| Author(s) |
National Institute of Statistics, Ministry of Planning, Phnom Penh, Cambodia Directorate General for Health, Ministry of Health, Phnom Penh, Cambodia The DHS Program, ICF International, Rockville, Maryland, USA |
| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................ xvii
ACKNOWLEDGMENTS ......................................................................................................................... xix
MAP OF CAMBODIA ............................................................................................................................... xx
1 INTRODUCTION ........................................................................................................................... 1
1.1 Geodemography, History, and Economy ............................................................................. 1
1.1.1 Geodemography ..................................................................................................... 1
1.1.2 History ................................................................................................................... 2
1.1.3 Economy ................................................................................................................ 2
1.2 Health Status and Policy ...................................................................................................... 2
1.3 Objective and Survey Organization ..................................................................................... 4
1.4 Sample Design ..................................................................................................................... 4
1.5 Questionnaires ..................................................................................................................... 5
1.6 Training and Fieldwork ....................................................................................................... 7
1.7 Biomarker Testing ............................................................................................................... 7
1.7.1 Anthropometric Measurement ............................................................................... 7
1.7.2 Hemoglobin Testing............................................................................................... 8
1.7.3 Micronutrient Testing ............................................................................................ 8
1.8 Data Processing ................................................................................................................... 8
1.9 Sample Coverage ................................................................................................................. 8
2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS .............................. 11
2.1 Characteristics of the Household Population ..................................................................... 11
2.1.1 Age and Sex Composition ................................................................................... 11
2.1.2 Household Composition ....................................................................................... 13
2.2 Education of the Household Population ............................................................................ 14
2.3 Housing Characteristics ..................................................................................................... 17
2.3.1 Water Supply ....................................................................................................... 18
2.3.2 Sanitation Facilities .............................................................................................. 20
2.3.3 Hand Washing ...................................................................................................... 21
2.3.4 Flooring Material and Cooking Arrangements .................................................... 22
2.4 Household Possessions ...................................................................................................... 23
2.5 Household Wealth ............................................................................................................. 23
2.6 Birth Registration .............................................................................................................. 24
2.7 Children’s Living Arrangements, Orphanhood, and School Attendance by Survivorship of Parents ..... 25
2.7.1 Children’s Living Arrangements and Orphanhood .............................................. 25
2.7.2 School Attendance by Survivorship of Parents .................................................... 27
3 UTILIZATION OF HEALTH SERVICES FOR ACCIDENT, ILLNESS, OR INJURY ...... 29
3.1 Accidental Death or Injury ................................................................................................ 29
3.1.1 Frequency of Accidental Death or Injury ............................................................ 29
3.1.2 Type of Accident ................................................................................................. 30
3.2 Prevalence and Severity of Illness or Injury ...................................................................... 32
3.3 Treatment Sought for Illness or Injury .............................................................................. 33
3.4 Utilization of Health Care Facilities .................................................................................. 34
3.5 Cost for Health Care .......................................................................................................... 36
3.5.1 Distribution of Cost for Health Care .................................................................... 36
3.5.2 Expenditures for Health Care ............................................................................... 36
3.5.3 Sources of Money for Health Care Expenditures ................................................ 38
4 DISABILITY ................................................................................................................................. 41
4.1 Disability among the General Household Population ........................................................ 41
4.2 Disability among Ill or Injured Household Members ........................................................ 43
4.3 Disability and Employment ............................................................................................... 44
5 RESPONDENT CHARACTERISTICS ...................................................................................... 47
5.1 Characteristics of Survey Respondents ............................................................................. 47
5.2 Educational Attainment and Literacy ................................................................................ 49
5.3 Access to Mass Media ....................................................................................................... 52
5.4 Employment ...................................................................................................................... 55
5.4.1 Employment Status .............................................................................................. 55
5.4.2 Occupation ........................................................................................................... 57
5.4.3 Earnings, Employers, and Continuity of Employment ........................................ 59
5.5 Health Insurance ................................................................................................................ 60
5.6 Use of Tobacco .................................................................................................................. 62
6 FERTILITY ................................................................................................................................... 67
6.1 Current Fertility Levels and Differentials .......................................................................... 67
6.2 Fertility Trends .................................................................................................................. 70
6.2.1 Comparison of Current and Cumulative Fertility Levels ..................................... 70
6.2.2 Retrospective Data ............................................................................................... 70
6.2.3 Comparison with Previous CDHS ....................................................................... 71
6.3 Children Ever Born and Living ......................................................................................... 72
6.4 Birth Intervals .................................................................................................................... 73
6.5 Age at First Birth ............................................................................................................... 75
6.6 Teenage Pregnancy and Motherhood ................................................................................ 76
7 PRACTICE OF ABORTION ....................................................................................................... 79
