| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................ xvii
STEERING COMMITTEE ...................................................................................................................... xix
CONTRIBUTORS TO THE REPORT ................................................................................................... xxi
ABBREVIATIONS ................................................................................................................................. xxiii
MILLENNIUM DEVELOPMENT GOAL INDICATORS .................................................................. xxv
MAP OF NIGERIA ................................................................................................................................. xxvi
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 Population and Health Policies ............................................................................................ 3
1.3.1 National Population Policy .................................................................................... 3
1.3.2 Health Policy .......................................................................................................... 4
1.4 Organisation of the 2013 Nigeria Demographic and Health Survey ................................... 6
1.4.1 Sample Design ....................................................................................................... 7
1.4.2 Questionnaires ....................................................................................................... 7
1.4.3 Recruitment and Training of Field Staff ................................................................ 9
1.4.4 Fieldwork ............................................................................................................... 9
1.4.5 Data Processing .................................................................................................... 10
1.5 Response Rates .................................................................................................................. 10
2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS .............................. 11
2.1 Household Environment .................................................................................................... 11
2.1.1 Drinking Water .................................................................................................... 11
2.1.2 Household Sanitation Facilities ........................................................................... 13
2.1.3 Housing Characteristics ....................................................................................... 14
2.1.4 Household Possessions ........................................................................................ 15
2.2 Wealth Index ..................................................................................................................... 15
2.3 Hand Washing ................................................................................................................... 16
2.4 Household Population by Age, Sex, and Residence .......................................................... 18
2.5 Household Composition .................................................................................................... 19
2.6 Birth Registration .............................................................................................................. 20
2.7 Education of the Household Population ............................................................................ 23
2.7.1 Educational Attainment ....................................................................................... 23
2.7.2 School Attendance Ratios .................................................................................... 26
3 CHARACTERISTICS OF RESPONDENTS ............................................................................. 31
3.1 Characteristics of Survey Respondents ............................................................................. 31
3.2 Educational Attainment by Background Characteristics ................................................... 33
3.3 Literacy .............................................................................................................................. 36
3.4 Exposure to Mass Media ................................................................................................... 39
3.5 Employment ...................................................................................................................... 42
3.6 Occupation ......................................................................................................................... 46
3.7 Type of Employment ......................................................................................................... 49
3.8 Health Insurance Coverage ................................................................................................ 50
3.9 Use of Tobacco .................................................................................................................. 52
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 53
4.1 Marital Status ..................................................................................................................... 53
4.2 Polygyny ............................................................................................................................ 54
4.3 Age at First Marriage ......................................................................................................... 57
4.4 Age at First Sexual Intercourse ......................................................................................... 58
4.5 Recent Sexual Activity ...................................................................................................... 61
5 FERTILITY ................................................................................................................................... 65
5.1 Current Fertility ................................................................................................................. 65
5.2 Fertility Differentials ......................................................................................................... 67
5.3 Fertility Trends .................................................................................................................. 70
5.4 Children Ever Born and Living ......................................................................................... 71
5.5 Birth Intervals .................................................................................................................... 72
5.6 Postpartum Amenorrhoea, Abstinence, and Insusceptibility ............................................. 74
5.7 Menopause ......................................................................................................................... 77
5.8 Age at First Birth ............................................................................................................... 77
5.9 Teenage Pregnancy and Motherhood ................................................................................ 78
6 FERTILITY PREFERENCES ..................................................................................................... 81
