Philippines - Demographic and Health Survey - 2018

Publication date: 2018

Philippines National Demographic and Health Survey 2017 P hilippines 2017 N ational D em ographic and H ealth S urvey Philippines National Demographic and Health Survey 2017 Philippine Statistics Authority Quezon City, Philippines The DHS Program ICF Rockville, Maryland, USA October 2018 The 2017 Philippines National Demographic and Health Survey (NDHS 2017) was carried out by the Philippine Statistics Authority (PSA). Funding for the NDHS 2017 was provided by the Government of the Philippines. The United States Agency for International Development (USAID) provided technical assistance and equipment through ICF under The DHS Program, which assists countries in the collection of data to monitor and evaluate population, health, and nutrition programs. Since 1993, an NDHS has been implemented in the country approximately every five years under The DHS Program. Additional information about the NDHS 2017 may be obtained from the Philippine Statistics Authority, PSA Complex, East Ave., Diliman, Quezon City; telephone: +63 (02)-462-6600; email: info@psa.gov.ph; Internet: psa.gov.ph. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1-301-407-6500; fax: +1-301-407-6501; email: info@DHSprogram.com; Internet: www.DHSprogram.com. Cover photo is provided courtesy of Karen Lakey Isenhower. Recommended citation: Philippine Statistics Authority (PSA) and ICF. 2018. Philippines National Demographic and Health Survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF. Contents • iii CONTENTS TABLES AND FIGURES . vii PREFACE . xv ABBREVIATIONS . xvii READING AND UNDERSTANDING TABLES FROM THE NDHS 2017 . xix SUSTAINABLE DEVELOPMENT GOAL INDICATORS . xxvii MAP OF THE PHILIPPINES . xxviii 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.4 Pretest . 3 1.5 Training of Field Staff . 3 1.6 Fieldwork . 3 1.7 Data Processing . 4 1.8 Response Rates . 4 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 5 2.1 Drinking Water Sources and Treatment . 5 2.2 Sanitation . 6 2.3 Exposure to Smoke inside the Home . 7 2.4 Household Wealth . 8 2.5 Handwashing . 9 2.6 Household Population and Composition . 9 2.7 Birth Registration . 10 2.8 Education . 10 2.8.1 Educational Attainment . 10 2.8.2 School Attendance . 11 3 CHARACTERISTICS OF RESPONDENTS . 27 3.1 Basic Characteristics of Survey Respondents . 27 3.2 Education . 28 3.3 Mass Media Exposure and Internet Usage . 29 3.4 Employment . 30 3.5 Occupation . 31 3.6 Health Insurance Coverage . 32 3.7 Tobacco Use and Alcohol Consumption . 33 3.7.1 Tobacco Use . 33 3.7.2 Alcohol Consumption . 33 4 MARRIAGE AND EXPOSURE TO THE RISK OF PREGNANCY . 47 4.1 Marital Status . 47 4.2 Age at First Marriage . 48 4.3 Age at First Menstruation (Menarche) . 49 4.4 Age at First Sexual Intercourse . 49 4.5 Recent Sexual Activity . 50 4.6 Spouses Living Separately . 50 iv • Contents 5 FERTILITY . 57 5.1 Current Fertility . 57 5.2 Children Ever Born and Living . 58 5.3 Birth Intervals . 59 5.4 Insusceptibility to Pregnancy . 59 5.5 Age at First Birth . 60 5.6 Childbearing among Teenagers and Youth . 61 6 FERTILITY PREFERENCES . 71 6.1 Desire for Another Child . 71 6.2 Ideal Family Size . 72 6.3 Fertility Planning Status . 73 6.4 Wanted Fertility Rates . 74 6.5 Couples’ Consensus on Family Size. 74 7 FAMILY PLANNING . 81 7.1 Contraceptive Knowledge and Use . 82 7.2 Source of Modern Contraceptive Methods . 83 7.3 Cost of Contraceptive Methods . 84 7.4 Informed Choice . 84 7.5 Demand for Family Planning . 85 7.6 Contact of Nonusers with Family Planning Providers . 87 7.7 Attitudes toward Minors’ Use of Contraception. 87 8 INFANT AND CHILD MORTALITY . 103 8.1 Infant and Child Mortality . 104 8.2 Biodemographic Risk Factors . 104 8.3 Perinatal Mortality . 106 8.4 High-risk Fertility Behavior . 106 9 MATERNAL HEALTH CARE . 111 9.1 Antenatal Care Coverage . 112 9.1.1 Skilled Providers . 112 9.1.2 Timing and Number of ANC Visits . 112 9.2 Components of ANC Visits . 113 9.3 Protection against Neonatal Tetanus . 113 9.4 Problems Experienced during Pregnancy and Delivery . 114 9.5 Delivery Services . 114 9.5.1 Institutional Deliveries . 114 9.5.2 Skilled Assistance during Delivery . 115 9.5.3 Delivery by Caesarean . 116 9.6 Postnatal Care . 117 9.6.1 Postnatal Health Check for Mothers . 117 9.6.2 Postnatal Health Check for Newborns . 117 9.7 Problems in Accessing Health Care . 118 10 CHILD HEALTH . 137 10.1 Birth Weight . 137 10.2 Vaccination of Children . 138 10.3 Symptoms of Acute Respiratory Infection . 141 10.4 Fever . 142 10.5 Diarrheal Disease . 142 Contents • v 10.5.1 Prevalence of Diarrhea and Treatment-seeking Behavior . 142 10.5.2 Feeding Practices . 142 10.5.3 Oral Rehydration Therapy and Other Treatments . 143 10.6 Treatment of Childhood Illness: Summary . 144 10.7 Disposal of Children’s Stools . 144 11 BREASTFEEDING, COMPLEMENTARY FEEDING, AND MICRONUTRIENT SUPPLEMENTATION . 161 11.1 Infant and Young Child Feeding . 161 11.1.1 Initiation of Breastfeeding . 162 11.1.2 Breastfeeding Status and Complementary Feeding by Age . 163 11.1.3 Duration of Breastfeeding . 164 11.2 Micronutrient Intake and Supplementation among Children . 164 11.3 Micronutrient Intake among Mothers . 165 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR . 173 12.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods . 173 12.2 Knowledge about Mother-to-Child Transmission . 175 12.3 Discriminatory Attitudes towards People Living with HIV . 175 12.4 Multiple Sexual Partners . 176 12.5 Coverage of HIV Testing Services . 176 12.5.1 Awareness of HIV Testing Services and Experience with HIV Testing . 176 12.6 HIV/AIDS-Related Knowledge and Behavior among Young People . 177 12.6.1 Knowledge . 177 12.6.2 First Sex . 178 12.6.3 Premarital Sex . 178 12.6.4 Multiple Sexual Partners . 178 12.6.5 Coverage of HIV Testing Services . 178 13 HEALTH CARE UTILIZATION AND FINANCING . 189 13.1 Health Insurance . 189 13.1.1 Health Insurance Coverage . 190 13.1.2 PhilHealth Insurance Coverage . 190 13.2 Recent Health Care Treatment . 191 13.3 Hospital Care . 191 13.4 Cost of Treatment . 192 14 WOMEN’S EMPOWERMENT . 201 14.1 Married Women’s Employment . 202 14.2 Control over Women’s Earnings . 202 14.3 Control over Men’s Earnings . 203 14.4 Women’s Ownership of Assets . 203 14.5 Bank Accounts and Mobile Phones . 204 14.6 Women’s Participation in Decision Making . 204 14.7 Attitudes towards Wife Beating . 205 14.8 Negotiating Sexual Relations . 206 15 VIOLENCE AGAINST WOMEN . 219 15.1 Measurement of Violence . 220 15.2 Women’s Experience of Physical Violence . 220 15.2.1 Perpetrators of Physical Violence . 221 15.3 Experience of Sexual Violence . 221 vi • Contents 15.3.1 Prevalence of Sexual Violence . 221 15.3.2 Perpetrators of Sexual Violence . 222 15.4 Experience of Different Forms of Violence . 222 15.5 Marital Control by Husband/Partner . 222 15.6 Forms of Spousal Violence . 223 15.6.1 Prevalence of Spousal Violence . 223 15.7 Injuries to Women due to Spousal Violence . 225 15.8 Violence Initiated by Women against Husbands . 225 15.9 Help Seeking among Women Who Have Experienced Violence . 226 15.9.1 Sources for Help . 226 REFERENCES . 251 APPENDIX A SAMPLE DESIGN . 253 A.1 Introduction . 253 A.2 Sample Frame . 253 A.3 Sample Design and Implementation . 256 A.4 Sample Probabilities and Sampling Weights . 259 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 261 APPENDIX C DATA QUALITY TABLES . 285 APPENDIX D PERSONS INVOLVED IN THE NATIONAL DEMOGRAPHIC AND HEALTH SURVEY (NDHS) 2017 . 289 APPENDIX E QUESTIONNAIRES . 299 Tables and Figures • vii TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 Table 1.1 Results of the household and individual interviews . 4 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 5 Table 2.1 Household drinking water . 13 Table 2.2 Drinking water source according to region and wealth . 14 Table 2.3 Availability of water . 14 Table 2.4 Household sanitation facilities . 15 Table 2.5 Sanitation facility type according to region and wealth . 16 Table 2.6 Sanitation facility waste removal . 17 Table 2.7 Household characteristics . 18 Table 2.8 Tenure status of housing unit . 19 Table 2.9 Household possessions . 20 Table 2.10 Wealth quintiles . 20 Table 2.11 Handwashing . 21 Table 2.12 Household population by age, sex, and residence . 22 Table 2.13 Household composition . 22 Table 2.14 Birth registration of children under age 5 . 23 Table 2.15.1 Educational attainment of the female household population . 24 Table 2.15.2 Educational attainment of the male household population . 25 Table 2.16 School attendance ratios . 26 Figure 2.1 Household drinking water by residence . 6 Figure 2.2 Household toilet facilities by residence . 7 Figure 2.3 Household wealth by residence. 8 Figure 2.4 Population pyramid . 9 Figure 2.5 Birth registration by household wealth . 10 Figure 2.6 Secondary school attendance by household wealth . 12 3 CHARACTERISTICS OF RESPONDENTS . 27 Table 3.1 Background characteristics of respondents . 35 Table 3.2 Residence characteristics of respondents . 36 Table 3.3 Educational attainment . 36 Table 3.4 Exposure to mass media . 37 Table 3.5 Internet usage . 38 Table 3.6 Employment status . 39 Table 3.7 Occupation . 40 Table 3.8 Type of employment . 41 Table 3.9 Health insurance coverage . 42 Table 3.10 Tobacco smoking . 43 Table 3.11 Smokeless tobacco use and any tobacco use . 44 Table 3.12 Alcohol consumption . 45 Figure 3.1 Education by residence . 28 Figure 3.2 Trends in education . 28 Figure 3.3 Complete secondary education complete or higher by region . 29 Figure 3.4 Exposure to mass media . 30 viii • Tables and Figures Figure 3.5 Occupation by residence . 31 Figure 3.6 Health insurance coverage by residence . 32 Figure 3.7 Health insurance coverage by household wealth . 32 4 MARRIAGE AND EXPOSURE TO THE RISK OF PREGNANCY . 47 Table 4.1 Current marital status . 52 Table 4.2 Age at first marriage . 52 Table 4.3 Median age at first marriage by background characteristics . 53 Table 4.4 Age at first menstruation . 53 Table 4.5 Age at first sexual intercourse . 54 Table 4.6 Median age at first sexual intercourse according to background characteristics . 54 Table 4.7 Recent sexual activity . 55 Table 4.8 Spousal separations . 56 Figure 4.1 Marital status . 48 Figure 4.2 Trends in early sexual intercourse and marriage . 48 Figure 4.3 Women’s median age at first marriage by residence . 48 Figure 4.4 Median age at first sex and first marriage . 49 5 FERTILITY . 57 Table 5.1 Current fertility . 63 Table 5.2 Fertility by background characteristics . 63 Table 5.3.1 Trends in age-specific fertility rates . 64 Table 5.3.2 Trends in age-specific and total fertility rates . 64 Table 5.4 Children ever born and living . 64 Table 5.5 Birth intervals . 65 Table 5.6 Postpartum amenorrhea, abstinence, and insusceptibility . 66 Table 5.7 Median duration of amenorrhea, postpartum abstinence, and postpartum insusceptibility . 67 Table 5.8 Menopause . 67 Table 5.9 Age at first birth . 68 Table 5.10 Median age at first birth . 68 Table 5.11 Teenage pregnancy and motherhood . 69 Table 5.12 Sexual and reproductive health behaviors before age 15 . 69 Table 5.13 Early pregnancy and motherhood . 70 Figure 5.1 Trends in fertility by residence . 58 Figure 5.2 Fertility by region . 58 Figure 5.3 Fertility by household wealth . 58 Figure 5.4 Median age at first birth by residence . 61 Figure 5.5 Teenage pregnancy and motherhood by region . 61 Figure 5.6 Teenage and youth pregnancy and motherhood by household wealth . 62 6 FERTILITY PREFERENCES . 71 Table 6.1 Fertility preferences by number of living children . 75 Table 6.2 Fertility preferences according to age . 76 Table 6.3 Desire to limit childbearing . 76 Table 6.4 Ideal number of children by number of living children . 77 Table 6.5 Ideal number of children by background characteristics . 77 Table 6.6 Fertility planning status . 78 Table 6.7 Wanted fertility rates . 78 Table 6.8 Couples’ consensus on family size . 79 Tables and Figures • ix Figure 6.1 Desire to limit childbearing by number of living children . 72 Figure 6.2 Ideal family size by number of living children . 73 Figure 6.3 Fertility planning status . 73 Figure 6.4 Trends in wanted and actual fertility . 74 7 FAMILY PLANNING . 81 Table 7.1 Knowledge of contraceptive methods . 88 Table 7.2 Knowledge of contraceptive methods according to background characteristics . 89 Table 7.3 Current use of contraception by age . 90 Table 7.4.1 Trends in current use of contraception . 91 Table 7.4.2 Current use of contraception according to background characteristics . 92 Table 7.5 Timing of sterilization . 93 Table 7.6 Knowledge of fertile period . 93 Table 7.7 Knowledge of fertile period by age . 93 Table 7.8 Source of modern contraceptive methods . 94 Table 7.9 Cost of modern contraceptive methods . 95 Table 7.10 Informed choice . 96 Table 7.11.1 Need and demand for family planning among currently married women . 97 Table 7.11.2 Need and demand for family planning among all women and among sexually active unmarried women . 98 Table 7.12 Decision making about family planning . 99 Table 7.13 Future use of contraception . 100 Table 7.14 Exposure to family planning messages . 100 Table 7.15 Contact of nonusers with family planning providers . 101 Table 7.16 Attitude toward minors’ use of contraception . 102 Figure 7.1 Contraceptive use . 82 Figure 7.2 Trends in contraceptive use . 83 Figure 7.3 Modern contraceptive use by region . 83 Figure 7.4 Source of modern contraceptive methods . 84 Figure 7.5 Demand for family planning . 85 Figure 7.6 Unmet need by residence . 86 Figure 7.7 Unmet need by region . 86 8 INFANT AND CHILD MORTALITY . 103 Table 8.1 Early childhood mortality rates . 107 Table 8.2 Five-year early childhood mortality rates according to background characteristics . 107 Table 8.3 Ten-year early childhood mortality rates according to additional characteristics . 108 Table 8.4 Perinatal mortality . 109 Table 8.5 High-risk fertility behavior . 110 Figure 8.1 Trends in early childhood mortality rates . 104 Figure 8.2 Childhood mortality by previous birth interval . 105 Figure 8.3 Under-5 mortality by region . 105 Figure 8.4 Under-5 mortality by household wealth . 105 9 MATERNAL HEALTH CARE . 111 Table 9.1 Antenatal care . 120 Table 9.2 Number of antenatal care visits and timing of first visit . 121 Table 9.3 Components of antenatal care . 122 Table 9.4 Tetanus toxoid injections . 123 x • Tables and Figures Table 9.5 Problems experienced during pregnancy and delivery . 124 Table 9.6 Pre-term births . 125 Table 9.7 Place of delivery . 126 Table 9.8 Reasons for not delivering in a health facility . 127 Table 9.9 Assistance during delivery . 128 Table 9.10 Caesarean section . 129 Table 9.11 Duration of stay in health facility after birth . 130 Table 9.12 Cost of delivery . 130 Table 9.13 Timing of first postnatal check for the mother . 131 Table 9.14 Type of provider of first postnatal check for the mother . 132 Table 9.15 Timing of first postnatal check for the newborn . 133 Table 9.16 Type of provider of first postnatal check for the newborn . 134 Table 9.17 Content of postnatal care for newborns . 135 Table 9.18 Problems in accessing health care . 136 Figure 9.1 Trends in antenatal care coverage . 112 Figure 9.2 Trends in place of birth . 114 Figure 9.3 Health facility births by birth order . 115 Figure 9.4 Assistance during delivery . 115 Figure 9.5 Skilled assistance at delivery by household wealth . 116 Figure 9.6 Postnatal care by place of delivery . 117 10 CHILD HEALTH . 137 Table 10.1 Child’s size and weight at birth. 146 Table 10.2 Vaccinations by source of information . 147 Table 10.3 Possession and observation of vaccination cards according to background characteristics . 148 Table 10.4.1 Vaccinations by background characteristics . 149 Table 10.4.2 Vaccinations by residence and region . 150 Table 10.5 Prevalence and treatment of symptoms of ARI . 151 Table 10.6 Source of advice or treatment for children with symptoms of ARI . 152 Table 10.7 Prevalence and treatment of fever . 153 Table 10.8 Source of advice or treatment for children with fever . 154 Table 10.9 Prevalence and treatment of diarrhea . 155 Table 10.10 Feeding practices during diarrhea . 156 Table 10.11 Oral rehydration therapy, zinc, and other treatments for diarrhea . 157 Table 10.12 Source of advice or treatment for children with diarrhea . 158 Table 10.13 Disposal of children’s stools . 159 Figure 10.1 Childhood vaccinations . 140 Figure 10.2 Trends in childhood vaccinations . 140 Figure 10.3 Vaccination coverage by region . 141 Figure 10.4 Feeding practices during diarrhea . 143 Figure 10.5 Treatment of diarrhea . 143 Figure 10.6 Prevalence and treatment of childhood illness . 144 11 BREASTFEEDING, COMPLEMENTARY FEEDING, AND MICRONUTRIENT SUPPLEMENTATION . 161 Table 11.1 Initial breastfeeding . 167 Table 11.2 Infant feeding practices by age . 168 Table 11.3 Median duration of breastfeeding . 169 Table 11.4 Micronutrient intake among children . 170 Table 11.5 Iron tablets with folic acid . 171 Table 11.6 Micronutrient intake among mothers . 172 Tables and Figures • xi Figure 11.1 Trends in breastfeeding and prelacteal feeding . 162 Figure 11.2 Prelacteal feeding by household wealth . 163 Figure 11.3 Median duration of breastfeeding by household wealth . 164 Figure 11.4 Micronutrient intake among children by residence . 165 Figure 11.5 Iron tablet intake during pregnancy by region . 166 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR . 173 Table 12.1 Knowledge of HIV or AIDS . 180 Table 12.2 Knowledge of HIV prevention methods . 181 Table 12.3 Comprehensive knowledge about HIV . 182 Table 12.4 Knowledge of prevention of mother-to-child transmission of HIV . 182 Table 12.5 Discriminatory attitudes towards people living with HIV . 183 Table 12.6 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months . 184 Table 12.7 Coverage of prior HIV testing . 185 Table 12.8 Comprehensive knowledge about HIV among young women . 186 Table 12.9 Age at first sexual intercourse among young women . 186 Table 12.10 Premarital sexual intercourse among young women . 187 Table 12.11 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months among young women . 187 Table 12.12 Recent HIV tests among young women . 188 Figure 12.1 Knowledge of HIV prevention among women by region . 174 Figure 12.2 Knowledge of mother-to-child transmission (MTCT) . 175 Figure 12.3 Discriminatory attitudes towards people living with HIV by household wealth . 176 Figure 12.4 Knowledge of where to obtain an HIV test by region . 177 Figure 12.5 Knowledge of where to obtain an HIV test by household wealth . 177 13 HEALTH CARE UTILIZATION AND FINANCING . 189 Table 13.1 Health insurance coverage . 193 Table 13.2 Type of PhilHealth insurance . 194 Table 13.3 Treatment-seeking behavior . 195 Table 13.4 Specific types of health facilities utilized . 196 Table 13.5 Reason for seeking health care . 197 Table 13.6 Average travel time to health facility visited . 197 Table 13.7 In-patient hospital care . 198 Table 13.8 Aspects of in-patient care . 199 Table 13.9 Average costs of care . 199 Figure 13.1 Trends in PhilHealth coverage . 190 Figure 13.2 PhilHealth coverage by residence . 191 Figure 13.3 Average costs of care . 192 14 WOMEN’S EMPOWERMENT . 201 Table 14.1 Employment and cash earnings of currently married women . 207 Table 14.2 Control over women’s cash earnings and relative magnitude of women’s cash earnings . 208 Table 14.3 Women’s control over their own earnings and over those of their husbands . 209 Table 14.4 Ownership of assets . 210 Table 14.5 Ownership and use of bank accounts and mobile phones . 211 Table 14.6 Participation in decision making . 212 Table 14.7 Women’s participation in decision making by background characteristics . 212 xii • Tables and Figures Table 14.8 Attitude toward wife beating . 213 Table 14.9 Attitudes toward negotiating safer sexual relations with husband . 214 Table 14.10 Ability to negotiate sexual relations with husband . 215 Table 14.11 Indicators of women’s empowerment . 216 Table 14.12 Current use of contraception by women’s empowerment . 216 Table 14.13 Ideal number of children and unmet need for family planning by women’s empowerment . 217 Table 14.14 Reproductive health care by women’s empowerment . 217 Table 14.15 Early childhood mortality rates by women’s status . 218 Figure 14.1 Employment by age . 202 Figure 14.2 Control over women’s earnings . 203 Figure 14.3 Ownership of assets . 204 Figure 14.4 Women’s participation in decision making . 205 15 VIOLENCE AGAINST WOMEN . 219 Table 15.1 Experience of physical violence . 228 Table 15.2 Persons committing physical violence . 229 Table 15.3 Experience of sexual violence. 230 Table 15.4 Age at first experience of sexual violence . 231 Table 15.5 Persons committing sexual violence . 232 Table 15.6 Experience of different forms of violence . 232 Table 15.7 Experience of violence during pregnancy . 233 Table 15.8 Marital control exercised by husbands . 235 Table 15.9 Forms of spousal violence . 237 Table 15.10 Spousal violence by background characteristics . 238 Table 15.11 Spousal violence by husband’s characteristics and empowerment indicators . 240 Table 15.12 Violence by any husband/partner in the last 12 months . 241 Table 15.13 Experience of spousal violence by duration of marriage . 241 Table 15.14 Injuries to women due to spousal violence . 242 Table 15.15 Violence by women against their husband by women’s background characteristics . 243 Table 15.16 Violence by women against their husband by husband’s characteristics and empowerment indicators . 245 Table 15.17 Help seeking to stop violence . 246 Table 15.18 Sources for help to stop the violence . 247 Table 15.19 Awareness of anti-violence protection orders . 248 Table 15.20 Awareness of places to seek help from violence . 249 Figure 15.1 Women’s experience of violence by marital status . 221 Figure 15.2 Spousal violence by region . 224 Figure 15.3 Spousal violence by husband’s alcohol consumption . 224 Figure 15.4 Help seeking by type of violence experienced . 226 APPENDIX A SAMPLE DESIGN . 253 Table A.1 Households and PSUs . 254 Table A.2 PSU Replicates . 255 Table A.3 Sample allocation and completed interviews . 257 Table A.4 Housing unit allocation . 258 Table A.5 Sample implementation: Women . 260 Tables and Figures • xiii APPENDIX B ESTIMATES OF SAMPLING ERRORS . 261 Table B.1 List of selected variables for sampling errors, Philippines NDHS 2017 . 263 Table B.2 Sampling errors: Total sample, Philippines NDHS 2017 . 264 Table B.3 Sampling errors: Urban sample, Philippines NDHS 2017 . 265 Table B.4 Sampling errors: Rural sample, Philippines NDHS 2017 . 266 Table B.5 Sampling errors: National Capital Region sample, Philippines NDHS 2017 . 267 Table B.6 Sampling errors: Cordillera Administrative Region sample, Philippines NDHS 2017 . 268 Table B.7 Sampling errors: Ilocos Region sample, Philippines NDHS 2017 . 269 Table B.8 Sampling errors: Cagayan Valley sample, Philippines NDHS 2017 . 270 Table B.9 Sampling errors: Central Luzon sample, Philippines NDHS 2017 . 271 Table B.10 Sampling errors: CALABARZON sample, Philippines NDHS 2017 . 272 Table B.11 Sampling errors: MIMAROPA Region sample, Philippines NDHS 2017 . 273 Table B.12 Sampling errors: Bicol sample, Philippines NDHS 2017 . 274 Table B.13 Sampling errors: Western Visayas sample, Philippines NDHS 2017 . 275 Table B.14 Sampling errors: Central Visayas sample, Philippines NDHS 2017 . 276 Table B.15 Sampling errors: Eastern Visayas sample, Philippines NDHS 2017 . 277 Table B.16 Sampling errors: Zamboanga Peninsula sample, Philippines NDHS 2017 . 278 Table B.17 Sampling errors: Northern Mindanao sample, Philippines NDHS 2017 . 279 Table B.18 Sampling errors: Davao sample, Philippines NDHS 2017 . 280 Table B.19 Sampling errors: SOCCSKSARGEN sample, Philippines NDHS 2017 . 281 Table B.20 Sampling errors: Caraga sample, Philippines NDHS 2017 . 282 Table B.21 Sampling errors: Autonomous Region in Muslim Mindanao sample, Philippines NDHS 2017 . 283 APPENDIX C DATA QUALITY TABLES . 285 Table C.1 Household age distribution . 285 Table C.2 Age distribution of eligible and interviewed women . 286 Table C.3 Completeness of reporting . 