| Author(s) |
Ministry of Health and Social Services, Windhoek, Namibia National Statistics Agency, Windhoek, Namibia ICF International, Rockville, Maryland, USA |
| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................ xvii
MILLENNIUM DEVELOPMENT GOAL INDICATORS ................................................................... xix
MAP OF NAMIBIA .................................................................................................................................... xx
1 INTRODUCTION ........................................................................................................................... 1
1.1 Geography, History, and Economy ..................................................................................... 1
1.1.1 Geography .............................................................................................................. 1
1.1.2 History ................................................................................................................... 1
1.1.3 Economy ................................................................................................................ 2
1.2 Population ............................................................................................................................ 2
1.3 Health Services and Programmes ........................................................................................ 3
1.4 Survey Objectives ................................................................................................................ 4
1.5 Organisation of the Survey .................................................................................................. 4
1.6 Survey Implementation........................................................................................................ 4
1.6.1 Sample Design ....................................................................................................... 4
1.6.2 Questionnaires ....................................................................................................... 5
1.6.3 Anaemia and HIV Testing ..................................................................................... 6
1.6.4 Blood Glucose and Blood Pressure Testing ........................................................... 7
1.6.5 Pretest..................................................................................................................... 8
1.6.6 Household Listing .................................................................................................. 8
1.6.7 Training of Field Staff ........................................................................................... 8
1.6.8 Data Collection ...................................................................................................... 8
1.6.9 Data Processing ...................................................................................................... 9
1.7 Response Rates .................................................................................................................... 9
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION .............................. 11
2.1 Household Characteristics ................................................................................................. 11
2.1.1 Drinking Water .................................................................................................... 11
2.1.2 Sanitation Facilities and Waste Disposal ............................................................. 13
2.1.3 Housing Characteristics ....................................................................................... 14
2.1.4 Household Possessions ........................................................................................ 15
2.2 Household Wealth ............................................................................................................. 16
2.3 Hand Washing ................................................................................................................... 17
2.4 Household Population by Age, Sex, and Residence .......................................................... 18
2.5 Household Composition .................................................................................................... 20
2.6 Birth Registration .............................................................................................................. 20
2.7 Children’s Living Arrangements and Parental Survival .................................................... 21
2.8 Education of the Household Population ............................................................................ 22
2.8.1 Educational Attainment ....................................................................................... 22
2.8.2 School Attendance Ratios .................................................................................... 24
2.9 Utilisation of Health Services and Out-of-Pocket Expenditure for Health Care ............... 26
3 CHARACTERISTICS OF SURVEY RESPONDENTS ............................................................ 29
3.1 Characteristics of Survey Respondents ............................................................................. 29
3.2 Educational Attainment by Background Characteristics ................................................... 31
3.3 Literacy .............................................................................................................................. 33
3.4 Exposure to Mass Media ................................................................................................... 35
3.5 Employment ...................................................................................................................... 37
3.5.1 Employment Status .............................................................................................. 37
3.5.2 Occupation ........................................................................................................... 40
3.5.3 Earnings, Employers, and Continuity of Employment for Women ..................... 42
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 45
4.1 Marital Status ..................................................................................................................... 45
4.2 Polygyny ............................................................................................................................ 46
4.3 Age at First Marriage ......................................................................................................... 48
4.4 Age at First Sexual Intercourse ......................................................................................... 49
4.5 Recent Sexual Activity ...................................................................................................... 51
5 FERTILITY ................................................................................................................................... 55
5.1 Current Fertility ................................................................................................................. 55
5.2 Fertility by Background Characteristics ............................................................................ 56
5.3 Fertility Trends .................................................................................................................. 57
5.4 Children Ever Born and Living ......................................................................................... 58
5.5 Birth Intervals .................................................................................................................... 59
5.6 Postpartum Amenorrhoea, Abstinence, and Insusceptibility ............................................. 60
5.7 Median Duration of Postpartum Insusceptibility by Background Characteristics ............. 61