6.1 Desire for More Children .................................................................................................. 81
6.2 Desire to Limit Childbearing by Background Characteristics ........................................... 83
6.3 Ideal Family Size ............................................................................................................... 85
6.4 Fertility Planning Status .................................................................................................... 86
6.5 Wanted Fertility Rates ....................................................................................................... 87
7 FAMILY PLANNING .................................................................................................................. 89
7.1 Knowledge of Contraceptive Methods .............................................................................. 89
7.2 Knowledge of Contraceptive Methods by Background Characteristics ............................ 91
7.3 Current Use of Contraception ............................................................................................ 92
7.4 Current Use of Contraception by Background Characteristics .......................................... 94
7.5 Trends in Contraceptive Use ............................................................................................. 97
7.6 Source of Modern Contraceptive Methods ........................................................................ 98
7.7 Use of Social Marketing Brand Pills ................................................................................. 98
7.8 Use of Social Marketing Brand Condoms ......................................................................... 99
7.9 Informed Choice .............................................................................................................. 101
7.10 Rates of Discontinuing Contraceptive Methods .............................................................. 102
7.11 Reasons for Discontinuing Contraceptive Methods ........................................................ 103
7.12 Knowledge of the Fertile Period ...................................................................................... 104
7.13 Need and Demand for Family Planning .......................................................................... 104
7.14 Future Use of Contraception ............................................................................................ 110
7.15 Exposure to Family Planning Messages in the Media ..................................................... 110
7.16 Exposure to Specific Family Planning Messages ............................................................ 112
7.17 Contact of Nonusers with Family Planning Providers ..................................................... 114
8 INFANT AND CHILD MORTALITY ...................................................................................... 117
8.1 Data Quality ..................................................................................................................... 118
8.2 Levels and Trends in Infant and Child Mortality ............................................................ 118
8.2.1 Early Childhood Mortality Rates ....................................................................... 118
8.2.2 Trends in Early Childhood Mortality ................................................................. 119
8.3 Early Childhood Mortality Rates by Socioeconomic Characteristics .............................. 120
8.4 Demographic Differentials in Early Childhood Mortality Rates ..................................... 121
8.5 Perinatal Mortality ........................................................................................................... 122
8.6 High-Risk Fertility Behaviour ......................................................................................... 123
9 REPRODUCTIVE HEALTH .................................................................................................... 127
9.1 Antenatal Care ................................................................................................................. 128
9.1.1 Number and Timing of Antenatal Visits ............................................................ 130
9.1.2 Components of Antenatal Care .......................................................................... 131
9.1.3 Tetanus Toxoid Injections .................................................................................. 133
9.2 Delivery ........................................................................................................................... 135
9.2.1 Place of Delivery................................................................................................ 135
9.2.2 Reasons for Not Delivering in a Health Facility ................................................ 137
9.2.3 Assistance during Delivery ................................................................................ 139
9.3 Postnatal Care .................................................................................................................. 141
9.3.1 Timing of First Postnatal Checkup for Mother .................................................. 141
9.3.2 Provider of First Postnatal Checkup for Mother ................................................ 143
9.4 Newborn Care .................................................................................................................. 145
9.4.1 Timing of First Postnatal Checkup for Newborn ............................................... 145
9.4.2 Provider of First Postnatal Checkup for Newborn ............................................. 147
9.4.3 Use of Clean Home Delivery Kits ..................................................................... 149
9.4.4 Newborn Care Practices ..................................................................................... 151
9.5 Problems in Accessing Health Care ................................................................................ 153
10 CHILD HEALTH ........................................................................................................................ 155
10.1 Child’s Size and Weight at Birth ..................................................................................... 156
10.2 Vaccination Coverage...................................................................................................... 158
10.2.1 Vaccination Coverage by Background Characteristics ...................................... 159
10.2.2 Trends in Vaccination Coverage ........................................................................ 161
10.3 Acute Respiratory Infection ............................................................................................. 161
10.4 Fever ................................................................................................................................ 163
10.5 Diarrhoeal Disease ........................................................................................................... 165
10.5.1 Prevalence of Diarrhoea ..................................................................................... 166
10.5.2 Treatment of Diarrhoea ...................................................................................... 167
