| Author(s) |
Liberia Institute of Statistics and Geo-Information Services (LISGIS), Monrovia, Liberia Ministry of Health and Social Welfare, Monrovia, Liberia National AIDS Control Program, Monrovia, Liberia ICF International Inc., Rockville, Maryland, USA |
| Table of contents |
LIST OF TABLES AND FIGURES ................................................................................................................. ix
FOREWORD .................................................................................................................................................. xvii
ACKNOWLEDGMENTS ............................................................................................................................... xxi
MILLENIUM DEVELOPMENT GOAL INDICATORS .......................................................................... xxiii
MAP OF LIBERIA ........................................................................................................................................ xxiv
1 INTRODUCTION ................................................................................................................................. 1
1.1 HISTORY, GEOGRAPHY, AND ECONOMY........................................................................ 1
1.2 OBJECTIVES OF THE SURVEY ............................................................................................ 2
1.3 ORGANIZATION OF THE SURVEY ..................................................................................... 2
1.4 SURVEY IMPLEMENTATION .............................................................................................. 2
1.4.1 Sample Design ............................................................................................................. 2
1.4.2 Questionnaires ............................................................................................................. 3
1.4.3 HIV Testing ................................................................................................................. 4
1.4.4 Training of Field Staff ................................................................................................. 5
1.4.5 Fieldwork ..................................................................................................................... 6
1.4.6 Data Processing ............................................................................................................ 6
1.5 RESPONSE RATES ................................................................................................................. 7
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION ...................................... 9
2.1 HOUSEHOLD CHARACTERISTICS ..................................................................................... 9
2.1.1 Drinking Water .......................................................................................................... 10
2.1.2 Sanitation Facilities and Waste Disposal ................................................................... 11
2.1.3 Housing Characteristics ............................................................................................. 12
2.1.4 Household Possessions .............................................................................................. 14
2.1.5 Distance to a Health Facility ...................................................................................... 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 ............................................................................................ 19
2.6 BIRTH REGISTRATION ....................................................................................................... 20
2.7 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL .................... 21
2.8 EDUCATION OF THE HOUSEHOLD POPULATION ........................................................ 23
2.8.1 Educational Attainment ............................................................................................. 23
2.8.2 School Attendance Ratios .......................................................................................... 25
2.9 UTILIZATION OF HEALTH SERVICES AND OUT-OF-POCKET EXPENDITURES FOR HEALTH CARE .. 29
3 CHARACTERISTICS OF RESPONDENTS ................................................................................... 33
3.1 CHARACTERISTICS OF SURVEY RESPONDENTS ......................................................... 33
3.2 EDUCATIONAL ATTAINMENT BY BACKGROUND CHARACTERISTICS ................. 35
3.3 LITERACY ............................................................................................................................. 37
3.4 EXPOSURE TO MASS MEDIA ............................................................................................ 40
3.5 EMPLOYMENT STATUS ..................................................................................................... 42
3.6 OCCUPATION ....................................................................................................................... 45
3.7 TYPE OF EMPLOYMENT .................................................................................................... 48
3.8 HEALTH INSURANCE COVERAGE ................................................................................... 48
3.9 USE OF TOBACCO ............................................................................................................... 50
3.10 USE OF ALCOHOL ............................................................................................................... 53