5.8 Menopause ......................................................................................................................... 62
5.9 Age at First Birth ............................................................................................................... 62
5.10 Median Age at First Birth by Background Characteristics ................................................ 63
5.11 Teenage Pregnancy and Motherhood ................................................................................ 63
6 FERTILITY PREFERENCES ..................................................................................................... 65
6.1 Fertility Preferences by Number of Living Children ......................................................... 65
6.2 Desire to Limit Childbearing by Background Characteristics ........................................... 66
6.3 Ideal Number of Children .................................................................................................. 67
6.4 Mean Ideal Number of Children by Background Characteristics ...................................... 69
6.5 Fertility Planning Status .................................................................................................... 69
6.6 Wanted Fertility Rates ....................................................................................................... 70
7 FAMILY PLANNING .................................................................................................................. 71
7.1 Knowledge of Contraceptive Methods .............................................................................. 71
7.2 Current Use of Contraception ............................................................................................ 72
7.3 Current Use of Contraception by Background Characteristics .......................................... 74
7.4 Source of Modern Contraceptive Methods ........................................................................ 76
7.5 Informed Choice ................................................................................................................ 77
7.6 Rates of Discontinuing Contraceptive Methods ................................................................ 78
7.7 Reasons for Discontinuing Contraceptive Methods .......................................................... 79
7.8 Knowledge of the Fertile Period ........................................................................................ 80
7.9 Need and Demand for Family Planning ............................................................................ 80
7.10 Future Use of Contraception .............................................................................................. 82
7.11 Exposure to Family Planning Messages in the Media ....................................................... 82
7.12 Contact of Nonusers with Family Planning Providers ....................................................... 83
8 INFANT AND CHILD MORTALITY ........................................................................................ 85
8.1 Background and Assessment of Data Quality ................................................................... 85
8.2 Infant and Child Mortality Levels and Trends .................................................................. 87
8.3 Socioeconomic Differentials in Early Childhood Mortality .............................................. 88
8.4 Demographic Differentials in Early Childhood Mortality ................................................. 89
8.5 Perinatal Mortality ............................................................................................................. 90
8.6 High-Risk Fertility Behaviour ........................................................................................... 91
9 ADULT AND MATERNAL MORTALITY ............................................................................... 93
9.1 Assessment of Data Quality .............................................................................................. 94
9.2 Estimates of Adult Mortality ............................................................................................. 95
9.3 Estimates of Maternal Mortality ........................................................................................ 95
10 MATERNAL HEALTH CARE ................................................................................................... 99
10.1 Antenatal Care ................................................................................................................. 100
10.2 Number and Timing of Antenatal Care Visits ................................................................. 101
10.3 Components of Antenatal care ........................................................................................ 102
10.4 Tetanus Toxoid ................................................................................................................ 104
10.5 Place of Delivery ............................................................................................................. 104
10.6 Assistance during Delivery .............................................................................................. 106
10.7 Postnatal Care .................................................................................................................. 108
10.7.1 Postnatal Checkup for the Mother ..................................................................... 108
10.7.2 Postnatal Care for the Newborn ......................................................................... 111
10.8 Problems in Accessing Health Care ................................................................................ 113
11 CHILD HEALTH ........................................................................................................................ 115
11.1 Child’s Weight and Size at Birth ..................................................................................... 115
11.2 Vaccination of Children ................................................................................................... 117
11.2.1 Sources of Information ...................................................................................... 117
11.2.2 Vaccination Coverage ........................................................................................ 117
11.2.3 Trends in Vaccination Coverage ........................................................................ 119
11.3 Prevalence and Treatment of Acute Respiratory Infection .............................................. 120
11.4 Prevalence and Treatment of Fever ................................................................................. 120
11.5 Diarrhoeal Disease ........................................................................................................... 122
11.5.1 Prevalence of Diarrhoea ..................................................................................... 122
11.5.2 Treatment of Diarrhoea ...................................................................................... 122
11.5.3 Feeding Practices during Diarrhoea ................................................................... 124
11.6 Knowledge of ORS Packets ............................................................................................ 124
11.7 Disposal of Children’s Stools .......................................................................................... 126
12 NUTRITION OF CHILDREN AND ADULTS ........................................................................ 129
12.1 Nutritional Status of Children .......................................................................................... 130
12.1.1 Measurement of Nutritional Status among Young Children .............................. 130
12.1.2 Data Collection .................................................................................................. 131