10.5.3 Feeding Practices during Diarrhoea ................................................................... 169
10.6 Knowledge of ORS Packets ............................................................................................ 171
10.7 Stool Disposal .................................................................................................................. 171
11 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 175
11.1 Nutritional Status of Children .......................................................................................... 175
11.1.1 Measurement of Nutritional Status among Young Children .............................. 176
11.1.2 Data Collection .................................................................................................. 177
11.1.3 Measures of Child Nutritional Status ................................................................. 177
11.1.4 Trends in Children’s Nutritional Status ............................................................. 180
11.2 Breastfeeding and Complementary Feeding .................................................................... 181
11.2.1 Initiation of Breastfeeding ................................................................................. 181
11.2.2 Breastfeeding Status by Age .............................................................................. 184
11.2.3 Duration of Breastfeeding .................................................................................. 186
11.2.4 Types of Complementary Foods ........................................................................ 187
11.3 Infant and Young Child Feeding (IYCF) Practices ......................................................... 188
11.4 Micronutrient Intake among Children ............................................................................. 192
11.5 Nutritional Status of Women ........................................................................................... 195
11.6 Micronutrient Intake among Mothers .............................................................................. 197
12 MALARIA ................................................................................................................................... 201
12.1 Mosquito Nets ................................................................................................................. 202
12.2 Indoor Residual Spraying ................................................................................................ 204
12.3 Access to an Insecticide-Treated Net (ITN) .................................................................... 206
12.4 Use of Mosquito Nets by Persons in the Household ....................................................... 208
12.5 Use of Existing ITNs ....................................................................................................... 210
12.6 Use of Mosquito Nets by Children under Age 5 ............................................................. 212
12.7 Use of Mosquito Nets by All Women and Pregnant Women Age 15-49 ........................ 213
12.8 Prophylactic Use of Antimalarial Drugs and Use of Intermittent Preventive Treatment in Pregnant Women ....... 215
12.9 Prevalence and Prompt Treatment of Fever in Children under Age 5 ............................. 217
12.10 Source of Advice or Treatment for Children with Fever ................................................. 220
13 HIV- AND AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ............ 223
13.1 HIV and AIDS Knowledge, Transmission, and Prevention Methods ............................. 224
13.1.1 Awareness of HIV and AIDS............................................................................. 224
13.1.2 Knowledge of HIV Prevention Methods ........................................................... 226
13.1.3 Rejection of Misconceptions about HIV/AIDS ................................................. 228
13.2 Knowledge of Mother-to-Child Transmission of HIV .................................................... 231
13.3 Accepting Attitudes Toward Those Living with HIV and AIDS .................................... 233
13.4 Attitudes Towards Negotiating Safer Sex ....................................................................... 236
13.5 Attitudes Toward Condom Education for Youth ............................................................. 238
13.6 Higher-Risk Sex .............................................................................................................. 240
13.6.1 Multiple Sexual Partners .................................................................................... 240
13.6.2 Point Prevalence and Cumulative Prevalence of Concurrent Sexual Partners ... 243
13.7 Transactional Sex ............................................................................................................ 245
13.8 Testing for HIV ............................................................................................................... 246
13.8.1 General HIV Testing .......................................................................................... 246
13.8.2 HIV Counselling and Testing during Pregnancy ............................................... 250
13.9 Male Circumcision .......................................................................................................... 252
13.10 Self-Reporting of Sexually Transmitted Infections ......................................................... 256
13.11 Prevalence of Medical Injections..................................................................................... 258
13.12 HIV- and AIDS-Related Knowledge and Behaviour among Youth ................................ 260
13.12.1 Knowledge about HIV and AIDS and of Sources for Condoms ........................ 260
13.12.2 Age at First Sexual Intercourse among Youth ................................................... 262
13.12.3 Trends in Age at First Sexual Intercourse among Youth ................................... 264
13.12.4 Abstinence and Premarital Sex .......................................................................... 264
13.12.5 Multiple Partnerships among Young People...................................................... 266
13.12.6 Age Mixing in Sexual Relationships among Young Women Age 15-19 .......... 268
13.12.7 Recent HIV Tests among Youth ........................................................................ 270
14 ADULT AND MATERNAL MORTALITY ............................................................................. 273
14.1 Data ................................................................................................................................. 274
14.2 Direct Estimates of Adult Mortality ................................................................................ 275
14.2.1 Trends in Adult Mortality .................................................................................. 276
14.3 Direct Estimates of Maternal Mortality ........................................................................... 277
15 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES ... 279
15.1 Employment and Form of Earnings ................................................................................. 280
15.2 Control Over and Relative Magnitude of Women’s and Husbands’ Earnings ................ 280