286 Table C.4 Births by calendar years . 287 Table C.5 Reporting of age at death in days . 287 Table C.6 Reporting of age at death in months . 288 Preface • xv PREFACE he Philippine Statistics Authority (PSA) presents the final report on the 2017 Philippines National Demographic and Health Survey (NDHS). The survey provides information on fertility, fertility preferences, family planning practices, childhood mortality, maternal and child health, knowledge and attitudes regarding HIV/AIDS, and violence against women. These indicators are crucial in policy-making, program planning, and monitoring and evaluation of population and health programs, including those anchored on the attainment of related Sustainable Development Goals (SDGs). The NDHS 2017 is the sixth DHS survey to be conducted in the Philippines in collaboration with the worldwide Demographic and Health Surveys (DHS) Program and the 11th national DHS overall. Fieldwork for the survey was carried out from August 14 to October 27, 2017, covering a national sample of over 31,000 households and more than 25,000 women age 15-49. The NDHS 2017 was funded by the Government of the Philippines. The United States Agency for International Development (USAID) provided technical assistance and equipment through ICF under The DHS Program. The PSA would like to express its deepest gratitude to the Department of Health and the University of the Philippines Population Institute for their invaluable contributions during the preparatory phase of the survey. Great appreciation is also extended to the survey team of the PSA for their hard work and dedication: the staff of the Social Sector Statistics Service, Demographic and Health Statistics Division (DHSD), who worked tirelessly throughout all stages of the survey; selected staff of the National Censuses Service and the Information Technology and Dissemination Service for their support during the training process; the Finance and Administrative Service for its assistance in managing the logistics for support operations; the staff of the Regional Statistical Services Offices and Provincial Statistical Offices for overseeing the data collection activities; and the 90 interviewing teams composed of team supervisors and interviewers. The PSA is equally grateful to the survey respondents who patiently shared their time and information during the interviews. LISA GRACE S. BERSALES, PhD Undersecretary National Statistician and Civil Registrar General Philippine Statistics Authority October 2018 T Abbreviations • xvii ABBREVIATIONS 4Ps Pantawid Pamilyang Pilipino Program AIDS acquired immune deficiency syndrome ANC antenatal care ARI acute respiratory infection ARMM Autonomous Region in Muslim Mindanao ART antiretroviral therapy ASFR age-specific fertility rate BCG Bacille Calmette-Guérin BHW barangay health worker BEmONC Basic Emergency Obstetric and Newborn Care CAPI computer-assisted personal interviewing CAR Cordillera Administrative Region CBR crude birth rate CDC Centers for Disease Control and Prevention CEmONC Comprehensive Emergency Obstetric and Newborn Care CPH Census of Population and Housing CSPro Censuses and Surveys Processing DEFT design effect DHS Demographic and Health Survey DHSD Demographic and Health Statistics Division DOH Department of Health DPT diphtheria-pertussis-tetanus DSWD Department of Social Welfare and Development EARF Enumeration Areas Reference File ENC essential newborn care EO Executive Order FASDs fetal alcohol spectrum disorders GAR gross attendance ratio GATS Global Adult Tobacco Survey GFR general fertility rate GPI gender parity index GPS global positioning system GSIS Government Service Insurance System HepB hepatitis B HFEP Health Facilities Enhancement Program Hib Haemophilus influenzae type b HIV human immunodeficiency virus HU housing unit HUC highly urbanized city ICF ICF (originally, Inner City Fund) IFSS Internet file streaming system IPV inactivated polio vaccine xviii • Abbreviations IUD intrauterine contraceptive device IYCF infant and young child feeding kg kilogram KMC kangaroo mother care LAM lactational amenorrhea method LGU local government unit LPG liquefied petroleum gas MCP Maternity Care Package MCW Magna Carta of Women MMR measles-mumps-rubella MNTE Maternal and Neonatal Tetanus Elimination MSF Master Sample Frame MTCT mother-to-child transmission NAR net attendance ratio NCR National Capital Region NCRFW National Commission on the Role of Filipino Women NDS National Demographic Survey NDHS National Demographic and Health Survey NGO nongovernmental organization NHIP National Health Insurance Program NHTS-PR National Household Targeting System for Poverty Reduction OPV oral polio vaccine ORS oral rehydration salts ORT oral rehydration therapy PNP Philippine National Police PSA Philippine Statistics Authority PSU primary sampling unit RA Republic Act RHF recommended homemade fluids RHU rural health unit SDGs Sustainable Development Goals SDM standard days method SE standard error SSS Social Security System SSU secondary sampling unit STI sexually transmitted infection TFR total fertility rate UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAD vitamin A deficiency VAW violence against women VIP ventilated improved pit latrine WHO World Health Organization Reading and Understanding Tables from the NDHS 2017 • xix READING AND UNDERSTANDING TABLES FROM THE PHILIPPINES NATIONAL DEMOGRAPHIC AND HEALTH SURVEY 2017 (NDHS) he NDHS 2017 final report is based on approximately 175 tables of data. They are located for quick reference through links in the text (electronic version) and at the end of each chapter. Additionally, this reader-friendly report features about 70 figures that clearly highlight trends, subnational patterns, and background characteristics. Colorful maps display breakdowns by regions. The text highlights key points in bullets and clearly identifies indicator definitions in boxes. While the text and figures featured in each chapter highlight some of the most important findings from the tables, not every finding can be discussed or displayed graphically. For this reason, NDHS data users should be comfortable reading and interpreting tables. The following pages provide an introduction to the organization of NDHS tables, the presentation of background characteristics, and a brief summary of sampling and understanding denominators. In addition, this section provides some exercises for users as they practice their new skills in interpreting NDHS tables. T Family Planning • 83 Patterns by background characteristics ■ Modern contraceptive use is highest among currently married women with 3-4 living children (50%) (Table 7.4.2). ■ Currently married women in rural areas are more likely than those in urban areas to use modern methods (42% versus 38%). ■ The modern contraceptive prevalence rate is highest among women in Cagayan Valley (57%), largely as a result of the high percentage of pill users (36%). Half (51%) of women in SOCCSKSARGEN also use modern contraceptive methods (Figure 7.3). ■ The median age at sterilization among women is 32.1 years. Women were most likely to be sterilized at age 30-34 (36%) (Table 7.5). Knowledge of the Fertile Period Only 1 in 4 women (24%) correctly report that a woman is most at risk of pregnancy if she has intercourse halfway between two menstrual periods. Forty-three percent of women incorrectly believe that a woman is more likely to conceive immediately after her menstrual cycle has ended, and 16% report that they do not know when the fertile period is. Among women who use cycle-related methods such as rhythm, only 38% have correct knowledge of the fertile period during the ovulatory cycle (Table 7.6). Women age 35-39 are most likely to have correct knowledge of the fertile period (30%) (Table 7.7). 7.2 SOURCE OFMODERN CONTRACEPTIVEMETHODS Source of modern contraceptives The place where the modern meth od currently being used was obta ined the last time it was acquired Sample: Women age 15-49 currently using a modern contraceptive method Figure 7.2 Trends in contraceptive use Figure 7.3 Modern contraceptive use by region Percentage of currently married women age 15-49 25 28 33 34 38 40 15 20 16 17 18 14 1993 NDS 1998 NDHS 2003 NDHS 2008 NDHS 2013 NDHS 2017 NDHS Percentage of currently married women age 15-49 currently using a contraceptive method Any traditional method Any modern method xx • Reading and Understanding Tables from the NDHS 2017 Example 1: Exposure to Mass Media A Question Asked of All Survey Respondents Table 3.4 Exposure to mass media Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Philippines NDHS 2017 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 16.8 78.6 36.9 9.9 14.8 4,897 20-24 15.3 76.9 38.1 10.0 15.6 4,175 25-29 13.8 76.8 35.4 8.9 16.4 3,717 30-34 13.6 76.7 35.1 7.0 14.8 3,243 35-39 15.3 75.8 36.1 8.2 15.6 3,360 40-44 14.3 76.7 35.2 8.6 16.5 2,837 45-49 13.3 77.8 36.0 8.1 14.5 2,845 Residence Urban 18.9 78.6 37.0 10.8 12.8 12,252 Rural 11.0 75.7 35.5 6.9 18.0 12,822 Region National Capital Region 25.1 73.6 38.4 13.0 11.5 4,400 Cordillera Admin. Region 21.5 66.1 30.2 14.9 27.5 440 I - Ilocos Region 16.2 90.3 51.0 11.0 5.7 1,258 II - Cagayan Valley 13.3 72.6 26.0 8.4 24.2 802 III - Central Luzon 15.1 87.8 24.0 10.5 9.4 2,453 IVA - CALABARZON 6.5 85.0 24.8 2.8 12.4 4,016 MIMAROPA Region 9.9 69.8 22.4 5.5 26.3 621 V - Bicol 5.1 79.8 35.6 3.1 13.6 1,551 VI - Western Visayas 15.2 80.4 54.7 10.6 9.4 1,498 VII - Central Visayas 30.3 75.2 56.2 19.6 14.2 1,607 VIII - Eastern Visayas 7.9 79.0 38.0 4.5 12.9 997 IX - Zamboanga Peninsula 9.5 76.7 41.4 6.8 15.3 764 X - Northern Mindanao 7.0 65.7 36.1 3.7 27.9 998 XI - Davao 16.1 64.9 34.1 7.6 24.0 1,203 XII - SOCCSKSARGEN 16.9 81.8 54.6 13.7 13.0 1,038 XIII - Caraga 14.6 70.0 38.9 9.7 21.1 648 ARMM 5.0 40.5 17.3 2.0 54.3 780 Education No education 3.8 34.3 23.9 3.3 56.9 200 Grades 1-6 4.8 63.0 32.4 3.0 27.5 3,245 Grades 7-10 11.5 78.5 36.0 7.1 14.5 11,558 Grade 11 20.8 83.3 36.3 12.4 11.1 934 Post-secondary 10.9 80.4 35.9 7.1 15.1 1,144 College 23.9 80.6 38.5 13.7 11.4 7,994 Wealth quintile Lowest 6.6 51.9 34.3 4.1 36.1 4,209 Second 9.5 77.1 36.5 5.5 16.6 4,629 Middle 13.8 83.9 36.4 8.9 10.7 4,918 Fourth 16.9 84.1 35.5 9.7 9.2 5,527 Highest 24.1 83.0 37.9 14.0 9.6 5,791 Total 14.8 77.1 36.2 8.8 15.5 25,074 Step 1: Read the title and subtitle—highlighted in orange in Example 1. They tell you the topic and specific population group being described. In this case, the table is about women age 15-49 and the frequency of their exposure to different types of media. All eligible female respondents age 15-49 were asked these questions. Step 2: Scan the column headings—highlighted in green in Example 1. They describe how the information is categorized. In this table, the first three columns of data show different types of media that women access at least once a week. The fourth column shows women who access all three types of media, while the fifth column shows women who do not access any of the three types of media at least once a week. The last column lists the number of women age 15-49 interviewed in the survey. Step 3: Scan the row headings—the first vertical column highlighted in blue in Example 1. These show the different ways the data are divided into categories based on population characteristics. In this case, the table presents women’s exposure to media by age, urban-rural residence, region, educational level, and wealth quintile. Most of the tables in the NDHS report will be divided into these same categories. 2 3 4 5 1 Reading and Understanding Tables from the NDHS 2017 • xxi Step 4: Look at the row at the bottom of the table highlighted in pink in Example 1. These percentages represent the totals of all women age 15-49 and their access to different types of media. In this case, 14.8%* of women read a newspaper at least once a week, 77.1% watch television at least once a week, and 36.2% listen to the radio at least once a week. Step 5: To find out what percentage of women age 15-49 with college education access all three media at least once a week, draw two imaginary lines, as shown on the table. This shows that 13.7% of women age 15-49 with college education access all three types of media at least once a week. Step 6: By looking at patterns by background characteristics, we can see how exposure to mass media varies across the Philippines. Mass media are often used to communicate health messages. Knowing how mass media exposure varies among different groups can help program planners and policy makers determine how to most effectively reach their target populations. *For the purpose of this document data are presented exactly as they appear in the table including decimal places. However, the text in the remainder of this report rounds data to the nearest whole percentage point. Practice: Use the table in Example 1 to answer the following questions: a) What percentage of women in the Philippines do not access any of the three media at least once a week? b) Which age group of women are most likely to listen to the radio at least once a week? c) Compare women in urban areas to women in rural areas – which group is more likely to read a newspaper at least once a week? d) What are the lowest and highest percentages (range) of women who do not access any of the three media types at least once a week by region? e) Is there a clear pattern in exposure to radio at least once a week by education level? f) Is there a clear pattern in exposure to newspapers at least once a week by wealth quintile? Answers: a) 15.5% b) Women age 20-24: 38.1% of women in this age group listen to the radio weekly c) Women in urban areas, 18.9% read a newspaper at least once a week, compared with 11.0% of women in rural areas d) Women with no exposure to media at least once a week ranges from a low of 5.7% in Ilocos Region to a high of 54.3% in ARMM. e) Yes. Exposure to radio generally increases as a woman’s level of education increases; 23.9% of women with no education listen to the radio on a weekly basis compared with 38.5% of women with college education. f) Yes. Exposure to newspapers increases as household wealth increases; 6.6% of women in the lowest wealth quintile read a newspaper on a weekly basis compared with 24.1% of women in the highest wealth quintile. xxii • Reading and Understanding Tables from the NDHS 2017 Example 2: Prevalence and Treatment of Symptoms of ARI A Question Asked of a Subgroup of Survey Respondents Table 10.5 Prevalence and treatment of symptoms of ARI Among children under age 5, percentage who had symptoms of acute respiratory infection (ARI) in the 2 weeks preceding the survey, and among children with symptoms of ARI in the 2 weeks preceding the survey, percentage for whom advice or treatment was sought, according to background characteristics, Philippines NDHS 2017 Among children under age 5: Among children under age 5 with symptoms of ARI: Background characteristic Percentage with symptoms of ARI1 Number of children Percentage for whom advice or treatment was sought2 Percentage for whom advice or treatment was sought same or next day Number of children Age in months <6 0.4 886 * * 4 6-11 1.5 985 * * 15 12-23 2.0 1,933 (72.2) (13.9) 38 24-35 1.7 1,835 (50.9) (18.3) 31 36-47 1.5 1,975 (67.6) (32.3) 29 48-59 1.6 2,056 (66.6) (19.6) 34 Sex Male 2.0 5,070 70.8 16.9 102 Female 1.0 4,600 60.0 33.5 48 Mother's smoking status Smokes cigarettes/tobacco 2.2 468 * * 10 Does not smoke 1.5 9,202 67.6 22.2 140 Cooking fuel Electricity or gas 1.2 4,159 (83.1) (22.2) 48 Kerosene (0.0) 73 nc nc 0 Coal/lignite * 7 nc nc 0 Charcoal 1.7 1,048 * * 18 Wood/straw3 1.9 4,382 58.7 16.8 84 No food cooked in household * 2 nc nc 0 Residence Urban 1.3 4,282 (79.8) (25.3) 57 Rural 1.7 5,389 59.6 20.2 93 Region National Capital Region 1.3 1,178 * * 16 Cordillera Admin. Region 0.5 152 * * 1 I - Ilocos Region 2.0 435 * * 9 II - Cagayan Valley 0.9 364 * * 3 III - Central Luzon 0.9 874 * * 8 IVA - CALABARZON 0.5 1,553 * * 7 MIMAROPA Region 3.1 254 * * 8 V - Bicol 2.8 669 * * 19 VI - Western Visayas 3.4 636 * * 22 VII - Central Visayas 0.9 572 * * 5 VIII - Eastern Visayas 4.5 447 (68.5) (26.8) 20 IX - Zamboanga Peninsula 1.7 393 * * 7 X - Northern Mindanao 0.6 460 * * 3 XI - Davao 1.6 507 * * 8 XII - SOCCSKSARGEN 0.7 523 * * 4 XIII - Caraga 2.7 310 * * 8 ARMM 0.7 345 * * 2 Mother's education No education 0.0 108 nc nc 0 Grades 1-6 2.6 1,724 65.7 19.3 46 Grades 7-10 1.5 4,963 68.8 21.9 74 Grade 11 * 16 nc nc 0 Post-secondary 1.1 447 * * 5 College 1.0 2,413 (72.8) (33.1) 25 Wealth quintile Lowest 1.8 2,707 56.8 10.8 48 Second 1.6 2,135 (54.9) (27.8) 33 Middle 1.6 1,903 (80.4) (29.9) 31 Fourth 1.4 1,625 * * 24 Highest 1.1 1,299 * * 14 Total 1.5 9,670 67.3 22.2 150 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. nc = No cases 1 Symptoms of ARI include short, rapid breathing which was chest-related and/or difficult breathing which was chest-related. 2 Includes advice or treatment from the following sources: public sector, private medical sector, and shop/store. Excludes advice or treatment from a traditional practitioner/hilot or friends/relatives 3 Includes grass, shrubs, crop residues 1 2 3 4 Reading and Understanding Tables from the NDHS 2017 • xxiii Step 1: Read the title and subtitle. In this case, the table is about two separate groups of children: all children under age 5 (a) and children under age 5 with symptoms of acute respiratory infection (ARI) in the 2 weeks before the survey (b). Step 2: Identify the two panels. First, identify the columns that refer to all children under age 5 (a), and then isolate the columns that refer only to those children under age 5 with symptoms of ARI in the 2 weeks before the survey (b). Step 3: Look at the first panel. What percentage of children under age 5 have symptoms of ARI in the 2 weeks before the survey? It’s 1.5%. Now look at the second panel. How many children under age 5 are there who had symptoms of ARI in the 2 weeks before the survey? It’s 150 children or 1.5% of the 9,670 children under age 5 (with rounding). The second panel is a subset of the first panel. Step 4: Only 1.5% of children under age 5 had symptoms of ARI in the 2 weeks before the survey. Once these children are further divided into the background characteristic categories, there may be too few cases for the percentages to be reliable. • What percentage of children under age 5 who had symptoms of ARI in the 2 weeks before the survey in urban areas had advice or treatment sought? 79.8%. This percentage is in parentheses because there are between 25 and 49 children (unweighted) in this category. Readers should use this number with caution—it may not be reliable. (For more information on weighted and unweighted numbers, see Example 3.) • What percentage of children under age 5 who had symptoms of ARI in the 2 weeks before the survey in the National Capital Region had advice or treatment sought? There is no number in this cell—only an asterisk. This is because there are fewer than 25 children (unweighted) in this group. Results for this group are not reported. The subgroup is too small, and therefore the data are not reliable. Note: When parentheses or asterisks are used in a table, the explanation will be noted under the table. If there are no parentheses or asterisks in a table, you can proceed with confidence that enough cases were included in all categories that the data are reliable. xxiv • Reading and Understanding Tables from the NDHS 2017 Example 3: Understanding Sampling Weights in NDHS Tables A sample is a group of people who have been selected for a survey. In the NDHS, the sample is designed to represent the national population age 15-49. In addition to national data, most countries want to collect and report data on smaller geographical or administrative areas. However, doing so requires a minimum sample size per area. For the Philippines NDHS 2017, the survey sample is representative at the national and regional levels, and for urban and rural areas. To generate statistics that are representative of the country as a whole and the 17 regions, the number of women surveyed in each region should contribute to the size of the total (national) sample in proportion to size of the region. However, if some regions have small populations, then a sample allocated in proportion to each region’s population may not include sufficient women from each region for analysis. To solve this problem, regions with small populations are oversampled. For example, let’s say that you have enough money to interview 25,074 women and want to produce results that are representative of the Philippines as a whole and its regions (as in Table 3.1). However, the total population of the Philippines is not evenly distributed among the regions: some regions, such as National Capital Region, are heavily populated while others, such as MIMAROPA Region are not. Thus, MIMAROPA Region must be oversampled. A sampling statistician determines how many women should be interviewed in each region in order to get reliable statistics. The blue column (1) at the right in the table above shows the actual number of women interviewed in each region. Within the regions, the number of women interviewed ranges from 866 in Zamboanga Peninsula to 2,574 in National Capital Region. The number of interviews is sufficient to get reliable results in each region. With this distribution of interviews, some regions are overrepresented and some regions are underrepresented. For example, the population in National Capital Region is about 18% of the population in the Philippines, while MIMAROPA Region’s population contributes only 3% of the population in the Philippines. But as the blue column shows, the number of women interviewed in National Capital Region accounts for only about 10% of the total sample of women interviewed (2,574/25,074) and the number of women interviewed in MIMAROPA Region accounts for 5% of the total sample of women interviewed (1,257/25,074). This unweighted distribution of women does not accurately represent the population. In order to get statistics that are representative of the Philippines, the distribution of the women in the sample needs to be weighted (or mathematically adjusted) such that it resembles the true distribution in the country. Women from a small region, like MIMAROPA Region, should only contribute a small amount to the national total. Women from a large region, like National Capital Region, should contribute much more. Therefore, DHS statisticians mathematically calculate a “weight” which is used to adjust the number of women from each region so that each region’s contribution to the total is proportional to the actual population of the region. The numbers in the purple column (2) represent the “weighted” values. The weighted values can be smaller or larger than the unweighted values at region level. The total national Table 3.1 Background characteristics of respondents Percent distribution of women age 15-49 by selected background characteristics, Philippines NDHS 2017 Background characteristic Weighted percent Weighted number Unweighted number Region National Capital Region 17.5 4,400 2,574 Cordillera Admin. Region 1.8 440 1,469 I - Ilocos Region 5.0 1,258 970 II - Cagayan Valley 3.2 802 1,067 III - Central Luzon 9.8 2,453 2,056 IVA - CALABARZON 16.0 4,016 1,414 MIMAROPA Region 2.5 621 1,257 V - Bicol 6.2 1,551 1,642 VI - Western Visayas 6.0 1,498 1,742 VII - Central Visayas 6.4 1,607 1,313 VIII - Eastern Visayas 4.0 997 1,595 IX - Zamboanga Peninsula 3.0 764 866 X - Northern Mindanao 4.0 998 1,518 XI - Davao 4.8 1,203 1,266 XII - SOCCSKSARGEN 4.1 1,038 1,140 XIII - Caraga 2.6 648 1,426 ARMM 3.1 780 1,759 Total 100.0 25,074 25,074 1 2 3 Reading and Understanding Tables from the NDHS 2017 • xxv sample size of 25,074 women has not changed after weighting, but the distribution of the women in the regions has been changed to represent their contribution to the total population size. How do statisticians weight each category? They take into account the probability that a woman was selected in the sample. If you were to compare the green column (3) to the actual population distribution of the Philippines, you would see that women in each region are contributing to the