12.1.3 Levels of Child Malnutrition ............................................................................. 131
12.1.4 Trends in Child Malnutrition ............................................................................. 133
12.2 Initiation of Breastfeeding ............................................................................................... 134
12.3 Breastfeeding Status by Age ............................................................................................ 135
12.4 Duration of Breastfeeding ............................................................................................... 138
12.5 Types of Complementary Foods ...................................................................................... 138
12.6 Infant and Young Child Feeding Practices ...................................................................... 139
12.7 Prevalence of Anaemia in Children ................................................................................. 142
12.8 Micronutrient Intake and Supplementation among Children ........................................... 143
12.9 Presence of Iodised Salt in Households ........................................................................... 146
12.10 Adult Nutritional Status ................................................................................................... 146
12.10.1 Nutritional Status of Women ............................................................................. 146
12.10.2 Nutritional Status of Men ................................................................................... 148
12.10.3 Anaemia in Women ........................................................................................... 149
12.10.4 Anaemia in Men ................................................................................................. 150
12.11 Micronutrient Intake among Mothers .............................................................................. 150
13 MALARIA ................................................................................................................................... 153
13.1 Ownership of Mosquito Nets ........................................................................................... 153
13.2 Indoor Residual Spraying ................................................................................................ 156
13.3 Access to an Insecticide-Treated Net .............................................................................. 157
13.4 Use of Mosquito Nets ...................................................................................................... 158
13.4.1 Use of Mosquito Nets by Persons in the Household .......................................... 158
13.4.2 Use of Existing Mosquito Nets .......................................................................... 160
13.4.3 Use of Mosquito Nets by Children under Age 5 ................................................ 160
13.4.4 Use of Mosquito Nets by Pregnant Women ....................................................... 161
13.5 Use of Intermittent Preventive Treatment of Malaria During Pregnancy ........................ 163
13.6 Prevalence, Diagnosis, and Prompt Treatment of Children with Fever ........................... 163
13.7 Prevalence of Low Haemoglobin in Children ................................................................. 166
14 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ....................... 169
14.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods .................................... 170
14.1.1 Knowledge of AIDS .......................................................................................... 170
14.1.2 Knowledge of HIV Prevention .......................................................................... 171
14.1.3 Comprehensive Knowledge about HIV/AIDS ................................................... 173
14.2 Knowledge about Mother-to-Child Transmission ........................................................... 176
14.3 Attitudes toward People Living with HIV/AIDS ............................................................ 178
14.4 Attitudes toward Negotiating Safer Sexual Relations with Husbands ............................. 180
14.5 Attitudes toward Condom Education for Young People ................................................. 182
14.6 Higher-Risk Sex .............................................................................................................. 183
14.6.1 Multiple Sexual Partners .................................................................................... 183
14.6.2 Point Prevalence and Cumulative Prevalence of Concurrent Sexual Partners ... 186
14.7 Paid Sex ........................................................................................................................... 187
14.8 Male Circumcision .......................................................................................................... 189
14.9 Self-Reporting of Sexually Transmitted Infections ......................................................... 192
14.10 Injections ......................................................................................................................... 193
14.11 HIV/AIDS-Related Knowledge and Behaviour among Young People ........................... 195
14.11.1 Knowledge about HIV/AIDS and Source for Condoms .................................... 195
14.11.2 First Sex ............................................................................................................. 196
14.11.3 Premarital Sex .................................................................................................... 198
14.11.4 Multiple Sexual Partners among Youth ............................................................. 199
14.11.5 Age Mixing in Sexual Relationships ................................................................. 201
15 HIV PREVALENCE ................................................................................................................... 203
15.1 Participation Rates for HIV Testing ................................................................................ 204
15.2 HIV Prevalence ............................................................................................................... 208
15.2.1 HIV Prevalence by Age ..................................................................................... 208
15.2.2 HIV Prevalence by Socioeconomic Characteristics ........................................... 209
15.2.3 HIV Prevalence by Demographic and Health Characteristics ........................... 211
15.2.4 HIV Prevalence by Sexual Risk Behaviour ....................................................... 213
15.3 HIV Prevalence among Young People ............................................................................ 216
15.4 HIV Prevalence by Other Characteristics Related to HIV Risk ...................................... 217
15.5 HIV Prevalence among Couples ...................................................................................... 219
16 SELF-REPORTED PRIOR HIV TESTING AND TREATMENT ........................................ 221
16.1 Coverage of HIV Testing Services .................................................................................. 221
16.2 HIV Testing among Youth .............................................................................................. 224
16.3 Couple Counselling and Testing ...................................................................................... 225
16.4 Place of Last HIV Test .................................................................................................... 229
16.5 HIV Prevalence by Prior HIV Test Results ..................................................................... 229