15.2.1 Control Over Wife’s Earnings ........................................................................... 280
15.2.2 Control Over Husband’s Earnings ..................................................................... 282
15.3 Control Over Women’s Earnings and Relative Size of Husband’s and Wife’sv Earnings ............. 284
15.4 Ownership of Assets ........................................................................................................ 285
15.5 Women’s Participation in Decision Making .................................................................... 288
15.6 Attitudes Toward Wife Beating ....................................................................................... 292
15.7 Women’s Empowerment Indices ..................................................................................... 296
15.8 Current Use of Contraception by Women’s Status .......................................................... 297
15.9 Ideal Family Size and Unmet Need by Women’s Status ................................................. 298
15.10 Women’s Status and Reproductive Health Care .............................................................. 299
15.11 Differentials in Infant and Child Mortality by Women’s Status ...................................... 300
16 DOMESTIC VIOLENCE ........................................................................................................... 301
16.1 Measurement of Violence ................................................................................................ 302
16.1.1 Use of Valid Measures of Violence ................................................................... 302
16.1.2 Ethical Considerations ....................................................................................... 303
16.1.3 Subsample for the Violence Module .................................................................. 303
16.2 Women Experiencing Physical Violence ........................................................................ 303
16.3 Perpetrators of Physical Violence .................................................................................... 306
16.4 Experience of Sexual Violence ........................................................................................ 307
16.5 Persons Committing Sexual Violence ............................................................................. 309
16.6 Age at First Experience of Sexual Violence .................................................................... 309
16.7 Experience of Different Forms of Violence .................................................................... 309
16.8 Violence during Pregnancy ............................................................................................. 310
16.9 Marital Control by Husband or Partner ........................................................................... 311
16.10 Forms of Spousal Violence .............................................................................................. 313
16.11 Spousal Violence by Background Characteristics ........................................................... 315
16.12 Violence by Spousal Characteristics and Women’s Empowerment Indicators ............... 317
16.13 Recent Spousal Violence ................................................................................................. 319
16.14 Onset of Spousal Violence .............................................................................................. 321
16.15 Types of Injuries Caused by Spousal Violence ............................................................... 321
16.16 Violence by Women Against Their Spouse ..................................................................... 322
16.17 Help-seeking Behaviour by Women who Experience Violence ...................................... 325
16.18 Sources of Help ............................................................................................................... 327
16.19 Domestic Violence Faced by Widowed Women ............................................................. 328
17 ORPHANS AND VULNERABLE CHILDREN ...................................................................... 329
17.1 Orphans and Vulnerable Children ................................................................................... 330
17.1.1 Children’s Living Arrangements and Orphanhood ............................................ 330
17.1.2 Orphaned and Vulnerable Children ................................................................... 331
17.2 Social and Economic Situation of Orphaned and Vulnerable Children........................... 333
17.2.1 School Attendance ............................................................................................. 333
17.2.2 Basic Material Needs ......................................................................................... 334
17.2.3 Orphans Living with Siblings ............................................................................ 336
17.2.4 Nutritional Status ............................................................................................... 337
17.2.5 Sex Before Age 15 ............................................................................................. 338
17.3 Care and Support for Orphaned and Vulnerable Children............................................... 339
17.3.1 Widows Dispossessed of Property ..................................................................... 339
17.3.2 External Support for Households with OVCs .................................................... 341
18 FEMALE GENITAL CUTTING ............................................................................................... 345
18.1 Knowledge of Female Circumcision ............................................................................... 346
18.2 Prevalence of Female Circumcision ................................................................................ 348
18.3 Age at Circumcision ........................................................................................................ 351
18.4 Circumcision of Daughters .............................................................................................. 353
18.5 Person Who Performed Circumcision ............................................................................. 357
18.6 Attitudes Toward Female Circumcision .......................................................................... 358
REFERENCES ......................................................................................................................................... 363
APPENDIX A ADDITIONAL TABLES .............................................................................................. 369
APPENDIX B SAMPLE DESIGN AND IMPLEMENTATION ........................................................ 377
APPENDIX C ESTIMATES OF SAMPLING ERRORS ................................................................... 385
APPENDIX D DATA QUALITY TABLES ......................................................................................... 397
APPENDIX E PERSONS INVOLVED IN THE SURVEY ................................................................ 401
APPENDIX F QUESTIONNAIRES ..................................................................................................... 411 |