total sample with the same weight that they contribute to the population of the country. The weighted number of women in the survey now accurately represents the proportion of women who live in National Capital Region and the proportion of women who live in MIMAROPA Region. With sampling and weighting, it is possible to interview enough women to provide reliable statistics at national and regional levels. In general, only the weighted numbers are shown in each of the NDHS tables, so don’t be surprised if these numbers seem low: they may actually represent a larger number of women interviewed. Sustainable Development Goal Indicators • xxvii SUSTAINABLE DEVELOPMENT GOAL INDICATORS Philippines NDHS 2017 Sex Total NDHS table number Indicator Male Female 3. Good health and well-being 3.1.2 Proportion of births attended by skilled health personnel na na 84.4 9.9 3.2.1 Under-five mortality rate1 28 26 27 8.1 and 8.2 3.2.2 Neonatal mortality rate1 13 14 14 8.1 and 8.2 3.7.1 Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods na 56.1 na 7.11.2 3.7.2 Adolescent birth rates per 1,000 women a) Girls aged 10-14 years2 na 0 na 5.1 b) Women aged 15-19 years3 na 47 na 5.1 3.a.1 Age-standardized prevalence of current tobacco use among persons aged 15 years and older4 na 5.1 na 3.1 3.b.1 Proportion of the target population covered by all vaccines included in their national program a) Coverage of DPT containing vaccine (3rd dose)5 80.2 79.4 79.8 10.4.1 b) Coverage of measles containing vaccine (2nd dose)6 48.8 44.7 46.8 10.4.1 5. Gender equality 5.2.1 Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months7,8 na 14.7 na 15.12 a) Physical violence na 4.4 na 15.12 b) Sexual violence na 2.2 na 15.12 c) Psychological violence na 12.9 na 15.12 5.3.1 Proportion of women aged 20-24 years who were married or in a union before age 15 and before age 18 a) before age 15 na 2.2 na 4.2 b) before age 18 na 16.5 na 4.2 5.6.1 Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care9 na 79.8 na na 5.b.1 Proportion of individuals who own a mobile telephone10 na 85.8 na 14.5 Residence NDHS table number 7. Affordable clean energy Urban Rural Total 7.1.1 Proportion of population with access to electricity 96.4 90.3 93.0 2.7 7.1.2 Proportion of population with primary reliance on clean fuels and technology11 70.3 31.5 48.9 2.7 Sex NDHS table number 8. Decent work and economic growth Male Female Total 8.10.2 Proportion of adults (15 years and older) with an account at a bank or other financial institution or with a mobile-money-service provider12 na 22.3 na 14.5 16. Peace, justice, and strong institutions 16.9.1 Proportion of children under 5 years of age whose births have been registered with a civil authority 92.3 91.2 91.8 2.14 17. Partnerships for the goals 17.8.1 Proportion of individuals using the Internet13 na 67.8 na 3.5 na = Not applicable 1 Expressed in terms of deaths per 1,000 live births for the 5-year period preceding the survey 2 Equivalent to the age-specific fertility rate for girls age 10-14 for the 3-year period preceding the survey, expressed in terms of births per 1,000 girls age 10-14 3 Equivalent to the age-specific fertility rate for women age 15-19 for the 3-year period preceding the survey, expressed in terms of births per 1,000 women age 15-19 4 Data are not age-standardized and are available for women age 15-49 only 5 The percentage of children age 12-23 months who received 3 doses of DPT-containing vaccine 6 The percentage of children age 24-35 months who received 2 doses of measles and/or MMR vaccine 7 Data are available for women age 15-49 who have ever been in union only 8 In the DHS, psychological violence is termed emotional violence 9 Data are available for currently married women who are not pregnant only 10 Data are available for women age 15-49 only 11 Measured as the percentage of the population using clean fuel for cooking 12 Data are available for women age 15-49 who have and use an account at bank or other financial institution; information on use of a mobile-money- service provider is not available 13 Data are available for women age 15-49 who have used the internet in the past 12 months xxviii • Map of The Philippines Introduction and Survey Methodology • 1 INTRODUCTION AND SURVEY METHODOLOGY 1 he 2017 Philippines National Demographic and Health Survey (NDHS) is the sixth Demographic and Health Survey (DHS) conducted in the Philippines as part of The Demographic and Health Surveys (DHS) Program and the 11th national demographic survey conducted since 1968. It was implemented by the Philippine Statistics Authority (PSA). Data collection took place from August 14 to October 27, 2017. Funding for the NDHS 2017 was provided by the Government of the Philippines. The United States Agency for International Development (USAID) provided technical assistance and equipment through ICF under The DHS Program, which assists countries in the collection of data to monitor and evaluate population, health, and nutrition programs. 1.1 SURVEY OBJECTIVES The primary objective of the NDHS 2017 is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the NDHS 2017 collected information on marriage, fertility levels, fertility preferences, awareness and use of family planning methods, breastfeeding, maternal and child health, child mortality, awareness and behavior regarding HIV/AIDS, women’s empowerment, domestic violence, and other health-related issues such as smoking. The information collected through the NDHS 2017 is intended to assist policymakers and program managers in the Department of Health (DOH) and other organizations in designing and evaluating programs and strategies for improving the health of the country’s population. 1.2 SAMPLE DESIGN The Philippines has 17 administrative regions, namely the National Capital Region (NCR), Cordillera Administrative Region (CAR), Region I (Ilocos Region), Region II (Cagayan Valley), Region III (Central Luzon), Region IV-A (CALABARZON), MIMAROPA Region, Region V (Bicol Region), Region VI (Western Visayas), Region VII (Central Visayas), Region VIII (Eastern Visayas), Region IX (Zamboanga Peninsula), Region X (Northern Mindanao), Region XI (Davao Region), Region XII (SOCCSKSARGEN), Caraga Region, and the Autonomous Region in Muslim Mindanao (ARMM). Each of these regions is composed of provinces, highly urbanized cities (HUCs), or other special areas, which are subdivided into cities, municipalities, and barangays. The barangays are the smallest local government unit. National government offices are usually (but not always) concentrated in the regional centers, and the seat of the provincial government is situated in each of the respective provinces. The country has 81 provinces, 33 HUCs, and 42,036 barangays. The sampling scheme provides data representative of the country as a whole, for urban and rural areas separately, and for each of the country’s administrative regions. The sample selection methodology for the NDHS 2017 is based on a two-stage stratified sample design using the Master Sample Frame (MSF), designed and compiled by the PSA. The MSF is constructed based on the results of the 2010 Census of Population and Housing and updated based on the 2015 Census of Population. The first stage involved a systematic selection of 1,250 primary sampling units (PSUs) distributed by province or HUC. A PSU can be a barangay, a portion of a large barangay, or two or more adjacent small barangays. In the second stage, an equal take of either 20 or 26 sample housing units were selected from each sampled PSU using systematic random sampling. In situations where a housing unit contained one to three households, all households were interviewed. In the rare situation where a housing unit contained more than three households, no more than three households were interviewed. The survey interviewers were instructed to interview only the pre-selected housing units. No replacements and no changes of the pre- T 2 • Introduction and Survey Methodology selected housing units were allowed in the implementing stage in order to prevent bias. Survey weights were calculated, added to the data file, and applied so that weighted results are representative estimates of indicators at the regional and national levels. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the households the night before the survey were eligible to be interviewed. Among women eligible for an individual interview, one woman per household was selected for a module on domestic violence. 1.3 QUESTIONNAIRES Two questionnaires were used for the NDHS 2017: the Household Questionnaire and the Woman’s Questionnaire. Both questionnaires, based on The DHS Program’s standard Demographic and Health Survey (DHS-7) questionnaires, were adapted to reflect the population and health issues relevant to the Philippines. Input was solicited from various stakeholders representing government agencies, universities, and international agencies. After all questionnaires were finalized in English, they were translated into six major languages: Tagalog, Cebuano, Ilocano, Bikol, Hiligaynon, and Waray. The Household and Woman’s Questionnaires were programmed into tablet computers to allow for computer-assisted personal interviewing (CAPI) for data collection purposes, with the capability to choose any of the languages for each questionnaire. In addition, information about the fieldworkers for the survey was collected through a self-administered Fieldworker Questionnaire. The Household Questionnaire was used to list all members of and visitors to the selected households. Basic demographic information was collected on the characteristics of each person listed, including his or her age, sex, marital status, education, and relationship to the head of the household. The data on age and sex of household members obtained in the Household Questionnaire were used to identify women who were eligible for individual interviews. The Household Questionnaire also collected information on health insurance coverage for each household member; characteristics of the household’s housing unit, such as source of drinking water, type of toilet facility, and materials used for the floor of the housing unit; and ownership of various durable goods. In addition, a Philippines-specific section was included that collected information on utilization of health facilities by household members. The Woman’s Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics:  Background characteristics (including age, marital status, education, religion, and ethnic group)  Pregnancy history and child mortality  Knowledge, use, and source of family planning methods  Fertility preferences (including desire for more children and ideal number of children)  Antenatal, delivery, and postnatal care  Vaccinations and childhood illnesses  Women’s work and husbands’ background characteristics  Knowledge, awareness, and behavior regarding HIV/AIDS  Other health issues  Domestic violence (including measures of physical, sexual, and emotional violence) The purpose of the Fieldworker Questionnaire was to collect basic background information on the people who were collecting data in the field (the team supervisors and field interviewers). Tablet computers were used for data collection by the enumerators. The tablet computers were equipped with Bluetooth® technology to enable remote electronic transfer of files, such as assignments from the team supervisor to the interviewers, individual questionnaires to survey team members, and completed Introduction and Survey Methodology • 3 questionnaires from interviewers to team supervisors. The CAPI data collection system employed in the NDHS 2017 was developed by The DHS Program with the mobile version of CSPro. The CSPro software was developed jointly by the U.S. Census Bureau, Serpro S.A., and The DHS Program. The survey protocol was reviewed and approved by the ICF Institutional Review Board. 1.4 PRETEST A pretest was conducted on April 21, 2017, in a barangay in Quezon City, prior to finalizing the design of the survey materials. It was aimed at checking the flow and clarity of the questions and the sustainability of respondents’ attitudes and motivation in answering the questions. A briefing for the pretest was held from April 17-19, 2017, at the PSA central office in Eton Centris Cyberpod 3 in Quezon City. The briefing focused on the concepts used in the survey, field enumeration and supervision procedures, and specific instructions for completing the questionnaires. To further prepare the briefing participants for the pretest interviews, participants engaged in practice interviews following the discussion of the questionnaires. For the pretest itself, a team approach was adopted so that interviewers could easily communicate and resolve any problems encountered during data gathering. Each interviewer was required to interview two households and at least three eligible respondents as follows: one woman age 15-49 with one or more children age 5 or below, one woman age 15-49 who was a current user of a family planning method, and one woman age 15-49 who had never been married. A debriefing was held on April 24, 2017, to discuss experiences in the administration of the questionnaires, including problems encountered and recommendations for their resolution. 1.5 TRAINING OF FIELD STAFF Training of the field staff was conducted in two stages. The first was the training of the Task Force, and the second was the training of the interviewing teams. The Task Force training was conducted from May 29 to June 17, 2017. The first 2 weeks of training took place in Pasig, Metro Manila, and focused on questionnaire content. The third week, in Clark, Pampanga, focused on CAPI training and included 3 days of field practice. Trainees were regional and provincial PSA staff members, including one information technology (IT) specialist per region. Selected staff from the Demographic and Health Statistics Division (DHSD) of the Social Sector Statistics Service of the PSA, professors from the University of the Philippines Population Institute, and staff from ICF acted as trainers. There were also resource speakers from the DOH for certain topics. The second stage of training, referred to as the second level training, took place from July 10-29, 2017, in 18 training centers spread through the regions. Second-level instructors were members of the Task Force who had completed the first stage of training. A total of 216 field interviewers, 90 team supervisors, 19 regional supervisors, and 18 regional IT specialists took part in the second‐level training. On August 8-9, 2017, a workshop was held in Quezon City with the regional supervisors and IT specialists, staff from the PSA central office, and ICF staff. During the workshop, issues that came up during the second level training were addressed and final corrections to the programming and translations were made. The supervisors and IT specialists were also trained on the collection of GPS points. 1.6 FIELDWORK Survey data collection was carried out from August 14 to October 27, 2017, by the 90 field teams. Each team consisted of a team supervisor and two to three field interviewers, all of whom were female. Fieldwork monitoring was an integral part of the NDHS 2017. Regional and team supervisors were engaged to supervise their teams on a full-time basis. Field check tables based on data from completed questionnaires were generated weekly by the central office and used to monitor progress and provide regular feedback to the field teams. 4 • Introduction and Survey Methodology 1.7 DATA PROCESSING The processing of the NDHS 2017 data began almost as soon as fieldwork started. As data collection was completed in each PSU, all electronic data files were transferred via an Internet file streaming system (IFSS) to the PSA central office in Quezon City. These data files were registered and checked for inconsistencies, incompleteness, and outliers. The field teams were alerted to any inconsistencies and errors while still in the PSU. Secondary editing involved resolving inconsistencies and the coding of open- ended questions; the former was carried out in the central office by a senior data processor, while the latter was taken on by regional coordinators and central office staff during a 5-day workshop following the completion of the fieldwork. Data editing was carried out using the CSPro software package. The concurrent processing of the data offered a distinct advantage, because it maximized the likelihood of the data being error-free and accurate. Timely generation of field check tables allowed for more effective monitoring. The secondary editing of the data was completed by November 2017. The final cleaning of the data set was carried out by data processing specialists from The DHS Program by the end of December 2017. Throughout this report, numbers in the tables reflect weighted numbers. Percentages based on fewer than 25 unweighted cases are suppressed and replaced with an asterisk; percentages based on 25 to 49 unweighted cases are shown in parentheses to caution readers when interpreting data that a percentage based on fewer than 50 cases may not be statistically reliable. 1.8 RESPONSE RATES Table 1.1 shows response rates for the NDHS 2017. A total of 31,791 households were selected for the sample, of which 27,855 were occupied. Of the occupied households, 27,496 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 25,690 women age 15-49 were identified for individual interviews; interviews were completed with 25,074 women, yielding a response rate of 98%. The household response rate is slightly lower in urban areas than in rural areas (98% and 99%, respectively); however, there is no difference by urban-rural residence in response rates among women (98% for each). Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence (unweighted), Philippines NDHS 2017 Residence Total Result Urban Rural Household interviews Households selected 10,502 21,289 31,791 Households occupied 9,173 18,682 27,855 Households interviewed 9,021 18,475 27,496 Household response rate1 98.3 98.9 98.7 Interviews with women age 15-49 Number of eligible women 9,234 16,456 25,690 Number of eligible women interviewed 9,016 16,058 25,074 Eligible women response rate2 97.6 97.6 97.6 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents Housing Characteristics and Household Population • 5 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION 2 Key Findings  Drinking water and sanitation: 95% of households use an improved source of drinking water, and 76% use improved toilet facilities.  Electricity: 93% of households have electricity.  Clean fuel for cooking: Half of households (51%) use clean fuel for cooking.  Tobacco smoking inside the home: In 28% of households, someone smokes inside the house on a daily basis, and in 8% of households someone smokes inside on a weekly basis.  Household composition: On average, households in the Philippines have 4.2 members, and 21% of households are female-headed.  Birth registration: 92% of children under age 5 had their births registered with the civil authorities; this includes 68% with a birth certificate and 24% whose birth was registered but who do not have a birth certificate.  School attendance: 94% of girls age 6-11 attend primary school, as compared with 93% of boys. The net attendance ratio (NAR) drops in secondary school: 83% of girls and 74% of boys age 12-17 attend secondary school. nformation on the socioeconomic characteristics of the household population in the NDHS 2017 provides a context to interpret demographic and health indicators and can furnish an approximate indication of the representativeness of the survey. In addition, this information sheds light on the living conditions of the population. This chapter presents information on source of drinking water, sanitation, exposure to smoke inside the home, wealth, handwashing, household population composition, birth registration, educational attainment, and school attendance. 2.1 DRINKING WATER SOURCES AND TREATMENT Improved sources of drinking water Include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, and rainwater. Households that use bottled water or refilling stations for drinking are classified as using an improved source only if the water they use for cooking and handwashing comes from an improved source. Sample: Households I 6 • Housing Characteristics and Household Population Improved sources of water protect against outside contamination so that water is more likely to be safe to drink. In the Philippines, 95% of households use an improved source of drinking water (98% of urban households and 93% of rural households) (Table 2.1). By region, the proportion of the household population using an improved source of drinking water ranges from 71% in the Autonomous Region in Muslim Mindanao (ARMM) to more than 99% in the National Capital Region (NCR) (Table 2.2). The most common source of drinking water among both urban and rural households is bottled water or a refilling station, followed by water piped into their dwelling/yard/plot or piped to a neighbor (Figure 2.1). Among urban households, 58% use bottled water or a refilling station, 28% use water piped into their dwelling/yard/plot, and 3% use water piped to a neighbor. Thirty- one percent of rural households use bottled water or a refilling station, 19% have water piped into their dwelling/yard/plot, and 4% use water piped to a neighbor. One percent of urban households use a public tap or standpipe, as compared with 5% of rural households. Two percent of urban households and 7% of rural households use an unimproved source of drinking water. Overall, 80% of Filipino households have water on the premises, including 91% of urban households and 71% of rural households. Three percent of households travel 30 minutes or longer to fetch water. Most households (79%) report that they do not treat their water prior to drinking. Boiling is the most common water treatment method, used by 12% of all households. Overall, 15% of households use an appropriate method to treat their drinking water. Table 2.3 presents information on the availability of water in the last 2 weeks among households using piped water or water from a tube well or borehole. Ten percent of such households reported having a water interruption of at least a single day in the last 2 weeks. 2.2 SANITATION Improved toilet facilities Include any non-shared toilet of the following types: flush/pour flush toilets to piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP) latrines; pit latrines with slabs; and composting toilets. Sample: Households Figure 2.1 Household drinking water by residence 27 31 23 3 1 5 12 4 20 9 3 14<1 <1 1 44 58 31 5 2 7 Total Urban Rural Percent distribution of households by source of drinking water Unimproved source Bottled water/refilling station, improved source for cooking/handwashing Rainwater Protected well or spring Tube well or borehole Public tap/standpipe Piped water into dwelling/ yard/plot/neighbor’s yard Note: Percentages do not sum to 100% due to rounding. Housing Characteristics and Household Population • 7 As shown in Figure 2.2, three quarters (76%) of households in the Philippines use improved toilet facilities, which are non-shared facilities that prevent people from coming into contact with human waste and can reduce the transmission of cholera, typhoid, and other diseases. Shared toilet facilities of an otherwise acceptable type are also common; 20% of urban households use a shared facility, as compared with 15% of rural households. Three percent of households in the Philippines use unimproved facilities, with an additional 5% not using any facility (Table 2.4). By region, the proportion of the household population using an improved toilet facility ranges from 35% in ARMM to 87% in Central Luzon. Twenty-two percent of the household population in ARMM, 13% in Central Visayas, and 11% in Western Visayas have no toilet facility at all (Table 2.5). Among households using a toilet that flushes to a septic tank or pit latrine and among households using a pit latrine or a composting toilet, 7% reported that their septic tank, pit latrine, or composting toilet has ever been full. Among households with a full septic tank, pit latrine, or composting toilet, 40% reported that their septic tank, latrine, or composting toilet was closed or covered and a new latrine or tank was constructed; 31% of households reported that their septic waste was removed to a treatment plant by a service provider (Table 2.6). 