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dSGJHpFDu8sN0484L13z7PeCjYdqiP2u7N13ooVSnBooUW0VLrShkCzukFWcbZHRG27SJY1WaZmil3jUIJSVCZsZUGJZi9NotJVLqvuYkA4isRxMEXTFYlq5XPQzkyyBxnRpoYZhCNsBDFbcJnVyMzpzQPD4WglHMhl2mqm3ZZfOo/50clzWp/pAFPsVAZy4gX9ZoYy9ta3Ffcc5K8JWJQCKoq9kVlaaQW8ALMcVzio2JR1eesrCD+55GHDQaJmLxVv25bHCFYJFcemoQOkQNGTgrUqTd51KFOipQJA1kV728q4QV6qG1W+nkplL489nQdnvFL3aMyKzSLanGJQu9qyuabFnCEVxTfPHtXT+97BesKheU8hZRk6Sw/NRW8z7lg5GVUfpEgyvBy96zVN5+l5P6SIpoLIB3Tq/lXAl8kJN4jNgslxPwQEspw5ABSyKLDTauUxQ5U99cjwVcSHy2zhTmak66qOZkXbhP6oYft3cWxKI3IbdZhU5/5qPJvhso8zm6YcogqzTvo7AAnj3Gjst88NkbDE9Z5W1mdyZqA8fPYZ5K7bJOwlPJzPrcphugU24AJ1j/7BR7bPLPZg74LroPSt1We3aYQ9/A+GPqSWgSzphIa1sLYBa96I6PGzhrmC6OMIjPWOlpIyvFWT64b8jGMT4Q6HCUOxcPWJ3zjb1bJrpYJr9EXPaV06qM6yRmFfNWGt1UhBEa3WiWGF0ZymVizJHlh7MpzEbIK90ClCZszNRauFz+RnIsq8ZFsgnW95E1NR+uihrjL4zZBZ9zbFAdGLnXzRZ866YXPGXc+VCd8KJ86J3VfFbPU4mn5QsRG576oKAPFlXSaUBuqRityXIdYGN/ZVaXRwSWcMNisIvSy9wTL6EpEvhxKsXUUM4QW++7yxEi3jkidZMzRhmKbDitTtYfMPMps0pVOHSzjtBm9ZVHD0ZN0JhY478j+XlJCv8wuOT1b3sNy0l1BXlX7LEVE4lx05J1HGqTQ7U3F6zQtM3KyoNI89AS8EPyRYNi9OEHAY4FFMNhdsXHsL0cBQmgg6Ec5rhQ/XwJvW8wIduzLEGWrp9nhw4vvRiA2+xzl+mqbpRHgPdFkIzIeJrvFjP3ofj6O5Uicc7kcDK4wAlPAYms72D5SjXMT4covXyOPgDzSOCHHNff5SIAeH0ijPnxCJH0cJB1nQXChjtd7+hSnzbDE6korEma/xLWjT7bYlDBHAzjo/LJMwhMdgNEDSwqJuv9QdWMV9LFCofiH+ZvWEaSF8jI42xbZA54dMK/K6rKwuJDlqQ+TYUmv7jn7O+PLad50pk9vS3qaoLGtd/v2w9Kkzd7sNh4c7ffyMgc5WENYlTsD7uriJ6hL2ZTOFc8GOpS4EGopZ6CFivxxms47F7sjB7ylq+ENJg/DT1GhkYy6j78A8nrz4nRXhQUlNJ7ZUKOLyftaVXRNE96ipRKd40WCZ0y75mLHZJpFORn+vlRRYKO1DiOanYMkJS1inovelwGNhJ5dvTazttUUfPRTR/yMglm8yrXzYNCbXf7Z5jl0LOCw/bzZut9MgNXW8WFKgCf9CYUICNzkcc/uKc32tZtsAJdfbT21A3Jzeo69G6SaHO+2tocJ31PUlr4ZOhwNdB/32BhItxqUb6BtcbeJFKJGfy5ioAphrjgVNfTchMe5pjh+T4uXyarHPZyWYv+qjkSanYY42JSU1MbpZVrFnn5qpURuFEcFBo2vaSTOZJaHdxuI5d3vS1mpSpNV2jUot+G7OMpAaFSsDHZ2E8GwMU/7rNh3b7aWaopElF1NGFX9yTfYgaUcm43/sHm+2rUPu+7b85H+ZusB4nyAzJhSNntTbLzVrtl5BhOnzzvj5R3Wb2P8E2PzOEmmQk9b/2f7HAqvdh+U9jCI3G0ldzNwzP1g+K3paVBdcYCsgeura7PvyR9oUVpBxBH+Q4asgSb1GxGDleHnoiamfTFOUuO2qL+lNlnkquQ7i8ldS2G5zker6oW4wBObLCeqNTq5PcpVNdKPrFyquuIAw6DzejAGLeY2HkfzshiEdZq1F7P+xcZZzUoXm++Pdg0U8M1er91Z9Wq/X02YK3V+ECy+gi3bWKgCv6VMyAT8HjbnYsrE+Id9/2Z/f0M7bXUv/sXWjzi60zAzSdzT3m+4x37/bK+f9tk/bZw7T1V3+w4x8+HRx+Rx2Pd0qOYsk82bqP9SLstM4IOxqi3nAQkyq314V367pfEoV9QNk8hOD+ISzydkT6JzEJOm5FjVnSgRjUPBuqduF+gVKw2myELA062vtumxJY88M2LbYnOedO6TBOCLjftmYzS7B152a17jfWv+flN754cZ2A+b/y/3zaDvHLWJp619XRyqnoYA5EA2D5Rxs9/drv3lvqh4dNDOYSCIwh+2xput7Z6qK9+8tdKTU/qEGAoDyYBrMzZb35vJ5DS5f9iczQz2tHsejL1lOB0Nl0cgxUJB0oCSrMoZkeK5j5d6aKz+RKB9c6GhpcHSk+IelTnrnKN4HMwwitf4YQU9jhjIA/M1zRBMZpEdjH1Tvneqm66ngzwX9JJVM+9ZCOeITU+7HB7X0xcdrHq3sW8dwm7p3TwFQrmZMX2pLkR418uE+28mDEDu3TziE8J5dsERtaK6lJAF7UZ0Kz87DDI3m38XdGavR5Iv/NOuqyboN67D2CxONtj6/wsxL4MouRdXawzfqxsXvPf3s5Gv/B17IeO/s5jyj+Sn2vsmlML5olOkkPXUAgh9zT4WT1HdpjIIXW/pp9NkUATYEDF7k4epSkBXX6a3QFlLjJfmT3Mq7zlfnulGkJ3jnJ+N5q33Jf1cgJe0cHTxFxAQTI2YZOt4Lw57HzbOL5bWwLs+27petv4fgBw4vxnBr0gbeFS+U/kNzWhGIvNePPUDCMRYtiZAMhQCKF2KnwNb9CDNy77fW6fXfNk8xWo4M2uCJom0q/5qL5yMnrwWOfR7uaXfbU2/mXKRqmDsP5q8sO7H+Ujfjfh8MQN7Wg59gE2bjk5wFApQKVyB8bRjUn1yjEsnPvWR4M8KeHOlxtO5LOukCbFQ5qoSUn/NPl90IaIVE0VmOba7zptiZh9eneOxZjxgY/fUtfA8DoSw2nwgDN8saBhlSb+akhfzNKQGn21OsMwbUgVbwx/Mig+j5FDMm+3RxEHvu9k98NSaPY4uagFhTiTJSOLv1WPXacZAr+vqvHTPJ1dTwH764a6bHtzE94euL8XrxTxthJYcq2Sv9EWHxrD177bGX23Nr4eFAZMpVWWh6ndbw3dDw52NbTH+0b3ozkLH+Q2dhBrPdIuaz55dUmK5X05zlck46annLDTf5zNxXocUi6yXagix3uumGdCRVfQl01pH62pDsm1CPjOEbUIza/xiSv0wsfzZWCgs+wZmZ7b+yQT6NC+GSO/22WfzgGLXfoVQER+RSKiaVLR+QC0tHbHOkOUBcmPL+oKHKDEnYphs1FftysXK1452mhfqYBhH8g7MZ/PID/pHI2NFHrktzrRLFBE69tRpYL8ZafmjyfV3pHPdx0Ouebdd/TfSI7bJlD8jXzSDXAY175GPqe43Wj8qUsfzdeXS/omHOXoc+dv93ivh6GoZxTPjKU3lrYJIwCi79N7vK2B2BtM8o6MHY17wuKwHZQxi/t1u/WYw9ck2Q+hMeP8kS3zogZS77ekvOrd6tBdj0g35XQfJOE1pmYn3ZxZydoaV1+GHmW+o1ti9h0LJgbSA3uTx3fuvnSSq8RmQrkNs7rFn8w7GapWd1WTHclrFERIYJTLR1XJIGE6RSF78HgaMvfzdNFflOA/ArJnF2Zwo8pkVPoSLGKhTvuPUlrueFCNoRArAwrGo/Dhyr9PcqzJRKkNHGbpqqPTol9+/Xc59skVVZm0yqDKPeJgn8PXKYx6LDtGCsfX2MCu1mIa0AEzP7n1ld/C7TmnBx+7299eaKdzFKiz4D/BaINTwcjOqd7C/0z3ixXhnccVc72QeB7DRWrI/R8jYZwJ80ZscaZqM/Za8toq4CUMCerBghQQ+CeTSi9Ug/F0YL4sfkTFVrGaoP0w28Oo/GRS/bD/w3LvJqVnTeLfuyjcztN1Czfk62URwwI5GbPTzwsTiSR7lX6zZqUjrh2KXS3Jd1GKpaTxxQ0LyUCU/qQvt8c2PbeQ0Ot46DAXj4SNqRUkrYC+r68B4VC1eGEwi37LvVhPkzea9CY5P5YmMoM3rofjsfV2cuNl8zbwRTLGxdGhCRtw074d3vZuxvtgrbEzOK/PIhfGMT2Hxb2M6sts9d9vLzfbcALNQlpipaib0eHjvHWMALvUQbQExAupUN9ijO+teAKsMTwfn3JAj2jVfzQeZbtgefphDHGY8jwPYEiemiroHRS0PFqdvE/Tj3D8fKAllJYfNpmanCsCeTohdruqiR100zowQQpd5zD2ONqiLUVUIBpUDVCEOIQ8Dm6QH2WvkVkgZKDj7+3Ei0UZpzLzPYgohjxDqp+5OsdzPLBfuIxTvZihvhhQYY2fKYCSiVo9RxdtFi+I3vkNcRSi7KX7SYLgdZ8DskZIodW//AYKtIIF1rYzL2ZkxUjRAN4tYWN/LxIVKz2mx13JHwHxBmuPpxFe75xcoM5+8Bt0gx7SsGuYabX6xxaTuQJw6q2VWP+K0VNImbBXt0Bn/6LwnJfnbMt8zppklo8UUPcLt8qQOcjoIFXlW9X+3BptDnGt271+L/2MKiB8QJkpmYJr0SqzBBILY1/gc/uGPNBR5ZUXkOagY/pMfDPGZdU0wRJ6qUNXpfPmRRKyaTTMzyjfWMfWUbEqEQLLhBUz3RehkZwmeB9KCAgGJkWdUpe16kAnK2tMnHtZyqEW3A2J42jUrD0tDiYVVHRjQZp78sMH/YTk7lL9bzGwWT5dRjA4PjCd64mhBnDXB63F+pMw+4ervGQe2SmvnE6VQLZ/YTTokrCAAd0ELKJhqPHVr2y7mBYhfO9snjZvmuQDULVkKMyLSKstUCyvxYJWIGSuTc3hm994JhfLJoP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)}80%{background-image:url(data:image/png;base64,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Ethiopia

