . . 2 YES . . . . . . . . [ NO . . . . . . . . . 2] SKiP TO 808< 8K~'i;'i~,8] GO TO [7] IF HALE OR DiED BEFORE 10 YEARS OF AGE GO TO [7] YES . . . . . . . . 1 NO . . . . . . . . . 2 GO TO [71<] MALE . . . . . . . 1 FEF, ALE . . . . . 2 YES . . . . . . . . 1 NO . . . . . . . . . 2 SKIP TO 808<] 8K~'io'?;;~] GO lO [8] IF MALE OH DIED BEFORE 10 YEARS OF AGE GO 10 [0] YES . . . . . . . . 1 NO . . . . . . . . . 2 GO TO [81< ] HALE . . . . . . . I FE/4ALE . . . . . 2 YES . . . . . . . . 1 NO . . . . . . . . . 2] SKIP TO 808< DK . . . . . . . . . O0 TO [91 <~ GO TO [9] IF MALE OR DIED BEFORE 10 YEARS OF AGE GO TO [9] ' YES . . . . . . . . 1 NO . . . . . . . . . 2 00 TO [91< ] KALE . . . . . . . 1 FEK~LE . . . . . 2 YES . . . . . . . . 1 NO . . . . . . . . . 2 ] SKIP TO 808< GO TO [18] IF MALE OR DIED BEFORE 10 YEARS OF AGE GO TO [18] YES . . . . . . . . 1 NO . . . . . . . . . 2 GO TO [18] J MALE . . . . . . . 1 FEf4ALE . . . . . 2 YES . . . . . . . . 1 NO . . . . . . . . . 2 SKIP TO 808<] DK . . . . . . . . * GO TO [11]~ GO TO [11] IF MALE OR DIED BEFORE 1C YEARS OF AGE GO 10 [11] YES . . . . . . . . I NO . . . . . . . . . 2 GO TO [11] J 811 Was (NAME) pregnant Hen she died? YES . . . . . . . . 11 YES . . . . . . . . 11 YES . . . . . . . . 11 YES . . . . . . . . 1~ YES . . . . . . . . 11 SKIP TO 014<--J SKIP TO 014<~ SKIP TO 014<-J SKIP TO 816<J SKIP TO 814, J NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 J 812 B id (~A~qE) d ie dur ing ch i [db iech? YES . . . . . . . . 1 YES . . . . . . . . T YES . . . . . . . . T YES . . . . . . . . ! YES . . . . . . . . I SKIP TO 815< '~ SKIP 10 815 <'~ SKIP TO 815 <'~ SKIP TO 815 <'~ SKIP ;0 015< '~ NO . 2 NO . Z NO . . . . . . . 2 NO . . . . . . . 2 NO . Z l as t ch i ld d id (NAME) d ie? (Bays 8Y . . ] 8Y . .1 OY. ,1 8Y . .1 OY. .1 I f <98, months i f <12, e lse years ) . MO.2 MO.2 XO. .2 HO.2 14(3.2 ,YR. .3 YR. .3 YR. ,3 YR. .3 YR. .3 816 Was the death re la ted to pregnancy or YES . . . . . . . . 1~ YES . . . . . . . . 1~ YES . . . . . . . . ,]1 YES . . . . . . . . ,]1 YES . . . . . . . . I , comptJcaEio¢~ of pregnancy or SKiP TO 816<-- SKIP TO 016< SKIP TO 016<~ SKIP TO 816 ,4 SKiP TO 816<- de l ivery? NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 DK . . . . . . . . . 8 DK . . . . . . . . . B OK . . . . . . . . . 8 DK . . . . . . . . . 8 DK . . . . . . . . . 8 8 . I CHECK BO~AND SO9: YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . ] I DEATH IN THE PAST 20 YEARS AN8 AGE AT DEATH BET~EN 15 AND 58 He . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 816 Ho~ many ch l td ren has iNANE) g iven 817 J GO BACK TO 806 FOR NEXT BROTHER/SISTER; OR IF NO MORE SROTHER/SISIER ~SKIP TO B1B 37 219 [11) [12] [13) (14] [15] | P~ease Dive mm the ne~es of a~ y~r I brothers a~d s i s te rs bern to your own Bother . i ta r t i r lg w i th the e ldes t . 805 ~ I s {MN~) i I l [e or fe~mle? KALE . . . . . . . 1 MALE . . . . . . . 1 MALE . . . . . . . I MALE . . . . . . . 1 MALE . . . . . . . 1 I FEMALE . . . . . 2 FENALE . . . . . 