4 MARRIAGE AND SEXUAL ACTIVITY ........................................................................................ 57
4.1 MARITAL STATUS ............................................................................................................... 57
4.2 POLYGYNY ........................................................................................................................... 58
4.3 AGE AT FIRST MARRIAGE ................................................................................................ 60
4.4 AGE AT FIRST SEXUAL INTERCOURSE .......................................................................... 62
4.5 RECENT SEXUAL ACTIVITY ............................................................................................. 64
5 FERTILITY ......................................................................................................................................... 69
5.1 CURRENT FERTILITY ......................................................................................................... 69
5.2 FERTILITY BY BACKGROUND CHARACTERISTICS .................................................... 70
5.3 FERTILITY TRENDS ............................................................................................................ 71
5.4 CHILDREN EVER BORN AND LIVING ............................................................................. 72
5.5 BIRTH INTERVALS .............................................................................................................. 73
5.6 POSTPARTUM AMENORRHEA, ABSTINENCE, AND INSUSCEPTIBILITY ................ 75
5.7 MEDIAN DURATION OF POSTPARTUM INSUSCEPTIBILITY BY BACKGROUND CHARACTERISTICS ....... 75
5.8 MENOPAUSE ......................................................................................................................... 77
5.9 AGE AT FIRST BIRTH .......................................................................................................... 77
5.10 MEDIAN AGE AT FIRST BIRTH BY BACKGROUND CHARACTERISTICS ................ 78
5.11 TEENAGE PREGNANCY AND MOTHERHOOD .............................................................. 79
6 FERTILITY PREFERENCES ........................................................................................................... 81
6.1 FERTILITY PREFERENCES BY NUMBER OF LIVING CHILDREN .............................. 81
6.2 DESIRE TO LIMIT CHILDBEARING BY BACKGROUND CHARACTERISTICS ......... 82
6.3 IDEAL NUMBER OF CHILDREN ........................................................................................ 84
6.4 MEAN IDEAL NUMBER OF CHILDREN BY BACKGROUND CHARACTERISTICS .. 86
6.5 FERTILITY PLANNING STATUS ........................................................................................ 86
6.6 WANTED FERTILITY RATES ............................................................................................. 87
7 FAMILY PLANNING ........................................................................................................................ 89
7.1 KNOWLEDGE OF CONTRACEPTIVE METHODS ............................................................ 89
7.2 CURRENT USE OF CONTRACEPTION .............................................................................. 91
7.3 CURRENT USE OF CONTRACEPTION BY BACKGROUND CHARACTERISTICS ..... 92
7.4 SOURCE OF MODERN CONTRACEPTIVE METHODS ................................................... 95
7.5 USE OF SOCIAL MARKETING BRAND PILLS ................................................................. 96
7.6 INFORMED CHOICE ............................................................................................................ 97
7.7 RATES OF DISCONTINUING CONTRACEPTIVE METHODS ........................................ 98
7.8 REASONS FOR DISCONTINUING CONTRACEPTIVE METHODS ................................ 98
7.9 KNOWLEDGE OF THE FERTILE PERIOD ........................................................................ 99
7.10 NEED AND DEMAND FOR FAMILY PLANNING .......................................................... 100
7.11 FUTURE USE OF CONTRACEPTION ............................................................................... 104
7.12 EXPOSURE TO FAMILY PLANNING MESSAGES IN THE MEDIA ............................. 105
7.13 CONTACT OF NONUSERS WITH FAMILY PLANNING PROVIDERS ........................ 106
8 INFANT AND CHILD MORTALITY ............................................................................................ 109
8.1 BACKGROUND AND ASSESSMENT OF DATA QUALITY .......................................... 109
8.2 INFANT AND CHILD MORTALITY LEVELS AND TRENDS ....................................... 111
8.3 SOCIOECONOMIC DIFFERENTIALS IN EARLY CHILDHOOD MORTALITY .......... 112
8.4 DEMOGRAPHIC DIFFERENTIALS IN EARLY CHILDHOOD MORTALITY .............. 113
8.5 PERINATAL MORTALITY ................................................................................................ 114
8.6 HIGH-RISK FERTILITY BEHAVIOR ................................................................................ 115
9 MATERNAL HEALTH CARE ....................................................................................................... 117
9.1 PRENATAL CARE ............................................................................................................... 117
9.2 NUMBER AND TIMING OF PRENATAL VISITS ............................................................ 120
9.3 COMPONENTS OF PRENATAL CARE ............................................................................. 120
9.4 TETANUS TOXOID ............................................................................................................. 122