Demographic and
Health Survey
2005

Central Statistical Agency


Addis Ababa, Ethiopia

ORC Macro
Calverton, Maryland, USA

September 2006
The 2005 Ethiopia Demographic and Health Survey (2005 EDHS) is part of the worldwide MEASURE DHS project
which is funded by the United States Agency for International Development (USAID). The opinions expressed
herein are those of the authors and do not necessarily reflect the views of USAID.

Additional information about the 2005 EDHS may be obtained from the Central Statistical Agency (CSA), P.O. Box
1143, Addis Ababa, Ethiopia; Telephone: (251) 111 55 30 11/111 15 78 41, Fax: (251) 111 55 03 34, E-mail:
[email protected]. Additional information about the DHS project may be obtained from ORC Macro, 11785
Beltsville Drive, Calverton, MD 20705 USA; Telephone: 301-572-0200, Fax: 301-572-0999, E-mail:
[email protected], Internet: http://www.measuredhs.com.

Suggested citation:

Central Statistical Agency [Ethiopia] and ORC Macro. 2006. Ethiopia Demographic and Health Survey 2005.
Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro.
CONTENTS

TABLES AND FIGURES ........................................................................................................... ix


FOREWORD ..........................................................................................................................xvii
ACKNOWLEDGMENTS ........................................................................................................ xix
NATIONAL STEERING COMMITTEE MEMBERS ......................................................... xxi
SUMMARY OF FINDINGS ..................................................................................................xxiii
MILLENNIUM DEVELOPMENT GOAL INDICATORS, ETHIOPIA 2005 .................................xxix

CHAPTER 1 INTRODUCTION

1.1 History, Geography, and Economy ..................................................................................1


1.2 Population.......................................................................................................................3
1.3 Health Priorities and Programming ..................................................................................4
1.4 Objectives of the Survey ..................................................................................................5
1.5 Organization of the Survey ..............................................................................................6
1.6 Sample Design.................................................................................................................7
1.7 Questionnaires ................................................................................................................7
1.8 Haemoglobin and HIV Testing .........................................................................................8

1.8.1 Haemoglobin Testing .......................................................................................8


1.8.2 HIV/AIDS Testing .............................................................................................9

1.9 Listing, Pretest, Training and Fieldwork ..........................................................................10

1.9.1 Listing ............................................................................................................10


1.9.2 Pretest............................................................................................................10
1.9.3 Training and Fieldwork ..................................................................................10

1.10 Data Processing .............................................................................................................11


1.11 Response Rates..............................................................................................................12

CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS

2.1 Household Population By Age And Sex..........................................................................13


2.2 Household Composition ................................................................................................14
2.3 Household Education ....................................................................................................17

2.3.1 Educational Attainment of Household Population ..........................................17


2.3.2 School Attendance Ratios...............................................................................19

2.4 Household Characteristics .............................................................................................23


2.5 Household Possessions ..................................................................................................27
2.6 Socioeconomic Status Index ..........................................................................................28

Contents | iii
CHAPTER 3 CHARACTERISTICS OF RESPONDENTS

3.1 Characteristics of Survey Respondents ...........................................................................31


3.2 Educational Attainment and Literacy..............................................................................33
3.3 Access to Mass Media ....................................................................................................37
3.4 Employment ..................................................................................................................39

3.4.1 Employment Status ........................................................................................39


3.4.2 Occupation....................................................................................................42
3.4.3 Earnings, Employers and Continuity of Employment .......................................44

CHAPTER 4 FERTILITY

4.1 Current Fertility .............................................................................................................47


4.2 Fertility Differentials.......................................................................................................48
4.3 Fertility Trends...............................................................................................................50
4.4 Children Ever Born and Surviving...................................................................................51
4.5 Birth Intervals ................................................................................................................52
4.6 Age at First Birth ............................................................................................................53
4.7 Teenage Pregnancy and Motherhood ............................................................................55

CHAPTER 5 FAMILY PLANNING

5.1 Knowledge of Contraceptive Methods ...........................................................................57


5.2 Ever Use of Contraceptive Methods ...............................................................................59
5.3 Current Use of Contraceptive Methods..........................................................................61

5.3.1 Trends in Contraceptive Use ..........................................................................64


5.3.2 Number of Children at First Use of Contraception..........................................64

5.4 Use of Social Marketing Brands......................................................................................65


5.5 Knowledge of Fertile Period...........................................................................................66
5.6 Source of Family Planning Methods ...............................................................................66
5.7 Informed Choice ...........................................................................................................67
5.8 Contraceptive Discontinuation.......................................................................................69
5.9 Future Use of Contraception..........................................................................................70
5.10 Reasons for Not Intending to Use A Contraceptive Method in the Future.......................71
5.11 Preferred Method of Contraception for Future Use ........................................................72
5.12 Exposure to Family Planning Messages ...........................................................................72
5.13 Contact of Nonusers with Family Planning Providers......................................................73
5.14 Husband's Knowledge of Wife's Use of Contraception ...................................................75
5.15 Men's Attitude about Contraception ..............................................................................76

CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY

6.1 Current Marital Status ....................................................................................................79


6.2 Polygyny........................................................................................................................80
6.3 Age at First Marriage ......................................................................................................82
6.4 Age at First Sexual Intercourse .......................................................................................83
6.5 Recent Sexual Activity....................................................................................................85

iv Ň Contents
6.6 Postpartum Amenorrhoea, Abstinence and Insusceptibility ...........................................88
6.7 Menopause ...................................................................................................................90

CHAPTER 7 FERTILITY PREFERENCES

7.1 Desire for More Children...............................................................................................91


7.2 Need for Family Planning Services .................................................................................95
7.3 Ideal Family Size............................................................................................................97
7.4 Fertility Planning ............................................................................................................99

CHAPTER 8 INFANT AND CHILD MORTALITY

8.1 Assessment of Data Quality..........................................................................................102