2 FEI4ALE . . . . . 2 FENALE . . . . . 2 FEMALE . . . . . 2 "+ I I s ( l IA /~) s t i l t a l i ve? YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 I NO . . . . . . . . . 2] NO . . . . . . . . . 21 NO . . . . . . . . . Z l NO . . . . . . . . . 2] NO . . . . . . . . . Z 1 SKIP TO 808< SKIP TO SOD<J SKIP TO 608,~ SKIP TO 808< SKIP TO 808<- DK . . . . . . . . . DK . . . . . . . . . DK . . . . . . . . . OK 807 i ~low o ld ia (NAME) as of h i s /her I GO TO (121 GO TO [131 GO TO [14] GO TO [151 SKIP TO 818 IF MALE OR 1F KALE OR IF MA~.E OR I f MALE OR 1F MALE OR DIED BEFORE 10 DIED BEFORE 10 DIED BEFORE 10 DIED BEFORE 10 DIED BEFORE 10 YEARS OF AGE YEARS OF AGE YEARS OF AGE YEARS OF AGE YEARS OF AGE GO TO [12] GO TO [ I ] ] GO TO [14] GO TO [15] SKIP TO 818 810 J Has (NN4E) ever been pregnsnt? YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . I I Re . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2] GO TO [121< ] GO TD [131< ] GO TO [141<] GO TO [151,] SKIP TO 818( 811 J Was (MA/¢E) p regr .~t when she died? YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . ~ YES . . . . . . . . 1 YES . . . . . . . . SKIP TO D14< ~j SKIP TO 814< '~ SKiP TO 814¢ SKIP TO 814'( '~ SKIP TO 814¢ I NO . . . . . . . . . 2 NO . . . . . . . . . 2 HO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 812 I D id (NAME) d ie dur ing ch i ldb i r th? YES . . . . . . . . F YES . . . . . . . . 1 YES . . . . . . . . I1 YES . . . . . . . . ~ YES . . . . . . . . 1 SKIP TO 815< r~ SKIP TO 8IS< ~ SKIP FO 815< SKIP TO 815< SKIP TO E1B,-- ' ] I Me . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 I~o . . . . . . . . . 2 NO . . . . . . . . . 2 DY.1 DY.,1 DY.1 Last ch i ld d id (NN4E) d ie? (Days DY.1 I f .(90. I ,onths I f <12. e l se years ) . 140.2 140.2 j~ . .~ i ~ . . z ~ . . z YR, " ] L - - - ,~ YR . .3 YR, .3 YR.~ YR.3 °" I " ' " " deaL,, re ,a t . .o ,~ . .~y o,- YER . . . . . . . . ~! ,ES . . . . . . . . ,1 .EE . . . . . . . . ,~ Y . . . . . . . . . ~ TED . . . . . . . . , ,1 ¢o~ot icat ion l o f pregnar~cy or SKIP TO 816< SKIP TO 816< ~ SKIP TD 816< SKiP TO 816< SKIP TO 816 ,~ de l ivery? KO . . . . . . . . . 2 ~O . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2 OK . . . . . . . . . 8 OK . . . . . . . . . 8 DK . . . . . . . . . 8 DK . . . . . . . . . 8 DK . . . . . . . . . D 81~ i CHECK ~Ol) AND 809: YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 YES . . . . . . . . 1 I DEATH 1)1 1HE PASt 2D YEARS KMO AGE AT DEATH 6ETbIEEN 15 AND 50 NO . . . . . . . . . 2 HO . . . . . . . . . 2 NO . . . . . . . . . 2 flO . . . . . . . . . 