7.1 Number of Lifetime Induced Abortions ............................................................................ 79
7.2 Practice of Abortion in the Past Five Years ....................................................................... 81
7.2.1 Pregnancy Duration at the Time of Abortion ....................................................... 81
7.2.2 Place of Abortion ................................................................................................. 82
7.2.3 Persons Who Helped with the Abortion .............................................................. 83
7.2.4 Method Used for the Abortion ............................................................................. 83
8 FAMILY PLANNING .................................................................................................................. 85
8.1 Knowledge of Contraceptive Methods .............................................................................. 85
8.2 Current Use of Contraceptive Methods ............................................................................. 86
8.3 Use of Social Marketing Brands ........................................................................................ 89
8.4 Knowledge of Fertile Period .............................................................................................. 90
8.5 Timing of Sterilization....................................................................................................... 91
8.6 Source of Family Planning Methods ................................................................................. 91
8.7 Informed Choice ................................................................................................................ 92
8.8 Future Use of Contraception .............................................................................................. 93
8.9 Exposure to Family Planning Messages ............................................................................ 94
8.10 Contact of Nonusers with Family Planning Providers ....................................................... 95
9 OTHER PROXIMATE DETERMINANTS OF FERTILITY .................................................. 97
9.1 Marital Status ..................................................................................................................... 97
9.2 Polygamy ........................................................................................................................... 98
9.3 Age at First Union ............................................................................................................. 99
9.4 Age at First Sexual Intercourse ....................................................................................... 102
9.5 Recent Sexual Activity .................................................................................................... 105
9.6 Postpartum Amenorrhea, Abstinence, and Insusceptibility ............................................. 108
9.7 Termination of Exposure to Pregnancy ........................................................................... 109
10 FERTILITY PREFERENCES ................................................................................................... 111
10.1 Desire for More Children ................................................................................................ 111
10.2 Need and Demand for Family Planning Services ............................................................ 114
10.3 Ideal Family Size ............................................................................................................. 116
10.4 Fertility Planning ............................................................................................................. 118
11 ADULT AND MATERNAL MORTALITY ............................................................................. 121
11.1 Data Quality Issues .......................................................................................................... 121
11.2 Adult Mortality ................................................................................................................ 123
11.3 Maternal Mortality ........................................................................................................... 123
12 INFANT AND CHILD MORTALITY ...................................................................................... 127
12.1 Assessment of Data Quality ............................................................................................ 128
12.2 Levels and Trends in Childhood Mortality ...................................................................... 128
12.3 Socioeconomic Differentials in Childhood Mortality ..................................................... 129
12.4 Demographic Differentials in Mortality .......................................................................... 131
12.5 Perinatal Mortality ........................................................................................................... 132
12.6 High-Risk Fertility Behavior ........................................................................................... 133
13 MATERNAL HEALTH ............................................................................................................. 137
13.1 Antenatal Care ................................................................................................................. 137
13.1.1 Source of Antenatal Care ................................................................................... 137
13.1.2 Components of Antenatal Care .......................................................................... 139
13.1.3 Tetanus Toxoid Vaccinations ............................................................................ 141
13.2 Childbirth and Delivery ................................................................................................... 141
13.2.1 Place of Delivery................................................................................................ 142
13.2.2 Assistance at Delivery ........................................................................................ 143
13.3 Postnatal Care and Practices ............................................................................................ 144
13.4 Perceived Problems in Accessing Women’s Health Care ............................................... 149
14 CHILD HEALTH ........................................................................................................................ 151
14.1 Child’s Size at Birth ........................................................................................................ 151
14.2 Immunization of Children ............................................................................................... 152
14.3 Acute Respiratory Infection ............................................................................................. 155
14.4 Fever ................................................................................................................................ 157
14.5 Diarrhea ........................................................................................................................... 158
14.6 Feeding Practices ............................................................................................................. 161
14.7 Knowledge of ORS Packets ............................................................................................ 163
14.8 Stool Disposal .................................................................................................................. 163
15 EARLY CHILDHOOD EDUCATION AND DEVELOPMENT ........................................... 165
15.1 Early Childhood Education and Learning ....................................................................... 165
15.2 Adequate Care for Young Children ................................................................................. 169
15.3 Early Childhood Development ........................................................................................ 170
16 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 173
16.1 Nutritional Status of Children .......................................................................................... 174
16.1.1 Measurement of Nutritional Status among Young Children .............................. 174
16.1.2 Measures of Child Nutritional Status ................................................................. 175
16.1.3 Trends in Children’s Nutritional Status ............................................................. 177
16.2 Initiation of Breastfeeding ............................................................................................... 178
16.3 Breastfeeding Status by Age ............................................................................................ 180
16.4 Duration of Breastfeeding ............................................................................................... 181
16.5 Types of Complementary Foods ...................................................................................... 183