2.3 EXPOSURE TO SMOKE INSIDE THE HOME Exposure to smoke inside the home, from either cooking with solid fuels or smoking tobacco, has potentially harmful health effects. Forty-eight percent of households in the Philippines use solid fuels, consisting mostly of wood and charcoal, for cooking (Table 2.7). Use of solid fuels for cooking is much more common in rural areas (67%) than urban areas (25%). Exposure to smoke from cooking is greater when cooking takes place inside the house rather than in a separate building or outdoors. In the Philippines, the majority of households (77%) cook inside their house. Eight percent of households cook in a separate building, and 14% cook outside. Exposure to tobacco smoke is common in the Philippines. In 28% of households, someone smokes inside the house on a daily basis, and in 8% of households someone smokes inside on a weekly basis. Other Housing Characteristics The survey collected data on access to electricity, flooring materials, and number of rooms used for sleeping. Overall, 93% of households in the Philippines have electricity. The most common flooring materials are cement (52% of households) and ceramic tiles (21%). Forty-three percent of households use one room for sleeping. Half of households (52%) own both the house and lot in which they live, and 19% of households own the house but rent the lot for free or with the consent of the owner. An additional 14% rent the house or room including the lot, and 11% rent the house and lot for free with the consent of the owner (Table 2.8). Figure 2.2 Household toilet facilities by residence 76 76 76 17 20 15 3 2 45 3 6 Total Urban Rural Percent distribution of households by type of toilet facilities No facility/ bush/field Unimproved facility Shared facility Improved facility Note: Percentages do not sum to 100% due to rounding. 8 • Housing Characteristics and Household Population 2.4 HOUSEHOLD WEALTH Household Durable Goods The survey collected information about household effects, means of transportation, ownership of agricultural land and farm animals, and whether any household member was a beneficiary of the Pantawid Pamilyang Pilipino Program (4Ps). As shown in Table 2.9, 89% of households have a mobile phone, 77% have a television, 67% have a watch, 51% have a radio, 43% have a refrigerator, and 22% have a computer. More than one-third (36%) of households have a motorcycle/scooter, 19% have a bicycle, and 10% have an automobile. Overall, 15% of households own agricultural land and 32% own farm animals. Rural households are more likely than urban households to own agricultural land (22% versus 7%) or farm animals (47% versus 14%). Sixteen percent of households are beneficiaries of 4Ps, including 8% of urban households and 23% of rural households. Wealth Index Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, and housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by her or his score, and then dividing the distribution into five equal categories, each comprising 20% of the population. Sample: Households Table 2.10 shows the distribution of the de jure household population by wealth quintile according to residence and region. Urban households are more likely than rural households to fall into the higher wealth quintiles, while rural households are more likely to fall into the lower wealth quintiles. Fifty- five percent of the urban population is in the two highest wealth quintiles. By contrast, 53% of the non-urban population falls in the two lowest wealth quintiles (Figure 2.3). Wealth varies widely by region. Forty-two percent of the population in NCR is in the highest wealth quintile, as compared with only 1% of the population in ARMM. Conversely, 70% of the population in ARMM is in the lowest wealth quintile, compared with only 1% in NCR. Table 2.10 also includes the Gini coefficient, a measure of the level of concentration of wealth, with 0 being an equal wealth distribution and 1 a totally unequal distribution. The Gini coefficient is 0.22, which suggests that wealth is somewhat evenly distributed across the population. However, wealth is distributed more evenly in the urban population than in the rural population (0.15 versus 0.24). Figure 2.3 Household wealth by residence 9 2914 25 21 1927 15 29 13 Urban Rural Percent distribution of de jure population by wealth quintiles Wealthiest Fourth Middle Second Poorest Note: Percentages may not sum to 100% due to rounding. Housing Characteristics and Household Population • 9 2.5 HANDWASHING Handwashing is an important step in improving hygiene and preventing the spread of disease. Rather than asking direct questions on the practice of handwashing, which can be subject to over-reporting, interviewers in the NDHS 2017 asked to see the place where members of the household most often wash their hands. A place for washing hands was observed in 93% of households, making the data fairly representative (Table 2.11). In 89% of the households where a place for handwashing was observed, interviewers found that soap and water were present. Six percent of handwashing locations had water but no soap, 2% had soap but no water, and 3% did not have soap, water, or any other cleaning agents. Patterns by background characteristics  Households in ARMM (13%) are most likely to have no water, soap, or other cleansing agent, followed by households in SOCCSKSARGEN (9%) and Eastern Visayas (5%).  Availability of soap and water increases with increasing wealth. Almost all households (98%) in the highest wealth quintile have soap and water for handwashing, while 75% of households in the lowest quintile have soap and water. 2.6 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same housing unit(s), who acknowledge one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit. De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors). De jure population All persons who are usual residents of the selected households, whether or not they stayed in the household the night before the interview. How data are calculated All tables are based on the de facto population unless otherwise specified. A total of 111,643 individuals stayed overnight in the 27,496 households interviewed in the NDHS 2017. Fifty-one percent (56,970) of these individuals were male and 49% (54,673) were female (Table 2.12), yielding a sex ratio of 104 males per 100 females. The population pyramid in Figure 2.4 illustrates the distribution of the population by 5-year age groups and sex. Children under age 15 account for 33% of the population, while individuals age 65 and older make up only 6%. Figure 2.4 Population pyramid 10 6 2 2 6 10 <5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Age Percent distribution of the household population Male Female 2610 10 • Housing Characteristics and Household Population The majority of households in the Philippines are male-headed (79%). Female-headed households are more common in urban than rural areas (24% and 18%, respectively). The average household consists of 4.2 usual members. Rural households are on average slightly larger than urban households (4.3 and 4.1 persons per household, respectively) (Table 2.13). Trends: The percentage of male-headed households decreased from 86% in 1993 to 79% in 2017. Over the same time period, mean household size declined from 5.3 members to 4.2 members, a decrease of 1.1 persons. 2.7 BIRTH REGISTRATION Registered birth Child has a birth certificate or child does not have a birth certificate, but his/her birth is registered with the civil authorities. Sample: De jure children under age 5 Table 2.14 presents information on the percentage of children under age 5 who have a birth certificate and the percentage who do not have a birth certificate but whose birth has been registered with the civil authorities. Overall, 92% of children under age 5 had their births registered with the civil authorities; this includes 68% with a birth certificate and 24% whose birth was registered but who do not have a birth certificate. Patterns by background characteristics  Birth registration increases with increasing household wealth. Eighty-three percent of children in the lowest wealth quintile have had their births registered, as compared with 98% of children in the highest quintile (Figure 2.5).  The percentage of children who have had their birth registered ranges from 60% in ARMM to 99% in Cordillera Administrative Region (CAR). 2.8 EDUCATION 2.8.1 Educational Attainment Median educational attainment Half of the population has completed less than the median number of years of schooling, and half of the population has completed more than the median number of years of schooling. Sample: De facto household population age 6 and older Tables 2.15.1 and 2.15.2 present information on educational attainment among the household population age 6 and over. Overall, 4% of women and girls age 6 and over have never been to school, 22% have attended some primary school, 12% have completed primary but advanced no further, 18% have attended some secondary school, 18% have completed secondary school but advanced no further, and 26% have attained some education after secondary school. Women and girls age 6 and over have completed a median of 9.1 years of schooling. Educational attainment among men and boys is similar to that among women and girls. Five percent of men and boys age 6 and over have never attended school, 26% have attended some primary school, 11% Figure 2.5 Birth registration by household wealth 83 92 95 97 98 Lowest Second Middle Fourth Highest Percentage of de jure children under age 5 whose births are registered with the civil authorities Poorest Wealthiest Housing Characteristics and Household Population • 11 have completed primary school, 19% have attended some secondary school, 17% have completed secondary school but advanced no further, and 22% have attained some education after secondary school. Men and boys age 6 and over have completed a median of 8.1 years of schooling, or a year less than women and girls age 6 and over. Trends: Median years of schooling among females increased from 5.7 years in 1993 to 9.1 years in 2017; over the same period, median years of schooling increased from 5.6 years to 8.1 years among males. Patterns by background characteristics  The median number of years of schooling is higher in urban areas than rural areas among both females (10.2 years versus 7.8 years) and males (10.1 years versus 6.8 years).  Among both females and males, median number of years of schooling is highest in NCR (10.7 years and 10.6 years, respectively) and lowest in ARMM (5.4 years and 4.2 years, respectively). Two percent of females and 3% of males in NCR have no education; by contrast, 15% of females and 13% of males in ARMM have no education.  Educational attainment increases with increasing household wealth. Females in the lowest wealth quintile have completed a median of 5.6 years of schooling, as compared with a median of 12.2 years among females in the highest wealth quintile. Median number of years of schooling increases from 4.5 years among males in the lowest wealth quintile to 11.5 among those in the highest quintile. 2.8.2 School Attendance Net attendance ratio (NAR) Percentage of the school-age population that attends primary or secondary school. Sample: Children age 6-11 for primary school NAR and children age 12-17 for secondary school NAR Gross attendance ratio (GAR) The total number of children attending primary school divided by the official primary school-age population, and the total number of children attending secondary school divided by the official secondary school-age population. Sample: Children age 6-11 for primary school GAR and children age 12-17 for secondary school GAR School attendance ratios are shown in Table 2.16. Ninety-four percent of girls age 6-11 attend primary school, as compared with 93% of boys. The net attendance ratio (NAR) drops in secondary school: 83% of girls and 74% of boys age 12-17 attend secondary school. The gross attendance ratio (GAR) for primary school is 104 for girls and 107 for boys; the GAR for secondary school is 92 for girls and 85 for boys. These figures indicate that a number of children outside the official school-age population for that level are attending primary school but not secondary school. 12 • Housing Characteristics and Household Population Gender parity indices (GPI) The ratio of female to male students attending primary school and the ratio of female to male students attending secondary school. Each index reflects the magnitude of the gender gap. Sample: Primary school students and secondary school students The gender parity index (GPI) for the GAR at the primary school level is 0.97, indicating that in primary school there are slightly more male than female students. However, at the secondary school level, the GPI for the GAR is 1.08, indicating that there are more girls than boys attending secondary school. Patterns by background characteristics  At the primary school level, the NAR ranges from 89% in ARMM to 95% in CAR, Western Visayas, Eastern Visayas, and Zamboanga Peninsula. At the secondary school level, the NAR ranges from 50% in ARMM to 85% in Ilocos Region.  At the secondary school level, NARs rise with increasing wealth, from 60% in the lowest wealth quintile to 90% in the highest quintile. In each quintile, the NARs for girls are higher than those for boys, although the difference between boys and girls generally decreases with increasing wealth (Figure 2.6). LIST OF TABLES For more information on household population and housing characteristics, see the following tables:  Table 2.1 Household drinking water  Table 2.2 Drinking water source according to region and wealth  Table 2.3 Availability of water  Table 2.4 Household sanitation facilities  Table 2.5 Sanitation facility type according to region and wealth  Table 2.6 Sanitation facility waste removal  Table 2.7 Household characteristics  Table 2.8 Tenure status of housing unit  Table 2.9 Household possessions  Table 2.10 Wealth quintiles  Table 2.11 Handwashing  Table 2.12 Household population by age, sex, and residence  Table 2.13 Household composition  Table 2.14 Birth registration of children under age 5  Table 2.15.1 Educational attainment of the female household population  Table 2.15.2 Educational attainment of the male household population  Table 2.16 School attendance ratios Figure 2.6 Secondary school attendance by household wealth 69 81 85 87 92 53 72 79 84 88 Lowest Second Middle Fourth Highest Net attendance ratio for secondary school among children age 12-17 Girls Boys WealthiestPoorest Housing Characteristics and Household Population • 13 Table 2.1 Household drinking water Percent distribution of households and de jure population by source of drinking water and by time to obtain drinking water, percentage of households and de jure population using various methods to treat drinking water, and percentage using an appropriate treatment method, according to residence, Philippines NDHS 2017 Households Population Characteristic Urban Rural Total Urban Rural Total Source of drinking water Improved source 97.6 92.8 95.0 97.3 92.6 94.7 Piped into dwelling/yard/plot 28.2 19.4 23.5 26.4 19.6 22.6 Piped to neighbor 3.1 3.5 3.3 3.5 3.4 3.4 Public tap/standpipe 1.3 4.8 3.2 1.4 5.0 3.4 Tube well/borehole 3.9 19.7 12.4 4.6 19.8 13.0 Protected dug well 1.2 5.5 3.5 1.4 5.4 3.6 Protected spring 1.6 8.1 5.1 1.6 8.2 5.2 Rainwater 0.1 0.6 0.4 0.1 0.6 0.4 Bottled water/refilling station, improved source for cooking/handwashing1 58.2 31.2 43.6 58.3 30.6 43.0 Unimproved source 2.4 7.2 5.0 2.7 7.4 5.3 Unprotected dug well 0.8 2.4 1.6 1.0 2.5 1.8 Unprotected spring 0.5 2.7 1.7 0.6 2.8 1.8 Tanker truck/cart with small tank 0.5 0.6 0.5 0.5 0.7 0.6 Surface water 0.0 0.3 0.2 0.0 0.3 0.2 Bottled water/refilling station, unimproved source for cooking/handwashing1 0.6 1.3 0.9 0.6 1.2 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Time to obtain drinking water (round trip) Water on premises2 90.6 71.3 80.2 89.5 70.8 79.2 Less than 30 minutes 7.7 23.7 16.3 8.4 24.0 17.0 30 minutes or longer 1.7 4.9 3.4 2.0 5.1 3.7 Don’t know 0.1 0.1 0.1 0.1 0.1 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Water treatment prior to drinking3 Boiled 7.5 15.5 11.8 8.7 17.3 13.4 Bleach/chlorine added 0.2 0.7 0.5 0.2 0.8 0.5 Strained through cloth 2.7 8.9 6.0 3.1 9.6 6.6 Ceramic, sand, or other filter 4.6 1.8 3.1 4.9 1.8 3.2 Solar disinfection 0.0 0.1 0.0 0.0 0.1 0.0 Let stand and settle 1.0 1.5 1.2 1.0 1.6 1.3 Other 0.2 0.6 0.4 0.1 0.6 0.4 No treatment 84.7 73.6 78.7 83.0 71.4 76.6 Percentage using an appropriate treatment method4 12.1 17.9 15.2 13.5 19.7 16.9 Number of households/population 12,703 14,793 27,496 52,058 64,147 116,205 Note: Total includes 3 households for which source of drinking water was classified as other. 1 Households using bottled water for drinking are classified as using an improved or unimproved source according to their water source for cooking and handwashing 2 Includes water piped to a neighbor 3 Respondents may report multiple treatment methods, so the sum of treatment may exceed 100% 4 Appropriate water treatment methods include boiling, bleaching, filtering, and solar disinfecting 14 • Housing Characteristics and Household Population Table 2.2 Drinking water source according to region and wealth Percent distribution of de jure population by drinking water source, according to region and wealth quintile, Philippines NDHS 2017 Source of drinking water Background characteristic Improved source Unimproved source Total Number of persons Region National Capital Region 99.5 0.5 100.0 16,594 Cordillera Admin. Region 84.6 15.4 100.0 2,131 I - Ilocos Region 98.8 1.2 100.0 6,156 II - Cagayan Valley 92.3 7.6 100.0 4,208 III - Central Luzon 99.4 0.5 100.0 11,196 IVA - CALABARZON 96.9 3.1 100.0 17,753 MIMAROPA Region 93.1 6.9 100.0 3,004 V - Bicol 91.3 8.7 100.0 7,359 VI - Western Visayas 92.1 7.9 100.0 7,874 VII - Central Visayas 96.2 3.8 100.0 7,383 VIII - Eastern Visayas 96.4 3.6 100.0 5,084 IX - Zamboanga Peninsula 90.8 9.2 100.0 3,959 X - Northern Mindanao 95.5 4.5 100.0 4,849 XI - Davao 91.8 8.2 100.0 6,264 XII - SOCCSKSARGEN 92.8 7.2 100.0 5,469 XIII - Caraga 92.8 7.2 100.0 3,243 ARMM 70.9 29.1 100.0 3,679 Wealth quintile Lowest 83.7 16.3 100.0 23,252 Second 94.2 5.8 100.0 23,226 Middle 97.3 2.7 100.0 23,237 Fourth 98.7 1.3 100.0 23,250 Highest 99.5 0.5 100.0 23,240 Total 94.7 5.3 100.0 116,205 Note: Total includes 3 cases for which source of drinking water was classified as other. Table 2.3 Availability of water Percent distribution of households and de jure population using piped water or water from a tube well or borehole, by availability of water in the last 2 weeks, according to residence, Philippines NDHS 2017 Households Population Availability of water in last 2 weeks Urban Rural Total Urban Rural Total Not available for at least 1 day 8.0 11.3 9.6 8.5 11.3 9.9 Available with no interruption of at least 1 day 91.3 88.2 89.8 90.8 88.2 89.5 Don’t know/missing 0.6 0.5 0.6 0.7 0.5 0.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population using piped water or water from a tube well1 11,819 11,125 22,944 48,245 48,230 96,476 1 Includes households/population reporting piped water or water from a tube well or borehole as their main source of drinking water and households/population reporting bottled water as their main source of drinking water if their main source of water for cooking and handwashing is piped water or water from a tube well or borehole Housing Characteristics and Household Population • 15 Table 2.4 Household sanitation facilities Percent distribution of households and de jure population by type of toilet/latrine facilities and percent distribution of households and de jure population with a toilet/latrine facility by location of the facility, according to residence, Philippines NDHS 2017 Households Population Type and location of toilet/latrine facility Urban Rural Total Urban Rural Total Improved sanitation 75.6 75.8 75.7 79.0 76.3 77.5 Flush/pour flush to piped sewer system 5.9 3.5 4.6 6.0 3.3 4.5 Flush/pour flush to septic tank 67.1 62.0 64.4 70.4 62.2 65.9 Flush/pour flush to pit latrine 2.3 7.5 5.1 2.4 7.9 5.4 Ventilated improved pit (VIP) latrine 0.0 0.4 0.2 0.0 0.4 0.3 Pit latrine with slab 0.2 2.2 1.3 0.2 2.3 1.4 Composting toilet 0.0 0.1 0.1 0.0 0.1 0.1 Unimproved sanitation 24.4 24.2 24.3 21.0 23.7 22.5 Shared facility1 19.6 14.9 17.1 16.2 14.1 15.0 Flush/pour flush to piped sewer system 1.1 0.5 0.8 1.1 0.4 0.7 Flush/pour flush to septic tank 17.5 11.1 14.1 14.1 10.3 12.0 Flush/pour flush to pit latrine 0.7 2.4 1.6 0.8 2.3 1.6 Ventilated improved pit (VIP) latrine 0.0 0.1 0.1 0.0 0.1 0.1 Pit latrine with slab 0.1 0.4 0.3 0.1 0.4 0.3 Composting toilet 0.0 0.0 0.0 0.0 0.0 0.0 Public toilet 0.1 0.4 0.2 0.1 0.4 0.3 Unimproved facility 1.9 3.5 2.7 2.0 3.8 3.0 Flush/pour flush not to sewer/septic tank/pit latrine 0.9 0.3 0.6 0.9 0.4 0.6 Pit latrine without slab/open pit 0.5 1.9 1.3 0.6 2.0 1.4 Bucket 0.1 0.1 0.1 0.0 0.1 0.1 Hanging toilet/hanging latrine 0.3 0.9 0.6 0.3 1.1 0.8 Other 0.1 0.2 0.2 0.1 0.2 0.1 Open defecation (no facility/bush/ field) 3.0 5.8 4.5 2.9 5.8 4.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population 12,703 14,793 27,496 52,058 64,147 116,205 Location of toilet facility In own dwelling 78.6 54.9 66.1 77.9 54.4 65.1 In own yard/plot 19.0 39.3 29.8 19.6 39.8 30.6 Elsewhere 2.4 5.7 4.1 2.6 5.7 4.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population with a toilet/latrine facility 12,313 13,873 26,186 50,492 60,127 110,619 Note: Total includes 5 cases for which information on location of toilet facility is missing. 