8.2 Levels and Trends in Infant and Child Mortality ...........................................................103
8.3 Socioeconomic Differentials in Childhood Mortality ....................................................104
8.4 Demographic Differentials in Mortality ........................................................................105
8.5 Perinatal Mortality .......................................................................................................107
8.6 High-Risk Fertility Behaviour........................................................................................108

CHAPTER 9 MATERNAL HEALTH

9.1 Antenatal Care.............................................................................................................111


9.2 Delivery Care ..............................................................................................................116
9.3 Postnatal Care .............................................................................................................119
9.4 Problems in Accessing Health Care ..............................................................................120

CHAPTER 10 CHILD HEALTH

10.1 Child’s Size at Birth......................................................................................................127


10.2 Vaccination Coverage ..................................................................................................128
10.3 Acute Respiratory Infection..........................................................................................132
10.4 Fever ...........................................................................................................................134
10.5 Prevalence of Diarrhoea ..............................................................................................135
10.6 Diarrhoea Treatment ...................................................................................................136
10.7 Feeding Practices.........................................................................................................138
10.8 Knowledge of ORS Packets .........................................................................................139
10.9 Stool Disposal..............................................................................................................140

CHAPTER 11 NUTRITION OF CHILDREN AND WOMEN

11.1 Initiation of Breastfeeding ............................................................................................143


11.2 Breastfeeding Status by Age .........................................................................................144
11.3 Duration and Frequency of Breastfeeding ....................................................................147
11.4 Types of Supplemental Food........................................................................................148
11.5 Foods Consumed by Mothers .....................................................................................149
11.6 Micronutrient Intake ...................................................................................................150

11.6.1 Iodine Intake................................................................................................151


11.6.2 Micronutrient Intake Among Children ..........................................................151
11.6.3 Micronutrient Intake among Mothers ...........................................................154

Contents | v
11.7 Prevalence of Anaemia ................................................................................................156

11.7.1 Prevalence of Anaemia in Children ..............................................................156


11.7.2 Prevalence of Anaemia in Women ...............................................................157

11.8 Nutritional Status .........................................................................................................159

11.8.1 Nutritional Status of Children .......................................................................159


11.8.2 Trends in Children’s Nutritional Status .........................................................162
11.8.3 Nutritional Status of Women .......................................................................163

CHAPTER 12 MALARIA

12.1 Introduction .................................................................................................165

12.1.1 Malaria Vector Control...................................................................165


12.1.2 Malaria Diagnosis and Treatment ...................................................174

CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR

13.1 Knowledge of HIV/AIDS and of Transmission and Prevention Methods ........................179

13.1.1 Awareness of AIDS.......................................................................................179


13.1.2 Knowledge of Ways to Reduce HIV/AIDS Transmission ................................179
13.1.3 Knowledge about Transmission ....................................................................181
13.1.4 Knowledge about Mother-to-Child Transmission ..........................................185

13.2 Stigma Associated with AIDS and Attitudes Related to HIV/AIDS .................................187
13.3 Attitudes Towards Negotiating Safer Sex ......................................................................189
13.4 Higher-Risk Sex ...........................................................................................................191

13.4.1 Multiple Sexual Partners and Higher-Risk Sex...............................................191


13.4.2 Paid Sex.......................................................................................................195

13.5 Testing for HIV ............................................................................................................195


13.6 Reports of Recent Sexually Transmitted Infections .......................................................199
13.7 Male Circumcision.......................................................................................................200
13.8 Injections ....................................................................................................................200
13.9 HIV/AIDS-Related Knowledge and Behaviour among Youth.........................................202

13.9.1 Knowledge about HIV/AIDS and Source for Condoms..................................202


13.9.2 Age at First Sex and Condom Use at First Sexual Intercourse ........................205
13.9.3 Recent Sexual Activity ..................................................................................207
13.9.4 Higher-Risk Sex............................................................................................209
13.9.5 Age-Mixing in Sexual Relationships ..............................................................210
13.9.6 Drunkenness during Sexual Intercourse........................................................210
13.9.7 HIV Testing ..................................................................................................212

vi Ň Contents
CHAPTER 14 HIV PREVALENCE AND ASSOCIATED FACTORS

14.1 Coverage of HIV Testing in the EDHS ..........................................................................213


14.2 HIV Prevalence............................................................................................................215
14.2.1 HIV Prevalence by Age.................................................................................216
14.2.2 HIV Prevalence by Socio-economic Characteristics ......................................217
14.2.3 HIV Prevalence by Other Sociodemographic Characteristics ........................218
14.2.4 HIV Prevalence by Sexual Risk Behaviour ....................................................220
14.2.5 HIV Prevalence by Other Characteristics Related to HIV Risk .......................222

14.3 HIV Prevalence and Male Circumcision .......................................................................223


14.4 HIV Prevalence among Couples.................................................................................223
14.5 EDHS and ANC Surveillance Results ............................................................................225
14.6 Effect of Nonresponse on the EDHS HIV Prevalence Results ........................................229

CHAPTER 15 ADULT AND MATERNAL MORTALITY

15.1 Data Quality Issues ......................................................................................................231


15.2 Adult Mortality ............................................................................................................232
15.3 Maternal Mortality .......................................................................................................233

CHAPTER 16 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH


OUTCOME

16.1 Employment and Form of Earnings...............................................................................235


16.2 Control Over and Relative Magnitude of Women’s Earnings ........................................236
16.3 Woman’s Participation in Decisionmaking ...................................................................238
16.4 Attitude Towards Refusing Sex with Husband ..............................................................241
16.5 Attitudes Towards Wife Beating ...................................................................................244
16.6 Current Use of Contraception by Women’s Status .......................................................247
16.7 Ideal Family Size and Unmet Need by Women’s status...............................................247
16.8 Reproductive Health Care by Women’s Status.............................................................248
16.9 Early Childhood Mortality Rates by Women’s Status ....................................................249
16.10 Property Dispossession ................................................................................................250
16.11 Harmful Traditional Practices.......................................................................................252

REFERENCES ............................................................................................................. 261

APPENDIX A SAMPLE IMPLEMENTATION ..................................................................265

APPENDIX B ESTIMATES OF SAMPLING ERRORS .....................................................271

APPENDIX C DATA QUALITY TABLES .........................................................................289

APPENDIX D PERSONS INVOLVED IN THE 2005 ETHIOPIA DEMOGRAPHIC


AND HEALTH SURVEY ............................................................................297

APPENDIX E QUESTIONNAIRES ..................................................................................301

Contents | vii
TABLES AND FIGURES

Page
CHAPTER 1 INTRODUCTION

Table 1.1 Basic demographic indicators..........................................................................3


Table 1.2 Results of the household and individual interviews........................................12

CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS

Table 2.1 Household population by age, sex, and residence.........................................13


Table 2.2 Household composition................................................................................14
Table 2.3 Children's living arrangements and orphanhood ............................................15
Table 2.4 Succession planning ......................................................................................16
Table 2.5.1 Educational attainment of household population: female ..............................18
Table 2.5.2 Educational attainment of household population: male.................................19
Table 2.6 School attendance ratios ...............................................................................20
Table 2.7 Grade repetition and dropout rates...............................................................22
Table 2.8 Household drinking water.............................................................................24
Table 2.9 Household sanitation facilities.......................................................................25
Table 2.10 Household characteristics .............................................................................26
Table 2.11 Household possessions .................................................................................27
Table 2.12 Wealth quintiles............................................................................................28
Table 2.13 Birth registration of children under age five ...................................................29

Figure 2.1 Population pyramid ......................................................................................14


Figure 2.2 Age-Specific Attendance Rates ......................................................................23

CHAPTER 3 CHARACTERISTICS OF RESPONDENTS

Table 3.1 Background characteristics of respondents ....................................................32


Table 3.2.1 Educational attainment by background characteristics: women .....................33
Table 3.2.2 Educational attainment by background characteristics: men..........................34
Table 3.3.1 Literacy: women ...........................................................................................35
Table 3.3.2 Literacy: men................................................................................................36
Table 3.4.1 Exposure to mass media: women..................................................................37
Table 3.4.2 Exposure to mass media: men.......................................................................38
Table 3.5.1 Employment status: women ..........................................................................40
Table 3.5.2 Employment status: men...............................................................................41
Table 3.6.1 Occupation: women.....................................................................................42
Table 3.6.2 Occupation: men .........................................................................................43
Table 3.7.1 Type of employment: women.......................................................................44
Table 3.7.2 Type of employment: men............................................................................45

CHAPTER 4 FERTILITY

Table 4.1 Current fertility .............................................................................................47

Tables and Figures | ix


Table 4.2 Fertility by background characteristics ...........................................................49
Table 4.3 Trends in age-specific fertility rates................................................................50
Table 4.4 Trends in age-specific and total fertility rates .................................................50
Table 4.5 Children ever born and living........................................................................51
Table 4.6 Birth intervals................................................................................................53
Table 4.7 Age at first birth ............................................................................................54
Table 4.8 Median age at first birth by background characteristics..................................55
Table 4.9 Teenage pregnancy and motherhood............................................................56