9.5 PLACE OF DELIVERY ....................................................................................................... 124
9.6 ASSISTANCE DURING DELIVERY .................................................................................. 125
9.7 POSTNATAL CARE FOR THE MOTHER ......................................................................... 128
9.8 POSTNATAL CARE FOR THE NEWBORN ...................................................................... 131
9.9 PROBLEMS IN ACCESSING HEALTH CARE ................................................................. 135
10 CHILD HEALTH .............................................................................................................................. 137
10.1 CHILD’S WEIGHT AND SIZE AT BIRTH ........................................................................ 137
10.2 VACCINATION OF CHILDREN ........................................................................................ 139
10.3 PREVALENCE AND TREATMENT OF ACUTE RESPIRATORY INFECTION ............ 143
10.4 PREVALENCE AND TREATMENT OF FEVER ............................................................... 145
10.5 DIARRHEAL DISEASE ....................................................................................................... 147
10.5.1 Prevalence of Diarrhea ............................................................................................. 147
10.5.2 Treatment of Diarrhea .............................................................................................. 149
10.5.3 Feeding Practices during Diarrhea ........................................................................... 151
10.6 KNOWLEDGE OF ORS PACKETS .................................................................................... 153
10.7 DISPOSAL OF CHILDREN’S STOOLS ............................................................................. 154
11 NUTRITION OF CHILDREN AND ADULTS .............................................................................. 157
11.1 NUTRITIONAL STATUS OF CHILDREN ......................................................................... 157
11.1.1 Measurement of Nutritional Status among Young Children .................................... 158
11.1.2 Data Collection ........................................................................................................ 159
11.1.3 Levels of Child Malnutrition ................................................................................... 159
11.1.4 Trends in Child Malnutrition ................................................................................... 161
11.2 BREASTFEEDING ............................................................................................................... 162
11.2.1 Initiation of Breastfeeding ....................................................................................... 162
11.2.2 Breastfeeding Status by Age .................................................................................... 164
11.2.3 Median Duration of Breastfeeding ........................................................................... 166
11.3 DIETARY DIVERSITY AMONG YOUNG CHILDREN ................................................... 167
11.3.1 Foods and Liquids Consumed by Infants and Young Children ............................... 168
11.3.2 Infant and Young Child Feeding (IYCF) Practices .................................................. 169
11.4 MICRONUTRIENT INTAKE AND SUPPLEMENTATION AMONG CHILDREN ......... 171
11.5 PRESENCE OF IODIZED SALT IN HOUSEHOLDS ........................................................ 174
11.6 ADULT NUTRITIONAL STATUS ...................................................................................... 175
11.6.1 Nutritional Status of Women ................................................................................... 175
11.6.2 Nutritional Status of Men ......................................................................................... 177
11.7 MICRONUTRIENT INTAKE AMONG MOTHERS .......................................................... 178
12 MALARIA ......................................................................................................................................... 181
12.1 OWNERSHIP OF MOSQUITO NETS ................................................................................. 182
12.2 INDOOR RESIDUAL SPRAYING ...................................................................................... 183
12.3 ACCESS TO MOSQUITO NETS ......................................................................................... 185
12.4 USE OF MOSQUITO NETS ................................................................................................ 186
12.4.1 Use of Mosquito Nets by Persons in the Household ................................................ 186
12.4.2 Use of Existing Mosquito Nets ................................................................................ 188
12.4.3 Use of Mosquito Nets by Children Under 5............................................................. 189
12.4.4 Use of Mosquito Nets by Pregnant Women ............................................................. 192
12.5 INTERMITTENT PREVENTIVE TREATMENT OF MALARIA IN PREGNANCY ....... 193
12.6 PREVALENCE, DIAGNOSIS, AND PROMPT TREATMENT OF FEVER AMONG CHILDREN ............ 195
13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR ................................ 201
13.1 HIV/AIDS KNOWLEDGE, TRANSMISSION, AND PREVENTION METHODS ........... 202
13.2 KNOWLEDGE ABOUT MOTHER-TO-CHILD TRANSMISSION ................................... 208