16.6 Self-Reported Use of Antiretroviral Medications (ARVs) .............................................. 232
16.7 HIV Testing during Pregnancy ........................................................................................ 233
16.8 Early Infant Diagnosis ..................................................................................................... 235
17 BLOOD PRESSURE AND BLOOD GLUCOSE ..................................................................... 237
17.1 Coverage Rates for Blood Pressure and Blood Glucose Measurement ........................... 237
17.2 High Blood Pressure ........................................................................................................ 238
17.2.1 History and Treatment of High Blood Pressure ................................................. 239
17.2.2 Prevalence of High Blood Pressure ................................................................... 241
17.3 Diabetes ........................................................................................................................... 247
17.3.1 History of Diabetes ............................................................................................ 248
17.3.2 Prevalence and Treatment of Diabetes ............................................................... 250
18 OTHER HEALTH ISSUES........................................................................................................ 253
18.1 Knowledge of and Attitudes toward Tuberculosis .......................................................... 253
18.2 Cancer Screening ............................................................................................................. 255
18.2.1 Breast Cancer and Cervical Cancer Screening ................................................... 255
18.2.2 Prostate Cancer Screening ................................................................................. 257
18.3 Use of Tobacco ................................................................................................................ 258
18.4 Alcohol Consumption ...................................................................................................... 261
18.5 Use of Seatbelts ............................................................................................................... 264
18.6 Physical Activity ............................................................................................................. 266
18.7 Consumption of Water, Fruits, and Vegetables ............................................................... 269
18.8 Mental Health .................................................................................................................. 271
18.9 Health Insurance .............................................................................................................. 274
19 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES ... 277
19.1 Women’s and Men’s Employment .................................................................................. 277
19.2 Women’s Control over Their Own Earnings and Relative Magnitude of Women’s Earnings ........ 278
19.3 Women’s Ownership of Assets ....................................................................................... 282
19.4 Women’s and Men’s Participation in Decision Making .................................................. 284
19.5 Attitudes toward Wife Beating ........................................................................................ 288
19.6 Women’s Empowerment Indicators ................................................................................ 291
19.7 Current Use of Contraception by Women’s Empowerment ............................................ 291
19.8 Ideal Family Size and Unmet Need by Women’s Empowerment ................................... 292
19.9 Women’s Empowerment and Reproductive Health Care ................................................ 293
20 DOMESTIC VIOLENCE ........................................................................................................... 295
20.1 Valid Measures of Domestic Violence ............................................................................ 295
20.1.1 Use of Valid Measures of Violence ................................................................... 295
20.1.2 Ethical Considerations for the Domestic Violence Module in the 2013 NDHS ............... 296
20.1.3 Subsample for the Violence Module .................................................................. 297
20.2 Experience of Physical Violence ..................................................................................... 297
20.3 Perpetrators of Physical Violence .................................................................................... 299
20.4 Experience of Sexual Violence ........................................................................................ 299
20.5 Perpetrators of Sexual Violence ...................................................................................... 301
20.6 Experience of Different Forms of Violence .................................................................... 301
20.7 Violence during Pregnancy ............................................................................................. 302
20.8 Marital Control by Husband ............................................................................................ 303
20.9 Forms of Spousal Violence .............................................................................................. 305
20.10 Spousal Violence by Background Characteristics ........................................................... 306
20.11 Violence by Spousal Characteristics and Women’s Empowerment Indicators ............... 308
20.12 Recent Spousal Violence ................................................................................................. 310
20.13 Onset of Spousal Violence .............................................................................................. 310
20.14 Physical Consequences of Spousal Violence .................................................................. 311
20.15 Women’s Violence Against Their Husbands .................................................................. 312
20.16 Help-Seeking Behaviour by Women Who Experience Violence .................................... 315
20.17 Sources of Help to Stop Violence .................................................................................... 316
REFERENCES ......................................................................................................................................... 317
APPENDIX A SAMPLE SELECTION ................................................................................................ 323
A.1 Introduction ..................................................................................................................... 323
A.2 Sampling Frame ............................................................................................................... 323
A.3 Sampling Procedure and Sample Allocation ................................................................... 324
A.4 Sampling Probabilities ..................................................................................................... 326
APPENDIX B ESTIMATES OF SAMPLING ERRORS ................................................................... 335
APPENDIX C DATA QUALITY TABLES ......................................................................................... 355
APPENDIX D PARTICIPANTS IN THE 2013 NAMIBIA DEMOGRAPHIC AND
HEALTH SURVEY ....................................................................................................... 361
APPENDIX E QUESTIONNAIRES ..................................................................................................... 367 |