Figure 4.1 Age-specific Fertility Rates by Urban-Rural Residence ...................................48


Figure 4.2 Total Fertility Rates by Background Characteristics ........................................49

CHAPTER 5 FAMILY PLANNING

Table 5.1 Knowledge of contraceptive methods ...........................................................58


Table 5.2 Couples' knowledge of contraceptive methods..............................................59
Table 5.3.1 Ever use of contraception: women ................................................................60
Table 5.3.2 Ever use of contraception: men.....................................................................61
Table 5.4 Current use of contraception ........................................................................62
Table 5.5 Current use of contraception by background characteristics ..........................63
Table 5.6 Trends in current use of contraception..........................................................64
Table 5.7 Number of living children at first use of contraception ..................................65
Table 5.8.1 Pill brands.....................................................................................................65
Table 5.8.2 Condom brands ............................................................................................65
Table 5.9 Knowledge of fertile period...........................................................................66
Table 5.10 Source of modern contraceptive methods.....................................................67
Table 5.11 Informed choice ...........................................................................................68
Table 5.12 First-year contraceptive discontinuation rates ................................................69
Table 5.13 Reasons for discontinuation ..........................................................................70
Table 5.14 Future use of contraception ..........................................................................70
Table 5.15 Reason for not intending to use contraception in the future ..........................71
Table 5.16 Preferred method of contraception for future use..........................................72
Table 5.17 Exposure to family planning messages ...........................................................73
Table 5.18 Contact of nonusers with family planning providers ......................................74
Table 5.19 Husbands/partners knowledge of women's use of contraception ...................75
Table 5.20 Men's attitude about contraception...............................................................76

Figure 5.1 Trends in Current Use of Contraception, Ethiopia 1990-2005.......................64

CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY

Table 6.1 Current marital status ....................................................................................80


Table 6.2 Number of co-wives and wives .....................................................................81
Table 6.3 Age at first marriage ......................................................................................82
Table 6.4 Median age at first marriage .........................................................................83
Table 6.5 Age at first sexual intercourse ........................................................................84
Table 6.6 Median age at first intercourse ......................................................................85
Table 6.7.1 Recent sexual activity: women ......................................................................86
Table 6.7.2 Recent sexual activity: men...........................................................................87
Table 6.8 Postpartum amenorrhoea, abstinence and insusceptibility.............................89

x | Tables and Figures


Table 6.9 Median duration of postpartum insusceptibility by background
characteristics ...............................................................................................90
Table 6.10 Menopause...................................................................................................90

CHAPTER 7 FERTILITY PREFERENCES

Table 7.1 Fertility preferences by number of living children ..........................................92


Table 7.2.1 Desire to limit childbearing: women .............................................................93
Table 7.2.2 Desire to limit childbearing: men ..................................................................94
Table 7.3 Need for family planning ..............................................................................96
Table 7.4 Ideal number of children ..............................................................................97
Table 7.5 Mean ideal number of children.....................................................................98
Table 7.6 Fertility planning status..................................................................................99
Table 7.7 Wanted fertility rates.................................................................................. 100

Figure 7.1 Fertility Preferences of Currently Married Women Age 15-49 .......................92
Figure 7.2 Desire to Limit Childbearing Among Currently Married Women, by
Number of Living Children, 2000 and 2005..................................................94

CHAPTER 8 INFANT AND CHILD MORTALITY

Table 8.1 Early childhood mortality rates ................................................................... 103


Table 8.2 Early childhood mortality rates by socioeconomic characteristics................ 105
Table 8.3 Early childhood mortality rates by demographic characteristics................... 106
Table 8.4 Perinatal mortality...................................................................................... 108
Table 8.5 High-risk fertility behaviour ........................................................................ 109

Figure 8.1 Early Childhood Mortality Rates for the Period 0-4 Years Preceding the
Survey, 2000 and 2005.............................................................................. 104
Figure 8.2 Under-Five Mortality by Selected Demographic Characteristics.................. 106

CHAPTER 9 MATERNAL HEALTH

Table 9.1 Antenatal care............................................................................................ 112


Table 9.2 Number of antenatal care visits and timing of first visit ............................... 113
Table 9.3 Components of antenatal care ................................................................... 114
Table 9.4 Tetanus toxoid injections ........................................................................... 115
Table 9.5 Place of delivery ........................................................................................ 117
Table 9.6 Assistance during delivery .......................................................................... 118
Table 9.7 Timing and type of provider of first postnatal checkup ............................... 120
Table 9.8 Problems in accessing health care .............................................................. 121
Table 9.9.1 Knowledge and attitude concerning tuberculosis among women................ 123
Table 9.9.2 Knowledge and attitude concerning tuberculosis among men .................... 124
Table 9.10 Use of tobacco: men ................................................................................. 125

CHAPTER 10 CHILD HEALTH

Table 10.1 Child's size at birth ..................................................................................... 128


Table 10.2 Vaccinations by source of information........................................................ 129
Table 10.3 Vaccinations by background characteristics ................................................ 131

Tables and Figures | xi


Table 10.4 Vaccinations in the first year of life............................................................. 132
Table 10.5 Prevalence and treatment of symptoms of ARI ........................................... 133
Table 10.6 Prevalence and treatment of fever.............................................................. 135
Table 10.7 Prevalence of diarrhoea ............................................................................. 136
Table 10.8 Diarrhoea treatment .................................................................................. 137
Table 10.9 Feeding practices during diarrhoea ............................................................ 139
Table 10.10 Knowledge of ORS packets or prepackaged liquids .................................... 140
Table 10.11 Disposal of children's stools........................................................................ 141

Figure 10.1 Percentage of Children Age 12-23 Months with Specific Vaccinations........ 129

CHAPTER 11 NUTRITION OF CHILDREN AND WOMEN

Table 11.1 Initial breastfeeding.................................................................................... 144


Table 11.2 Breastfeeding status by age ........................................................................ 145
Table 11.3 Median duration and frequency of breastfeeding ....................................... 147
Table 11.4 Foods and liquids consumed by children in the day or night preceding
the interview.............................................................................................. 149
Table 11.5 Foods consumed by mothers in the day and night preceding
the interview.............................................................................................. 150
Table 11.6 Presence of iodized salt in household ........................................................ 151
Table 11.7 Micronutrient intake among children ......................................................... 153
Table 11.8 Micronutrient intake among mothers ......................................................... 155
Table 11.9 Prevalence of anaemia in children ............................................................. 157
Table 11.10 Prevalence of anaemia in women .............................................................. 158
Table 11.11 Nutritional status of children ...................................................................... 160
Table 11.12 Nutritional status of women by background characteristics......................... 164

Figure 11.1 Breastfeeding Practices by Age ................................................................... 146


Figure 11.2 Trends in Infant Feeding Practice for Children 0-5 Months and
6-9 Months, 2000 and 2005 ...................................................................... 146
Figure 11.3 Nutritional Status of Children Under Age Five ............................................ 162

CHAPTER 12 MALARIA

Table 12.1 Household possession of mosquito nets ..................................................... 166


Table 12.2 Use of mosquito nets by children ............................................................... 168
Table 12.3 Use of mosquito nets by women................................................................ 169
Table 12.4 Use of mosquito nets by population age five and older .............................. 171
Table 12.5 Coverage of spraying programs .................................................................. 172
Table 12.6 Prophylactic use of antimalarial drugs and use of intermittent preventive
treatment (IPT) by women during pregnancy.............................................. 174
Table 12.7 Prevalence and prompt treatment of children with fever ............................ 175
Table 12.8 Type and timing of antimalarial drugs received by children with fever........ 177

CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR

Table 13.1 Knowledge of AIDS.................................................................................... 179


Table 13.2 Knowledge of methods of HIV prevention.................................................. 181
Table 13.3.1 Misconceptions and comprehensive knowledge about AIDS: women ........ 183

xii | Tables and Figures


Table 13.3.2 Misconceptions and comprehensive knowledge about AIDS: men............. 184
Table 13.4 Knowledge of prevention of mother to child transmission of HIV ............... 186
Table 13.5.1 Accepting attitudes toward those living with HIV: women.......................... 188
Table 13.5.2 Accepting attitudes toward those living with HIV: men .............................. 189
Table 13.6 Attitudes toward negotiating safer sex with husband................................... 190
Table 13.7.1 Multiple sexual partners and higher-risk sexual intercourse in the past
12 months: women ................................................................................... 192
Table 13.7.2 Multiple sexual partners and higher-risk sexual intercourse in the past
12 months: men ........................................................................................ 193
Table 13.8 Payment by men for sexual intercourse...................................................... 195
Table 13.9.1 Coverage of prior HIV testing: women ....................................................... 196
Table 13.9.2 Coverage of prior HIV testing: men............................................................ 197
Table 13.10 Pregnant women counselled and tested for HIV......................................... 198
Table 13.11 Self-reported prevalence of sexually-transmitted infections (STI) and
STI symptoms ............................................................................................ 199
Table 13.12 Prevalence of male circumcision ................................................................ 200
Table 13.13 Prevalence of injections ............................................................................. 201
Table 13.14 Comprehensive knowledge about AIDS and a source for condoms
among youth ............................................................................................. 203
Table 13.15 Adult support for education about condom use to prevent AIDS................ 204
Table 13.16 Age at first sex among youth ...................................................................... 205
Table 13.17 Condom use at first sexual intercourse among youth.................................. 207
Table 13.18 Premarital sexual intercourse and condom use among youth ..................... 208
Table 13.19 Higher-risk sexual intercourse among youth .............................................. 209
Table 13.20 Drunkenness during sexual intercourse among youth................................. 211
Table 13.21 Recent HIV tests among youth ................................................................... 212