2 NO . . . . . . . . . Z 816 I HO~ many ch i ld ren has (NAME) g iven I GO BACK TO 806 FOR NEXT BROTHER/SISTER; OR IF NO MORE BROTHER/SISTER ~SKIP TO 818 RECORD THE TIHE. 220 INSTRUCTIOWS: GNLY ONE CODE SHOULD ~ 12 DEC APPEAR IN AMY ~K~X. FOR COLLI4NS 11 ~OV 1, 6, 7, ANO 8 ALL NONTHS SHOULD 10 OCT BE TILLED IN. 09 $EP 1 08 AUG |NFORI4ATIQM TO EE CODED FOD EACH COLUMN 9 07 JUL 9 06 JUH COL.I: Births, Pregnancies, CO~tr~cmptive Use 3 05 MAY D DIRTHS 04 AFR P PREGNANC]ES 03 HAR T TERMKRATIGIdS ~2 FEE 01 JAN 0 NO NETHOD 1 PILL 12 DEC 2 IUO 11 NOV 3 INJECTIONS 10 OCT 4 DIAPHRAC4~/FOJOIJJELLT 09 SEP S CONDOR I 08 AUG 6 FEMALE STERILIZATION g 07 JUL 7 MALE STERIL[ZAYI(~ 9 06 JUN O PERIODIC ABSTINENCE 2 05 MAY 9 V]THDRA~AL OG APR ~THES, 03 MAR (SPECIFY) 02 YEB Ol JAN COL.2: Disco~tin~ation of contraceptive Use I BECAME PREGNAHT WHILE USING 12 DEC 2 MANYED TO BECOME PREGNANT 11 NOV 3BUSBANOOLSAPPROVED 10 OCT 6 SIDE EFFECTS 09 SEP S HEALTH CONCERNS I 08 AUG 6 INACCESSIBLE/UNAVAILABLE 9 07 JUL 7 RANTED NO RE EFFECTIVE HETHO0 9 Ob JUN 8 INCOWVENIEMT TO USE I 05 MAY 9 INFREQUENT SEX/HUSBAJ~D A~AY/OLD/ 04 APR DIFFICULT TO GET PREGNAHT 03 MAR C COST TOO NJCR 02 FEB F FATAL[STIC 01JAH A MEHO~AUSE/HAD HYSTERECTOMY D KARITAL OISSOLUTIO~/SEPARATID~ ~ 12 DEC W OTHER. 11 NOV (SPECIFY) 10 ~I E DOD~T KNOU 09 SEP I 08 AUG COL.3: Postpartum Amenorrheo 9 07 JUL X PERIOD DID NOT RETURN 9 06 JUR 0 LESS THAN ONE MONTH 0 05 HAY O~ APE COL.6: Postpartum Abstinence 03 MAR X HO SEXUAL RELATIONS 02 FEB 0 LESS THAN ONE NOIITH 01 JAN COL.3: Orris)feedinG 12 DEC tk~EkBYFEEDtHG I1 NOV O LESS THAN ONE MONTH 10 OCT 8 NEVER 8REASTFED 09 SEP 1 08 AUG COL.6: Narrisge/Unton 9 D7 JUL X IN ON[OD (MARRIED ON LIVING TOGETHER) D 06 JUN O NOT IN UNION 9 05 HAY O~ APR SOL.T: Moves la~d Types of COmmUnities 03 MAR X CHANGE OF GOI'S4URITY 02 FEB I CITY 01 JAN 2T~ ] BARRIO/RURAL AREA 12 DEC 11 NOV ~.OL.8: Type of Employment 10 OCT 0 OlD I~T I~3RK 09 SEP 1 PAID EMPLOYEE, AWAY FROR HONE 1 O~ AUG 2 PAID ENPLOYEE, At ~OH~ 9 07 JUL 3 SELF-EI4PLOYED, AWAY FROM HONE 8 06 JUN 4 SELF-EMPLOYED, A1 HON~ 8 05 NAY 5 UNPAID ~ORKER, AWAY FROM BONE 06 APR 6 UNPAID ~KER, AT HONE 03 MAR 02 FEB Ol JAH 1 ~ 3 4 02 . O3 04 05 os i O7 Oe i [ _ J 0v ,11012 ' I I 15 17 18 19 2;' 2H 31 33 3935 I . 36 _ j 3s 39 ~ ) 41 ~2 /.4 J - - So 51 52 53 5~ 55 5b 57 58 59 60 61" - - 62 63 X i 67 69 70- - - - t 71 5 6 I I ! i 78 i l ]o l 1" O7 il 14 15 16 17 I" ZO 21 22 Z3 24 25 26 E7 2g 29 30 31 32 33 FEB JAM 47 ~8 .I "°EC 50 NOV I 51 53 54 55 56 57 58 59 61 DEC ~ OCY SEP 6~ AUG 1 67 69 APR 70 MAR 71 FEB 72 JAN DEE 80V OCT SEP ~J~G1 JUL 9 JUN 9 MAY 3 APe MAR FEE JAN DEC NOV OCT 8EP AUG 1 JUL 9 JUN 9 MAY 2 APR MAR FEB JAN DEC NOV OCT SEP AUG 1 JUL 9 JUR 9 MAY 1 APR DEC NOV OCT EEP AUG 1 JUL 9 JUN 9 MAY 0 APR MAR FEB JAN OCT SEP AUG I JUL q JUH O NAY 9 APE MAR FEB JAN JUL 9 JUR 8 14AY 8 I t LAEI CH]LD EORN PR[OR TO JAN. 1988 NAME: MONTH. YEAR. 39 221 OBSERVATION SHEET In terv iewer ' s Observat ions Name of In terv iewer : Date: SuDerv isor ' s Observat ions Name of Superv isor : Date: Ed i tor ' s Observat ions Name of Ed i tor : Date: 4O 222 NDS FORM 3 NSCB CLEARANCE No. A0447-R013 HN (Expires January 31, 1994) Republic of the Philippines NATIONAL STATISTICS OFFICE 1993 NATIONAL DEMOGRAPHIC SURVEY HEALTH SERV1CEAVAILABILITY QUESTIONNAIRE IDENTIFICATION PROVINCE CITY/MUNICIPALITY BARANGAY c,o~R~o~ . I I I I URBAN/RURAL (Urban = I ,Rura I = 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . INTERVIEWER'S