13.3 ATTITUDES TOWARD PEOPLE LIVING WITH HIV/AIDS ........................................... 210
13.4 ATTITUDES TOWARD NEGOTIATING FOR SAFER SEXUAL RELATIONS WITH HUSBANDS ..... 213
13.5 ATTITUDES TOWARDS CONDOM EDUCATION FOR YOUNG PEOPLE .................. 214
13.6 MULTIPLE SEXUAL PARTNERS ..................................................................................... 215
13.7 PAID SEX ............................................................................................................................. 220
13.8 COVERAGE OF HIV TESTING SERVICES ...................................................................... 222
13.9 MALE CIRCUMCISION ...................................................................................................... 227
13.10 SELF-REPORTING OF SEXUALLY TRANSMITTED INFECTIONS ............................. 227
13.11 INJECTIONS ........................................................................................................................ 229
13.12 HIV/AIDS-RELATED KNOWLEDGE AND BEHAVIOR AMONG YOUNG PEOPLE .. 231
13.12.1 Knowledge about HIV/AIDS and Source for Condoms .......................................... 231
13.12.2 First Sex ................................................................................................................... 232
13.12.3 Premarital Sex .......................................................................................................... 234
13.12.4 Multiple Sexual Partners .......................................................................................... 236
13.12.5 Age-mixing in Sexual Relationships ........................................................................ 237
13.12.6 Coverage of HIV Testing Services .......................................................................... 238
14 HIV PREVALENCE ......................................................................................................................... 241
14.1 COVERAGE RATES FOR HIV TESTING ......................................................................... 242
14.2 HIV PREVALENCE ............................................................................................................. 245
14.2.1 HIV Prevalence by Age and Sex .............................................................................. 245
14.2.2 HIV Prevalence by Socioeconomic Characteristics ................................................. 246
14.2.3 HIV Prevalence by Other Sociodemographic and Health Characteristics ............... 247
14.2.4 HIV Prevalence by Sexual Risk Behavior ............................................................... 249
14.3 HIV PREVALENCE AMONG YOUNG PEOPLE .............................................................. 251
14.4 HIV PREVALENCE BY OTHER CHARACTERISTICS RELATED TO HIV RISK ........ 253
14.5 HIV PREVALENCE AMONG COUPLES .......................................................................... 254
15 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES ......... 257
15.1 WOMEN’S AND MEN’S EMPLOYMENT ........................................................................ 257
15.2 WOMEN’S CONTROL OVER THEIR OWN EARNINGS AND RELATIVE MAGNITUDE OF WOMEN’S EARNINGS .............. 258
15.3 WOMEN’S OWNERSHIP OF ASSETS .............................................................................. 262
15.4 WOMEN’S AND MEN’S PARTICIPATION IN DECISION MAKING ............................ 265
15.5 ATTITUDES TOWARD WIFE BEATING ......................................................................... 269
15.6 WOMEN’S EMPOWERMENT INDICATORS ................................................................... 272
15.7 CURRENT USE OF CONTRACEPTION BY WOMEN’S EMPOWERMENT ................. 272
15.8 IDEAL FAMILY SIZE AND UNMET NEED BY WOMEN’S EMPOWERMENT .......... 273
15.9 WOMEN’S EMPOWERMENT AND REPRODUCTIVE HEALTH CARE ...................... 274
15.10 DIFFERENTIALS IN INFANT AND CHILD MORTALITY BY WOMEN’S EMPOWERMENT .................... 275
15.11 FEMALE GENITAL CUTTING ......................................................................................... 275
15.12 ATTITUDES TOWARD CHILD BEATING ....................................................................... 277
16 ADULT AND MATERNAL MORTALITY ................................................................................... 281
16.1 ASSESSMENT OF DATA QUALITY ................................................................................. 281
16.2 ESTIMATES OF ADULT MORTALITY ............................................................................ 282
16.3 ESTIMATES OF MATERNAL MORTALITY.................................................................... 283
REFERENCES ............................................................................................................................................... 287
APPENDIX A SAMPLE DESIGN .............................................................................................................. 291
APPENDIX B ESTIMATES OF SAMPLING ERRORS ......................................................................... 303
APPENDIX C DATA QUALITY TABLES ............................................................................................... 333
APPENDIX D PARTICIPANTS IN THE 2013 LIBERIA DEMOGRAPHIC AND HEALTH
SURVEY ............................................................................................................................... 339
APPENDIX E QUESTIONNAIRES ........................................................................................................... 345 |