Figure 13.1 Percentage of Women and Men Age 15-49 with Comprehensive
Knowledge about AIDS .............................................................................. 185
Figure 13.2 Multiple Sexual Partners and Higher-Risk Sexual Intercourse in the
Past 12 Months among Men Age 15-49 ..................................................... 194

CHAPTER 14 HIV PREVALENCE AND ASSOCIATED FACTORS

Table 14.1 HIV testing coverage by residence and region ............................................ 214
Table 14.2 HIV testing coverage by background characteristics.................................... 215
Table 14.3 HIV prevalence by age............................................................................... 217
Table 14.4 HIV prevalence by socioeconomic characteristics....................................... 218
Table 14.5 HIV prevalence by demographic characteristics ......................................... 219
Table 14.6 HIV prevalence by sexual behaviour .......................................................... 221
Table 14.7 HIV prevalence by STI status and prior HIV testing status ........................... 222
Table 14.8 HIV prevalence by male circumcision ........................................................ 223
Table 14.9 HIV prevalence among couples.................................................................. 224
Table 14.10 HIV prevalence results from the EDHS and the National Antenatal
Care Surveillance System ........................................................................... 226
Table 14.11 Observed and adjusted HIV prevalence among women and men ............. 229
Table 14.12 Observed and adjusted HIV prevalence among women and men by
background characteristics ......................................................................... 230

Figure 14.1 HIV Prevalence among Women and Men Age 15-49 ................................. 216

Tables and Figures | xiii


Figure 14.2 HIV Prevalence among EDHS Respondents by Antenatal Care Status and
HIV Rate from ANC Surveillance Data ....................................................... 226
Figure 14.3 2005 Ethiopia Sample Cluster Locations and 2005 HIV Sentinel
Surveillance Sites ....................................................................................... 228
Figure 14.4 HIV Prevalence by Distance from 2005 ANC Sentinel Sites, EDHS
Respondents Age 15-49 ............................................................................. 229

CHAPTER 15 ADULT AND MATERNAL MORTALITY

Table 15.1 Adult mortality rates................................................................................... 232


Table 15.2 Direct estimates of maternal mortality ........................................................ 233

CHAPTER 16 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND


HEALTH OUTCOME

Table 16.1 Employment and cash earnings of currently married women...................... 235
Table 16.2 Control over women's earnings and relative magnitude of women's
earnings ..................................................................................................... 237
Table 16.3 Women's control over her own earnings and over those of her husband/
partner....................................................................................................... 238
Table 16.4 Women's participation in decisionmaking .................................................. 239
Table 16.5 Women's participation in decisionmaking by background characteristics.... 240
Table 16.6.1 Attitude toward refusing sexual intercourse with husband: women ............ 242
Table 16.6.2 Attitude toward refusing sexual intercourse with husband: men ................. 243
Table 16.7.1 Attitude toward wife beating: women ........................................................ 245
Table 16.7.2 Attitude toward wife beating: men............................................................. 246
Table 16.8 Current use of contraception by women's status......................................... 247
Table 16.9 Ideal number of children and unmet need for family planning by
women’s status .......................................................................................... 248
Table 16.10 Reproductive health care by women's status .............................................. 249
Table 16.11 Early childhood mortality rates by women's status ...................................... 250
Table 16.12 Widows dispossessed of property............................................................... 251
Table 16.13 Knowledge, prevalence, and support of female circumcision ..................... 253
Table 16.14 Daughter's circumcision experience and type of circumcision .................... 254
Table 16.15 Knowledge, prevalence, and support of uvulectomy or tonsillectomy......... 255
Table 16.16 Daughter's uvulectomy/tonsillectomy ......................................................... 256
Table 16.17 Knowledge, prevalence, and support of marriage by abduction.................. 257
Table 16.18 Daughter's marriage by abduction .............................................................. 258
Table 16.19 Prevalence of obstetric fistula ..................................................................... 259

Figure 16.1 Number of Household Decisions in Which Currently Married Women


Participate ................................................................................................. 241

APPENDIX A SAMPLE IMPLEMENTATION

Table A.1 Sample implementation: women ............................................................... 265


Table A.2 Sample implementation: men .................................................................... 266
Table A.3 Coverage of HIV testing among eligible respondents by social and
demographic characteristics: women ......................................................... 267

xiv | Tables and Figures


Table A.4 Coverage of HIV testing among eligible respondents by social and
demographic characteristics: men .............................................................. 268
Table A.5 Coverage of HIV testing by sexual behaviour characteristics: women ......... 269
Table A.6 Coverage of HIV testing by sexual behaviour characteristics: men .............. 270

APPENDIX B ESTIMATES OF SAMPLING ERRORS

Table B.1 List of selected variables for sampling errors ............................................... 274
Table B.2 Sampling errors for national sample ........................................................... 275
Table B.3 Sampling errors for urban sample............................................................... 276
Table B.4 Sampling errors for rural sample................................................................. 277
Table B.5 Sampling errors for Tigray Region............................................................... 278
Table B.6 Sampling errors for Affar Region................................................................. 279
Table B.7 Sampling errors for Amhara Region ............................................................ 280
Table B.8 Sampling errors for Oromiya Region .......................................................... 281
Table B.9 Sampling errors for Somali Region.............................................................. 282
Table B.10 Sampling errors for Benishangul-Gumuz Region......................................... 283
Table B.11 Sampling errors for SNNP Region............................................................... 284
Table B.12 Sampling errors for Gambela Region .......................................................... 285
Table B.13 Sampling errors for Harari Region .............................................................. 286
Table B.14 Sampling errors for Addis Ababa Region..................................................... 287
Table B.15 Sampling errors for Dire Dawa Region ....................................................... 288

APPENDIX C DATA QUALITY TABLES

Table C.1 Household age distribution ........................................................................ 289


Table C.2.1 Age distribution of eligible and interviewed women ................................... 290
Table C.2.2 Age distribution of eligible and interviewed men........................................ 290
Table C.3 Completeness of reporting ......................................................................... 291
Table C.4 Births by calendar years ............................................................................. 292
Table C.5 Reporting of age at death in days ............................................................... 293
Table C.6 Reporting of age at death in months........................................................... 294

Tables and Figures | xv


FOREWORD

The 2005 Ethiopia Demographic and Health Survey (EDHS) was conducted under the
auspices of the Ministry of Health and implemented by the then Population and Housing Census
Commission Office (PHCCO), now merged with the Central Statistical Agency (CSA). The key
findings of the survey were released in a preliminary report in November 2005. This final report
details the findings of the survey. The first ever Demographic and Health Survey (DHS) in Ethiopia
was conducted in 2000. The 2005 EDHS differed from the 2000 EDHS mainly because it included
testing for the prevalence of anaemia and HIV. Major stakeholders from various Ministries were
closely involved in the management and oversight of the survey and analysis of the survey results.

The primary objective of the 2005 EDHS was to provide up-to-date information for policy
makers, planners, researchers and programme managers, which would allow guidance in the planning,
implementation, monitoring and evaluation of population and health programmes in the country. The
information obtained from the EDHS, in conjunction with statistical information obtained from the
Welfare Monitoring Survey (WMS) and Household Income, Consumption and Expenditure Survey
(HICES), will provide critical information for the monitoring and evaluation of the country’s Plan for
Accelerated and Sustained Development to End Poverty (PASDEP), the various sector development
policies and programmes, and assist in the monitoring of the progress towards meeting the
Millennium Development Goals (MDGs).

The 2005 EDHS collected information on the population and health situation, covering topics
on family planning, fertility levels and determinants, fertility preferences, infant, child, adult and
maternal mortality, maternal and child health, nutrition, malaria, women’s empowerment, and
knowledge of HIV/AIDS. In addition the EDHS includes population estimates of HIV and anaemia
prevalence in the country. Key indicators relating to each of the above topics are provided for the nine
regional states and two city administrations. In addition, data are also provided by urban and rural
residence for the country. Findings from the survey indicate some improvements in major health and
demographic variables in the past five years.