NAME I I I I DATE OF VISIT: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DAY MONTH NAME DATE FIELD EDITED BY OFFICE EDITED BY KEYED BY KEYED BY 223 SECTION 1A. CO~MURITY CHARACTERISTICS No.J QUESTIONS J COOING CATEGORIES J SKIP TO J QUESTIONS IOl TO 104 ARE TO BE ANSWERED BY THE SUPERVISOR UPON ARRIVAL AT THE CLUSTER. I ° l'~Oran'~=°'°c~ °w°'arr°'u°°~ I ~H~,.o,,o~o" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~"'' . . . . . . . . . . . . . . . '~'I ! 102 J Is the barangay part of an urban center/poblacion? J YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 • 109 I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I 104 | DENSITY OF BARANGAY l COMPACT . . . . . . . . . . . . . . . . . . . . . . . . . 1 SCATTERED . . . . . . . . . . . . . . . . . . . . . . . 2 THE REMAINING QUESTIONS IN SECTIONS ONE AND TWO ARE TO BE ANSWERED BY ANY BARANGAY OFFICIAL. 105 J What is the name of the nearest urban center /~btac ion? J. 'o°l"°~'ar'nk~'°rst°"°n°ares~urOa°c°n°r' ~,ac o~ I 'IL~ET'~'° O~B,N T,, .,A~,ST CE~T,R . . . . . . . . . . . . . ~ I 107 J What are the commonly used types of t ransportat ion to go to the nearest urban center? (CIRCLE ALL APPLICABLE) WALKING . . . . . . . . . . . . . . . . . . . . . . . . . A | I PERSOHAL VEHICLE/CART . . . . . . . . . . . B HIRED VEHICLE/CART . . . . . . . . . . . . . . C PUBLIC TRANSPORIATION . . . . . . . . . . . D OTHER E (SPECIFY) 108 J What is the main access route to this barangay? ALL WEATHER ROAD . . . . . . . . . . . . . . . . I J I SEASONAL ROAD . . . . . . . . . . . . . . . . . . . 2 I OTHER (RIVER/RAILWAY) . . . . . . . . . . . 3 TRAIL/PATH/ALLEY . . . . . . . . . . . . . . . . 4 109 1J What is the main source of drinking water in the barangay~ I COMMUNITY WATER SYSTEM . . . . . . . . . . I 1091J What is the main source of drinking water in the barangay~ I TUBED/PIPED WELL . . . . . . . . . . . . . . . . 2 OPEN DUG WELL . . . . . . . . . . . . . . . . . . . 3 DEVELOPED SPRING . . . . . . . . . . . . . . . . 4 RAINWATER . . . . . . . . . . . . . . . . . . . . . . . 5 J OTHER 6 (SPECIFY) l'OlI°thereeIectricityinthisbarangay~ I YESBo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 '1 ' ' ' 1 Is th°r° a "° " r sY ' t ° in th ' ' °ran°ay? I YES RO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ '1 112 J What type of to i te t fac i t i t ies are used by most househotds J FLUSB/WATER-SEALED . . . . . . . . . . . . . . 1 I in th is barangay? I SANITARY PIT/ANTIPOLO . . . . . . . . . . . 2 I OPEN PRIVY . . . . . . . . . . . . . . . . . . . . . . ] J DROP TYPE/OVERHANG TYPE . . . . . . . . . 4 I NO FACILITY/BUSH/FIELD . . . . . . . . . . 5 J OTHER , , ,6 (SPECIFY) 113 What is the ~ jor econ~ic ac t iv i ty of the barangay inhabitants? (CIRCLE ONE) FARMING . . . . . . . . . . . . . . . . . . . . . . . . . 1 FISHING . . . . . . . . . . . . . . . . . . . . . . . . . 2 TRADE/MARKETING . . . . . . . . . . . . . . . . . 3 MANUFACTURING . . . . . . . . . . . . . . . . . . . 4 MINING/QUARRYING . . . . . . . . . . . . . . . . 