The Turkmenistan Demographic and Health Survey (TDHS 2000) is the first national survey of maternal and child health in Turkmenistan. It is a nationally representative survey of 7,919 women of reproductive age (15-49). Survey fieldwork was conducted from June to September 2000.
The TDHS was sponsored by the Ministry of Health and Medical Industry (MOHMI) of the Republic of Turkmenistan. The Gurbansoltan Eje Clinical Research Center for Maternal and Child Health implemented the survey with technical assistance from the Demographic and Health Surveys Program. The National Institute of State Statistics and Information (Turkmenmelihasabat) conducted sampling activities for the survey. The U.S. Agency for InternationalDevelopment (USAID) provided funding for the survey. UNFPA/Turkmenistan assisted with survey coordination and logistic support.
The purpose of the survey was to develop a single integrated set of data for the government of Turkmenistan to use in planning effective policies and programs in the areas of health and nutrition. TDHS 2000 collected data on women's reproductive history, knowledge and use of contraceptive methods, breastfeeding practices and nutrition, vaccination coverage, and episodes of diseases among children under the age of five. Information on the knowledge of and attitudes toward HIV/AIDS, other sexually transmitted infections, and tuberculosis were also collected. The survey also included the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutrition status.
The TDHS 2000 also contributes to the growing international database on demographic and health-related variables.
The TDHS was designed to provide policymakers and program managers at MOHMI with detailed information on the health status of women and children. Some of the health indicators provided by the TDHS-such as fertility and infant mortality rates-are available from other sources. However, other survey indicators are not available from other sources-for example anemia status and nutritional indices for women and children. Thus, when taken together, the TDHS and existing data provide a more complete picture of health conditions in Turkmenistan than was previously available.
- Fertility rates. For the three years preceding the survey (mid-1997 to mid-2000), the estimated crude birth rate was 24.6 births per 1,000 population. This is higher than the MOHMI rate of 20.3 (the average of the annual rates for calendar years 1997 to 1999).
- Knowledge of contraceptive methods is widespread in Turkmenistan. Among currently married women, knowledge of at least one method is universal (99 percent). Married women have knowledge of, on average, six methods of contraception. Married women of all ages, all educational levels, all ethnic groups, and all regions of the country have a high level of knowledge of contraceptive methods.
- Abortion rates. For the three-year period preceding the survey (mid-1977 to mid2000), the total abortion rate for Turkmenistan was 0.9. The total abortion rate was higher in urban areas (1.0 abortions per woman) than in rural areas (0.7 abortions per woman). The highest levels of induced abortion were in Ashgabad City and the Lebap Region (1.1 and 1.2 abortions per woman, respectively).
- Antenatal care. Almost all respondents who gave birth in the last five years (98 percent) received antenatal care from either a doctor (81 percent) or a nurse/midwife (17 percent). In general, in Turkmenistan women seek antenatal care early and continue to receive care throughout their pregnancy. The median number of antenatal care visits is ten.
- Infant Mortality Rates In the TDHS, infant mortality data were collected based on the international definition of a live birth, i.e., a birth that shows any sign of life, irrespective of the gestational age at the time of delivery (United Nations, 1999). Because of the difference between the government data collection system and that of the TDHS in the definition of a live birth, the TDHS estimate of the infant mortality rate (IMR) would be expected to exceed the official government estimates.
- The TDHS was the first study of anemia in Turkmenistan based on a nationally representative sample of women and children. The survey measured the hemoglobin level of capillary blood.
- Acquired Immune deficiency Syndrome(Aids) Compared with other parts of the world, Turkmenistan has been relatively untouched by the AIDS epidemic. Currently, there is only one known case of AIDS and one other person known to be HIV positive in Turkmenistan. Almost no respondents reported that they knew an HIV-infected person or anyone who had died of AIDS.
- Knowledge. Awareness and knowledge ofHIV/AIDSislimited. Seventy-threepercentof respondents reported having heard of HIV/ AIDS, but only 50 percent believe that they could adoptbehavior patterns thatwould reduce their risk of contracting the disease. Further evidence of limited knowledge of HIV/AIDS was the fact that only 31 percent of respondents recognized that condom use is a risk-reducing behavior.
Kind of Data
Sample survey data
Unit of Analysis
- Women age 15-49
The Turkmenistan Demographic and Health Survey (TDHS) is a nationally representative survey. The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).
Unit of Analysis
- Women age 15-49
The population covered by the 2000 TKMDHS is defined as the universe of all women in the reproductive ages (i.e., women 15-49).
Producers and sponsors
Authoring entity/Primary investigators
Gurbansoltan Eje Clinical Research Center for Maternal and Child Health (MCH Institute)
Ministry of Health and Medical Industry
U.S. Agency for International Development
United Nations Population Fund
The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).
