Nepal 1996: Results from the Family Health SurveySource: Studies in Family Planning, Vol. 29, No. 3 (Sep., 1998), pp. 329-333Published by: Population CouncilStable URL: http://www.jstor.org/stable/172279 .

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DATA

Nepal 1996: Results from the Family Health Survey

Introduction

The Nepal Family Health Survey (NFHS) was conducted under the aegis of the Family Health Division, Depart- ment of Health Services, Ministry of Health, Nepal, and

implemented by New ERA, Nepal, within the framework of the DHS Program of Macro International. Data for this

nationally representative survey were collected from 8,082 households, and complete individual interviews were conducted among 8,429 women aged 15-49. The in- terviews took place between mid-January and mid-June 1996.

The summary statistics presented below were taken from the Nepal country report,' with exceptions as noted.

Fertility 2.1 Fertility trends

8

6

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- 2

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E UN estimates

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4.6

1955-60 '60-65 '65-70 '70-75 '75-80 '80-85 '85-90 1993-96

Years

2.2 Fertility differentials, 1996

1.1 General characteristics of the population Percent

Characteristic 1965 1985 change Demographic

Population size (mil.) 10.4 17.0 +63.5 Crude birth rate (/1,000) 43.6 41.6 -4.6 Crude death rate (/11000) 23.8 15.8 -33.6 Population growth rate (%/year) 1.98 2.58 +30.3 Life expectancy (years) 40.0 49.6 +24.0

Socioeconomic GNP per capita ($) - 180 -

Adult literacy (%) - 26

Sources: See notes 2 and 3. aGNP per capita is given for 1991.

1.2 Percentage distribution of women surveyed, by level of education, according to residence

Residence Level of education Rural Urban Total a. None 82.9 48.1 80.0 b. Primary 10.6 15.4 11.0 c. Secondary+ 6.5 36.5 9.0 Total 100.0 100.0 100.0 (N) (7,717) (712) (8,429)

6

a) 7g4

.D

2

0 Rural Urban

Residence a b c

Educational level4

2.3 Age-specific fertility Years prior to survey

Age 0-4 5-9 10-14 15-19 15-19 131 156 158 147 20-24 271 294 301 302 25-29 230 262 287 297 30-34 164 193 233 (264) 35-39 102 125 (193) na 40-44 39 (59) na na 45-49 (14) na na na

Note: Age-specific fertility is measured in births per 1,000 women per year in each age group. Numbers in parentheses are partially truncated rates. na = Not available.

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Fertility Preferences

3.1 Mean ideal number of children, by age and number of living children for ever-married women

4

I 3 -o

C.- 0 a 2

C

a) V1

3.5 3.6 3.3

_ 3. 32 3.4

2.6 3y^ Of.0 v 2.8 2.7 2.

2.5

Current Contraceptive Use 4.1 Contraceptive prevalence differentials C 100

9 90 u Modern methods

80 i 80- rl Traditional methods X

70-

E 60- /// 50-

E 40 -

) 30 - 26.5 26.4

20-

Ita Q: I

Rural Urban

Residence

20-24 30-34 40-44

45+ 0 1 2 3 4 5 6+

Number of living children*

0o - I i I ...... 15-19 25-29 35-39

Age Includes current pregnancy.

3.2 Desire to stop childbearing among currently married women, by number of living children

100 -

: 86.7 88.5 85.7

o 80- 75.6 |

60 594 58.7

60 - 0 40 -

(D 20 -

IL r o ta 0 1 2 3 4 5 6 Total

Number of living children*

*Includes current pregnancy. **lncludes sterilized women.

3.3 Percentage distribution of births in the three years preceding the survey, by planning status, according to birth order, 1996

Birth order*

Planning status 1 2 3 4+ All Wanted then 78.3 69.3 60.7 48.3 61.9 Wanted later 20.0 28.9 24.7 10.9 19.2 Want no more 0.6 1.1 13.5 40.3 18.1 Missing 1.1 0.7 1.1 0.5 0.8 Total 100.0 100.0 100.0 100.0 100.0 (N) (1,200) (1,103) (875)(1,966) (5,144)

Includes current pregnancy.

a b c Educational level 4

2.5

26.0

Total

4.2 Contraceptive prevalence, by age and number of living children

c 70 a) E o 60 -o .? 50

E 40 5t

C 30

O 20 o

C 10 a)

C.)