5 SERVICES . . . . . . . . . . . . . . . . . . . . . . . . 6 OTHER 7 (SPECIFY) 224 SECTION lB. AVAILABILITY OF SERVICE FACILITIES/CENTERS NEAREST TO OR WITHIN THE BARANGAY. INTERVIEWER: How I would l i ke to ask you about the nearest avai lable schools and service fac i l i t i es /centers . How do you usual ly go there and how long does i t take to get there from here? SERVICE FACILITY/CENTER A. EDUCATION I. Elementary 2. High School 3. Col lege/Univers i ty 114 DISTANCE TO SERVICE FACILITY/ CENTER (IN KM.) IF 'DO' - IF '00' - - IF '00 + - 115 MOST COMMON TYPE OF TRANSPORT I I I I I I 116 TRAVEL TIME TO GET THERE HR. I [ ~ NIN. 2 HR. I ~ - ~ MIN. 2 [ - -~ HR. I MIX. 2 [ ~ B. GENERAL SERVICES 1. Barangay ha l l 2. Postal service 3. Church/chapel/mosque with a service at least once a month 4. Market place where trading activities are carried on at least once a week 5. Publ ic l ib rary 6. Cinema 7. Public transportation IF '00 ' - IF '00' IF '00' IF 'OO' If ' 00 ' - IF '00 ' - ,F '00~0 ~ I I IT I I I I I I I I HR. MIN. HR, MIH. HR. MIN. HR. MIN. HR. MIN. HR. MIN. HR. MIN. FTTI 2 F-TT- , F--FF- FF-F , FT-FI , F-TFI F~ ' F-l-I~ FTTI , F-FFI COOES: O. 114:97 km or more . 97 Less than I km/located w/in barangay . DO No known facility . 98 Q. 115: Walking . . . . . . . . . . 1 Q. 116: RECORD IN MINUTES IF Private vehic le/ LESS THAN 2 HOURS AND Cart . . . . . . . . . . . 2 IN IIOURS IF 2 HOURS Hired Vehicle/ OR MORE. Cart . 3 Public Transport.4 225 Other . . . . . . . . . . . . 5 ] NO. I 201 SECTION 2. QUESTIONS AND FILTERS What is the nearest health facility that provides health or famity ptannin g services to (NAME OF BARANGAY)? HEALTH AND FAMILY PLANNING SERVICES I COOING CATEGORIES GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . I RBU/PUERtCULTURE CENTER . . . . . . . . . . 2 BGY HEALTH STATION . . . . . . . . . . . . . . . 3 PRIVATE HOSPITAL . . . . . . . . . . . . . . . . . 4 PRIVATE CLINIC . . . . . . . . . . . . . . . . . . . 5 OTHER 6 (SPECIFY) SKIP I TO 202 I How far is the facility from here in kilometers? I RECORD '00' IF LESS THAN I KM OR WITHIN THE BGY, IF 97 KM OR MORE RECORD '97'~ IF UNKNO~dN RECORD '98' KILO.ETERS . FF l l 203 How do most persons in th i s barangay get from here to (HEALTH FACILITY) ? WALKING . . . . . . . . . . . . . . . . . . . . . . . . . 1 - - PERSONAL VEHICLE/CART . . . . . . . . . . . 2 P206 HIRED VEHICLE/CART . . . . . . . . . . . . . . 3 - - | PUBLIC TRANSPORTATION . . . . . . . . . . . 4 I I OTHER 5 p206 (SPECIFY) How often per week is pubtic transport available to NO. OF TIMES PER WEEK . residents to go to the facility ~ 205 How long does it take to get from here to r ~ (HEALTH FACILITY) using (MEANS MENTIONED IN 203)? HOURS . I I0 I 1 1 RECORD IN MINUTES IF LESS IHAN 2 HOURS AND IN HOURS IF 2 HOURS OR MORE. MINUTES . . . . . . . . . . . . . . 