The CSA would like to acknowledge a number of organizations and individuals who
contributed to the successful completion of the 2005 EDHS. The Agency is grateful for the
commitment of the Government of Ethiopia and the generous funding support primarily by the United
States Agency for International Development (USAID) and the President’s Emergency Plan for AIDS
Relief (PEPFAR), the Dutch and Irish Governments, and the United Nations Population Fund
(UNFPA). We also appreciate UNICEF for supplying weighing scales and salt test kits; and
WHO/Ethiopia and the Japan International Cooperation Agency (JICA) for each lending a vehicle to
support fieldwork. We would also like to thank ORC Macro in Maryland, U.S.A. for technical
assistance in all aspects of the survey. The agency extends a special thanks to the Ministry of Health,
to all the member institutions of the EDHS Steering Committee and to development partners and
stakeholders, who contributed to the successful completion of the survey. Special thanks also goes to
the Ethiopia Health and Nutrition Research Institute (EHNRI), which handled the testing of the blood
samples for determining the HIV status of the surveyed population. We also wish to acknowledge the
tireless effort of the CSA staff who made this survey a success.

Finally, we highly appreciate the field staff and, more importantly, the survey respondents,
who were critical to the successful completion of this survey.

Samia Zekaria
Director General
Central Statistical Agency

Foreword | xvii
ACKNOWLEDGMENTS

The following persons contributed to the preparation of this report

Mrs. Samia Zekaria, Central Statistical Agency


Mr. Gebeyehu Abelti, Central Statistical Agency
Mr. Genene Bizuneh, Central Statistical Agency
Mrs. Gezu Berhanu, Central Statistical Agency
Mr. Behailu G/Medhin, Central Statistical Agency
Mr. Mekonen Tesfaye, Central Statistical Agency
Mr. Yehualashet Mekonen, Central Statistical Agency
Mrs. Alemtsehay Biru, Central Statistical Agency
Mrs. Genet Mengistu, National Office of Population
Mr. Ambachew Medhin, Ministry of Health/ WHO
Mrs. Hiwot Mengistu, Ministry of Health
Dr. Yared Mekonen, Ethiopian Health and Nutrition Research Institute
Mr. Woldemariam Girma, Ethiopian Health and Nutrition Research Institute
Dr. Aseged Woldu, HIV/AIDS Prevention and Control Office
Mr. Hailu Belachew, CORHA
Dr. Pav Govindasamy, ORC Macro
Dr. Ann Way, ORC Macro
Mr. Albert Themme, ORC Macro
Dr. Alfredo Aliaga, ORC Macro
Dr. Sidney Moore, ORC Macro
Ms. Kaye Mitchell, ORC Macro
Ms. Anne Cross, ORC Macro
Ms. Joy Fishel, ORC Macro

Acknowledgments | xix
NATIONAL STEERING COMMITTEE MEMBERS

Mrs. Samia Zekaria CSA


Mr. Amare Isaias PHCCO
Dr. Tesfanesh Belay MOH
Mr. Misganaw Lijalen HAPCO
Dr. Tsehaynesh Messele EHNRI
Dr. Yared Mekonnen EHNRI
Mr. Hiruy Mitiku NOP
Mrs. Genet Mengistu NOP
Dr. Yemane Teklay ESTA
Mr. Hailu Belachew CORHA
Mr. Genene Bizuneh CSA
Mr. Kefene Asfaw CSA
Mr. Behailu G/Medhin CSA
Mrs. Gezu Berhanu CSA
Mr. Gebeyehu Abelti CSA
Dr. Monique Rakotomalala UNFPA
Mr. Jude Edochie UNFPA
Mrs. Mulugojjam Assaye UNFPA
Mrs. Meron Tewfik UNFPA
Dr. Alemach Teklehaimanot UNICEF
Dr. Habtamu Argaw WHO
Ms. Sue Anthony USAID
Mrs. Mary Ann Abeyta-Behnke USAID
Dr. Omer Ahmed Omer USAID
Dr. Kidest Lulu USAID
Dr. Pav Govindasamy ORC Macro
Mr. Bernard Ghaleb ORC Macro

National Steering Committee Members | xxi


SUMMARY OF FINDINGS

The 2005 Ethiopia Demographic and Health Marriage patterns are an important
Survey (EDHS) is a nationally representative determinant of fertility levels in a population.
survey of 14,070 women age 15-49 and 6,033 Although there was a marked decline in the
men age 15-59. The EDHS is the second percentage of women in union from 72 percent in
comprehensive survey conducted in Ethiopia as 1990 to 64 percent in 2000, little change was
part of the worldwide Demographic and Health observed in women currently in union in the last
Surveys (DHS) project. The primary purpose of five years. Similar trends were observed in the
the EDHS is to furnish policymakers and median age at marriage and the median age at
planners with detailed information on fertility, first sexual intercourse, with obvious increases in
family planning, infant, child, adult and maternal the ten-year period between 1990 and 2000 and
mortality, maternal and child health, nutrition little change in the five-year period between
and knowledge of HIV/AIDS and other sexually 2000 and 2005.
transmitted infections. In addition, in one of two
households selected for the survey, women age Ethiopian women generally begin sexual
15-49 and children age 6-59 months were tested intercourse at the time of their first marriage.
for anaemia, and women age 15-49 and men age This can be seen from the identical medians in
15-59 were tested for HIV. The 2005 EDHS is age at first marriage and age at first sexual
the first survey in Ethiopia to provide population- intercourse (16.1). Men, on the other hand, are
based prevalence estimates for anaemia and HIV. sexually active before marriage, although the
difference in age at first intercourse and age at
FERTILITY first marriage has narrowed over the past five
years. The median age at first sexual intercourse
Survey results indicate that there has been a for men is 21.2 years while the median age at
decline in fertility from 6.4 births per woman in first marriage is 23.8. In general, Ethiopian men
1990 to 5.4 births per woman in 2005, a one marry nearly eight years later than women.
child drop in the last 15 years. The decline was
more pronounced in the 10 years between 1990 Data from the 2005 EDHS show that 12
and 2000 than in the five years between 2000 and percent of currently married women are married
2005 and in urban than in rural areas. Rural to men who are in a polygynous union. Older
women on average have two and a half children women, rural women, women residing in
more than urban women. There is a substantial Gambela, uneducated women, and women in the
differential in fertility by region ranging from a poorest wealth quintile are more likely to be in a
low of 1.4 children per woman in Addis Ababa polygynous union than other women. About one
to a high of 6.2 children per woman in Oromiya. in fifteen men is in a polygynous union. The
Education and wealth have a marked effect on extent of polygyny has declined over the past
fertility, with uneducated mothers having three five years.
times as many children as women with at least
some secondary education and women in the The interval between births is relatively long
lowest wealth quintile having twice as many in Ethiopia. The median number of months since
children as women in the highest wealth quintile. the preceding birth is 33.8. Twenty-one percent
of nonfirst births occur within two years of a
Childbearing starts early. At current age- previous birth, 35 percent occur between 24 and
specific rates of childbearing, an Ethiopian 35 months later and 44 percent occur at least
woman will have had more than half of her three years after a previous birth. Postpartum
lifetime births by age 30, and nearly three- insusceptibility is one of the major factors
fourths by age 35. contributing to the long birth interval in Ethiopia.
The median duration of amenorrhea is 15.8
months, postpartum abstinence is 2.4 months,
and insusceptibility is 16.7 months.

Summary of Findings | xxiii


FAMILY PLANNING five years from 42 percent in 2000 to 18 percent
in 2005.
Overall, knowledge of contraception has
remained consistently high in Ethiopia over the Family planning information is largely
past five years with 88 percent of currently received through the radio with limited exposure
married women and 93 percent of currently through the television and print media. Twenty-
married men having heard of at least one method nine percent of women heard about family
of contraception. The pill, injectables, and planning on the radio compared with 11 percent
condom are the most widely known modern who heard about it from television and 8 percent
methods among both women and men. Currently who read about it in newspapers or magazines.
married men are more than twice as likely to
recognize the condom as a method of family The majority of Ethiopian women (78
planning than currently married women (84 percent) and men (76 percent) prefer to space or
percent versus 41 percent). limit the number of children they have, and have
a potential need for family planning. One in three
Twenty-four percent of currently married currently married women has an unmet need for
women and 19 percent of currently married men family planning (34 percent). The need for
have used a family planning method at least once spacing (20 percent) is higher than the need for
in their lifetime. Fifteen percent of currently limiting (14 percent). If all currently married
married women are using a method of women who say they want to space or limit the
contraception. Modern methods are more widely number of children were to use family planning,
used than traditional methods, with 14 percent of the contraceptive prevalence rate in Ethiopia
currently married women using a modern method would increase from 15 percent to 49 percent.
and 1 percent using a traditional method. The Currently, only 31 percent of the demand for
most popular modern method is the injectable family planning is being met.
used by one in ten currently married women.
About four in five currently married women CHILD HEALTH
obtain modern methods from the public sector,
while 17 percent and 3 percent, respectively, At current mortality levels, one in every 13
obtain their method from the private medical Ethiopian children dies before reaching age one,
sector or other private sources. while one in every eight does not survive to the
fifth birthday. Data from the 2005 EDHS show
Use of contraceptive methods tripled in the that infant mortality has declined by 19 percent
fifteen-year period between 1990 and 2005 from over the past 15 years from 95 deaths per 1,000
5 percent to 15 percent. The increase is live births to 77. Under-five mortality has gone
especially marked for modern methods which down by 25 percent from 166 deaths per 1,000
more than doubled in the five years between live births to 123. The corresponding declines in
2000 and 2005. This trend is mostly attributable neonatal and postneonatal mortality over the
to the recent rapid rise in the use of injectables 15-year period are 15 percent and 22 percent,
from 3 percent in 2000 to 10 percent in 2005. respectively.