42.7 39.6 40.7

39.0 38.5

30.7 27.9 06

15.8 11.7 6.5 i

20-24 30-34 40-44 34 I I ~~~~~,.I I~~~d I - b-ZU J 4- V I G a T

Age Number of living children

4.3 Percentage distribution of current users of modern methods, by most recent source of supply, according to method

Method Female Male

Injec- Con- Nor- sterili- sterili- Source Pill IUD tables dom plant zation zation All

Public sector 39.7 (60.8) 85.9 34.1 (87.6) 87.3 81.5 79.0

Hospital/district clinic 8.3 (52.3) 16.3 3.7 (53.6) 46.3 29.2 32.4 Primary health center 0.0 (0.0) 2.5 2.8 (3.1) 1.9 2.5 2.1

Family planning clinic 1.7 (3.6) 3.8 0.4 (4.5) 0.0 0.0 0.9 Health post 14.0 0.0) 30.7 19.5 (12.4) 0.0 0.0 7.7 Sub-health post 13.3 (0.0) 26.2 6.2 (0.0) 0.0 0.0 5.8 Mobile clinic 0.0 (0.0) 3.9 0.0 (4.7) 0.0 0.0 0.8 Mobile camp 0.0 (0.0) 0.0 0.0 (0.0) 38.7 49.8 28.3 Other 2.4 (5.0) 2.5 1.3 (9.3) 0.4 0.1 1.1 Private sector 36.4 (29.2) 13.5 38.3 (12.4) 9.1 10.6 14.1 Private hospital 0.0 (0.0) 3.6 0.0 (3.4) 2.3 3.3 2.4

Clinic/nursing home 4.1 (12.9) 1.4 1.5 (0.0) 0.7 0.7 1.2

Family Planning Association of Nepal 1.7 (10.8) 4.8 0.6 (9.0) 6.1 6.2 5.3

Pharmacy 26.3 (0.0) 2.1 32.7 (0.0) 0.0 0.0 4.3

Community health volunteer 4.3 (0.0) 0.2 2.9 (0.0) 0.0 0.0 0.5 Other 0.0 (5.5) 1.4 0.6 (0.0) 0.0 0.5 0.4

Other source 23.9 (10.0) 0.3 27.7 (0.0) 3.1 3.3 5.6 Female community health volunteer 18.0 (0.0) 0.0 6.7 (0.0) 0.0 0.0 1.5

Shop 0.7 (0.0) 0.0 12.7 (0.0) 0.0 0.0 1.0 Friends/relatives 1.4 (0.0) 0.0 1.2 (0.0) 0.0 0.0 0.2 Other 3.8 (10.0) 0.3 7.0 (0.0) 3.1 3.3 3.0 Don't know/missing 0.0 (0.0) 0.3 0.0 (0.0) 0.6 4.5 1.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 (N) (110) (21) (358) (154) (33) (963) (433) (2,077)

Note: Figures in parentheses are based on 25-49 unweighted cases.

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Contraception 5.1 Knowledge, ever use, and current use of methods among ever-married women (percent)

Know Ever Currently Method method used using" Any modern method 98.3 34.3 26.0 Pill 80.0 8.1 1.4 IUD 35.6 0.8 0.3 Injectables 84.8 10.2 4.5 Diaphragm/foam/jelly 28.2 0.6 0.1 Condom 74.8 6.2 1.9 Female sterilization 96.3 11.9 12.1 Male sterilization 89.8 5.5 5.4 Norplante 57.0 0.6 0.4 Any traditional method 43.9 6.0 2.5 Withdrawal 28.7 3.4 1.4 Periodic abstinence 36.6 3.2 0.9 Other 2.7 0.5 0.2 Any method 98.4 37.4 28.5

aPercentage distribution of currently married women.