2 I ] ] I 206 Does (HEALTH FACILITY) provide: prenatal care? delivery care? ch i ld immunization? fami ly planning services? postnatal care? YES NO DK PRENATAL CARE . . . . . . . . . . I 2 8 DELIVERY CARE . . . . . . . . . . I 2 8 CHILD IMMUNIZATION . . . . . I 2 8 FAMILY PLANNING . . . . . . . . I 2 8 POSTNAIAL CARE . . . . . . . . . I 2 8 207 CHECK Q. 206: IF "YES" IN FAMILY PLANNING SERVICES, Are the fo l lowing n~thcw:Is avai lable from (HEALTH FACILITY)? Pill? IUD? Inject ions? Condom? Female s ter i l i za t ion? Male s te r i l i za t ion? NO ? v YES NO DK PILL . . . . . . . . . . . . . . . . . . . I 2 8 IUD . . . . . . . . . . . . . . . . . . . . I 2 8 INJECTIONS . . . . . . . . . . . . . 1 2 8 CONDOM . 1 2 8 FEMALE STERILIZATIOH.,,I 2 B MALE STERILIZATION . . . . . I 2 0 YES t-t D216 I 4 226 gO. QUESTIONS AND FILTERS 209 What is the nearest hospital that provides health or Family planning services to (NAME OF BARANGAY) l COOING CATEGORIES I GOV'T HOSPITAL . . . . . . . . . . . . . . . . . . . 1 PRIVATE HOSPITAL . . . . . . . . . . . . . . . . . 2 OTHER 3 SKIP TO 210 HOW far is the hospital from here ( in kitoceters)9 RECORD '00' IF LESS THAN 1KM, IF 97 KM OR MORE RECORD '97 ' , IF UNKNO~/N RECORD '98' I KILOMETERS . . . . . . . . . . . . . . . . 211 Now do most persons in th is cornmunity get from here to (HOSPITAL) ? WALKING . . . . . . . . . . . . . . . . . . . . . . . . . I - - PERSONAL VEHICLE/CART . . . . . . . . . . . 2 HIRED VEHICLE/CART . . . . . . . . . . . . . . 3 - - PUBLIC TRANSPORTATION . . . . . . . . . . . 4 OTHER "214 5 ~214 (SPECIFY) 212 CHECK 102: IF NOT PART OF AN URBAN CENTER/PQBLACION, Mow often per week is public transport available to residents to go to the hospital? RECORD =00, IF LESS THAN ONCE PEg WEEK. IF UNKNO~N RECORD '98 i . J NO. OF T,MES PER WEEK . . . . . 213 I Now tong does i t take to get f r (~ here to the hospital using (MEANS MENTIONED IN 211) ? RECORD IN MINUTES IF LESS THAN 2 HOURS AND IN HOURS IF 2 HOLJRS OR MORE. J NOURS . . . . . . . . . . . . . . . . MINUTES . . . . . . . . . . . . . . 2 21/* Does the hospital provide: prenatal care? del ivery care? ch i ld immunization? family planning services? postnatal care? YES NO DK PRENATAL CARE . . . . . . . . . . 1 2 8 DELIVERY CARE . . . . . . . . . . 1 2 8 CHILD IMMUNIZATION . . . . . 1 2 8 FAMILY PLANNING . . . . . . . . I 2 8 POSTNATAL CARE . I 2 8 215 CHECK O. 214: IF "YES" IN FAMILY PLANNING SERVICES, Are the following methods avai lable from the hospital? P i l l ? IUD? Injections? Condom? FemaLe sterL l izat ion? Male s ter i l i za t ion? YES NO DK PILL . . . . . . . . . . . . . . . . . . . 1 2 8 IUO . . . . . . . . . . . . . . . . . . . . 1 2 8 INJECTIONS . 1 2 8 CONDOM . . . . . . . . . . . . . . . . . 1 2 8 FEMALE STERILIZATION.1 2 8 MALE STERILIZATION . . . . . 1 2 8 227 NO. 216 QUESTIONS AND FILTERS Ls (NAME OF BARANGAY) served by mobile outreach, that is , by a health un i t that arr ives regu lar ly nearby to provide health services to persons in th is community? IF YES: What is the name of the outreach point~ (BANE) IF NO: RECORD '000'. SKIP COOING CATEGORIES J TO m NO MOBILE DUTREACH . . . . . . . . . . . 