More than half of currently married women Mortality is consistently lower in urban areas
who were not using any family planning method than in rural areas. The lowest level is in Addis
at the time of the survey say they intend to use a Ababa, the most urbanized part of the country,
method in the future. The majority of prospective while the highest levels are in Benishangul-
users prefer injectables while a sizeable Gumuz, Gambela, and Amhara. Maternal
proportion cite the pill as their preferred method. education is strongly correlated with child
mortality. Under-five mortality among children
The desire for more children is frequently born to mothers with no education is more than
mentioned by currently married nonusers as a twice as high as that among children born to
reason for not intending to use a method of mothers with secondary education or higher.
contraception in the future. The proportion of
women who cited this reason for not wanting to Survival of infants and children is strongly
use a method has dropped markedly over the past influenced by the gender of the child, mother’s

xxiv | Summary of Findings


age at birth, birth order, and birth interval. Male The data show that only 6 percent of households
children experience higher mortality than female in Ethiopia own a mosquito net, with 3 percent of
children and the gender difference is especially households owning an insecticide-treated net
pronounced for infant mortality. Childhood (ITN). Consistent with the degree of risk of
mortality is relatively higher among children malaria, ownership of mosquito nets varies
born to mothers under age 20 and over age 40. inversely with altitude. For instance, 36 percent
First births and births of order seven and higher of households living in areas below 1,000 metres
also suffer significantly higher rates of mortality own some type of net, while the corresponding
than births of order two to six. Children born figure for households at altitudes above 2,000
within two years of a preceding birth are more metres or more is only 2 percent. Only 2 percent
than three times as likely to die within the first of children under five slept under a net the night
year of life as children born three or more years prior to the interview, while less than 2 percent
after an older sibling. slept under an ever-treated net and under an ITN.
Use of nets varies inversely with altitude with 19
Twenty percent of children age 12-23 percent of children living at altitudes less than
months had been fully vaccinated at the time of 1,000 metres sleeping under a net compared with
the survey. Three in five have received the BCG 4 percent or less among children living at
vaccination, and 35 percent have been vaccinated altitudes above 1,000 metres. Eleven percent of
against measles. The coverage for the first dose households occupying a dwelling had their inner
of DPT is relatively high (58 percent). However, walls sprayed with insecticide to prevent malaria,
only 32 percent go on to receive the third dose of 2 percent had been sprayed in the 6 months
DPT. Polio coverage is much higher than DPT preceding the survey, and 3 percent had white
coverage because of the success of the national insecticide powder visible on the inner walls.
immunization day campaigns during which polio
vaccines are administered. Nevertheless, the Nationally, 18 percent of children under age
dropout between the first and subsequent doses five had diarrhoea at some time in the two weeks
of polio is marked – a 40 percent decline before the survey, while 6 percent had diarrhoea
between the first and third dose. Vaccination with blood during the same period. Around one
coverage in Ethiopia has improved over the past in five of these children were taken to a health
five years. The percentage of children 12-23 provider. Thirty-seven percent of children with
months fully vaccinated at the time of the survey diarrhoea were treated with some kind of oral
increased by 43 percent from 14 percent in 2000 rehydration therapy (ORT): 20 percent were
to 20 percent in 2005. However, the percentage treated with ORS (solution prepared from ORS
who received none of the six basic vaccinations packets); 19 percent were given recommended
also increased from 17 percent in 2000 to 24 home fluids (RHF) prepared at home; and 9
percent in 2005. percent were given increased fluids. About half
of children with diarrhoea did not receive any
Thirteen percent of children under age five type of treatment at all.
showed symptoms of acute respiratory infection
(ARI) in the two weeks before the survey. Use of MATERNAL HEALTH
a health facility for the treatment of symptoms of
ARI is low, with only 19 percent of children Twenty-eight percent of mothers who had a
taken to a health facility or provider. live birth in the five years preceding the survey
received antenatal care from health professionals;
Nineteen percent of children under five were less than 1 percent of mothers received antenatal
reported to have had fever, a major manifestation care from trained and untrained traditional birth
of malaria, in the two weeks before the survey. attendants. More than seven in ten mothers did
Less than one in five children was taken to a not receive antenatal care. There was little
health facility or provider for treatment. A very improvement in the percentage of mothers who
small percentage of children with fever received received antenatal care from a health
antimalarial drugs (3 percent) or antibiotics (6 professional in the five years between the 2000
percent). and 2005 surveys. About one in ten women make
four or more antenatal care visits during their
The 2005 EDHS gathered information on the entire pregnancy. The median duration of
use of mosquito nets, both treated and untreated.

Summary of Findings | xxv


pregnancy for the first antenatal visit is 5.6 The data also show that complementary foods are
months, indicating that Ethiopian women start not introduced in a timely fashion for many
antenatal care at a relatively late stage of their children. At 6-8 months, only one in two children
pregnancy. is receiving complementary foods. The use of a
bottle with a nipple is not widespread in
Among mothers who received antenatal care Ethiopia. However, the proportion of children
31 percent reported that they were informed who are bottle-fed rises from 8 percent among
about pregnancy complications during their children age less than 2 months to 19 percent
antenatal care visits. Weight and blood pressure among children age 6-8 months, after which it
measurements were taken for 72 percent and 62 declines gradually.
percent of mothers, respectively. About one-
quarter of mothers gave urine and blood samples. More than half of Ethiopian children age 6-
59 months are classified as anaemic, with 21
For last live births in the five years preceding percent mildly anaemic, 28 percent moderately
the survey, only one in three women was anaemic, and 4 percent severely anaemic. The
protected against neonatal tetanus. Most of these prevalence of anaemia among women is less
women (28 percent) had received two or more pronounced than among children. Twenty-seven
tetanus injections while pregnant with the last percent of women age 15-49 are anaemic, with
birth. Despite the low coverage, there is evidence 17 percent mildly anaemic, 8 percent moderately
of improvement over time. The percentage of anaemic, and just over 1 percent severely
women who received two or more tetanus anaemic.
injections during pregnancy for the last birth
increased from 17 percent in 2000 to 28 percent The level of malnutrition is significant with
in 2005. nearly one in two (47 percent) Ethiopian children
under five years of age stunted (short for their
An overwhelming majority of births in the age), 11 percent wasted (thin for their height),
five years before the survey were delivered at and 38 percent underweight. In general, rural
home (94 percent). Five percent of births were children and children of uneducated mothers are
delivered in a public facility and 1 percent in a more likely to be stunted, wasted, or underweight
private facility. Six percent of births were than other children. Regional variation in
delivered with the assistance of a trained health nutritional status of children is substantial.
professional, that is, a doctor, nurse, or midwife, Stunting levels are above the national average in
while 28 percent were delivered by a traditional Amhara and SNNP. Wasting is higher than the
birth attendant (TBA). The majority of births (61 national average in Somali, Benishangul-Gumuz,
percent) were attended by a relative or some Amhara, Tigray and Dire Dawa. The percentage
other person. Five percent of births were of underweight children is above the national
delivered without any type of assistance at all. average in Somali, Amhara, Tigray and
Benishangul-Gumuz.
Postnatal care is extremely low in Ethiopia.
Nine in 10 mothers who had a live birth in the Survey results show that the level of chronic
five years preceding the survey received no energy deficiency among women in Ethiopia is
postnatal care at all and only 5 percent of relatively high. Twenty-seven percent of women
mothers received postnatal care within the fall below the cutoff of 18.5 for the body mass
critical first two days after delivery. index (BMI), which utilizes both height and
weight to measure thinness. Four percent of
BREASTFEEDING AND NUTRITION women are overweight or obese.