5.2 Percentage distribution of currently married women who are nonusers, by intention to practice contraception in the future, according to number of living children

Number of living children* Intention 0 1 2 3 4+ Total Never used

Intend to use in next 12 months 5.8 25.2 24.4 25.9 26.1 22.8 Intend to use later 51.3 39.3 32.0 25.4 11.4 28.7 Unsure as to timing 0.4 0.7 0.5 0.2 0.2 0.4 Unsure as to intention 7.3 3.4 2.5 2.2 1.0 2.8 Do not intend to use 32.5 21.1 26.0 27.9 42.7 31.3 Missing 0.0 0.1 0.3 0.3 0.0 0.1

Previously used Intend to use in next 12 months 0.4 4.6 6.6 10.0 9.2 6.7 Intend to use later 1.7 4.3 5.9 3.9 3.1 3.8 Unsure as to timing 0.0 0.0 0.0 0.1 0.1 0.0 Unsure as to intention 0.1 0.1 0.0 0.1 0.0 0.1 Do not intend to use 0.4 1.1 1.6 3.8 6.2 3.1 Missing 0.1 0.0 0.1 0.1 0.0 0.1

Total 100,0 100.0 100.0 100.0 100.0 100.0 *Includes current pregnancy.

5.3 Percentage distribution of currently married women who are nonusers,* by reason for nonuse, according to age group

Age Reason for nonuse <30 30-49 Total

Infrequent sex 4.3 7.9 6.8 Menopause/hysterectomy 0.7 25.8 18.5 Subfecund/infecund 2.4 6.4 5.2 Want children 35.4 7.2 15.3

Opposed to family planning 6.9 3.8 4.7 Husband opposed 6.7 3.3 4.3

Other(s) opposed 0.8 0.1 0.3

Religion 16.2 5.7 8.7 Lack of knowledge 4.1 1.6 2.3 Know no source 1.8 1.5 1.6 Health concerns 2.4 7.4 6.0 Fear side effects 13.0 16.7 15.7 Difficult to obtain 0.4 0.5 0.5 Cost 0.3 0.1 0.2 Interferes with body 0.5 0.3 0.4 Other 1.4 11.3 8.4 Don't know/missing 2.8 0.4 1.1

Total 100.0 100.0 100.0

(N) (569) (1,396) (1,966)

*Refers to women who are not using contraceptives and who do not intend to use them in the future.

Marital and Contraceptive Status 6.1 Percentage distribution of women, by current marital status, according to age

Aae

Marital status 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total

Never married 56.0 14.8 4.6 1.9 1.5 1.1 1.4 16.6 Married 43.3 84.0 93.3 93.1 91.7 88.7 83.1 79.0 Divorced/separated 0.5 1.1 1.3 2.7 2.6 2.7 3.4 1.7 Widowed 0.2 0.1 0.8 2.4 4.2 7.5 12.0 2.7

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

(N) (2,229) (1,909) (1,671) (1,387) (1,136) (933) (836)(10,101)

6.2 Differentials in median age at first birth

All women 25-49 (19.8)

'//// ////////// Rural (19.8)

2' // / / / Urban (19.8) Residence

7/////f<///// /// a(19.6)

W//M///////// b (19.7) Educational level 4a

2'II 'IJ/ //7/j c//(yc 215)

0 5 10 15 20 25 30 35

Median age at first birth, women aged 25-49

6.3 Union and contraceptive status

In union/ use contraceptives

Previously in union*

Single 16.6%

In union/ not using contraceptives

56.5%

*Divorced, separated, or widowed.

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Postpartum Variables

7.1 Differentials in duration of breasffeeding 35 -

31.3 31.3 30.2 CO 30 - ^ ^ 3a2

1 30-7 p72' 26.8

o 25- 24.5 E

t 20-%

E 15 X

Rural Urban a b c Residence Educational le

7.2 Median duration of postpartum interval

Infant Mortality 8.1 Infant mortality trends

Total

3vel4

8.2 Infant mortality differentials, 1986-96

^^^^^^ Amenorrheic (10.3)

^^^^^^W Nonsusceptible* (11.3)

Breastfeeding (31.0)

Abstinent (3.0)

I I i I

0

0 5 10 15 20 25 30 35 40 45 50

Median duration (months) *Amenorrheic and/or abstaining.

Rural Urban a . b c Total

Residence Educational level4

8.3 Children ever born, surviving, and proportion dead* Mean number of children

Age of Ever Proportion mother born Surviving Dead dead 15-19 0.52 0.47 0.05 0.10 20-24 1.69 1.51 0.18 0.11 25-29 3.01 2.62 0.39 0.13 30-34 4.07 3.40 0.67 0.16 35-39 4.86 3.97 0.89 0.18 40-44 5.79 4.47 1.32 0.23 45-49 6.09 4.51 1.58 0.26 Total 3.41 2.80 0.61 0.18

*Among currently married women.