000 ~END I 217 Under what authority is th is service oporatod~ CIRCLE ALL THAT APPLIES. NATIONAL GOV'T . . . . . . . . . . . . . . . . . . . A LOCAL GOV'T . . . . . . . . . . . . . . . . . . . . . . B CHURCH/RELIGIOJS GROJPS . . . . . . . . . . C CIVIC GROUPS/NGOS . . . . . . . . . . . . . . . . D PRIVAIE FIRMS . . . . . . . . . . . . . . . . . . . . E mOTHER ~ F 218 How far is the outreach point from here ( in k iL°ceters)? l I RECORD '00' IF LESS THAN I KM, KILOMETERS . . . . . . . . . . . . . . . . IF 97 KM OR MORE RECORD '97 t, IF UNKNOWN RECORD 198' 219 Now many t imes per quarter does the mobi le outreach | co~e to provide services ? [ TIMES PER QUARTER . . . . . . . l ie RECORD '00 ~ If LESS THAN I TIME PER QUARTER. IF UNKNOWN, RECORD '98' 220 How do most persons in this community get from here to the outreach point? WALKING . . . . . . . . . . . . . . . . . . . . . . . . . I - - PERSONAL VEHICLE/CART . . . . . . . . . . . 2 HIRED VEHICLE/CART . . . . . . . . . . . . . . 3 - - PUBLIC TRANSPORTATION . . . . . . . . . . . 4 OFHER 5 (SPECIFY) ~223 ~223 221 CHECK 102: IF NOT PART OF AN URBAN CENTER/POBLACION, Now often por week is public transport available to residents to go to the outreach point? RECORD ~00' If LESS THAN ONCE PER WEEK. IF UNKNOWN RECORD '98'. i NO. OF TIMES PER WEEK . . . . . . 222 ,N 2,o, I RECORD IN MINUTES IF LESS THAN 2 HC~JRS AND IN HOJRS | IF 2 HOURS OR MORE. I I HOURS . . . . . . . . . . . . . . . . I MINUTES . . . . . . . . . . . . . . 2 223 Does the outreach post provide: prenatal care? ch i ld immunization? fami ly planning services? YES NO DK PRENATAL CARE . . . . . . . . . . I 2 8 CHILD IMMUNIZATION . . . . . I 2 8 FAMILY PLANNING . . . . . . . . 1 2 8 224 CHECK O. 223: IF "YES" IN FAMILY PLANNING SERVICES, Are the fo l lowing methods avai lable from (HEALTH FACILITY NAME)? P i l l ? IUD? Injections? Condom? YES NO DK PILL . . . . . . . . . . . . . . . . . . . 1 2 8 IUD . . . . . . . . . . . . . . . . . . . . 1 2 8 INJECTIONS . 1 2 6 CONDOH . . . . . . . . . . . . . . . . . I 2 8 6 228 APPENDIX E SURVEY QUESTIONNAIRES Front Matter Title Page Citation Page Table of Contents List of Tables List of Figures Preface Summary of Findings Map of the Philippines Chapter 01 - Introduction Chapter 02 - Background Characteristics of Households Chapter 03 - Fertility Chapter 04 - Family Planning Chapter 05 - Other Proximate Determinants of Fertility Chapter 06 - Fertility Preferences Chapter 07 - Infant and Child Mortality Chapter 08 - Maternal and Child Health Chapter 09 - Infant Feeding and Supplementation Chapter 10 - Maternal Mortality Chapter 11 - Local Availability of Family Planning and Health Services References Appendix A - Sample Design Appendix B - Estimates of Sampling Errors Appendix C - Quality of the Data: Nonsampling Errors Appendix D - Persons Involved in The 1993 National Demographic Survey Appendix E - Survey Questionnaires Household Questionnaire Individual Questionnaire Health Service Availability Questionnaire

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