1 Facilities that would be considered improved if they were not shared by two or more households 16 • Housing Characteristics and Household Population Table 2.5 Sanitation facility type according to region and wealth Percent distribution of de jure population by type of sanitation facility, according to region and wealth quintile, Philippines NDHS 2017 Improved sanitation facility Unimproved sanitation Total Number of persons Background characteristic Shared facility1 Unimproved facility Open defecation Region National Capital Region 84.1 14.9 0.7 0.2 100.0 16,594 Cordillera Admin. Region 76.5 15.9 6.2 1.4 100.0 2,131 I - Ilocos Region 79.8 19.4 0.6 0.3 100.0 6,156 II - Cagayan Valley 81.2 16.1 1.2 1.5 100.0 4,208 III - Central Luzon 87.0 11.4 0.6 1.1 100.0 11,196 IVA - CALABARZON 85.6 12.3 0.9 1.2 100.0 17,753 MIMAROPA Region 74.8 15.6 3.6 5.9 100.0 3,004 V - Bicol 71.7 18.3 2.9 7.0 100.0 7,359 VI - Western Visayas 75.8 11.1 2.1 11.0 100.0 7,874 VII - Central Visayas 70.8 14.5 2.0 12.6 100.0 7,383 VIII - Eastern Visayas 77.8 12.2 2.4 7.7 100.0 5,084 IX - Zamboanga Peninsula 72.6 15.8 4.6 7.1 100.0 3,959 X - Northern Mindanao 76.3 14.1 4.7 4.9 100.0 4,849 XI - Davao 67.8 26.5 5.0 0.8 100.0 6,264 XII - SOCCSKSARGEN 68.6 20.9 2.3 8.2 100.0 5,469 XIII - Caraga 81.2 12.2 3.9 2.8 100.0 3,243 ARMM 35.4 11.2 31.6 21.8 100.0 3,679 Wealth quintile Lowest 46.3 23.9 10.5 19.2 100.0 23,252 Second 68.2 25.8 3.2 2.9 100.0 23,226 Middle 81.2 17.4 0.8 0.6 100.0 23,237 Fourth 93.2 6.4 0.4 0.0 100.0 23,250 Highest 98.5 1.5 0.0 0.0 100.0 23,240 Total 77.5 15.0 3.0 4.5 100.0 116,205 1 Facilities that would be considered improved if they were not shared by two or more households Housing Characteristics and Household Population • 17 Table 2.6 Sanitation facility waste removal Among households using a toilet that flushes to a septic tank or pit latrine, any form of pit latrine, or a composting toilet, percentage that have ever had a full septic tank, pit latrine, or composting toilet, and among households that have ever had a full septic tank, pit latrine, or composting toilet, percent distribution by what was done when it was full, according to background characteristics, Philippines NDHS 2017 Percentage of households that have ever had a full septic tank, pit latrine, or composting toilet Number of households with a flush toilet, pit latrine, or composting toilet Among households that have had a full septic tank, pit latrine, or composting toilet, percent distribution by what was done when it was full Number of households that have ever had a full septic tank, pit latrine, or composting toilet Background characteristic Removed by a service provider to a treatment plant Removed by a service provider and buried in a covered pit Removed by a service provider to unknown location Emptied by household and buried in a covered pit Emptied by household to uncovered pit, open ground, water body, or elsewhere Closed/ covered and constructed a new latrine/ septic tank Other/ don’t know Total Residence Urban 9.2 11,625 48.0 3.0 22.4 1.7 3.0 18.1 3.9 100.0 1,073 Rural 5.8 13,900 7.1 2.5 11.0 6.5 2.6 68.7 1.6 100.0 807 Region National Capital Region 13.9 3,572 75.9 0.7 21.1 0.1 0.3 0.9 1.0 100.0 495 Cordillera Admin. Region 6.5 515 0.7 13.1 19.2 10.3 1.7 55.0 0.0 100.0 33 I - Ilocos Region 9.0 1,268 19.0 4.0 3.0 18.3 1.6 53.4 0.7 100.0 115 II - Cagayan Valley 6.3 990 2.8 1.8 3.1 1.9 0.0 90.5 0.0 100.0 63 III - Central Luzon 4.7 2,106 41.6 2.3 0.9 6.1 12.1 30.7 6.3 100.0 100 IVA - CALABARZON 4.4 4,081 7.7 2.2 43.7 0.0 3.3 24.8 18.3 100.0 178 MIMAROPA Region 4.1 694 0.6 6.3 13.4 2.7 2.1 73.8 1.1 100.0 29 V - Bicol 6.4 1,576 8.1 0.7 12.4 5.0 2.9 66.9 4.1 100.0 101 VI - Western Visayas 9.1 1,792 1.8 0.9 5.6 5.5 7.8 77.8 0.5 100.0 164 VII - Central Visayas 9.6 1,674 32.3 6.7 33.1 3.1 2.6 22.2 0.0 100.0 161 VIII - Eastern Visayas 8.0 1,125 7.8 1.3 24.5 6.3 1.5 58.0 0.6 100.0 90 IX - Zamboanga Peninsula 10.0 866 14.0 4.4 6.5 2.7 3.4 66.9 2.2 100.0 87 X - Northern Mindanao 4.1 1,084 15.7 3.9 14.5 6.1 5.3 53.9 0.7 100.0 45 XI - Davao 5.1 1,836 27.4 5.6 8.0 3.1 0.6 55.2 0.0 100.0 93 XII - SOCCSKSARGEN 7.1 1,127 2.2 1.5 10.9 0.9 0.0 84.4 0.0 100.0 81 XIII - Caraga 6.8 677 1.8 11.4 11.1 7.4 6.1 58.8 3.4 100.0 46 ARMM 0.1 540 * * * * * * * 100.0 1 Wealth quintile Lowest 5.6 5,102 0.4 1.3 2.2 5.7 2.3 87.3 0.9 100.0 283 Second 6.0 5,338 6.5 1.6 10.0 7.1 4.0 67.0 3.8 100.0 321 Middle 6.8 5,271 29.3 2.8 13.5 3.9 5.5 42.6 2.4 100.0 359 Fourth 7.8 5,097 40.1 4.0 26.8 3.1 1.8 20.5 3.8 100.0 399 Highest 11.0 4,717 55.0 3.4 26.1 0.9 1.4 10.0 3.1 100.0 517 Total 7.4 25,525 30.5 2.8 17.5 3.7 2.8 39.8 2.9 100.0 1,880 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 18 • Housing Characteristics and Household Population Table 2.7 Household characteristics Percent distribution of households and de jure population by housing characteristics, percentage using solid fuel for cooking, percentage using clean fuel for cooking, and percent distribution by frequency of smoking in the home, according to residence, Philippines NDHS 2017 Households Population Housing characteristic Urban Rural Total Urban Rural Total Electricity Yes 96.3 89.6 92.7 96.4 90.3 93.0 No 3.7 10.4 7.3 3.6 9.7 7.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 Flooring material Earth, sand 3.8 10.6 7.5 4.2 10.4 7.6 Wood/planks 8.0 8.8 8.4 7.5 9.1 8.4 Palm/bamboo 3.7 11.4 7.9 4.0 11.1 7.9 Parquet or polished wood 1.1 1.3 1.2 0.9 1.3 1.1 Vinyl or asphalt strips 0.9 0.8 0.9 0.9 0.8 0.9 Ceramic tiles 28.3 15.4 21.4 27.9 15.1 20.8 Cement 53.0 51.1 52.0 53.4 51.7 52.5 Carpet 0.3 0.4 0.3 0.4 0.3 0.4 Marble 0.9 0.3 0.5 0.8 0.2 0.5 Total1 100.0 100.0 100.0 100.0 100.0 100.0 Rooms used for sleeping One 45.6 39.9 42.5 35.6 31.7 33.5 Two 35.9 40.9 38.6 39.1 43.1 41.3 Three or more 18.6 19.2 18.9 25.3 25.1 25.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Place for cooking In the house 82.9 71.7 76.9 83.1 71.1 76.5 In a separate building 4.8 11.1 8.1 5.1 11.6 8.7 Outdoors 10.2 17.0 13.8 11.2 17.2 14.5 No food cooked in household 2.1 0.3 1.1 0.7 0.1 0.3 Total2 100.0 100.0 100.0 100.0 100.0 100.0 Cooking fuel Electricity 6.2 1.0 3.4 3.8 0.9 2.2 LPG/natural gas/biogas 65.4 31.5 47.1 66.5 30.6 46.7 Kerosene 1.3 0.1 0.7 1.4 0.1 0.7 Coal/lignite 0.1 0.1 0.1 0.1 0.1 0.1 Charcoal 8.4 9.7 9.1 9.2 9.8 9.6 Wood 16.5 56.9 38.2 18.1 58.0 40.1 Straw/shrubs/grass 0.0 0.1 0.1 0.0 0.1 0.1 Agricultural crop 0.1 0.3 0.2 0.1 0.3 0.2 No food cooked in household 2.1 0.3 1.1 0.7 0.1 0.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Percentage using solid fuel for cooking3 25.1 67.1 47.7 27.6 68.3 50.1 Percentage using clean fuel for cooking4 71.5 32.5 50.5 70.3 31.5 48.9 Frequency of smoking in the home Daily 27.3 28.0 27.7 31.1 30.2 30.6 Weekly 7.0 8.9 8.0 7.2 9.0 8.2 Monthly 0.8 1.5 1.2 1.0 1.5 1.3 Less than once a month 1.7 3.1 2.5 1.8 3.3 2.6 Never 63.1 58.5 60.6 58.9 55.9 57.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population 12,703 14,793 27,496 52,058 64,147 116,205 LPG = Liquefied petroleum gas 1 Total includes 1 household with other flooring material 2 Total includes 5 households with the place for cooking identified as other 3 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, and agricultural crops 4 Includes electricity and LPG/natural gas/biogas Housing Characteristics and Household Population • 19 Table 2.8 Tenure status of housing unit Percent distribution of households by tenure status of the housing unit and lot occupied, according to background characteristics, Philippines NDHS 2017 Background characteristic Own house and lot Own house, rent lot Own house, rent-free lot with consent of owner Own house, rent-free lot without consent of owner Rent house/ room including lot Rent-free house and lot with consent of owner Rent-free house and lot without consent of owner Not applicable Total Number of households Residence Urban 45.7 1.4 12.7 2.9 24.6 12.1 0.6 0.0 100.0 12,703 Rural 57.6 2.0 24.6 2.0 4.1 9.5 0.2 0.1 100.0 14,793 Region National Capital Region 44.2 1.0 3.2 2.7 35.9 11.7 1.3 0.0 100.0 4,091 Cordillera Admin. Region 61.6 0.2 5.3 0.4 19.9 11.5 0.6 0.5 100.0 545 I - Ilocos Region 71.7 0.5 13.1 2.2 3.4 9.0 0.1 0.0 100.0 1,366 II - Cagayan Valley 80.5 0.3 10.9 1.1 2.3 4.7 0.0 0.3 100.0 1,009 III - Central Luzon 67.5 0.6 12.5 3.6 6.0 9.7 0.0 0.1 100.0 2,628 IVA - CALABARZON 56.1 0.5 12.1 2.5 20.4 8.4 0.0 0.0 100.0 4,145 MIMAROPA Region 52.3 1.1 18.2 2.6 7.9 17.6 0.0 0.3 100.0 731 V - Bicol 40.7 2.5 38.9 1.5 4.3 11.9 0.2 0.0 100.0 1,615 VI - Western Visayas 44.7 3.4 41.2 3.7 1.4 5.4 0.2 0.0 100.0 1,879 VII - Central Visayas 51.9 2.0 24.8 3.4 6.5 10.2 1.1 0.0 100.0 1,765 VIII - Eastern Visayas 47.2 6.2 33.8 0.7 1.9 10.1 0.0 0.0 100.0 1,150 IX - Zamboanga Peninsula 38.4 3.1 36.3 1.9 5.1 15.0 0.2 0.1 100.0 912 X - Northern Mindanao 56.8 3.5 17.2 2.0 7.2 13.0 0.2 0.1 100.0 1,142 XI - Davao 37.8 1.9 14.0 0.9 30.2 15.1 0.1 0.0 100.0 1,899 XII - SOCCSKSARGEN 53.2 1.0 23.7 3.3 5.0 13.5 0.2 0.0 100.0 1,236 XIII - Caraga 46.9 5.8 29.6 1.7 3.8 11.6 0.6 0.1 100.0 709 ARMM 37.0 0.7 47.8 2.2 0.7 11.3 0.3 0.0 100.0 673 Wealth quintile Lowest 33.5 2.3 45.2 4.1 1.9 12.6 0.4 0.1 100.0 5,434 Second 42.8 2.5 24.9 2.7 12.9 14.0 0.2 0.1 100.0 5,659 Middle 48.4 1.6 14.5 2.8 18.8 13.3 0.4 0.1 100.0 5,599 Fourth 58.4 1.3 8.3 1.9 20.9 8.5 0.7 0.0 100.0 5,542 Highest 78.7 0.7 2.3 0.4 13.3 4.5 0.1 0.0 100.0 5,262 Total 52.1 1.7 19.1 2.4 13.6 10.7 0.4 0.0 100.0 27,496 20 • Housing Characteristics and Household Population Table 2.9 Household possessions Percentage of households possessing various household effects, means of transportation, agricultural land, and livestock/farm animals, and percentage of households that are beneficiaries of 4Ps, according to residence, Philippines NDHS 2017 Residence Total Possession Urban Rural Household effects Radio 53.2 49.5 51.2 Television 83.3 71.3 76.9 Mobile phone 93.2 85.0 88.8 Watch 78.1 57.1 66.8 Computer/laptop 30.0 15.5 22.2 Non-mobile telephone 12.6 2.8 7.3 Refrigerator 51.2 35.3 42.7 Washing machine 50.6 29.5 39.3 DVD player 39.7 27.5 33.1 Audio component/karaoke 21.9 12.5 16.8 Air conditioning 21.3 8.4 14.4 Cable services 19.3 19.9 19.7 Means of transport Bicycle 20.4 18.5 19.4 Animal-drawn cart 0.7 2.9 1.9 Motorcycle/scooter 30.6 39.9 35.6 Car/truck 13.1 7.1 9.9 Boat with a motor 0.9 2.4 1.7 Boat without a motor 0.4 2.4 1.5 Ownership of agricultural land 7.1 22.1 15.1 Ownership of farm animals1 14.0 46.9 31.7 Beneficiary of 4Ps2 8.4 22.9 16.2 Number 12,703 14,793 27,496 1 Carabao, cattle, horses, pigs/swine, goats, sheep, chickens, or other poultry 2 Refers to whether the household or any member of the household is a beneficiary of the Pantawid Pamilyang Pilipino Program (4Ps) Table 2.10 Wealth quintiles Percent distribution of the de jure population by wealth quintiles, and the Gini coefficient, according to residence and region, Philippines NDHS 2017 Wealth quintile Total Number of persons Gini coefficient Residence/region Lowest Second Middle Fourth Highest Residence Urban 9.4 14.2 21.3 26.6 28.5 100.0 52,058 0.15 Rural 28.6 24.7 18.9 14.7 13.1 100.0 64,147 0.24 Region National Capital Region 0.6 5.9 19.7 32.0 41.8 100.0 16,594 0.12 Cordillera Admin. Region 15.5 18.6 24.5 25.1 16.3 100.0 2,131 0.22 I - Ilocos Region 10.4 24.0 24.8 21.6 19.3 100.0 6,156 0.23 II - Cagayan Valley 18.4 33.4 20.0 15.1 13.1 100.0 4,208 0.24 III - Central Luzon 6.7 11.6 21.9 33.9 25.9 100.0 11,196 0.16 IVA - CALABARZON 5.9 14.0 21.7 28.3 30.1 100.0 17,753 0.16 MIMAROPA Region 30.9 26.0 17.7 14.8 10.5 100.0 3,004 0.28 V - Bicol 33.2 24.1 20.6 13.0 9.1 100.0 7,359 0.25 VI - Western Visayas 31.6 28.3 19.4 10.4 10.3 100.0 7,874 0.23 VII - Central Visayas 20.4 24.9 24.0 14.9 15.7 100.0 7,383 0.22 VIII - Eastern Visayas 25.1 29.1 20.8 13.1 11.9 100.0 5,084 0.23 IX - Zamboanga Peninsula 45.4 21.0 14.6 8.9 10.1 100.0 3,959 0.32 X - Northern Mindanao 32.7 27.6 17.1 10.3 12.3 100.0 4,849 0.24 XI - Davao 29.6 30.0 19.7 11.3 9.4 100.0 6,264 0.19 XII - SOCCSKSARGEN 38.1 25.4 17.8 10.6 8.1 100.0 5,469 0.28 XIII - Caraga 32.6 27.7 16.0 12.8 10.8 100.0 3,243 0.28 ARMM 70.2 20.4 6.7 2.1 0.7 100.0 3,679 0.25 Total 20.0 20.0 20.0 20.0 20.0 100.0 116,205 0.22 Housing Characteristics and Household Population • 21 Table 2.11 Handwashing Percentage of households in which the place most often used for washing hands was observed by whether the location was fixed or mobile and total percentage of households in which the place for handwashing was observed, and among households in which the place for handwashing was observed, percent distribution by availability of water, soap, and other cleansing agents, according to background characteristics, Philippines NDHS 2017 Percentage of households in which place for washing hands was observed: Number of house- holds Among households in which place for handwashing was observed, percentage with: Number of house- holds in which a place for hand- washing was observed Background characteristic And place for hand- washing was a fixed place And place for hand- washing was mobile Total Soap and water1 Water and cleansing agent other than soap only2 Water only Soap but no water3 Cleansing agent other than soap only2 No water, no soap, no other cleansing agent Total Residence Urban 86.2 8.1 94.3 12,703 91.9 0.0 4.3 1.7 0.0 2.0 100.0 11,979 Rural 74.2 16.9 91.1 14,793 86.4 0.1 6.7 2.9 0.0 3.8 100.0 13,481 Region National Capital Region 92.9 1.4 94.3 4,091 95.2 0.0 3.7 0.4 0.0 0.7 100.0 3,857 Cordillera Admin. Region 74.2 17.5 91.7 545 83.6 0.3 11.5 2.0 0.0 2.5 100.0 500 I - Ilocos Region 80.0 18.3 98.3 1,366 90.8 0.0 5.5 0.6 0.0 3.2 100.0 1,343 II - Cagayan Valley 64.3 30.0 94.2 1,009 84.7 0.7 10.9 0.2 0.0 3.4 100.0 950 III - Central Luzon 83.9 4.0 87.9 2,628 93.3 0.0 2.5 2.0 0.0 2.1 100.0 2,309 IVA - CALABARZON 72.5 11.0 83.5 4,145 89.2 0.0 5.2 2.1 0.1 3.4 100.0 3,462 MIMAROPA Region 85.9 10.8 96.7 731 90.3 0.0 5.2 3.2 0.0 1.4 100.0 707 V - Bicol 79.1 18.2 97.3 1,615 82.1 0.0 10.2 4.5 0.0 3.3 100.0 1,572 VI - Western Visayas 85.2 5.0 90.2 1,879 96.9 0.0 1.3 0.9 0.0 0.8 100.0 1,696 VII - Central Visayas 63.4 32.5 95.9 1,765 94.1 0.2 1.9 2.2 0.0 1.5 100.0 1,692 VIII - Eastern Visayas 75.9 23.6 99.5 1,150 85.2 0.0 6.4 3.7 0.0 4.8 100.0 1,144 IX - Zamboanga Peninsula 88.2 9.9 98.0 912 88.0 0.0 9.3 1.2 0.0 1.6 100.0 894 X - Northern Mindanao 81.7 17.2 99.0 1,142 87.2 0.2 6.5 2.8 0.0 3.3 100.0 1,130 XI - Davao 83.6 12.7 96.3 1,899 84.0 0.0 6.5 5.8 0.0 3.6 100.0 1,829 XII - SOCCSKSARGEN 74.1 17.0 91.1 1,236 79.7 0.0 9.1 1.9 0.0 9.4 100.0 1,126 XIII - Caraga 92.7 2.2 94.9 709 87.2 0.0 3.1 6.0 0.0 3.7 100.0 673 ARMM 55.0 30.4 85.5 673 65.6 0.5 12.8 8.1 0.0 12.9 100.0 575 Wealth quintile Lowest 60.0 30.0 90.0 5,434 75.3 0.1 11.0 4.9 0.0 8.7 100.0 4,890 Second 74.5 19.8 94.3 5,659 85.3 0.1 7.8 3.2 0.1 3.6 100.0 5,334 Middle 85.8 10.1 95.8 5,599 91.4 0.1 4.6 1.9 0.0 2.0 100.0 5,365 Fourth 90.5 3.0 93.4 5,542 95.5 0.0 2.7 1.2 0.0 0.7 100.0 5,179 Highest 88.1 1.1 89.1 5,262 97.7 0.1 1.6 0.6 0.0 0.0 100.0 4,691 Total 79.7 12.9 92.6 27,496 89.0 0.1 5.5 2.4 0.0 3.0 100.0 25,460 1 Soap includes soap or detergent in bar, liquid, powder, or paste form. This column includes households with soap and water only as well as those that had soap and water and another cleansing agent. 2 Cleansing agents other than soap include locally available materials such as ash, mud, or sand 3 Includes households with soap only as well as those with soap and another cleansing agent 22 • Housing Characteristics and Household Population Table 2.12 Household population by age, sex, and residence Percent distribution of the de facto household population by various age groups, and percentage of the de facto household population age 10-19, according to sex and residence, Philippines NDHS 2017 Urban Rural Total Age Male Female Total Male Female Total Male Female Total <5 9.7 8.7 9.2 10.2 10.1 10.2 10.0 9.4 9.7 5-9 10.7 9.8 10.3 13.1 12.1 12.6 12.1 11.1 11.6 10-14 10.2 10.0 10.1 12.8 12.0 12.4 11.6 11.1 11.4 15-19 10.3 9.7 10.0 10.6 9.1 9.9 10.4 9.4 9.9 20-24 10.2 9.0 9.6 7.3 7.0 7.2 8.6 7.9 8.3 25-29 8.4 8.0 8.2 6.4 6.3 6.3 7.3 7.1 7.2 30-34 7.2 6.5 6.8 6.1 5.9 6.0 6.6 6.2 6.4 35-39 6.5 6.9 6.7 6.0 6.1 6.0 6.2 6.5 6.3 40-44 5.6 5.4 5.5 5.4 5.5 5.4 5.5 5.4 5.5 45-49 5.3 5.8 5.6 5.0 4.9 4.9 5.1 5.3 5.2 50-54 4.5 5.4 5.0 4.5 5.4 4.9 4.5 5.4 4.9 55-59 3.8 4.4 4.1 4.2 4.1 4.1 4.0 4.2 4.1 60-64 2.9 3.6 3.2 2.9 3.5 3.2 2.9 3.6 3.2 65-69 2.3 2.6 2.5 2.2 2.9 2.5 2.3 2.8 2.5 70-74 1.2 1.6 1.4 1.3 2.2 1.7 1.2 2.0 1.6 75-79 0.7 1.1 0.9 1.1 1.3 1.2 0.9 1.2 1.1 80+ 0.6 1.3 0.9 0.8 1.5 1.1 0.7 1.4 1.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Dependency age groups 0-14 30.6 28.5 29.6 36.2 34.1 35.2 33.7 31.6 32.7 15-64 64.5 64.8 64.7 58.4 57.9 58.2 61.1 61.0 61.1 65+ 4.8 6.7 5.7 5.4 8.0 6.6 5.1 7.4 6.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Child and adult populations 0-17 36.8 34.3 35.6 43.1 40.2 41.7 40.3 37.5 39.0 18+ 63.2 65.6 64.4 56.8 59.8 58.3 59.7 62.5 61.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Adolescents 10-19 20.5 19.7 20.1 23.4 21.1 22.3 22.1 20.5 21.3 Number of persons 25,340 24,861 50,202 31,630 29,812 61,441 56,970 54,673 111,643 Note: Total includes 26 persons for whom age is unknown. Table 2.13 Household composition Percent distribution of households by sex of head of household and by household size, and mean size of households, according to residence, Philippines NDHS 2017 Residence Total Characteristic Urban Rural Household headship Male 76.5 81.9 79.4 Female 23.5 18.1 20.6 Total 100.0 100.0 100.0 Number of usual members 1 11.4 7.2 9.2 2 12.8 12.9 12.8 3 17.8 16.7 17.2 4 20.1 20.7 20.4 5 15.9 16.8 16.4 6 9.2 11.7 10.6 7 5.9 6.4 6.2 8 3.1 3.7 3.4 9+ 3.7 3.8 3.8 Total 100.0 100.0 100.0 Mean size of households 4.1 4.3 4.2 Number of households 12,703 14,793 27,496 Note: Table is based on de jure household members, i.e., usual residents. Total includes 3 households with no usual household members. Housing Characteristics and Household Population • 23 Table 2.14 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Philippines NDHS 2017 Percentage of children whose births are registered and who: Total percentage of children whose births are registered Number of children Background characteristic Had a birth certificate Did not have a birth certificate Age <2 65.7 24.9 90.6 4,110 2-4 69.9 22.7 92.5 6,815 Sex Male 68.5 23.8 92.3 5,721 Female 68.0 23.2 91.2 5,204 Residence Urban 66.1 27.6 93.7 4,646 Rural 70.0 20.5 90.4 6,279 Region National Capital Region 49.0 48.3 97.3 1,230 Cordillera Admin. Region 65.0 33.8 98.8 180 I - Ilocos Region 89.6 6.9 96.5 513 II - Cagayan Valley 70.0 26.4 96.4 410 III - Central Luzon 72.5 19.1 91.6 1,016 IVA - CALABARZON 71.9 22.8 94.6 1,699 MIMAROPA Region 69.5 19.5 89.0 293 V - Bicol 91.3 5.4 96.6 750 VI - Western Visayas 55.2 34.4 89.6 712 VII - Central Visayas 75.7 22.0 97.7 668 VIII - Eastern Visayas 83.0 8.5 91.6 512 IX - Zamboanga Peninsula 57.0 32.0 89.0 461 X - Northern Mindanao 72.2 22.0 94.2 520 XI - Davao 58.1 30.8 88.9 578 XII - SOCCSKSARGEN 76.0 7.0 83.0 632 XIII - Caraga 69.9 15.8 85.7 362 ARMM 30.4 29.4 59.8 388 Wealth quintile Lowest 62.7 20.4 83.1 3,041 Second 69.9 22.3 92.2 2,455 Middle 71.8 23.2 95.0 2,156 Fourth 72.0 25.4 97.4 1,846 Highest 67.4 30.3 97.7 1,427 Total 68.3 23.5 91.8 10,925 24 • Housing Characteristics and Household Population Table 2.15.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Philippines NDHS 2017 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number of women Median years completed Age 6-9 26.0 73.9 0.0 0.0 0.0 0.0 0.0 100.0 4,888 1.0 10-14 0.5 49.2 22.3 28.0 0.0 0.0 0.0 100.0 6,062 5.0 15-19 0.5 3.2 3.5 69.0 7.3 16.4 0.0 100.0 5,128 9.5 20-24 0.8 4.0 4.1 11.3 26.1 53.7 0.0 100.0 4,342 11.6 25-29 0.9 6.0 5.5 11.6 35.0 41.0 0.0 100.0 3,873 10.7 30-34 1.2 6.5 6.2 12.1 34.6 39.3 0.1 100.0 3,382 10.7 35-39 1.1 6.8 8.4 10.7 29.8 43.1 0.1 100.0 3,540 10.8 40-44 1.8 9.2 11.3 12.6 30.3 34.9 0.0 100.0 2,974 10.5 45-49 1.9 10.4 14.5 13.2 28.5 31.5 0.0 100.0 2,913 10.4 50-54 2.4 12.0 14.3 13.4 24.8 33.0 0.0 100.0 2,955 10.3 55-59 2.1 17.5 20.6 10.9 21.8 27.1 0.1 100.0 2,307 9.7 60-64 2.8 21.4 22.4 11.2 17.4 24.5 0.2 100.0 1,949 8.2 65+ 4.9 27.8 28.7 7.3 10.2 20.8 0.4 100.0 4,027 6.6 Don’t know * * * * * * * 100.0 13 * Residence Urban 3.3 17.7 9.1 16.8 20.4 32.6 0.1 100.0 22,224 10.2 Rural 4.7 25.2 13.9 19.7 16.4 20.1 0.1 100.0 26,128 7.8 Region National Capital Region 2.4 12.1 6.9 13.3 22.3 42.9 0.0 100.0 7,500 10.7 Cordillera Admin. Region 4.3 20.7 7.9 15.6 15.0 36.4 0.2 100.0 863 10.2 I - Ilocos Region 3.3 19.3 11.6 20.3 21.4 24.1 0.1 100.0 2,488 9.6 II - Cagayan Valley 3.3 26.0 12.1 20.5 17.1 20.9 0.1 100.0 1,651 8.2 III - Central Luzon 3.7 20.1 13.4 18.7 21.5 22.6 0.0 100.0 4,734 9.2 IVA - CALABARZON 2.4 19.8 11.7 15.8 21.7 28.7 0.0 100.0 7,495 10.1 MIMAROPA Region 5.5 24.0 14.2 19.1 15.4 21.6 0.1 100.0 1,236 7.8 V - Bicol 4.1 22.1 17.2 23.0 15.3 18.2 0.0 100.0 3,121 7.8 VI - Western Visayas 3.4 27.0 12.2 18.5 16.8 22.0 0.1 100.0 3,230 8.1 VII - Central Visayas 3.8 25.5 11.7 21.1 15.8 21.9 0.2 100.0 3,182 8.0 VIII - Eastern Visayas 3.7 26.2 13.9 21.6 12.5 22.0 0.1 100.0 2,069 7.7 IX - Zamboanga Peninsula 6.9 29.1 12.3 20.4 10.8 20.1 0.4 100.0 1,607 6.9 X - Northern Mindanao 4.7 22.9 11.7 20.5 18.0 22.1 0.2 100.0 1,954 8.6 XI - Davao 4.4 24.3 14.7 21.1 14.3 21.2 0.0 100.0 2,343 7.7 XII - SOCCSKSARGEN 8.3 26.4 10.6 19.8 16.6 18.2 0.1 100.0 2,093 7.3 XIII - Caraga 3.7 24.9 11.6 22.9 17.0 19.6 0.1 100.0 1,312 8.1 ARMM 14.6 34.6 12.0 15.4 10.0 13.3 0.1 100.0 1,475 5.4 Wealth quintile Lowest 10.0 38.2 15.7 20.5 11.3 4.2 0.1 100.0 8,819 5.6 Second 4.5 27.0 15.4 22.9 18.8 11.3 0.1 100.0 9,168 7.0 Middle 2.9 20.8 12.5 19.7 24.7 19.3 0.1 100.0 9,499 9.3 Fourth 1.9 14.8 9.5 17.2 23.9 32.7 0.0 100.0 10,047 10.3 Highest 1.9 11.2 6.8 12.7 12.4 55.0 0.1 100.0 10,819 12.2 Total 4.1 21.7 11.7 18.4 18.2 25.8 0.1 100.0 48,352 9.1 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Completed grade 6 at the primary level 2 Completed grade 10 of high school under the old educational system or completed grade 12 under the current K-12 educational system Housing Characteristics and Household Population • 25 Table 2.15.2 Educational attainment of the male household population Percent distribution of the de facto male household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Philippines NDHS 2017 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number of men Median years completed Age 6-9 30.1 69.8 0.0 0.1 0.0 0.0 0.0 100.0 5,543 0.8 10-14 1.1 54.1 21.8 22.9 0.0 0.0 0.1 100.0 6,636 4.8 15-19 1.2 8.6 6.5 65.2 5.8 12.8 0.0 100.0 5,947 8.8 20-24 1.3 9.9 6.2 14.6 23.4 44.6 0.0 100.0 4,905 10.8 25-29 1.2 10.8 8.1 13.2 28.7 37.9 0.1 100.0 4,142 10.6 30-34 1.6 13.3 8.6 14.1 28.1 34.3 0.1 100.0 3,747 10.4 35-39 1.5 12.5 10.4 13.3 29.2 33.1 0.0 100.0 3,546 10.4 40-44 1.2 16.3 10.8 11.2 27.9 32.5 0.1 100.0 3,125 10.4 45-49 1.5 18.6 13.0 13.2 25.7 27.8 0.1 100.0 2,919 10.1 50-54 1.7 16.7 14.8 11.7 25.2 29.8 0.1 100.0 2,568 10.2 55-59 2.5 19.9 18.9 10.2 23.7 24.9 0.0 100.0 2,280 9.5 60-64 2.6 23.0 18.9 11.3 21.5 22.5 0.2 100.0 1,656 8.5 65+ 4.3 29.3 22.6 8.9 14.2 20.4 0.2 100.0 2,918 6.7 Don’t know * * * * * * * 100.0 12 * Residence Urban 3.8 20.6 8.8 17.2 19.2 30.3 0.1 100.0 22,325 10.1 Rural 5.6 30.5 13.4 20.0 14.7 15.7 0.1 100.0 27,617 6.8 Region National Capital Region 2.9 14.5 5.4 15.3 22.0 39.9 0.1 100.0 7,256 10.6 Cordillera Admin. Region 4.4 22.6 10.0 18.2 18.4 26.3 0.1 100.0 964 9.1 I - Ilocos Region 4.1 21.5 11.2 19.1 23.1 20.9 0.1 100.0 2,557 9.0 II - Cagayan Valley 4.0 30.4 10.7 21.9 14.9 18.0 0.1 100.0 1,836 7.3 III - Central Luzon 4.5 22.0 13.2 19.3 20.1 20.8 0.0 100.0 4,694 8.5 IVA - CALABARZON 4.7 21.1 12.1 18.2 20.6 23.4 0.0 100.0 7,294 9.1 MIMAROPA Region 6.3 30.1 12.5 20.1 13.6 17.4 0.0 100.0 1,324 6.8 V - Bicol 3.9 27.5 17.0 23.2 13.2 15.0 0.0 100.0 3,069 6.9 VI - Western Visayas 4.5 31.9 10.9 19.8 15.1 17.7 0.1 100.0 3,433 6.9 VII - Central Visayas 4.3 31.8 13.0 18.2 14.2 18.2 0.3 100.0 3,100 6.8 VIII - Eastern Visayas 6.3 32.1 13.8 21.8 10.1 15.9 0.1 100.0 2,214 6.6 IX - Zamboanga Peninsula 7.0 36.0 11.0 19.4 9.6 16.9 0.2 100.0 1,674 6.4 X - Northern Mindanao 4.5 28.8 13.8 19.4 15.3 17.9 0.3 100.0 2,143 7.0 XI - Davao 4.1 26.8 11.4 18.0 14.6 25.1 0.0 100.0 2,976 8.2 XII - SOCCSKSARGEN 7.1 33.4 10.8 20.3 12.5 15.9 0.0 100.0 2,377 6.6 XIII - Caraga 5.1 33.0 11.9 20.6 12.8 16.5 0.1 100.0 1,388 6.7 ARMM 12.9 46.2 10.5 13.6 6.4 10.5 0.0 100.0 1,641 4.2 Wealth quintile Lowest 9.8 46.1 15.2 17.0 8.8 2.9 0.1 100.0 10,059 4.5 Second 5.0 31.1 14.4 22.1 17.0 10.3 0.1 100.0 10,264 6.7 Middle 3.7 22.5 11.8 21.4 22.4 18.1 0.1 100.0 10,164 8.6 Fourth 3.1 17.5 9.2 17.9 22.0 30.1 0.1 100.0 9,948 10.2 Highest 2.4 12.1 5.6 15.0 13.2 51.5 0.0 100.0 9,507 11.5 Total 4.8 26.1 11.3 18.8 16.7 22.2 0.1 100.0 49,942 8.1 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Completed grade 6 at the primary level 2 Completed grade 10 of high school under the old educational system or completed grade 12 under the current K-12 educational system 26 • Housing Characteristics and Household Population Table 2.16 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de facto household population by sex and level of schooling, and the gender parity index (GPI), according to background characteristics, Philippines NDHS 2017 Net attendance ratio1 Gross attendance ratio2 Background characteristic Male Female Total Gender parity index3 Male Female Total Gender parity index3 PRIMARY SCHOOL Residence Urban 91.7 93.5 92.6 1.02 104.3 104.7 104.5 1.00 Rural 93.6 93.5 93.5 1.00 108.7 103.7 106.4 0.95 Region National Capital Region 93.0 92.8 92.9 1.00 103.4 104.8 104.1 1.01 Cordillera Admin. Region 95.5 94.6 95.1 0.99 107.9 103.9 106.0 0.96 I - Ilocos Region 94.6 93.5 94.1 0.99 102.2 102.0 102.1 1.00 II - Cagayan Valley 93.3 94.1 93.7 1.01 103.8 103.6 103.7 1.00 III - Central Luzon 89.8 91.0 90.4 1.01 100.7 98.4 99.6 0.98 IVA - CALABARZON 91.8 95.8 93.8 1.04 104.0 102.4 103.2 0.98 MIMAROPA Region 95.1 92.4 93.8 0.97 112.5 104.0 108.4 0.92 V - Bicol 93.3 93.7 93.5 1.00 107.7 102.2 105.0 0.95 VI - Western Visayas 95.8 93.4 94.7 0.98 109.8 108.3 109.1 0.99 VII - Central Visayas 92.3 94.5 93.3 1.02 106.1 106.3 106.2 1.00 VIII - Eastern Visayas 96.7 92.4 94.7 0.95 108.3 100.7 104.7 0.93 IX - Zamboanga Peninsula 94.7 94.6 94.6 1.00 117.7 107.8 112.9 0.92 X - Northern Mindanao 92.3 94.1 93.1 1.02 109.0 104.9 107.0 0.96 XI - Davao 91.8 95.0 93.2 1.03 107.6 108.8 108.1 1.01 XII - SOCCSKSARGEN 91.4 93.6 92.5 1.02 112.4 106.5 109.5 0.95 XIII - Caraga 92.8 91.6 92.2 0.99 108.8 102.9 106.1 0.95 ARMM 89.7 88.5 89.2 0.99 118.4 111.1 115.2 0.94 Wealth quintile Lowest 91.3 92.4 91.8 1.01 112.4 108.2 110.4 0.96 Second 92.3 93.7 93.0 1.01 105.8 104.8 105.3 0.99 Middle 93.8 94.2 94.0 1.00 104.6 103.8 104.2 0.99 Fourth 94.3 94.0 94.2 1.00 105.3 100.2 103.0 0.95 Highest 93.3 93.6 93.4 1.00 104.0 100.9 102.4 0.97 Total 92.8 93.5 93.1 1.01 107.0 104.1 105.6 0.97 SECONDARY SCHOOL Residence Urban 76.0 81.8 78.8 1.08 86.5 89.4 87.9 1.03 Rural 73.4 83.1 77.8 1.13 83.4 93.3 87.8 1.12 Region National Capital Region 79.9 81.2 80.6 1.02 91.3 88.2 89.7 0.97 Cordillera Admin. Region 77.5 83.2 80.1 1.07 85.4 91.2 88.1 1.07 I - Ilocos Region 82.3 87.1 84.7 1.06 92.1 92.0 92.0 1.00 II - Cagayan Valley 72.9 87.3 79.5 1.20 81.1 94.1 87.0 1.16 III - Central Luzon 81.9 83.8 82.8 1.02 88.0 93.3 90.6 1.06 IVA - CALABARZON 81.3 86.0 83.3 1.06 89.6 96.4 92.4 1.08 MIMAROPA Region 73.9 80.5 77.1 1.09 80.5 88.1 84.1 1.09 V - Bicol 76.6 85.7 80.9 1.12 89.2 97.0 92.9 1.09 VI - Western Visayas 71.2 80.4 75.6 1.13 83.0 88.2 85.5 1.06 VII - Central Visayas 74.5 83.3 79.2 1.12 88.0 93.4 90.9 1.06 VIII - Eastern Visayas 75.8 86.1 80.6 1.14 91.8 98.2 94.8 1.07 IX - Zamboanga Peninsula 61.9 81.2 70.8 1.31 70.9 92.4 80.8 1.30 X - Northern Mindanao 71.3 81.1 75.4 1.14 82.3 90.0 85.5 1.09 XI - Davao 70.3 81.8 75.7 1.16 79.0 88.5 83.5 1.12 XII - SOCCSKSARGEN 61.8 78.9 69.0 1.28 73.3 88.9 79.9 1.21 XIII - Caraga 70.9 84.9 77.6 1.20 84.0 99.8 91.6 1.19 ARMM 42.7 59.3 50.3 1.39 51.5 67.0 58.6 1.30 Wealth quintile Lowest 52.9 69.0 60.3 1.30 61.6 77.9 69.0 1.26 Second 71.7 81.4 76.3 1.13 82.8 89.0 85.8 1.08 Middle 79.3 85.0 82.0 1.07 90.4 94.7 92.4 1.05 Fourth 83.9 87.1 85.4 1.04 94.1 98.5 96.2 1.05 Highest 88.1 92.0 89.9 1.04 98.5 99.8 99.1 1.01 Total 74.4 82.5 78.2 1.11 84.6 91.6 87.9 1.08 1 The NAR for primary school is the percentage of the primary school-age (6-11 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary school-age (12-17 years) population that is attending secondary school. By definition, the NAR cannot exceed 100%. 