The sample design was specified in terms of a target number of households in the six regions of Turkmenistan. The overall target number of households was set at 6,800. This number was allocated to the regions as follows: 800 to Ashgabad City, 1,000 to each of 4 regions (Akhal, Balkan, Lebap and Mary) and 2,000 to the remaining region (Dashoguz), for which more intensive analysis was desired.
The six regions of the country were further stratified into urban areas (cities, towns and small settlements) and rural areas (villages). The sampling frame consisted of the list of standard segments. Each standard segment was created on the basis of contiguous blocks that have clear boundaries-coinciding to the extent possible with census supervisor areas-and have between 200 and 500 households according to measures of size estimated by projection from to the 1995 Census data.
The sample was designed as a two-stage probability sample. Within regions the sample was to be self-weighting. The first stage involved the selection of standard segments (PSUs) by systematic sampling with probability proportional to size. This resulted in the selection of 231 standard segments:118 in urban areas and 113 in rural areas. A household listing operation was conducted in each selected standard segment. In the second stage, households were selected with probability proportional to the inverse of the first stage selection probability. On average, the number of households selected per standard segment was 28.
Since the sample for each of the six survey regions was self-weighting, the sampling fraction for each region was an important design parameter. The sampling fractions were estimated with projected census figures. The weighting factors for the six survey regions are inversely proportional to the sampling fractions.
Implementation of the sample design resulted in the selection of 6,850 households. The data on household membership and age collected in the Household Questionnaire identified 8,250 women eligible for the Women's Questionnaire (i.e., women age 15-49 who were usual household members or who stayed in the household the night before the interviewer's visit).
From the 6,850 selected households, 6,391 were identified as current households and household interviews were completed in 6,302. This yields a household response rate of 98.6 percent. Of the 8,250 women who were eligible respondents, a total of 7,919 were interviewed. This yields an eligible woman response rate of 96.0 percent.
The overall response rate (94.7 percent) is the product of the household response rate and the eligible woman response rate. The overall response rate varies by region from 85.6 percent in Ashgabad City to 97.4 percent in the Balkan Region.
Among the 6,391 currently occupied households in the selected sample, the Household Schedule was completed in 6,302, for a response rate of 98.6 percent. Of the eligible 8,250 women age 15-49 in those households, 7,919 were interviewed for a response rate of 96.0 percent. The overall survey response rate was 94.7 percent.
Overall, the household response rate was 98.6 percent and the individual women response rate was 96.0 percent. As is usually the case in household surveys, response rates were somewhat higher in rural than in urban areas.
Dates of Data Collection (YYYY/MM/DD)
Mode of data collection
Type of Research Instrument
Two questionnaires were used for TDHS 2000: a) the Household Questionnaire and b) Women's Questionnaire. These questionnaires were based on the model survey instruments developed for the MEASURE DHS+ project and were adapted to the data needs of Turkmenistan during consultations with specialists in the area of reproductive health and child health and nutrition. The questionnaires were developed at first in English and then translated into Russian and Turkmen. A pretest was conducted in April 2000. Based on the pretest, the questionnaires were revised and finalized.
a) The Household Questionnaire was used to enumerate all usual members and visitors in a sample household and to collect information related to the socioeconomic status of the household. In the first part of the Household Questionnaire, information was collected on age, sex, education attainment, and relationship to the head of household for each person listed as a household member or visitor. A primary objective of the first part of the Household Questionnaire was to identify women who would be eligible for the individual interview. In the second part of the Household Questionnaire, information was collected on the characteristics of the dwelling unit, such as the source of water and the type of toilet facilities, and on the availability of a variety of consumer goods.
b) The Women's Questionnaire was used to collect information from eligible respondents (i.e., women age 15-49 who were usual household members or who were present in the household the night before interviewer's visit) on the following major topics:
- Background characteristics
- Pregnancy history
- Outcome of pregnancies, antenatal and postnatal care
- Child health and nutrition practices
- Child immunization and episodes of diarrhea and respiratory illness
- Knowledge and use of contraception
- Marriage and fertility preferences
- Husband's background and women's work
- Knowledge of HIV/AIDS and other sexually transmitted infections
- Maternal and child anthropometry
- Hemoglobin measurement of women and children.
Gurbansoltan Eje Clinical Research Center for Maternal and Child Health
Ministry of Health and Medical Industry
Questionnaires were returned to the MCH Institute for final editing and data processing. The office editing staff checked that questionnaires for all selected households and eligible respondents were returned from the field. Additionally, final editing included coding for a set of categories such as occupation and type of iron pills. Data were then entered and edited on computers using the Integrated System for Survey Analysis (ISSA) package, with data software translated into Russian. Office editing and data entry activities began on August 15 and were completed on October 14, 2000.
Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the TDHS 2000 to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.