16.6 Infant and Young Child Feeding (IYCF) Practices ......................................................... 184
16.7 Prevalence of Anemia in Children ................................................................................... 187
16.8 Micronutrient Intake among Children ............................................................................. 189
16.9 Use of Iodized Salt .......................................................................................................... 191
16.10 Nutritional Status of Women ........................................................................................... 192
16.11 Prevalence of Anemia in Women .................................................................................... 194
16.12 Micronutrient Intake among Mothers .............................................................................. 196
17 MICRONUTRIENTS ................................................................................................................. 199
17.1 Coverage of Micronutrient Testing ................................................................................. 200
17.2 Iron, Hemoglobin, and Parasitic Infections ..................................................................... 200
17.2.1 Anemia and Iron Status in Mothers ................................................................... 201
17.2.2 Anemia and Iron Status in Children ................................................................... 201
17.2.3 Intestinal Parasite Infection ................................................................................ 203
17.3 Vitamin and Calcium Deficiency .................................................................................... 203
17.3.1 Vitamin and Calcium Deficiency among Mothers ............................................. 203
17.3.2 Vitamin and Calcium Deficiency among Children ............................................ 203
17.4 Urine Iodine Concentration ............................................................................................. 205
18 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR .......................... 207
18.1 Knowledge of HIV/AIDS and of Transmission and Prevention Methods....................... 207
18.1.1 Awareness of AIDS ........................................................................................... 207
18.1.2 HIV Prevention Methods ................................................................................... 208
18.1.3 Knowledge about Transmission ......................................................................... 210
18.1.4 Knowledge of Mother-to-Child Transmission ................................................... 213
18.2 Stigma Associated with AIDS and Attitudes Related to HIV/AIDS ............................... 215
18.3 Attitudes towards Negotiating Safer Sex ......................................................................... 217
18.4 Multiple Sexual Partnerships ........................................................................................... 218
18.5 Testing for HIV ............................................................................................................... 223
18.6 Reports of Recent Sexually Transmitted Infections ........................................................ 227
18.7 Injections ......................................................................................................................... 229
18.8 HIV/AIDS-Related Knowledge and Behavior among Youth .......................................... 230
18.8.1 Knowledge about HIV/AIDS and Source for Condoms .................................... 231
18.8.2 Age at First Sex and Condom Use at First Sexual Intercourse .......................... 232
18.8.3 Recent Sexual Activity ...................................................................................... 234
18.8.4 Multiple Sexual Partnerships ............................................................................. 235
18.8.5 HIV Testing ....................................................................................................... 236
19 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES ... 239
19.1 Employment and Forms of Earnings ............................................................................... 239
19.2 Control over Women’s and Men’s Earnings ................................................................... 240
19.3 Participation in Household Decision Making .................................................................. 243
19.4 Ownership of Assets ........................................................................................................ 247
19.5 Attitudes towards Wife Beating ...................................................................................... 249
19.6 Women’s Empowerment Indicators ................................................................................ 252
19.7 Current Use of Contraception by Women’s Status .......................................................... 253
19.8 Ideal Family Size and Unmet Need by Women’s Status ................................................. 254
19.9 Reproductive Health Care and Women’s Empowerment Status ..................................... 255
20 DOMESTIC VIOLENCE ........................................................................................................... 257
20.1 Measurement of Violence ................................................................................................ 257
20.1.1 Use of Valid Measures of Violence ................................................................... 257
20.1.2 Ethical Considerations in the 2014 CDHS ......................................................... 258
20.1.3 Subsample for the Violence Module .................................................................. 259
20.2 Experience of Physical Violence ..................................................................................... 259
20.3 Perpetrators of Physical Violence .................................................................................... 261
20.4 Experience of Sexual Violence ........................................................................................ 262
20.5 Perpetrators of Sexual Violence ...................................................................................... 262
20.6 Age at First Experience of Sexual Violence .................................................................... 263
20.7 Experience of Different Forms of Violence .................................................................... 263
20.8 Violence during Pregnancy ............................................................................................. 264
20.9 Marital Control by Spouse ............................................................................................... 266
20.10 Forms of Spousal Violence .............................................................................................. 268
20.11 Spousal Violence by Background Characteristics ........................................................... 269
20.12 Violence by Spousal Characteristics and Women’s Empowerment Indicators ............... 271
20.13 Recent Spousal Violence by Any Husband or Partner .................................................... 273
20.14 Onset of Spousal Violence .............................................................................................. 273
20.15 Physical Consequences of Spousal Violence .................................................................. 274
20.16 Violence by Women against Their Husband ................................................................... 274
20.17 Help-seeking Behavior by Women Who Experience Violence ....................................... 276
REFERENCES ......................................................................................................................................... 279
APPENDIX A: SAMPLE IMPLEMENTATION .................................................................................. 281
A.1 Introduction ..................................................................................................................... 281
A.2 Sampling Frame ............................................................................................................... 281
A.3 Sampling Methodology and Procedure ........................................................................... 282
A.4 Sampling Probabilities ..................................................................................................... 284
APPENDIX B: ESTIMATES OF SAMPLING ERRORS .................................................................... 291
APPENDIX C: DATA QUALITY TABLES .......................................................................................... 317
APPENDIX D: PERSONS INVOLVED IN THE 2014 CAMBODIA DEMOGRAPHIC AND HEALTH SURVEY ........ 323
APPENDIX E: QUESTIONNAIRES ...................................................................................................... 327 |