2 The GAR for primary school is the total number of primary school students, expressed as a percentage of the official primary school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100%. 3 The gender parity index for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males. The gender parity index for secondary school is the ratio of the secondary school NAR (GAR) for females to the NAR (GAR) for males. Characteristics of Respondents • 27 CHARACTERISTICS OF RESPONDENTS 3 Key Findings  Age: Half of the women interviewed (51%) are under age 30.  Marital status: 60% of women are currently married or living together with a partner as if married.  Residential mobility: 2 in 5 women (39%) continue to live in the place they were born.  Education: More than 3 in 5 women (63%) have completed secondary education or higher.  Exposure to media: Television is still the most popular form of mass media among women, with almost 8 in 10 women (77%) watching at least once a week. Almost 7 out of 10 women (68%) have used the Internet in the past 12 months.  Employment: More than half of women (54%) were employed in the 12 months preceding the survey.  Health insurance coverage: 65% of women age 15-49 have some type of PhilHealth coverage; 29% have a form(s) of health insurance other than PhilHealth.  Tobacco use: 5% of women smoke a tobacco product.  Alcohol consumption: 3 in 4 women (74%) do not drink alcohol. his chapter presents information on the demographic and socioeconomic characteristics of the survey respondents such as age, education, place of residence, marital status, employment, and wealth status. This information is useful for understanding the factors that affect use of reproductive health services, contraceptive use, and other health behaviors. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS A total of 25,074 women age 15-49 were interviewed in the NDHS 2017 with the Woman’s Questionnaire (Table 3.1). Half (51%) of the survey respondents are under age 30. Eighty percent of respondents are Roman Catholic, 8% are Protestant, and 5% are Muslim. Tagalog remains the predominant ethnic group, representing 32% of the sample; Cebuano is a distant second at 17%, followed by Ilocano, Ilonggo, and Bikolano (8% each). More than one-third of women (36%) have never been married. A majority (60%) are currently married or living together with a partner as if married, with a small percentage divorced or separated (3%) or widowed (1%). By residence, respondents are almost evenly split between urban and rural areas (49% and 51%, respectively). Eighteen percent of women live in the National Capital Region (NCR), 16% reside in CALABARZON, and 10% live in Central Luzon. T 28 • Characteristics of Respondents At birth, over half of respondents (53%) resided in a barrio or rural area, 27% lived in a city, and 20% lived in a town or poblacion (Table 3.2). Thirty-nine percent of respondents have been living continuously since birth in the location where they were interviewed, and 27% have lived 10 or more years in the location where they were interviewed. 3.2 EDUCATION At the national level, 6% of women age 15-49 have some primary education, 7% have completed primary school but gone no further, 23% have some secondary education, 26% have completed secondary and gone no further, and 36% have more than a secondary education.1 One percent of women have no formal education (Figure 3.1). The median number of years of schooling is 10.6 years (Table 3.3). Trends: Median years of schooling among women age 15-49 has increased steadily since 1993, from 8.8 years to 10.6 years (Figure 3.2). Patterns by background characteristics  As expected, the percentage of women who have completed secondary school or higher is greater in urban areas than rural areas (71% and 55%, respectively) (Table 3.3). 1 The educational system in the Philippines changed in 2011-12, and the changes affect the way the education background characteristic is presented in the NDHS 2017 relative to previous DHS surveys. Prior to 2012, the educational system consisted of 6 years of elementary school (primary school) followed by 4 years of high school (secondary school). In the current K-12 system, grades 1-6 correspond to primary school, and grades 7-12 correspond to secondary school. However, secondary school is subdivided into junior high school (grades 7-10) and senior high school (grades 11-12). Thus, the K-12 system includes 2 more years of high school relative to the old system. The first class to graduate from the K-12 system was the 2018 class, and this occurred several months after NDHS 2017 fieldwork was completed. Figure 3.1 Education by residence Figure 3.2 Trends in education 1 <1 16 4 8 7 5 9 23 20 27 26 28 25 36 43 31 Total Urban Rural Percent distribution of women age 15-49 by highest level of schooling attended or completed More than secondary Completed secondary Some secondary Completed primary Some primary No education Note: Figure does not sum to 100% due to rounding. 8.8 9.1 9.2 9.4 9.5 10.6 1993 NDS 1998 NDHS 2003 NDHS 2008 NDHS 2013 NDHS 2017 NDHS Median years of schooling among women age 15-49 Characteristics of Respondents • 29  By region, the percentage of women who have completed secondary school or more is highest in NCR (80%), Cordillera Administrative Region (CAR) (74%), and CALABARZON (73%). Women in the Autonomous Region in Muslim Mindanao (ARMM) (37%) and Zamboanga Peninsula (48%) are least likely to have completed secondary school or higher (Figure 3.3).  Median years of schooling increases with increasing household wealth, from 8.1 years among women in the lowest wealth quintile to 13.3 years among women in the highest quintile. 3.3 MASS MEDIA EXPOSURE AND INTERNET USAGE Exposure to mass media Respondents were asked how often they read a newspaper, listened to the radio, or watched television. Those who responded at least once a week are considered regularly exposed to that form of media. Sample: Women age 15-49 Data on women’s exposure to mass media are essential in the development of educational programs and the dissemination of all types of information, particularly information about family planning and other important health topics. The NDHS 2017 results indicate that television is still the most popular form of mass media among women (with 77% watching television at least once a week). Thirty-six percent of women listen to the radio at least once a week, and 15% read a newspaper at least once a week. Nine percent of women are exposed to all three types of media weekly. Sixteen percent of women are not regularly exposed to any of the three forms of media (Table 3.4). The Internet is also a critical tool through which information is shared. Internet use includes accessing web pages, email, and social media. Seven in 10 women have ever used the Internet, and nearly all of the women who have used the Internet used it in the past 12 months (Table 3.5). Among those using the Internet in the past 12 months, more than half (53%) accessed it almost every day, and 31% used it at least once a week. Figure 3.3 Complete secondary education complete or higher by region Percentage of women age 15-49 with secondary education complete or higher 30 • Characteristics of Respondents Trends: Women’s exposure to all three types of media (newspaper, television, and radio) on a weekly basis declined from 37% in 2003 to 9% in 2017. Over this time period, the percentage of women who watch television at least once a week remained fairly consistent (ranging from 77% to 85%), but the percentage who read a newspaper weekly or listen to a radio declined dramatically; 44% of women read a newspaper at least once a week in 2003, as compared with 15% in 2017, and 78% of women listened to the radio at least once a week in 2003, compared with 36% in 2017. In accordance with these findings, the percentage of women who access none of the three media types rose from 8% in 2003 to 16% in 2017. Patterns by background characteristics  Exposure to media varies little by age; however, use of the Internet in the past 12 months declines with age, from 88% among women age 15-19 to 38% among women age 45-49.  The percentage of urban women who access each of the three types of media is slightly higher than the percentage of rural women, although the differences are surprisingly small (Figure 3.4). In contrast, women from urban areas are much more likely than those from rural areas to have accessed the Internet in the past 12 months (79% versus 57%) or almost every day (61% versus 42%).  By region, women in ARMM are most likely to report no regular exposure to any of the three types of media (54%) (Table 3.4) and are least likely to have used the Internet in the past 12 months (21%) (Table 3.5).  Internet usage increases with increasing wealth; 29% of women in the lowest wealth quintile accessed the Internet in the past 12 months, as compared with 95% in the highest quintile (Table 3.5). 3.4 EMPLOYMENT Currently employed Respondents who were employed in the 7 days before the survey Sample: Women age 15-49 Nearly half of women (46%) are currently employed. The vast majority of women who are not currently employed were not employed at any time in the 12 months preceding the survey (Table 3.6). Trends: Since 1998, the percentage of women who were employed at the time of the survey has been remarkably consistent, fluctuating between 46% and 48%. Patterns by background characteristics  A greater percentage of women in urban than rural areas are currently employed (49% versus 43%).  By region, the percentage of women currently employed ranges from 26% in ARMM to 58% in Central Visayas. Figure 3.4 Exposure to mass media 15 77 36 9 1619 79 37 11 1311 76 36 7 18 Reads newspaper Watches television Listens to radio All three media None of these media Percentage of women age 15-49 who are exposed to specific media on a weekly basis Total Urban Rural Characteristics of Respondents • 31  The percentage of women currently employed increases steadily with increasing household wealth. Only 37% of women in the lowest wealth quintile are currently employed, as compared with 56% in the highest quintile. 3.5 OCCUPATION Occupation Categorized as professional/technical/managerial, clerical, sales and services, skilled manual, unskilled manual, domestic service, agriculture, and armed forces Sample: Women age 15-49 who were currently employed or had worked in the 12 months before the survey Among women who were employed in the 12 months before the survey, 27% work in professional, technical, or managerial positions, and 27% are engaged in sales and services. One in 10 women are engaged in each of the following occupations: unskilled manual, agriculture, and clerical. Seven percent of women work in the domestic services sector, and 0.3% are in the armed forces (Table 3.7). Eight in 10 women (79%) who worked in the 12 months preceding the survey reported being paid in cash (without in-kind payments); nearly 2 in 10 women (18%) are not paid for their work. Three percent of women are paid in both cash and in-kind, and 1% receive only in-kind payments (Table 3.8). The majority of women who were employed in the past 12 months (64%) were employed by a non-family member. Twenty-six percent were self-employed, and 10% were employed by a family member. Most women (70%) were employed year-round. Trends: Among women employed in the past 12 months, there has been little change in the distribution of occupations relative to 2013. The exceptions are that the percentage of women in sales and services increased from 18% in 2013 to 27% in 2017, while the percentage in domestic services declined from 14% to 7% and the percentage in agriculture declined from 13% to 10%. Patterns by background characteristics  The distribution of women by occupation is similar in urban and rural areas except in the clerical and agriculture sectors; as expected, a higher percentage of urban than rural women work in the clerical sector (14% versus 6%) and a higher percentage of rural than urban women work in the agricultural sector (17% versus 3%) (Figure 3.5).  The most common occupational sector among women in the lowest wealth quintile is agriculture. The most common sector among women in the second and middle wealth quintiles is sales and services, and the most common sector among women in the fourth and highest quintiles is professional/technical/managerial. Figure 3.5 Occupation by residence 27 10 27 6 12 7 10 <1 28 14 28 6 12 8 3 1 27 6 26 5 11 7 17 <1 Professional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agricultural Armed forces Percentage of women age 15-49 employed in the 12 months before the survey by occupation Total Urban Rural 32 • Characteristics of Respondents  The proportion of women working in professional, technical, and managerial occupations increases with increasing household wealth, from 8% among those in the lowest wealth quintile to 45% among those in the highest quintile. The proportion of women employed in agriculture decreases sharply with increasing wealth, from 38% in the lowest wealth quintile to 1%-16% in the other wealth quintiles. 3.6 HEALTH INSURANCE COVERAGE Health care becomes more accessible when individuals are covered by health insurance, and one of the objectives of the Universal Health Program of the Philippines is to provide Filipinos with 100% health insurance coverage. Types of health insurance include PhilHealth, the Government Service Insurance System (GSIS), the Social Security System (SSS), and private insurance. A single individual may have more than one form of coverage. In total, 65% of women age 15-49 have some type of PhilHealth coverage; 32% have PhilHealth coverage through the formal economy, 19% have coverage through the National Household Targeting System for Poverty Reduction (NHTS-PR), and 10% have coverage through the informal economy (Table 3.9). Twenty-nine percent of women have a form(s) of health insurance other than PhilHealth, the most common being the Social Security System (26% of all women). Only 3% of women have private health insurance. One-third of women (32%) have no health insurance. Trends: The percentage of women with no form of health insurance has declined over the last decade, dropping from 57% in 2008 to 38% in 2013 and 32% in 2017. Patterns by background characteristics  The percentage of women with any form of PhilHealth coverage is nearly identical in urban and rural areas (65% and 64%, respectively). However, 41% of urban women and only 19% of rural women have a form of health insurance other than PhilHealth (Figure 3.6).  Insurance coverage varies widely by region. For example, 49% of women in ARMM have some form of PhilHealth coverage, as compared with 73% in Davao; only 3% of women in ARMM have a form of health insurance other than PhilHealth, compared with 55% in NCR.  Insurance coverage generally increases with increasing household wealth. The percentage of women with PhilHealth coverage is 59%-60% among those in the three lowest wealth quintiles and rises to 67% and 75%, respectively, among those in the fourth and highest wealth quintiles. More strikingly, only 4% of women in the lowest wealth quintile have any other form of health insurance, as compared with 57% of women in the highest quintile (Figure 3.7). Figure 3.6 Health insurance coverage by residence Figure 3.7 Health insurance coverage by household wealth 65 65 64 29 41 19 Total Urban Rural Percentage of women age 15-49 Any PhilHealth insurance Any other health insurance 59 60 60 67 75 4 12 24 38 57 Lowest Second Middle Fourth Highest Percentage of women age 15-49 Any PhilHealth insurance Any other health insurance WealthiestPoorest Characteristics of Respondents • 33 3.7 TOBACCO USE AND ALCOHOL CONSUMPTION 3.7.1 Tobacco Use Smoking is a risk factor for cardiovascular disease, lung cancer, and other forms of cancer, and it contributes to the severity of pneumonia, emphysema, and chronic bronchitis symptoms. Use of tobacco in the household adversely affects the health status of all household members. Overall, 5% of women age 15-49 smoke a tobacco product; 5% smoke cigarettes and 2% smoke another form of tobacco such as a pipe or cigar (Table 3.10). This result is consistent with the findings from the 2015 Global Adult Tobacco Survey (GATS), which measured the prevalence of women who smoke tobacco at 5% (GATS 2017). Among women who smoke cigarettes, 41% smoke fewer than 5 cigarettes a day, 23% smoke 5-9 cigarettes a day, 24% smoke 10-14 cigarettes a day, and 12% smoke 15 or more cigarettes a day (data not shown). Use of smokeless tobacco is rare among women in the Philippines. Only 0.3% of women report using any form of smokeless tobacco (Table 3.11). Trends: Since 2003, the prevalence of cigarette smoking among women age 15-49 has remained low, declining slightly from 7% to 5%. Patterns by background characteristics  Urban women (6%) are slightly more likely to smoke tobacco than rural women (4%) (Table 3.10).  Tobacco smoking prevalence ranges from 2% in ARMM and MIMAROPA Region to 8% in NCR.  Surprisingly, tobacco smoking varies little by wealth (5%-6% among all wealth quintiles). 3.7.2 Alcohol Consumption Alcohol intake in large amounts is associated with an increased risk of alcoholism, malnutrition, chronic pancreatitis, alcoholic liver disease, and cancer. Maternal alcohol use in the prenatal period is also of concern as it may cause miscarriage and stillbirth and contribute to a range of lifelong physical, behavioral, and intellectual disabilities. These disabilities are known as fetal alcohol spectrum disorders (FASDs) (CDC 2018). The NDHS 2017 included questions on alcohol consumption for the first time. In total, 0.3% of women report drinking alcohol on a daily basis, 26% drink alcohol on some days, and 74% do not drink alcohol. Among women who drink alcohol every day, the average number of drinks consumed is 2.3 (Table 3.12). Patterns by background characteristics  Urban women are more likely than rural women to drink alcohol every day or on some days (30% versus 22%).  The percentage of women who drink alcohol ranges from a low of 1% in ARMM to a high of 60% in Eastern Visayas.  The percentage of women who drink alcohol rises with increasing household wealth, from 19% among those in the lowest wealth quintile to 30% among those in the fourth and highest wealth quintiles. 34 • Characteristics of Respondents LIST OF TABLES For more information on the characteristics of survey respondents, see the following tables:  Table 3.1 Background characteristics of respondents  Table 3.2 Residence characteristics of respondents  Table 3.3 Educational attainment  Table 3.4 Exposure to mass media  Table 3.5 Internet usage  Table 3.6 Employment status  Table 3.7 Occupation  Table 3.8 Type of employment  Table 3.9 Health insurance coverage  Table 3.10 Tobacco smoking  Table 3.11 Smokeless tobacco use and any tobacco use  Table 3.12 Alcohol consumption Characteristics of Respondents • 35 Table 3.1 Background characteristics of respondents Percent distribution of women age 15-49 by selected background characteristics, Philippines NDHS 2017 Background characteristic Weighted percent Weighted number Unweighted number Age 15-19 19.5 4,897 5,120 20-24 16.7 4,175 3,914 25-29 14.8 3,717 3,686 30-34 12.9 3,243 3,287 35-39 13.4 3,360 3,291 40-44 11.3 2,837 2,903 45-49 11.3 2,845 2,873 Religion Roman Catholic 79.9 20,030 18,141 Protestant 7.6 1,906 2,314 Iglesia ni Cristo 3.1 781 726 Aglipay 0.7 186 335 Other Christian 2.3 573 783 Islam 5.0 1,263 2,321 Other 1.1 264 388 None 0.3 72 66 Ethnic group Tagalog 32.1 8,042 4,914 Cebuano 17.2 4,313 4,270 Ilocano 7.9 1,988 2,257 Ilonggo 7.6 1,895 1,904 Bikolano 7.6 1,904 1,587 Kapampangan 3.0 743 491 Maranao 1.3 325 647 Tausug 1.6 401 719 Bisaya 3.1 765 952 Waray 3.9 966 1,275 Other 14.9 3,732 6,058 Marital status Never married 35.8 8,971 8,652 Married 42.4 10,639 11,458 Living together 17.5 4,377 3,987 Divorced/separated 3.2 809 690 Widowed 1.1 277 287 Residence Urban 48.9 12,252 9,016 Rural 51.1 12,822 16,058 Region National Capital Region 17.5 4,400 2,574 Cordillera Admin. Region 1.8 440 1,469 I - Ilocos Region 5.0 1,258 970 II - Cagayan Valley 3.2 802 1,067 III - Central Luzon 9.8 2,453 2,056 IVA - CALABARZON 16.0 4,016 1,414 MIMAROPA Region 2.5 621 1,257 V - Bicol 6.2 1,551 1,642 VI - Western Visayas 6.0 1,498 1,742 VII - Central Visayas 6.4 1,607 1,313 VIII - Eastern Visayas 4.0 997 1,595 IX - Zamboanga Peninsula 3.0 764 866 X - Northern Mindanao 4.0 998 1,518 XI - Davao 4.8 1,203 1,266 XII - SOCCSKSARGEN 4.1 1,038 1,140 XIII - Caraga 2.6 648 1,426 ARMM 3.1 780 1,759 Education No education 0.8 200 314 Grades 1-6 12.9 3,245 3,853 Grades 7-10 46.1 11,558 11,468 Grade 11 3.7 934 951 Post-secondary 4.6 1,144 998 College 31.9 7,994 7,490 Wealth quintile Lowest 16.8 4,209 5,931 Second 18.5 4,629 5,491 Middle 19.6 4,918 4,856 Fourth 22.0 5,527 4,575 Highest 23.1 5,791 4,221 Total 100.0 25,074 25,074 Note: Education categories refer to the highest level of education in which at least one grade has been completed. No education includes respondents who completed nursery, kindergarten, or preschool only. 36 • Characteristics of Respondents Table 3.2 Residence characteristics of respondents Percent distribution of women age 15-49 by type of residence at birth and time living continuously in current location, Philippines NDHS 2017 Background characteristic Weighted percent Weighted number Unweighted number Type of residence at birth City 26.6 6,674 5,323 Town proper/poblacion 19.6 4,915 4,853 Barrio/rural area 53.3 13,355 14,698 Abroad 0.2 45 47 Don’t know 0.3 83 153 Time living continuously in current location <6 months 3.4 856 751 6-11 months 2.1 518 399 12-23 months 2.4 597 556 2-4 years 12.2 3,064 2,709 5-9 years 14.5 3,634 3,210 10+ years 26.6 6,660 6,730 Always/since birth 38.7 9,703 10,654 Visitor 0.2 43 65 Total 100.0 25,074 25,074 Table 3.3 Educational attainment Percent distribution of women age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Philippines NDHS 2017 Highest level of schooling Total Median years completed Number of women Background characteristic No education1 Some primary Completed primary2 Some secondary Completed secondary3 More than secondary Age 15-24 0.3 3.5 3.5 43.2 16.1 33.4 100.0 