Survey ID Number
BWA_1988_DHS_v01_M
Title
Family Health Survey II 1988
Abstract
The BFHS-II was a national sample survey designed to provide information on fertility, family planning, and health in Botswana. The BFHS-II involved interviewing a randomly selected group of women between 15 and 49 years of age. These women were asked questions about their background, the children they had given births to, their knowledge and use of family planning methods, some health matters and other information which will be helpful to policy-makers and administrators in the health and family planning areas.
The objectives of the BFHS-II are to provide information on family planning awareness, approval and use, basic indicators of maternal and child health, and other topics related to family health. In addition, the BFHS-II complements the data collected in the BDS, by obtaining information needed to explore trends in fertility and mortality, and to examine the factors that influence these basic demographic indicators, particularly, the proximate determinants of fertility.
Specific objectives are:
- To collect information on fertility and family planning;
- To find out what type of women are likely to have more or fewer children or to use or not use family planning;
- To collect information on certain health-related matters such as antenatal checkups, supervised deliveries, postnatal care, brcastfeeding, immunisation, and diarrhoea treatment;
- To develop skills in conducting periodic surveys designed to monitor changes in demographic rates, health status, and the use of family planning; and
- To provide internationally comparable data which can be used by researchers investigating topics related to fertility, mortality and maternal-child health.
MAIN RESULTS
- The BFHS-II found that current fertility levels in Botswana remain high; however, the results show a decline in fertility in recent years.
- The BFHS-II found that traditional practices of breastfeeding and post-partum abstinence continue to be important factors in protecting women from a subsequent pregnancy. However, there is evidence that the duration of these practices is being curtailed among urban women.
- Knowledge of family planning methods and of places to obtain them is critical in the decision whether to use family planning and which method to use. The BFHS-II found that the MCH/FP programme has been quite successful in educating women about family planning.
- Use of contraception is the most important measurement of success in a family planning programme. The BFHS-II found that more than half of Batswana women have used a modern method of family planning at sometime and three out of ten women are currently using a contraceptive method to delay or avoid a birth.
- The BFHS-II found that women who are not currently using family planning, but do not wish to become pregnant soon, report a number of barriers to using family planning. A significant number of these women do intend to use family planning in the future.
- The BFHS-II also looked at the issue of women's perceptions about their partner's attitudes toward family planning. Within couples, male approval is much lower than that of females, although the reported level of partner's approval has increased since 1984.
- The BFHS-II results suggest that Batswana women have a growing interest in spacing births but continue to have a preference for many children.
- The BFHS-II documents that many women had a birth sooner that they would have liked although only a minority of women had another birth when they preferred not to have any more children.
- Women can be considered in need of family planning if they are not currently using a method of contraception and either want no more births or want to postpone the next birth for two or more years. The BFHS-II found that 45 percent of women in union are in need of family planning.
- Since teenage pregnancy places the health and welfare of teenagers and their births at risk, the Government of Botswana encourages women to wait until age 20 before their first pregnancy. The BFHS-II found that nearly one-quarter of teenagers had at least one birth and an additional 5 percent were pregnant with their first child at the time of the survey.
- The BFHS-II also documents that the MCH/FP programme has made a successful contribution to the reduction of infant and child mortality, though children of mothers with no education and children born soon after a previous birth have higher mortality rates.
- The BFHS-II documents that maternal and child health services are widely used by women in Botswana and the programme has expanded significantly since 1984.
- The BFHS-II found that a significant proportion of ill children received appropriate treatment. Although a large proportion of children who suffered from diarrhoea were treated with oral rehydration therapy, of concern is the significant proportion for whom fluid and food intake was cut down during the diarrhoeal episode.
- The BFHS-II included questions on knowledge of AIDS, the ways the disease is transmitted, who is at highest risk, and behaviors that will help someone avoid the disease. In the absence of either a vaccine or a cure for AIDS, education about prevention is the main strategy for combatting the epidemic. Nearly all women interviewed in the BFHS-II had heard of AIDS. However, many women lack correct information or have misconceptions about the disease.
RECOMMENDATIONS
The results of the 1984 BFHS showed that the Botswana MCH/FP programme has made considerable progress in providing health and contraceptive services to women of childbearing age. The 1988 BFHS (BFHS-II) confirms this and documents the further progress made between 1984 and 1988. The results of the BFHS-II indicate that utilization of MCH services has increased, along with knowledge and use of family planning. However, the 1988 findings also point to areas of the MCH/FP programme that need improvement.
I. An area where additional effort is needed is in Information, Education, and Communication (also recommended in 1984):
- Counselling services should be strengthened so that they are better able to disseminate information about family planning and dispel misconceptions women have regarding the use of contraception. The strengthening of the services should be targeted not only towards clients but also health workers.
- Information, education, and communication (IEC) activities at the district level need strengthening by training or designating officers specifically to carry out these services.
II. Outstanding recommendations from the 1984 BFHS should continue to receive emphasis:
- Further efforts should be directed toward educating and counseling teenagers (both boys and girls) about responsible sexual behavior.
- Additional attention should be placed on informing men about the health and other benefits of family planning. Emphasis should be placed on the importance of couple communication in this area and on the fact that childbearing is the joint responsibility of the couple and not the choice of the man or woman alone.
- Stress should continue to be placed on the health benefits of traditional practices such as breastfeeding and post-partum abstinence.
IEC materials targeting special population subgroups, e.g., illiterate women, should be developed.
- Emphasis should be placed on identifying women in need of family planning services, particularly those concerned about limiting their family size. Counseling about family planning during the provision of antenatal and post-partum services is a key mechanism in reaching these women.
- Potential acceptors should be counseled about the most appropriate methods for their age, life situation and fertility intentions.
- Research should be undertaken to further investigate the determinants and consequences of adolescent childbearing.
- Acceptors should be informed about possible side effects associated with the method they adopt, and follow-up of acceptors should be emphasized to reduce the levels of discontinuation due to side effects.