332 Studies in Family Planning

Years

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75

50

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Health: Disease, Prevention, and Treatment

9.1 Percentage of children 12 to 23 months of age who have received specific vaccines, by residence and mother's educational level

Percent receiving vaccines All

Characteristic BCG DPT (3) Polio (3)* Measles Vaccines Total 76.0 53.5 50.9 56.6 43.3 Residence

Rural 75.2 51.9 49.2 55.2 41.5 Urban 87.6 77.4 77.4 77.2 71.1

Mother's education a. None 71.9 48.4 45.3 52.0 38.1 b. Primary 88.3 68.3 68.0 65.0 56.0 c. Secondary+ 100.0 91.0 92.2 92.9 82.3

*The coverage for DPT for children without vaccination cards is assumed to be the same as that for polio when the mother has reported that her child has been vacci- nated against polio.

9.2 Percentage of children younger than three years with diarrhea in two weeks prior to survey, and of those, percentage consulting health facility and percentage receiving different ORT treatments, by residence and mothers' educational level

Treatment Diarrhea in Consult In-

past two health ORS Home creased No Charactersitic weeks facility packets solution fluids treatment Total 27.5 13.8 25.9 4.2 35.0 34.7 Residence

Rural 27.7 13.6 25.0 3.9 34.5 35.3 Urban 23.8 18.3 40.7 9.0 42.6 25.6

Mother's education a. None 28.2 13.0 23.3 3.5 32.0 37.6 b. Primary 28.1 19.0 37.3 6.0 46.0 24.4 c. Secondary+ 20.1 14.3 36.0 9.0 51.3 18.6

9.3 Percentage distribution of types of assistance during delivery for births in the three years prior to survey, by residence Type of assistance Rural Urban Total Doctor 4.1 30.3 5.8 Trained nurse/auxiliary nurse/midwife 2.3 16.2 3.2 Maternal-child health worker 0.7 0.0 0.7 Other health professional 0.5 0.0 0.4 Traditional birth attendant 23.2 12.1 22.5 Relative/friend/other 57.7 37.3 56.4 Nobody 11.3 4.1 10.9 Missing 0.1 0.0 0.1 Total 100.0 100.0 100.0 (N) (4,097) (278) (4,375)

Nutritional Status: Anthropometric Measures

10.1 Percentage malnourished among children younger than three years according to children's weight-for- height measure, by residence and mother's educational level

Acute malnutrition5 Characteristic Severe Moderate/severe Total 1.7 11.2 Residence

Rural 1.7 11.6 Urban 0.6 5.8

Mother's education a. None 2.0 12.2 b. Primary 0.9 8.4 c. Secondary+ 0.0 4.7

10.2 Percentage malnourished among children younger than three years according to children's height-for-age measure, by residence and mother's educational level

Chronic malnutrition5 Characteristic Severe Moderate/severe Total 20.2 48.4 Residence

Rural 20.9 49.3 Urban 10.5 35.4

Mother's education a. None 22.7 52.4 b. Primary 13.9 40.1 c. Secondary+ 5.8 15.3

Notes

1 Nepal Family Health Survey 1996 (Family Health Division, Depart- ment of Health Services, Ministry of Health, Kathmandu, Nepal, New ERA, Kathmandu, Nepal, and Macro International, Calver-

ton, MD, March 1997). The NFHS used two types of question- naires: the Household Questionnaire and the Individual Ques- tionnaire. The contents and design of the questionnaires were based on the DHS Model B Questionnaire, designed for use in

countries with low contraceptive prevalence.

2 United Nations, "World population prospects 1990," Population Studies, No. 120 (1991).

3 World Bank, World Development Report, 1992 (New York: Oxford

University Press, 1992).

4 Key for education level: a = none; b = primary; c = secondary or

higher.

5 Based on comparison with NCHS/CDC/WHO international ref-

erence. Children two or more standard deviations below the me- dian of the reference (2.3 percent expected) are considered mod-

erately or severely undernourished; those three or more standard

deviations below the reference (0.1 percent expected) are severely undernourished.

This information was compiled by the Population Council in coopera- tion zvith Macro International,from the results of the Nepal 1996 Fam-

ily Health Survey.

Volume 29 Number 3 September 1998 333

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