10.4 9,072 15-19 0.1 3.2 3.0 70.3 7.2 16.1 100.0 9.6 4,897 20-24 0.5 3.8 4.0 11.5 26.6 53.7 100.0 11.6 4,175 25-29 0.7 5.7 5.3 11.8 35.9 40.6 100.0 10.7 3,717 30-34 1.0 6.4 6.2 12.3 34.8 39.3 100.0 10.7 3,243 35-39 0.9 6.8 8.2 10.8 30.6 42.7 100.0 10.8 3,360 40-44 1.2 9.4 11.2 12.8 30.6 34.8 100.0 10.5 2,837 45-49 1.7 10.4 14.6 13.2 28.4 31.8 100.0 10.4 2,845 Residence Urban 0.4 4.2 4.9 19.8 28.1 42.6 100.0 10.8 12,252 Rural 1.2 7.9 8.8 26.8 24.8 30.6 100.0 10.3 12,822 Region National Capital Region 0.2 1.7 3.1 15.3 27.7 52.0 100.0 11.5 4,400 Cordillera Admin. Region 0.4 3.4 3.8 18.7 20.2 53.5 100.0 11.7 440 I - Ilocos Region 0.4 3.4 5.2 26.0 30.6 34.4 100.0 10.5 1,258 II - Cagayan Valley 0.8 8.8 7.5 25.7 23.7 33.4 100.0 10.4 802 III - Central Luzon 0.8 4.2 7.6 23.4 30.6 33.4 100.0 10.5 2,453 IVA - CALABARZON 0.1 2.9 6.3 18.3 32.4 40.1 100.0 10.7 4,016 MIMAROPA Region 2.2 9.1 10.0 25.1 20.9 32.6 100.0 10.3 621 V - Bicol 0.3 5.5 10.9 31.8 23.9 27.5 100.0 10.2 1,551 VI - Western Visayas 0.4 8.5 5.6 28.8 25.2 31.6 100.0 10.4 1,498 VII - Central Visayas 0.6 8.3 7.1 28.0 25.4 30.7 100.0 10.4 1,607 VIII - Eastern Visayas 0.7 9.0 7.8 29.7 18.9 34.0 100.0 10.3 997 IX - Zamboanga Peninsula 2.0 12.5 9.8 28.1 17.9 29.7 100.0 10.0 764 X - Northern Mindanao 0.2 7.7 9.1 25.3 27.0 30.6 100.0 10.4 998 XI - Davao 0.7 9.3 9.3 27.2 22.0 31.5 100.0 10.3 1,203 XII - SOCCSKSARGEN 3.6 11.0 6.9 26.0 25.1 27.3 100.0 10.2 1,038 XIII - Caraga 0.5 8.7 6.8 29.2 25.2 29.5 100.0 10.3 648 ARMM 5.8 20.6 12.8 23.6 16.1 21.1 100.0 8.5 780 Wealth quintile Lowest 3.3 20.5 16.0 32.6 20.3 7.3 100.0 8.1 4,209 Second 0.4 8.1 11.0 30.8 30.2 19.5 100.0 10.1 4,629 Middle 0.3 3.5 5.5 23.5 36.8 30.3 100.0 10.5 4,918 Fourth 0.1 1.4 3.0 19.3 31.2 44.9 100.0 10.9 5,527 Highest 0.3 0.7 1.6 14.5 14.5 68.3 100.0 13.3 5,791 Total 0.8 6.1 6.9 23.4 26.4 36.4 100.0 10.6 25,074 1 No education includes respondents who completed nursery, kindergarten, or preschool only 2 Completed grade 6 at the primary level 3 Completed grade 10 of high school under the old educational system or completed grade 12 under the current K-12 educational system Characteristics of Respondents • 37 Table 3.4 Exposure to mass media Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Philippines NDHS 2017 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 16.8 78.6 36.9 9.9 14.8 4,897 20-24 15.3 76.9 38.1 10.0 15.6 4,175 25-29 13.8 76.8 35.4 8.9 16.4 3,717 30-34 13.6 76.7 35.1 7.0 14.8 3,243 35-39 15.3 75.8 36.1 8.2 15.6 3,360 40-44 14.3 76.7 35.2 8.6 16.5 2,837 45-49 13.3 77.8 36.0 8.1 14.5 2,845 Residence Urban 18.9 78.6 37.0 10.8 12.8 12,252 Rural 11.0 75.7 35.5 6.9 18.0 12,822 Region National Capital Region 25.1 73.6 38.4 13.0 11.5 4,400 Cordillera Admin. Region 21.5 66.1 30.2 14.9 27.5 440 I - Ilocos Region 16.2 90.3 51.0 11.0 5.7 1,258 II - Cagayan Valley 13.3 72.6 26.0 8.4 24.2 802 III - Central Luzon 15.1 87.8 24.0 10.5 9.4 2,453 IVA - CALABARZON 6.5 85.0 24.8 2.8 12.4 4,016 MIMAROPA Region 9.9 69.8 22.4 5.5 26.3 621 V - Bicol 5.1 79.8 35.6 3.1 13.6 1,551 VI - Western Visayas 15.2 80.4 54.7 10.6 9.4 1,498 VII - Central Visayas 30.3 75.2 56.2 19.6 14.2 1,607 VIII - Eastern Visayas 7.9 79.0 38.0 4.5 12.9 997 IX - Zamboanga Peninsula 9.5 76.7 41.4 6.8 15.3 764 X - Northern Mindanao 7.0 65.7 36.1 3.7 27.9 998 XI - Davao 16.1 64.9 34.1 7.6 24.0 1,203 XII - SOCCSKSARGEN 16.9 81.8 54.6 13.7 13.0 1,038 XIII - Caraga 14.6 70.0 38.9 9.7 21.1 648 ARMM 5.0 40.5 17.3 2.0 54.3 780 Education No education 3.8 34.3 23.9 3.3 56.9 200 Grades 1-6 4.8 63.0 32.4 3.0 27.5 3,245 Grades 7-10 11.5 78.5 36.0 7.1 14.5 11,558 Grade 11 20.8 83.3 36.3 12.4 11.1 934 Post-secondary 10.9 80.4 35.9 7.1 15.1 1,144 College 23.9 80.6 38.5 13.7 11.4 7,994 Wealth quintile Lowest 6.6 51.9 34.3 4.1 36.1 4,209 Second 9.5 77.1 36.5 5.5 16.6 4,629 Middle 13.8 83.9 36.4 8.9 10.7 4,918 Fourth 16.9 84.1 35.5 9.7 9.2 5,527 Highest 24.1 83.0 37.9 14.0 9.6 5,791 Total 14.8 77.1 36.2 8.8 15.5 25,074 38 • Characteristics of Respondents Table 3.5 Internet usage Percentage of women age 15-49 who have ever used the Internet and percentage who have used the Internet in the past 12 months, and among women who have used the Internet in the past 12 months, percent distribution by frequency of Internet use in the past month, according to background characteristics, Philippines NDHS 2017 Ever used the Internet Used the Internet in the past 12 months Number of women Among respondents who have used the Internet in the past 12 months, percentage who, in the past month, used the Internet: Background characteristic Almost every day At least once a week Less than once a week Not at all Total Number of women Age 15-19 88.9 87.7 4,897 55.3 31.6 12.2 0.8 100.0 4,292 20-24 86.1 83.6 4,175 59.3 25.9 13.8 1.1 100.0 3,492 25-29 76.1 73.8 3,717 50.8 31.6 16.6 1.0 100.0 2,745 30-34 67.3 65.4 3,243 50.0 29.4 19.5 1.1 100.0 2,120 35-39 60.4 58.0 3,360 53.1 32.3 13.4 1.2 100.0 1,948 40-44 48.5 46.6 2,837 43.5 37.1 18.6 0.9 100.0 1,321 45-49 40.6 38.4 2,845 46.3 31.3 21.6 0.8 100.0 1,094 Residence Urban 80.8 79.2 12,252 61.1 26.4 12.2 0.3 100.0 9,699 Rural 59.4 57.0 12,822 42.2 36.3 19.6 1.9 100.0 7,313 Region National Capital Region 90.3 88.9 4,400 69.9 20.6 9.5 0.0 100.0 3,913 Cordillera Admin. Region 69.5 68.1 440 43.5 38.6 17.3 0.6 100.0 299 I - Ilocos Region 62.5 59.9 1,258 53.1 31.7 13.2 2.1 100.0 754 II - Cagayan Valley 57.9 57.5 802 42.4 41.4 14.8 1.4 100.0 461 III - Central Luzon 75.5 73.6 2,453 55.3 24.9 19.5 0.4 100.0 1,805 IVA - CALABARZON 75.5 75.2 4,016 56.1 33.0 10.7 0.2 100.0 3,021 MIMAROPA Region 57.8 55.0 621 35.1 38.7 25.1 1.1 100.0 342 V - Bicol 62.5 58.5 1,551 34.7 35.0 26.7 3.6 100.0 908 VI - Western Visayas 61.2 59.1 1,498 41.8 40.3 17.0 0.9 100.0 885 VII - Central Visayas 74.1 71.3 1,607 55.2 29.2 14.3 1.3 100.0 1,146 VIII - Eastern Visayas 66.5 63.6 997 41.7 35.5 18.4 4.5 100.0 634 IX - Zamboanga Peninsula 56.9 50.7 764 43.7 36.0 16.9 3.4 100.0 388 X - Northern Mindanao 63.9 61.4 998 40.8 29.7 27.0 2.4 100.0 613 XI - Davao 63.6 61.0 1,203 44.8 35.2 19.1 0.9 100.0 734 XII - SOCCSKSARGEN 54.3 51.7 1,038 36.1 45.0 17.8 1.0 100.0 537 XIII - Caraga 65.3 63.2 648 44.1 34.5 20.2 1.2 100.0 410 ARMM 23.2 21.0 780 21.8 51.3 26.6 0.3 100.0 164 Education No education 10.9 10.2 200 * * * * 100.0 20 Grades 1-6 21.2 18.9 3,245 25.3 40.1 32.3 2.4 100.0 614 Grades 7-10 65.4 62.8 11,558 42.0 34.7 21.9 1.4 100.0 7,260 Grade 11 95.5 94.8 934 60.6 29.6 9.5 0.3 100.0 885 Post-secondary 84.2 80.9 1,144 51.9 32.9 14.2 1.0 100.0 926 College 92.5 91.4 7,994 65.4 25.6 8.4 0.6 100.0 7,307 Wealth quintile Lowest 32.3 29.0 4,209 18.3 40.5 36.7 4.5 100.0 1,222 Second 54.6 51.1 4,629 31.6 41.5 24.9 2.0 100.0 2,364 Middle 70.9 69.0 4,918 42.0 36.9 19.9 1.2 100.0 3,395 Fourth 83.9 82.4 5,527 56.2 30.5 12.9 0.4 100.0 4,553 Highest 95.1 94.6 5,791 74.1 20.0 5.7 0.1 100.0 5,478 Total 69.9 67.8 25,074 53.0 30.6 15.4 1.0 100.0 17,012 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Characteristics of Respondents • 39 Table 3.6 Employment status Percent distribution of women age 15-49 by employment status, according to background characteristics, Philippines NDHS 2017 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of women Background characteristic Currently employed1 Not currently employed Age 15-19 11.3 5.7 82.9 100.0 4,897 20-24 43.4 10.5 46.1 100.0 4,175 25-29 48.7 9.2 42.0 100.0 3,717 30-34 51.7 8.6 39.7 100.0 3,243 35-39 61.9 6.6 31.6 100.0 3,360 40-44 63.3 8.6 28.1 100.0 2,837 45-49 65.1 4.7 30.2 100.0 2,845 Marital status Never married 37.1 6.8 56.1 100.0 8,971 Married or living together 50.0 8.2 41.8 100.0 15,016 Divorced/separated/widowed 69.5 8.4 22.0 100.0 1,086 Number of living children 0 37.9 7.8 54.2 100.0 9,640 1-2 49.7 7.7 42.5 100.0 8,287 3-4 52.0 7.4 40.6 100.0 4,937 5+ 56.0 7.9 36.1 100.0 2,210 Residence Urban 49.3 6.5 44.2 100.0 12,252 Rural 43.2 8.9 47.9 100.0 12,822 Region National Capital Region 49.8 3.9 46.3 100.0 4,400 Cordillera Admin. Region 51.7 10.7 37.6 100.0 440 I - Ilocos Region 40.0 12.2 47.9 100.0 1,258 II - Cagayan Valley 45.4 7.3 47.2 100.0 802 III - Central Luzon 40.2 7.6 52.3 100.0 2,453 IVA - CALABARZON 47.3 8.3 44.4 100.0 4,016 MIMAROPA REGION 43.9 10.8 45.4 100.0 621 V - Bicol 47.4 9.8 42.8 100.0 1,551 VI - Western Visayas 46.9 10.1 43.0 100.0 1,498 VII - Central Visayas 57.8 8.7 33.5 100.0 1,607 VIII - Eastern Visayas 42.9 8.2 48.9 100.0 997 IX - Zamboanga Peninsula 42.3 7.1 50.5 100.0 764 X - Northern Mindanao 45.3 6.6 48.1 100.0 998 XI - Davao 47.1 4.8 48.1 100.0 1,203 XII - SOCCSKSARGEN 46.3 8.6 45.1 100.0 1,038 XIII - Caraga 49.3 13.9 36.9 100.0 648 ARMM 26.1 4.4 69.5 100.0 780 Education No education 46.3 6.4 47.3 100.0 200 Grades 1-6 46.7 8.6 44.8 100.0 3,245 Grades 7-10 39.4 8.4 52.2 100.0 11,558 Grade 11 6.0 4.3 89.7 100.0 934 Post-secondary 58.8 8.4 32.8 100.0 1,144 College 58.7 6.7 34.6 100.0 7,994 Wealth quintile Lowest 36.9 9.6 53.5 100.0 4,209 Second 41.1 10.1 48.8 100.0 4,629 Middle 44.9 9.0 46.1 100.0 4,918 Fourth 48.0 6.1 45.9 100.0 5,527 Highest 56.4 5.0 38.6 100.0 5,791 Total 46.2 7.7 46.1 100.0 25,074 1 “Currently employed” is defined as having done work in the past 7 days. Includes persons who did not work in the past 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 40 • Characteristics of Respondents Table 3.7 Occupation Percent distribution of women age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Philippines NDHS 2017 Background characteristic Profes- sional/ technical/ mana- gerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agri- cultural Armed forces Missing Total Number of women Age 15-19 4.1 4.4 40.3 4.5 13.6 19.6 12.4 0.6 0.4 100.0 836 20-24 23.6 16.1 30.6 5.1 11.8 6.0 5.1 1.0 0.6 100.0 2,251 25-29 27.3 14.1 28.8 6.2 10.0 5.6 7.4 0.0 0.7 100.0 2,155 30-34 30.3 10.8 27.3 4.1 11.5 6.0 9.7 0.0 0.2 100.0 1,954 35-39 31.7 10.9 23.8 5.9 11.4 4.7 11.2 0.0 0.5 100.0 2,300 40-44 29.9 5.6 22.3 5.7 13.3 8.7 14.1 0.1 0.3 100.0 2,040 45-49 31.2 3.9 24.5 6.7 11.2 7.6 14.1 0.7 0.1 100.0 1,987 Marital status Never married 26.1 14.3 27.0 6.7 10.5 9.4 4.4 0.8 0.8 100.0 3,937 Married or living together 28.4 8.1 27.0 5.2 12.2 5.6 13.2 0.1 0.2 100.0 8,737 Divorced/separated/widowed 23.6 9.6 29.2 4.4 11.8 13.9 7.2 0.3 0.0 100.0 847 Number of living children 0 27.6 14.8 26.5 6.4 9.6 8.9 4.7 0.6 0.8 100.0 4,412 1-2 30.6 10.9 28.8 4.7 10.8 5.3 8.6 0.1 0.2 100.0 4,762 3-4 26.9 4.9 27.6 5.3 13.8 7.4 13.9 0.1 0.1 100.0 2,934 5+ 17.0 3.1 22.3 6.2 16.6 7.8 25.8 0.7 0.3 100.0 1,413 Residence Urban 28.0 13.8 28.0 6.0 12.1 7.8 3.3 0.6 0.5 100.0 6,842 Rural 26.8 6.2 26.3 5.1 11.2 6.6 17.4 0.1 0.3 100.0 6,680 Region National Capital Region 32.0 19.7 20.8 7.1 7.5 10.4 0.4 1.3 0.9 100.0 2,365 Cordillera Admin. Region 27.2 6.5 22.5 1.1 10.9 3.1 27.5 0.2 0.9 100.0 275 I - Ilocos Region 21.9 4.3 32.3 4.8 12.8 11.9 11.2 0.0 0.7 100.0 656 II - Cagayan Valley 24.8 4.8 26.2 1.2 12.9 6.4 23.6 0.1 0.1 100.0 423 III - Central Luzon 28.2 11.4 31.7 7.3 10.0 5.4 5.7 0.1 0.3 100.0 1,171 IVA - CALABARZON 28.0 12.8 23.9 8.8 18.0 5.9 2.3 0.0 0.3 100.0 2,235 MIMAROPA Region 24.5 4.3 31.2 3.9 10.6 7.4 17.8 0.2 0.0 100.0 339 V - Bicol 23.3 4.8 32.8 5.1 14.5 7.9 11.3 0.2 0.0 100.0 887 VI - Western Visayas 25.8 5.1 27.4 3.3 11.1 9.0 18.0 0.3 0.1 100.0 854 VII - Central Visayas 23.9 9.4 30.9 4.6 13.3 5.5 11.9 0.2 0.3 100.0 1,070 VIII - Eastern Visayas 29.8 6.9 34.7 4.2 10.4 6.8 6.6 0.0 0.5 100.0 509 IX - Zamboanga Peninsula 30.1 3.8 25.5 5.5 10.6 5.7 17.6 0.0 1.2 100.0 378 X - Northern Mindanao 25.8 6.6 29.8 2.6 12.5 5.7 16.6 0.2 0.2 100.0 518 XI - Davao 29.4 9.4 30.8 3.6 6.4 6.6 13.1 0.5 0.0 100.0 624 XII - SOCCSKSARGEN 24.9 5.9 27.6 5.1 7.9 4.8 23.7 0.1 0.0 100.0 571 XIII - Caraga 27.3 6.6 26.2 3.5 12.3 5.5 18.0 0.0 0.6 100.0 409 ARMM 28.9 0.6 16.6 2.1 7.4 4.5 39.8 0.0 0.0 100.0 238 Education No education 13.4 1.0 10.1 5.0 9.0 5.0 55.5 0.0 0.9 100.0 105 Grades 1-6 10.5 0.3 20.9 7.1 16.8 11.9 31.6 0.5 0.3 100.0 1,793 Grades 7-10 15.0 2.8 35.5 6.9 17.1 11.2 11.4 0.1 0.0 100.0 5,528 Grade 11 4.1 3.5 33.0 6.0 14.1 22.9 16.2 0.0 0.1 100.0 96 Post-secondary 29.4 14.7 30.2 8.0 11.2 3.6 2.9 0.0 0.0 100.0 769 College 46.7 20.6 20.2 3.2 4.3 1.7 1.9 0.6 0.9 100.0 5,231 Wealth quintile Lowest 7.9 0.5 22.4 4.4 16.8 9.1 38.4 0.4 0.1 100.0 1,958 Second 16.0 3.6 33.7 6.1 16.2 8.2 15.9 0.2 0.1 100.0 2,371 Middle 23.1 6.1 35.7 6.5 16.3 5.7 6.0 0.1 0.5 100.0 2,650 Fourth 32.1 14.9 29.9 7.1 9.2 4.6 2.0 0.1 0.1 100.0 2,988 Highest 45.1 18.4 16.6 3.8 4.4 8.8 1.2 0.8 0.9 100.0 3,553 Total 27.4 10.0 27.1 5.6 11.7 7.2 10.3 0.3 0.4 100.0 13,521 Characteristics of Respondents • 41 Table 3.8 Type of employment Percent distribution of women age 15-49 employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to agricultural or nonagricultural occupation, Philippines NDHS 2017 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 45.1 82.4 78.6 Cash and in-kind 4.8 2.8 3.0 In-kind only 4.8 0.3 0.8 Not paid 45.3 14.5 17.6 Total 100.0 100.0 100.0 Type of employer Employed by family member 27.3 8.4 10.3 Employed by non-family member 41.8 65.8 63.5 Self-employed 30.9 25.8 26.2 Total 100.0 100.0 100.0 Continuity of employment All year 46.0 72.2 69.6 Seasonal 44.7 23.2 25.3 Occasional 9.3 4.6 5.1 Total 100.0 100.0 100.0 Number of women employed in the 12 months preceding the survey 1,390 12,078 13,521 Note: Total includes 54 women with missing information on type of employment who are not shown separately. 42 • C ha ra ct er is tic s of R es po nd en ts 42 • Characteristics of Respondents Ta bl e 3. 9 H ea lth in su ra nc e co ve ra ge P er ce nt ag e of w om en a ge 1 5- 49 w ith s pe ci fic ty pe s of h ea lth in su ra nc e co ve ra ge , p er ce nt ag e w ith a ny P hi lH ea lth in su ra nc e, a nd p er ce nt ag e w ith a ny o th er h ea lth in su ra nc e, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, P hi lip pi ne s N D H S 2 01 7 P hi lH ea lth in su ra nc e by ty pe o f c ov er ag e: G S IS S S S P riv at e1 O th er N on e D on ’t kn ow A ny P hi lH ea lth in su ra nc e A ny o th er he al th in su ra nc e N um be r o f w om en B ac kg ro un d ch ar ac te ris tic Fo rm al ec on om y In fo rm al ec on om y In di ge nt / N H TS -P R S po ns or ed Li fe tim e m em be rs S en io r ci tiz en O ve rs ea s Fi lip in o m em be r A ge 15 -1 9 24 .6 7. 0 23 .8 3. 7 0. 1 0. 5 1. 0 1. 2 12 .5 1. 4 0. 0 37 .4 0. 4 60 .2 14 .3 4, 89 7 20 -2 4 33 .8 7. 8 6. 8 1. 9 0. 1 0. 1 0. 3 1. 9 29 .2 1. 9 0. 0 46 .7 0. 2 50 .7 30 .8 4, 17 5 25 -2 9 36 .5 9. 0 15 .3 3. 6 0. 1 0. 1 0. 6 2. 8 31 .7 3. 5 0. 0 32 .4 0. 2 64 .7 34 .3 3, 71 7 30 -3 4 34 .0 11 .1 18 .6 4. 2 0. 2 0. 0 1. 2 3. 7 29 .0 2. 9 0. 0 27 .9 0. 1 68 .6 32 .6 3, 24 3 35 -3 9 35 .5 12 .5 19 .6 4. 2 0. 2 0. 1 1. 2 5. 4 32 .3 5. 4 0. 0 24 .3 0. 1 72 .7 36 .9 3, 36 0 40 -4 4 31 .4 11 .2 24 .5 4. 0 0. 0 0. 2 1. 5 4. 7 26 .9 4. 1 0. 1 23 .9 0. 1 72 .3 32 .3 2, 83 7 45 -4 9 29 .7 12 .3 23 .9 4. 2 0. 2 0. 2 0. 2 6. 0 24 .6 4. 4 0. 0 25 .3 0. 1 70 .3 30 .0 2, 84 5 R es id en ce U rb an 43 .7 9. 3 9. 1 2. 2 0. 1 0. 2 0. 7 3. 1 37 .3 4. 6 0. 0 31 .1 0. 2 65 .0 40 .5 12 ,2 52 R ur al 20 .7 10 .2 27 .6 4. 9 0. 1 0. 2 1. 0 3. 6 14 .9 1. 8 0. 0 33 .5 0. 1 64 .1 18 .5 12 ,8 22 R eg io n N at io na l C ap ita l R eg io n 60 .8 4. 4 3. 0 1. 3 0. 1 0. 1 0. 5 2. 8 52 .2 6. 1 0. 0 25 .4 0. 1 70 .0 55 .1 4, 40 0 C or di lle ra A dm in . R eg io n 17 .9 21 .1 19 .9 6. 7 0. 0 0. 1 0. 8 6. 8 19 .1 1. 2 0. 0 30 .5 0. 8 66 .5 23 .4 44 0 I - Il oc os R eg io n 18 .3 16 .7 25 .3 0. 8 0. 0 0. 0 0. 6 4. 7 18 .7 0. 4 0. 0 34 .9 0. 0 61 .1 22 .1 1, 25 8 II - C ag ay an V al le y 16 .9 24 .8 21 .1 1. 0 0. 0 0. 0 0. 5 4. 0 7. 0 1. 2 0. 0 34 .8 0. 7 63 .6 10 .2 80 2 III - C en tra l L uz on 38 .1 16 .4 5. 4 5. 0 0. 2 0. 0 1. 1 3. 7 30 .6 2. 7 0. 0 31 .4 0. 0 66 .1 34 .1 2, 45 3 IV A - C A LA B A R ZO N 40 .3 9. 8 8. 4 2. 0 0. 0 0. 1 2. 2 2. 4 28 .4 5. 1 0. 0 35 .3 0. 1 62 .4 32 .0 4, 01 6 M IM A R O P A R eg io n 20 .1 10 .7 22 .6 12 .6 0. 2 0. 1 0. 6 4. 3 15 .0 1. 2 0. 0 30 .8 0. 7 66 .6 18 .2 62 1 V - B ic ol 15 .8 5. 8 28 .4 10 .3 0. 1 0. 0 0. 3 3. 9 10 .5 0. 5 0. 0 38 .9 0. 0 59 .8 14 .4 1, 55 1 V I - W es te rn V is ay as 21 .0 6. 6 30 .1 2. 7 0. 1 0. 8 0. 5 4. 0 20 .0 1. 7 0. 0 34 .6 0. 3 61 .2 23 .6 1, 49 8 V II - C en tra l V is ay as 32 .4 2. 4 18 .2 2. 2 0. 0 1. 0 0. 6 3. 3 29 .6 5. 8 0. 0 37 .2 0. 5 56 .5 33 .2 1, 60 7 V III - E as te rn V is ay as 18 .3 6. 8 34 .9 4. 4 1. 1 0. 0 0. 5 5. 1 8. 2 2. 2 0. 0 32 .0 0. 1 65 .5 13 .2 99 7 IX - Za m bo an ga P en in su la 10 .9 9. 9 43 .6 3. 1 0. 0 0. 4 0. 4 2. 7 12 .0 1. 0 0. 0 26 .9 0. 4 67 .7 15 .2 76 4 X - N or th er n M in da na o 23 .4 8. 1 20 .8 12 .9 0. 3 0. 0 0. 5 3. 3 20 .6 0. 7 0. 0 33 .4 0. 0 64 .2 23 .1 99 8 X I - D av ao 23 .8 16 .9 31 .0 1. 1 0. 0 0. 0 0. 5 2. 7 22 .8 3. 1 0. 0 25 .3 0. 0 73 .1 26 .6 1, 20 3 X II - S O C C S K S A R G E N 16 .0 14 .4 35 .9 3. 4 0. 1 0. 2 0. 6 3. 3 9. 7 2. 0 0. 0 28 .5 0. 3 70 .2 13 .0 1, 03 8 X III - C ar ag a 19 .3 11 .5 32 .7 5. 0 0. 3 0. 3 0. 4 4. 7 20 .1 1. 2 0. 0 28 .7 1. 0 68 .6 22 .5 64 8 A R M M 6. 3 2. 3 39 .2 0. 8 0. 1 0. 2 0. 3 1. 9 1. 1 0. 1 0. 0 50 .9 0. 0 48 .9 2. 8 78 0 E du ca tio n N o ed uc at io n 9. 1 0. 6 46 .6 5. 7 0. 0 0. 1 0. 0 2. 0 1. 8 0. 0 0. 0 38 .0 0. 0 62 .0 3. 2 20 0 G ra de s 1- 6 7. 6 5. 3 36 .8 6. 2 0. 0 0. 3 0. 1 0. 1 5. 6 0. 5 0. 0 42 .5 0. 1 55 .7 6. 1 3, 24 5 G ra de s 7- 10 22 .4 9. 6 22 .7 4. 5 0. 1 0. 1 0. 6 0. 4 17 .9 1. 0 0. 0 37 .5 0. 2 59 .7 18 .7 11 ,5 58 G ra de 1 1 27 .1 10 .7 20 .6 3. 2 0. 1 1. 3 1. 0 1. 7 12 .0 2. 8 0. 0 33 .1 0. 1 63 .5 15 .3 93 4 P os t-s ec on da ry 46 .8 15 .4 8. 0 1. 9 0. 2 0. 1 1. 3 2. 1 44 .0 4. 1 0. 0 22 .9 0. 4 73 .3 46 .3 1, 14 4 C ol le ge 54 .5 11 .1 5. 8 1. 4 0. 2 0. 1 1. 4 9. 5 45 .2 7. 3 0. 0 21 .9 0. 2 74 .1 53 .8 7, 99 4 W ea lth q ui nt ile Lo w es t 4. 9 3. 6 43 .7 6. 2 0. 1 0. 4 0. 1 0. 1 3. 2 0. 3 0. 0 40 .6 0. 1 58 .6 3. 6 4, 20 9 S ec on d 14 .1 7. 8 32 .8 5. 0 0. 0 0. 2 0. 2 0. 7 11 .2 0. 7 0. 0 38 .4 0. 3 59 .5 12 .2 4, 62 9 M id dl e 27 .9 9. 0 18 .4 4. 0 0. 3 0. 1 0. 4 1. 7 22 .1 1. 8 0. 0 37 .5 0. 2 59 .5 24 .1 4, 91 8 Fo ur th 44 .1 12 .8 5. 8 3. 0 0. 2 0. 2 0. 9 3. 9 35 .0 2. 3 0. 0 29 .5 0. 2 66 .8 38 .4 5, 52 7 H ig he st 57 .4 13 .6 1. 3 0. 8 0. 1 0. 1 2. 2 8. 9 48 .5 9. 1 0. 0 19 .9 0. 2 75 .2 57 .1 5, 79 1 To ta l 31 .9 9. 8 18 .6 3. 6 0. 1 0. 2 0. 8 3. 4 25 .9 3. 2 0. 0 32 .3 0. 2 64 .6 29 .2 25 ,0 74 N ot e: R es ul ts re fe r t o w om en in te rv ie w ed w ith th e W om an ’s Q ue st io nn ai re , a lth ou gh d at a ar e ta ke n fro m th e H ou se ho ld Q ue st io nn ai re ; t hu s, a ns w er s m ay n ot b e pr ov id ed b y th e w om an h er se lf bu t r at he r b y th e re sp on de nt to th e H ou se ho ld Q ue st io nn ai re . P er ce nt ag es d o no t s um to 1 00 % b ec au se re sp on de nt s m ay re po rt m or e th an o ne ty pe o f i ns ur an ce . G S IS = G ov er nm en t S er vi ce In su ra nc e S ys te m S S S = S oc ia l S ec ur ity S ys te m N H TS -P R = N at io na l H ou se ho ld T ar ge tin g S ys te m fo r P ov er ty R ed uc tio n 1 In cl ud es p riv at e in su ra nc e co m pa ny , h ea lth m ai nt en an ce o rg an iz at io n, a nd p re -n ee d in su ra nc e pl an c om pa ny Characteristics of Respondents • 43 Table 3.10 Tobacco smoking Percentage of women age 15-49 who smoke various tobacco products, according to background characteristics, Philippines NDHS 2017 Percentage who smoke:1 Number of women Background characteristic Cigarettes2 Other type of tobacco3 Any type of tobacco Age 15-19 2.4 0.6 2.4 4,897 20-24 5.2 1.2 5.3 4,175 25-29 5.9 1.9 6.0 3,717 30-34 6.5 2.3 6.6 3,243 35-39 5.2 2.0 5.4 3,360 40-44 5.7 2.0 5.9 2,837 45-49 5.1 2.3 5.2 2,845 Maternity status Pregnant 2.3 0.8 2.3 1,028 Breastfeeding 3.9 1.6 4.0 3,466 Neither pregnant nor breastfeeding 5.3 1.7 5.4 20,580 Residence Urban 5.8 2.1 5.9 12,252 Rural 4.2 1.2 4.3 12,822 Region National Capital Region 7.9 3.4 7.9 4,400 Cordillera Admin. Region 2.7 1.0 3.0 440 I - Ilocos Region 2.9 1.0 2.9 1,258 II - Cagayan Valley 4.5 2.5 4.6 802 III - Central Luzon 5.8 2.7 5.9 2,453 IVA - CALABARZON 6.1 0.6 6.1 4,016 MIMAROPA Region 1.9 0.6 2.0 621 V - Bicol 4.2 0.3 4.2 1,551 VI - Western Visayas 3.9 1.7 3.9 1,498 VII - Central Visayas 4.1 1.1 4.5 1,607 VIII - Eastern Visayas 3.6 1.4 3.7 997 IX - Zamboanga Peninsula 3.3 0.9 3.4 764 X - Northern Mindanao 3.1 0.4 3.1 998 XI - Davao 4.5 2.5 4.5 1,203 XII - SOCCSKSARGEN 4.2 1.4 4.4 1,038 XIII - Caraga 4.4 1.9 5.9 648 ARMM 1.6 0.9 1.7 780 Education No education 4.3 1.8 5.1 200 Grades 1-6 5.9 1.8 6.1 3,245 Grades 7-10 5.9 2.1 5.9 11,558 Grade 11 1.2 0.2 1.3 934 Post-secondary 5.3 1.6 5.4 1,144 College 3.8 1.1 3.9 7,994 Wealth quintile Lowest 4.8 1.6 4.9 4,209 Second 4.7 2.0 4.9 4,629 Middle 5.1 1.6 5.2 4,918 Fourth 5.7 1.6 5.9 5,527 Highest 4.6 1.5 4.6 5,791 Total 5.0 1.7 5.1 25,074 1 Includes daily and occasional (less than daily) use 2 Cigarettes include kreteks 3 Includes pipes full of tobacco, cigars, cheroots, cigarillos, and water pipes 44 • Characteristics of Respondents Table 3.11 Smokeless tobacco use and any tobacco use Percentage of women age 15-49 who currently use smokeless tobacco, according to type of tobacco product, and percentage who use any type of tobacco, Philippines NDHS 2017 Tobacco product Percentage Snuff, by mouth 0.0 Chewing tobacco 0.1 Betel quid with tobacco 0.1 Any type of smokeless tobacco1 0.3 Any type of tobacco2 5.3 Number of women 25,074 Note: Table includes women who use smokeless tobacco daily or occasionally (less than daily). 1 Includes snuff by mouth, snuff by nose, chewing tobacco, and betel quid with tobacco 2 Includes all types of smokeless tobacco shown in this table along with cigarettes, kreteks, pipes, cigars, cheroots, cigarillos, and water pipes Characteristics of Respondents • 45 Table 3.12 Alcohol consumption Percent distribution of women age 15-49 by frequency of alcohol consumption, and among women who drink alcohol every day, average number of alcoholic drinks they consume each day, according to background characteristics, Philippines NDHS 2017 Background characteristic Percentage who drink alcohol: Total Number of women Among women who drink alcohol every day: Average number of alcoholic drinks consumed Number of women Every day Some days Not at all Age 15-19 0.1 16.0 83.9 100.0 4,897 * 2 20-24 0.3 30.8 68.9 100.0 4,175 * 13 25-29 0.3 31.9 67.8 100.0 3,717 * 10 30-34 0.3 28.1 71.6 100.0 3,243 * 9 35-39 0.1 28.5 71.4 100.0 3,360 * 5 40-44 0.4 24.2 75.4 100.0 2,837 * 11 45-49 0.5 23.1 76.4 100.0 2,845 * 14 Maternity status Pregnant 0.1 16.8 83.1 100.0 1,028 * 1 Breastfeeding 0.3 22.6 77.2 100.0 3,466 * 10 Neither pregnant nor breastfeeding 0.3 26.8 72.9 100.0 20,580 2.2 54 Residence Urban 0.3 30.1 69.6 100.0 12,252 (2.9) 32 Rural 0.3 21.7 78.1 100.0 12,822 (1.7) 33 Region National Capital Region 0.1 36.9 63.0 100.0 4,400 * 5 Cordillera Admin. Region 0.2 27.0 72.7 100.0 440 * 1 I - Ilocos Region 0.2 14.3 85.4 100.0 1,258 * 3 II - Cagayan Valley 0.7 10.9 88.4 100.0 802 * 6 III - Central Luzon 0.7 18.8 80.6 100.0 2,453 * 17 IVA - CALABARZON 0.2 22.9 76.9 100.0 4,016 * 8 MIMAROPA Region 0.5 26.3 73.3 100.0 621 * 3 V - Bicol 0.2 34.5 65.3 100.0 1,551 * 3 VI - Western Visayas 0.3 14.7 85.0 100.0 1,498 * 4 VII - Central Visayas 0.3 32.1 67.6 100.0 1,607 * 5 VIII - Eastern Visayas 0.3 59.8 40.0 100.0 997 * 2 IX - Zamboanga Peninsula 0.2 20.8 79.0 100.0 764 * 2 X - Northern Mindanao 0.1 15.2 84.7 100.0 998 * 1 XI - Davao 0.2 21.7 78.0 100.0 1,203 * 3 XII - SOCCSKSARGEN 0.3 14.9 84.8 100.0 1,038 * 3 XIII - Caraga 0.0 48.0 51.9 100.0 648 nc 0 ARMM 0.0 1.1 98.9 100.0 780 nc 0 Education No education 0.2 12.9 87.0 100.0 200 nc 0 Grades 1-6 0.3 21.6 78.1 100.0 3,245 * 11 Grades 7-10 0.4 23.7 75.9 100.0 11,558 (2.3) 41 Grade 11 0.0 13.2 86.8 100.0 934 nc 0 Post-secondary 0.1 30.4 69.5 100.0 1,144 * 2 College 0.1 31.6 68.2 100.0 7,994 * 11 Wealth quintile Lowest 0.3 18.5 81.2 100.0 4,209 * 12 Second 0.3 22.1 77.6 100.0 4,629 * 13 Middle 0.4 26.5 73.2 100.0 4,918 * 18 Fourth 0.3 29.7 70.0 100.0 5,527 * 17 Highest 0.1 29.7 70.2 100.0 5,791 * 5 Total 0.3 25.8 73.9 100.0 25,074 2.3 65 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. nc = No cases Marriage and Exposure to the Risk of Pregnancy • 47 MARRIAGE AND EXPOSURE TO THE RISK OF PREGNANCY 4 Key Findings Marital status: 60% of women age 15-49 are currently in a union; 42% are formally married and 18% are living together in a consensual union but are not formally married. Age at first marriage: The median age at first marriage among women age 25-49 is 22.5 years. Age at menarche: The mean age at first menstruation among women age 15-49 is 13.1 years. Age at first sexual intercourse: The median age at first sexual intercourse among women age 25-49 is 21.2 years. Thus, on average, women have sexual intercourse about 1.3 years before marriage. Recent sexual activity: 45% of women had sexual intercourse within the 4 weeks preceding the survey. Spousal separation: 20% of currently married women have ever lived separately from their husband or partner; among these women, 44% lived separately from their husband or partner for 1-11 months during the past 2 years. arriage and sexual activity help determine the extent to which women are exposed to the risk of pregnancy. Thus, they are important determinants of fertility levels. However, the timing and circumstances of marriage and sexual activity also have other profound consequences for women’s lives. 4.1 MARITAL STATUS Currently married Women who report being married or living together with a partner as though married at the time of the survey Sample: Women age 15-49 Sixty percent of women age 15-49 are currently married (also referred to as currently in a union); that is, they are either married (42%) or are living together in consensual unions (18%). Thirty-six percent of women age 15-49 have never been married. Three percent of women are divorced, have had their marriage annulled, or are separated; 1% are widowed (Figure 4.1). As expected, the percentage of women who have never been married decreases as age increases (Table 4.1), dropping from 91% among those age 15-19 to 8% among those age 45-49. Among young women who are in union, greater percentages are living together with a partner than are formally married, especially among those age 20-24: 26% of women in this age group are living together as if married and 15% are formally married. By age 25-29, the pattern is reversed (28% are living together with a partner and 43% are formally married). Taken together, these findings suggest that living together with a partner is a temporary marital arrangement, one that may lead to a formal marriage or separation. M 48 • Marriage and Exposure to the Risk of Pregnancy Trends: The percentage of women age 15-49 who are currently in union (60%) is the same as it was in 1993. However, the composition of the union has shifted. In 1993, 54% of women were formally married and only 5% were living together, while in 2017, 42% were formally married and 18% were living together. 4.2 AGE AT FIRST MARRIAGE Median age at first marriage Age by which half of respondents have been married. Sample: Women age 20-49 and 25-49 The median age at first marriage among women age 25-49 is 22.5 years (Table 4.2). In the Philippines, the legal age of marriage is 18 years, although marriage before this age is permitted among the indigenous peoples and among Muslims. Only 2% of women age 25-49 report that they were first married by age 15, and 15% were first married by age 18. By age 20, 31% of women were married, and by age 25, 65% were married. Trends: The percentage of women age 25-49 who had their first marriage by age 18 decreased slightly from 19% in 1993 to 15% in 2013 and remained at 15% in 2017 (Figure 4.2). Patterns by background characteristics  The percentage of never-married women decreases with increasing age. Ninety-one percent of women age 15-19 have never been married, as compared with only 57% of women age 20-24 and 26% of women age 25-29 (Table 4.2).  On average, women from urban areas marry about 1.5 years later than their rural counterparts (Figure 4.3).  The median age at first marriage among women age 25-49 varies by region, from a high of 24.2 years in the National Capital Region (NCR), the only region that is 100% urban, to a low of 20.8 years in the Autonomous Region in Muslim Mindanao (ARMM) (Table 4.3).  Median age at first marriage increases with increasing education and wealth. Figure 4.1 Marital status Figure 4.2 Trends in early sexual intercourse and marriage Figure 4.3 Women’s median age at first marriage by residence Never married 36% Married 42% Living together 18% Divorced/ annulled/ separated 3% Widowed 1% Percent distribution of women age 15-49 20 18 18 19 18 18 19 17 17 16 15 15 1993 NDS 1998 NDHS 2003 NDHS 2008 NDHS 2013 NDHS 2017 NDHS Percentage of women age 25-49 who had first sexual intercourse and were first married by age 18 First sex First marriage 22.5 23.3 21.8 Total Urban Rural Median age in years among women age 25-49 Marriage and Exposure to the Risk of Pregnancy • 49 4.3 AGE AT FIRST MENSTRUATION (MENARCHE) The start of puberty is marked by the onset of menstruation (menarche). The mean age at first menstruation among women age 15-49 is 13.1 years (Table 4.4). A look at mean age at menarche across different age groups indicates a declining trend over time. The mean age at first menstruation among the oldest group of women (age 45-49) is 13.5 years, while the mean age among the youngest group (age 15-19) is 12.8 years. This observation is supported by examining trends across surveys; the mean age at first menstruation among women age 15-49 decreased from 13.3 years in 2003 to 13.2 years in 2008 and 13.1 years in both 2013 and 2017. 4.4 AGE AT FIRST SEXUAL INTERCOURSE Median age at first sexual intercourse Age by which half of respondents have had sexual intercourse. Sample: Women age 20-49 and 25-49 Age at first sexual intercourse is another important indicator of the beginning of a woman’s exposure to the risk of childbearing and is thus a staple in demographic surveys. In the NDHS 2017, women were asked how old they were when they had sexual intercourse for the first time. The median age at first sexual intercourse among women age 25-49 is 21.2 years. Eighteen percent of women age 25- 49 engaged in sexual intercourse before age 18 and 56% by age 22. By age 25, 73% of women have had sexual intercourse (Table 4.5). A comparison of the median age at first intercourse with the median age at first marriage can be used as a measure of whether people are engaging in sex before marriage. The median age at first intercourse among women age 25-49 is more than 1 year younger than the median age at first marriage (21.2 years versus 22.5 years) (Figure 4.4). Trends: The percentage of women age 25-49 who had sexual intercourse by age 18 decreased slightly from 20% in 1993 to 18% in 2013 and 2017. Juxtaposing age at first sexual intercourse and age at first marriage reveals a widening gap between the percentage of women who had sexual intercourse by age 18 and the percentage married by age 18 (Figure 4.2). Patterns by background characteristics  In general, the median age at first sexual intercourse is higher among older cohorts of women than among younger cohorts. For example, the median age at first sexual intercourse among women age 40- 44 is 21.8 years, as compared with 20.4 years among women age 25-29 (Table 4.6).  Women age 25-49 in rural areas begin having sex about a year earlier than women in urban areas. The median age at first sex is 20.8 years among rural women and 21.6 years among urban women.  By region, the median age at first sexual intercourse among women age 25-49 varies from a low of 20.2 years in Davao to a high of 22.4 years in both NCR and Cordillera Administrative Region (CAR).  Median age at first sex increases by 6 years with increasing educational attainment, rising from 18.1 years among women age 25-49 with no education to 23.9 years among women with a college education. The largest difference (2.6 years) in median age is between those who have reached grades 7-10 and those with a post-secondary education (20.3 years versus 22.9 years). Figure 4.4 Median age at first sex and first marriage 21.2 22.5 Median age at first sex Median age at first marriage Median age in years among women age 25-49 50 • Marriage and Exposure to the Risk of Pregnancy  Median age at first sex also increases with increasing household wealth, from 19.4 years among women age 25-49 in the lowest wealth quintile to 23.4 years among women in the highest quintile. 4.5 RECENT SEXUAL ACTIVITY Sexual activity exposes women to the risk of pregnancy, particularly in the absence of contraception. Seven out of 10 women age 15-49 reported ever having sexual intercourse, with a large percentage (45%) reporting having had sex within the 4 weeks before the survey (Table 4.7). Fifteen percent of women had sex within the past year but not during the 4 weeks immediately prior to the survey, and 10% had not had sexual intercourse within the year before the survey. Patterns by background characteristics  Three quarters (73%) of currently married women had sexual intercourse within the 4 weeks before the survey. In contrast, 77% of women who are divorced, separated, or widowed did not have sexual intercourse within the year before the survey.  With the exception of women with a marital duration of less than 5 years, the percentage of currently married women reporting sexual activity within the past 4 weeks declines with marital duration, from 78% among those married 5-9 years to 63% among those married 25 or more years.  The percentage of women who had sexual intercourse in the 4 weeks before the survey is higher among those in rural areas than those in urban areas (48% versus 41%).  More than half of women in Davao, SOCCSKSARGEN, Northern Mindanao, and Cagayan Valley reported that their last sexual intercourse occurred within the 4 weeks before the survey. In contrast, only 36% of women in NCR and 37% of women in CAR reported recent sexual intercourse. 4.6 SPOUSES LIVING SEPARATELY Spouses living separately, whether permanently or temporarily, is also a useful indicator of sexual exposure, the need for contraception (if desired), and consequently the risk of pregnancy. In the Philippines, where overseas labor migration is commonplace, this indicator is particularly important in understanding fertility among women and designing programs for them. Overall, one out of five (20%) currently married women have ever lived separately from their husband or partner. Among currently married women who have lived separately from their partner, 44% have lived separately for a period of 1-11 months in the past 2 years, 13% for a period of 12-23 months, and 9% for longer than 23 months. Overall, 6% of currently married women report having lived separately from their husband or partner in the past 2 years because one of them lived abroad (Table 4.8). Patterns by background characteristics  The percentage of currently women who have ever lived separately from their husband peaks among those age 30-39 (22%).  The percentage of currently married women who report having ever lived separately from their husband is highest in Bicol (35%), followed by Caraga (33%) and Eastern Visayas (31%). Only 8% of women from ARMM report having ever lived separately from their husband.  Surprisingly, the regions where the highest percentages of currently married women reported that they had ever lived separately from their husbands do not overlap with the regions where the highest percentages of women lived separately from their husbands in the past 2 years because one of them lived overseas. The regions with the highest prevalence of one of the spouses having lived overseas are Marriage and Exposure to the Risk of Pregnancy • 51 CALABARZON (9% of currently married women) and Central Visayas (8% of currently married women).  The percentage of currently married women who have ever lived separately from their husband increases with increasing household wealth. Strikingly, only 1% of women in the lowest wealth quintile report having lived separately from their husband in the past 2 years because one of them lived overseas, as compared with 15% of women in the highest quintile. Similar patterns are observed with increasing educational attainment. LIST OF TABLES For more information on marriage and the risk of pregnancy, see the following tables:  Table 4.1 Current marital status  Table 4.2 Age at first marriage  Table 4.3 Median age at first marriage by background characteristics  Table 4.4 Age at first menstruation  Table 4.5 Age at first sexual intercourse  Table 4.6 Median age at first sexual intercourse according to background characteristics  Table 4.7 Recent sexual activity  Table 4.8 Spousal separations 52 • Marriage and Exposure to the Risk of Pregnancy Table 4.1 Current marital status Percent distribution of women age 15-49 by current marital status, according to age, Philippines NDHS 2017 Marital status Total Percentage of women currently in union Number of women Age Never married Married Living together Divorced/ annulled Separated Widowed 15-19 90.9 1.4 7.1 0.0 0.5 0.1 100.0 8.5 4,897 20-24 56.5 15.2 26.0 0.1 2.2 0.1 100.0 41.1 4,175 25-29 25.8 42.8 27.9 0.2 3.1 0.3 100.0 70.7 3,717 30-34 12.9 60.3 21.8 0.1 3.9 0.9 100.0 82.1 3,243 35-39 10.9 65.4 17.2 0.2 4.5 1.8 100.0 82.6 3,360 40-44 6.6 74.4 11.7 0.3 5.1 1.9 100.0 86.1 2,837 45-49 8.2 73.3 10.1 0.3 4.1 4.1 100.0 83.4 2,845 Total 15-49 35.8 42.4 17.5 0.2 3.1 1.1 100.0 59.9 25,074 Table 4.2 Age at first marriage Percentage of women age 15-49 who were first married by specific exact ages and median age at first marriage, according to current age, Philippines NDHS 2017 Percentage first married by exact age: Percentage never married Number of women Median age at first marriage Current age 15 18 20 22 25 15-19 1.1 na na na na 90.9 4,897 a 20-24 2.2 16.5 30.6 na na 56.5 4,175 a 25-29 2.3 16.7 35.4 50.5 66.3 25.8 3,717 21.9 30-34 2.2 14.3 31.3 49.2 68.9 12.9 3,243 22.1 35-39 2.7 13.3 29.1 43.4 63.9 10.9 3,360 22.9 40-44 2.6 14.1 28.2 43.7 64.1 6.6 2,837 22.9 45-49 2.1 14.7 29.3 44.4 62.1 8.2 2,845 22.7 20-49 2.4 15.1 30.8 na na 22.4 20,177 a 25-49 2.4 14.7 30.9 46.4 65.2 13.5 16,002 22.5 Note: The age at first marriage is defined as the age at which the respondent began living with her first spouse/partner. na = Not applicable due to censoring a = Omitted because less than 50% of the women began living with their spouse or partner for the first time before reaching the beginning of the age group Marriage and Exposure to the Risk of Pregnancy • 53 Table 4.3 Median age at first marriage by background characteristics Median age at first marriage among women by 5-year age groups and median age at first marriage among women age 25-49, according to background characteristics, Philippines NDHS 2017 Background characteristic Age 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 23.2 22.6 23.8 23.6 23.3 23.3 Rural 20.8 21.7 22.2 22.3 22.1 21.8 Region National Capital Region a 23.8 24.5 23.8 23.6 24.2 Cordillera Admin. Region a 23.0 23.0 22.9 25.7 23.7 I - Ilocos Region 21.9 21.5 21.4 22.9 22.0 22.1 II - Cagayan Valley 20.6 22.9 22.8 22.0 20.6 21.7 III - Central Luzon 21.8 22.5 22.6 22.7 23.2 22.6 IVA - CALABARZON 22.6 22.2 22.7 24.4 22.2 22.6 MIMAROPA Region 20.5 21.3 21.3 22.1 21.7 21.3 V - Bicol 21.9 21.4 22.3 21.8 22.6 21.9 VI - Western Visayas 21.3 21.3 24.1 22.9 22.7 22.0 VII - Central Visayas 22.6 22.7 23.5 22.8 23.7 23.0 VIII - Eastern Visayas 20.3 21.4 21.6 21.4 22.0 21.4 IX - Zamboanga Peninsula 20.6 21.1 22.2 22.4 22.0 21.4 X - Northern Mindanao 21.4 21.8 22.5 22.7 23.3 22.1 XI - Davao 20.9 21.0 23.5 22.7 23.1 22.2 XII - SOCCSKSARGEN 19.9 21.4 21.8 22.3 21.0 21.0 XIII - Caraga 21.2 22.4 22.1 22.8 22.5 22.0 ARMM 21.1 21.5 20.6 19.3 21.9 20.8 Education No education (17.0) (20.3) 17.4 19.9 18.1 18.5 Grades 1-6 19.0 19.4 19.5 20.0 20.2 19.6 Grades 7-10 20.3 21.2 21.5 22.0 22.1 21.3 Grade 11 * * nc nc nc nc Post-secondary 24.0 23.6 23.0 24.6 25.0 23.9 College a 24.6 25.4 26.0 26.1 a Wealth quintile Lowest 19.3 20.3 20.2 20.3 20.5 19.9 Second 20.4 20.9 21.4 21.4 20.9 21.0 Middle 21.9 22.1 22.8 22.4 22.6 22.3 Fourth 22.9 23.3 23.4 24.0 23.3 23.4 Highest a 24.5 24.9 25.2 25.0 a Total 21.9 22.1 22.9 22.9 22.7 22.5 Notes: The age at first marriage is defined as the age at which the respondent began living with her first spouse/partner. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. nc = No cases a = Omitted because less than 50% of the women began living with their spouse or partner for the first time before reaching the beginning of the age group Table 4.4 Age at first menstruation Percentage of women age 15-49 who had first menstruation (menarche) by specific exact ages and mean age at menarche, according to current age, Philippines NDHS 2017 Age Age at menarche Never men- struated Don’t know Total Number of women Mean age at menarche ≤10 11 12 13 14 ≥15 15-19 3.9 10.6 29.6 28.4 17.7 9.2 0.4 0.0 100.0 4,897 12.8 20-24 4.2 9.6 26.0 28.1 18.0 13.9 0.1 0.1 100.0 4,175 13.0 25-29 2.9 9.7 27.3 24.4 18.7 16.7 0.2 0.1 100.0 3,717 13.1 30-34 3.6 8.4 26.9 25.8 17.8 16.9 0.1 0.6 100.0 3,243 13.2 35-39 2.7 10.2 28.0 22.8 20.0 16.2 0.1 0.1 100.0 3,360 13.1 40-44 2.1 9.7 22.8 21.3 18.6 25.3 0.1 0.2 100.0 2,837 13.4 45-49 2.3 7.5 21.5 24.1 19.2 25.1 0.2 0.2 100.0 2,845 13.5 Total 3.2 9.5 26.4 25.4 18.5 16.6 0.2 0.2 100.0 25,074 13.1 54 • Marriage and Exposure to the Risk of Pregnancy Table 4.5 Age at first sexual intercourse Percentage of women age 15-49 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, Philippines NDHS 2017 Percentage who had first sexual intercourse by exact age: Percentage who never had intercourse Number of women Median age at first intercourse Current age 15 18 20 22 25 15-19 1.6 na na na na 87.8 4,897 a 20-24 2.4 20.7 40.1 na na 46.6 4,175 a 25-29 2.1 19.8 45.8 61.9 76.3 17.2 3,717 20.4 30-34 2.1 15.8 41.0 59.9 77.4 8.2 3,243 20.8 35-39 2.1 16.8 36.0 53.0 71.9 6.4 3,360 21.6 40-44 2.2 16.5 34.0 51.2 69.7 3.9 2,837 21.8 45-49 2.5 18.8 36.6 54.3 70.8 5.2 2,845 21.5 20-49 2.2 18.2 39.3 na na 16.5 20,177 a 25-49 2.2 17.6 39.1 56.4 73.4 8.6 16,002 21.2 15-24 2.0 na na na na 68.8 9,072 a na = Not applicable due to censoring a = Omitted because less than 50% of the women had sexual intercourse for the first time before reaching the beginning of the age group Table 4.6 Median age at first sexual intercourse according to background characteristics Median age at first sexual intercourse among women by 5-year age groups and median age at first sexual intercourse among women age 25-49, according to background characteristics, Philippines NDHS 2017 Background characteristic Age 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 21.0 21.1 21.9 22.3 21.9 21.6 Rural 19.9 20.6 21.4 21.5 21.1 20.8 Region National Capital Region 22.2 21.9 23.4 21.8 22.4 22.4 Cordillera Admin. Region 22.5 21.8 22.8 23.4 21.9 22.4 I - Ilocos Region 20.5 20.8 20.7 22.3 21.3 21.0 II - Cagayan Valley 19.6 21.4 21.3 21.7 20.5 20.8 III - Central Luzon 20.5 21.1 21.3 21.9 22.4 21.4 IVA - CALABARZON 20.6 20.9 22.0 23.9 21.0 21.5 MIMAROPA Region 19.7 20.6 20.6 21.2 21.0 20.6 V - Bicol 20.8 20.8 21.6 21.3 21.8 21.2 VI - Western Visayas 20.0 20.8 23.4 22.0 22.4 21.4 VII - Central Visayas 20.3 20.7 21.8 21.2 20.6 21.0 VIII - Eastern Visayas 19.8 19.9 21.0 20.3 21.6 20.4 IX - Zamboanga Peninsula 19.7 20.7 20.8 22.0 20.7 20.5 X - Northern Mindanao 19.8 20.1 20.2 20.7 21.7 20.3 XI - Davao 19.4 20.0 20.7 21.6 20.2 20.2 XII - SOCCSKSARGEN 19.2 20.5 20.8 21.3 20.3 20.3 XIII - Caraga 19.9 20.4 20.6 21.4 20.8 20.5 ARMM 20.7 21.2 20.7 18.9 22.1 20.6 Education No education (18.1) (19.5) 17.9 19.9 17.5 18.1 Grades 1-6 18.4 18.9 18.9 19.4 19.3 19.0 Grades 7-10 19.5 20.2 20.6 20.8 20.9 20.3 Grade 11 * * nc nc nc * Post-secondary 22.2 21.8 22.6 23.9 24.0 22.9 College 23.9 22.8 23.8 24.6 24.6 23.9 Wealth quintile Lowest 18.9 19.6 19.8 20.0 19.5 19.4 Second 19.4 20.1 20.5 20.5 19.9 20.0 Middle 20.6 21.1 21.5 21.6 21.3 21.1 Fourth 21.0 22.0 22.4 22.8 22.0 22.0 Highest 24.8 21.6 23.5 24.0 22.9 23.4 Total 20.4 20.8 21.6 21.8 21.5 21.2 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. nc = No cases Marriage and Exposure to the Risk of Pregnancy • 55 Table 4.7 Recent sexual activity Percent distribution of women age 15-49 by timing of last sexual intercourse, according to background characteristics, Philippines NDHS 2017 Timing of last sexual intercourse Never had sexual intercourse Total Number of women Background characteristic Within the past 4 weeks Within 1 year1 One or more years Age 15-19 7.0 3.7 1.6 87.8 100.0 4,897 20-24 32.7 13.7 7.0 46.6 100.0 4,175 25-29 54.8 17.8 10.1 17.2 100.0 3,717 30-34 63.9 17.5 10.4 8.2 100.0 3,243 35-39 63.5 17.5 12.6 6.4 100.0 3,360 40-44 61.5 20.7 13.9 3.9 100.0 2,837 45-49 53.8 23.8 17.1 5.2 100.0 2,845 Marital status Never married 2.2 4.3 8.5 85.0 100.0 8,971 Married or living together 73.0 21.8 5.2 0.0 100.0 15,016 Divorced/separated/widowed 7.1 16.1 76.7 0.1 100.0 1,086 Marital duration2 0-4 years 70.9 25.5 3.6 0.0 100.0 2,592 5-9 years 78.4 17.3 4.2 0.0 100.0 3,025 10-14 years 74.6 19.1 6.3 0.0 100.0 2,710 15-19 years 72.9 21.1 6.0 0.0 100.0 2,111 20-24 years 71.0 23.4 5.6 0.0 100.0 1,584 25+ years 63.0 28.2 8.9 0.0 100.0 1,380 Married more than once 73.7 22.7 3.6 0.0 100.0 1,614 Residence Urban 41.2 15.3 10.9 32.6 100.0 12,252 Rural 48.2 15.3 8.2 28.3 100.0 12,822 Region National Capital Region 36.0 13.4 12.1 38.5 100.0 4,400 Cordillera Admin. Region 36.5 12.8 11.5 39.1 100.0 440 I - Ilocos Region 39.9 16.4 9.9 33.8 100.0 1,258 II - Cagayan Valley 51.2 17.5 7.0 24.4 100.0 802 III - Central Luzon 43.8 15.5 10.3 30.4 100.0 2,453 IVA - CALABARZON 44.8 17.2 10.1 27.9 100.0 4,016 MIMAROPA Region 44.1 17.2 9.8 28.9 100.0 621 V - Bicol 43.3 18.1 7.1 31.5 100.0 1,551 VI - Western Visayas 47.0 15.0 9.6 28.5 100.0 1,498 VII - Central Visayas 45.8 15.8 8.4 30.0 100.0 1,607 VIII - Eastern Visayas 48.3 13.3 8.2 30.3 100.0 997 IX - Zamboanga Peninsula 49.6 16.7 8.2 25.6 100.0 764 X - Northern Mindanao 52.7 12.0 10.6 24.7 100.0 998 XI - Davao 55.2 16.6 7.6 20.6 100.0 1,203 XII - SOCCSKSARGEN 54.1 14.2 7.6 24.0 100.0 1,038 XIII - Caraga 49.8 17.3 7.6 25.3 100.0 648 ARMM 48.4 8.4 5.9 37.3 100.0 780 Education No education 59.0 14.7 9.9 16.3 100.0 200 Grades 1-6 61.7 16.9 10.4 10.9 100.0 3,245 Grades 7-10 47.8 15.4 8.4 28.4 100.0 11,558 Grade 11 1.7 2.5 0.3 95.5 100.0 934 Post-secondary 46.1 18.6 15.8 19.5 100.0 1,144 College 38.0 15.6 10.9 35.5 100.0 7,994 Wealth quintile Lowest 56.0 15.2 7.3 21.6 100.0 4,209 Second 50.9 14.9 8.3 25.9 100.0 4,629 Middle 46.0 16.8 9.5 27.7 100.0 4,918 Fourth 41.3 14.1 11.0 33.7 100.0 5,527 Highest 34.0 15.5 10.8 39.6 100.0 5,791 Total 44.8 15.3 9.5 30.4 100.0 25,074 1 Excludes women who had sexual intercourse within the past 4 weeks 2 Excludes women who are not currently married 56 • Marriage and Exposure to the Risk of Pregnancy Table 4.8 Spousal separations Percentage of currently married women age 15-49 who have ever lived separately from their husband/partner and percentage who have lived separately from their husband/partner in the past 2 years because one of them lived overseas, and among currently married women who have ever lived separately from their husband/partner, percent distribution of the number of months they have lived separately in the past 2 years, Philippines NDHS 2017 Percent- age of currently married women who have ever lived separately from their husband/ partner Percent- age of currently married women who have lived separately from their husband/ partner in the past 2 years because one of them lived overseas Number of currently married women Among women who have ever lived separately from their husband/partner, percent distribution of the number of months they have lived separately in the past 2 years Total Number of currently married women who have ever lived separately from their husband/ partner Background characteristic <1 month 1-11 months 12-23 months >23 months No separation in past 2 years Don’t know Age 15-19 12.0 1.0 419 48.3 45.3 0.4 0.0 6.0 0.0 100.0 50 20-24 17.7 2.6 1,718 22.1 55.4 8.9 4.9 8.7 0.0 100.0 305 25-29 20.0 5.7 2,628 18.7 48.8 15.8 6.7 9.3 0.9 100.0 525 30-34 21.7 7.2 2,663 17.2 45.6 13.5 9.0 14.2 0.5 100.0 578 35-39 21.9 7.1 2,775 22.9 38.8 13.8 8.7 15.8 0.0 100.0 607 40-44 21.0 6.2 2,443 12.2 44.4 10.9 12.7 19.7 0.0 100.0 513 45-49 17.6 4.8 2,372 14.1 31.6 14.8 11.5 27.7 0.3 100.0 418 Region National Capital Region 15.5 6.5 2,133 20.2 57.7 13.1 5.5 3.5 0.0 100.0 332 Cordillera Admin. Region 19.8

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