Breastfeeding is nearly universal in Ethiopia, HIV/AIDS AND STIs


and the median duration of any breastfeeding is
long (25.8 months). Exclusive breastfeeding, on Knowledge of AIDS is widespread in
the other hand, is relatively short, with a median Ethiopia. Ninety percent of women age 15-49
duration of 2.1 months. Contrary to WHO and 97 percent of men age 15-49 have heard of
recommendations, only around one in three AIDS. Women and men are most aware that the
children age 4-5 months is exclusively breastfed. chances of getting the AIDS virus can be reduced

xxvi | Summary of Findings


by limiting sex to one uninfected partner who has and the majority of them had received the results
no other partners (63 percent and 79 percent, of their test. Three percent of women reported
respectively) or by abstaining from sexual that they had received information and
intercourse (62 percent and 80 percent, counselling about HIV/AIDS during antenatal
respectively). Knowledge of condoms and the care for their most recent birth.
role they can play in preventing transmission of
the AIDS virus is much less common, Two percent each of sexually active women
particularly among women. and men reported that they had had an STI and/or
STI symptoms in the 12 months prior to the
Only 51 percent of women and 69 percent of survey.
men know that a healthy-looking person can
have the AIDS virus. Also, many women and Results from the 2005 EDHS indicate that
men erroneously believe that AIDS can be 1.4 percent of Ethiopian adults age 15-49 are
transmitted by mosquito bites. Larger infected with HIV. HIV prevalence among
proportions of respondents are aware that the women is nearly 2 percent, while for men 15-49,
AIDS virus cannot be transmitted by it is just under 1 percent. HIV prevalence levels
supernatural means or by sharing food. The rise with age, peaking among women in their late
EDHS results also show that a minority of 30s and among men in their early 40s. The age
women (16 percent) and men (30 percent) have pattern suggests that young women are
comprehensive knowledge of HIV/AIDS particularly vulnerable to HIV infection
transmission, that is, they know that both compared with young men. Urban residents have
condom use and limiting sex partners to one a significantly higher risk of HIV infection (6
uninfected partner are HIV prevention methods; percent) than rural residents (0.7 percent). The
that a healthy-looking person can have HIV; and risk of HIV infection among rural women and
reject the two most common local men is almost identical, while urban women are
misconceptions about HIV/AIDS —that AIDS more than three times as likely as urban men to
can be transmitted through mosquito bites and by be infected. Prevalence levels are highest in
sharing food with an infected person. Around Gambela (6 percent) and Addis Ababa (5
one-fifth of women and one-third of men age 15- percent). Other regions in which HIV prevalence
24 have comprehensive knowledge about exceeds the national average include Harari, Dire
HIV/AIDS. Dawa, Affar, Tigray and Amhara. HIV infection
levels increase directly with education among
Sixty-nine percent of women and 75 percent both women and men and are markedly higher
of men know that HIV can be transmitted by among those with a secondary or higher
breastfeeding. About one-fifth of women and education compared with those having less
one-fourth of men know that the risk of mother- education. Employed women and men are also
to-child transmission (MTCT) can be reduced more likely to be HIV infected than the
through the use of certain drugs during unemployed, as are women and men in the
pregnancy. highest wealth quintile compared with those in
the other wealth quintiles.
Information on higher-risk sex (sexual
intercourse with a partner who is neither a spouse WOMEN’S STATUS
nor a cohabiting partner) shows that less than 1
percent of women and 4 percent of men have had The DHS data shed some light on the status
two or more partners during the 12 months of women in Ethiopia. While the majority of
preceding the survey, and 3 percent of women Ethiopians have little or no education, women
and 9 percent of men have had higher-risk sexual are generally less educated than men. However,
intercourse. Among respondents who engaged in the male-female gap in education is more
higher-risk sexual intercourse, 24 percent of obvious at higher than at lower levels of
women and 52 percent of men reported condom education, indicating the government’s
use the last time they had sexual intercourse. recognition and successful intervention to
address gender disparity in more recent years.
Among the adult population age 15-49, 4
percent of women and 6 percent of men reported
that they had been tested for HIV at some time,

Summary of Findings | xxvii


Marked differences were observed in the between women’s status and utilization of health
levels of employment by gender. The majority of services. The more empowered a woman, the
men (86 percent) were employed at the time of more likely she is to receive antenatal, postnatal,
the survey, compared with 29 percent of women. and delivery care from a health professional. The
Nearly one in three currently married women relationship between childhood mortality and
was employed during the 12 months before the women’s empowerment is mixed.
survey. Three-tenths of employed women earn
cash only or cash and in-kind earnings. Nearly The EDHS provides insight into several
three-fifths of currently married women are not harmful traditional practices existent in Ethiopia.
paid at all. The practice of female circumcision is
widespread in Ethiopia, with three in four
Almost two-fifths of currently married women age 15-49 circumcised. Six percent of
women who receive cash earnings report that circumcised women reported that their vagina
they alone decide how their earnings are used, had been sewn closed (infibulation). More than
while more that half of currently married women two in five Ethiopian women themselves have
say that they decide jointly with their husband or had a uvulectomy or tonsillectomy. More than
partner. Information on women’s decisionmaking two-fifths of women with at least one daughter
autonomy shows that almost 53 percent of have a daughter who has had a uvulectomy or
currently married women make independent tonsillectomy. Eight percent of women reported
decision about daily household purchases. While that they had been married by abduction and
15 percent of women make sole decisions on about 1 percent with at least one daughter
their own health care, one-third say that their reported that a daughter was married by
husband or partner makes such decisions. abduction.
Decisions on large household purchases are
typically made by the husband or partner alone Around one in four women interviewed in
or jointly with their husband or partner. More the EDHS had heard of obstetric fistula and 1
than two-thirds of women say that decisions to percent of women who have ever given birth
visit family or relatives are made jointly with reported having experienced obstetric fistula. A
their husband or partner. small percentage of women (less than 1 percent)
reported that they had been treated for obstetric
The majority of women and men agree that a fistula. According to information gathered from
woman is justified in refusing to have sexual women who have heard of the condition, 4
intercourse with her husband or partner for at percent of other women resident in the household
least one of three specified reasons. Only one in also suffer from obstetric fistula.
ten women and men is of the opinion that a
woman cannot refuse sexual intercourse for any Maternal mortality is relatively high in
reason. On the other hand, a sizable proportion of Ethiopia with more than one in five deaths to
women (44 percent) and to a lesser extent men women age 15-49 in the seven years preceding
(23 percent), believe that a husband is justified in the survey attributed to pregnancy or pregnancy-
beating his wife if she refuses to have sex with related causes. The maternal mortality ratio,
him. Overall, eight in ten women and around half which measures the obstetric risk associated with
of men believe that there are at least some each live birth, is 673 deaths per 100,000 live
situations in which a husband is justified in births for the period 1994-2000.
beating his wife.
Direct estimates of male and female
EDHS data indicate a positive relationship mortality obtained from the sibling history
between women’s status and contraceptive use. gathered in the EDHS show that there were more
Contraceptive use is highest among women who female than male deaths in the seven years
participate in most household decisions, who preceding the survey (925 compared with 903).
agree that a woman can refuse sexual intercourse The female mortality rate is 6.4 deaths per 1,000
with her partner for all three specified reasons, population, which is 8 percent higher than the
and who believe that wife beating is not justified male mortality rate of 5.9 deaths per 1,000
for all five specified reasons. The data show that population.
mean ideal family size declines as women’s
status increases. Also, there is a correlation

xxviii | Summary of Findings


Millennium Development Goal Indicators, Ethiopia 2005

Goal Indicator Value

1. Eradicate extreme poverty Prevalence of underweight children under five years of age Male: 38.9% Total: 38.4%
and hunger Female: 37.9%
2. Achieve universal primary Net enrolment ratio in primary education1 Male: 42.2% Total: 42.3%
education Female: 42.4%
Proportion of pupils starting grade 1 who reach grade 51 Male: 73.7% Total: 78.0%
Female: 83.5%
Literacy rate of 15-24-year olds2 Male: 67.2% Total: 54.4%
Female: 41.6%
3. Promote gender equality Ratio of girls to boys in primary and secondary education Primary
and empower women education: 0.91
Secondary
education: 0.65
Ratio of literate women to men, 15-24 years old 0.62
Share of women in wage employment in the non-agricultural
sector3 76.5%
4. Reduce child mortality Under-five mortality rate (per 1,000 live births) 123 per 1,000
Infant mortality rate (per 1,000 live births) 77 per 1,000
Proportion of 1-year-old children immunised against measles Male: 36.4% Total: 34.9%
Female: 33.2%
5. Improve maternal health Maternal Mortality Ratio (per 100,000 live births) 673 per 100,000
Proportion of births attended by skilled health personnel 5.7%
6. Combat HIV/AIDS, Condom use rate of the contraceptive prevalence rate (any 1.32%
malaria, and other diseases modern method, currently married women 15-49)
Condom use at last high-risk sex (population age 15-24)4 Male: 46.8%
Female: 28.4%
Percentage of population age 15-24 years with Male: 33.3%
comprehensive knowledge of HIV/AIDS5 Female: 20.5%
Contraceptive prevalence rate (any modern method, 13.9%
currently married women 15-49)
Ratio of school attendance of orphans to school attendance of 0.9
non-orphans age 10-14 years
7. Ensure environmental Proportion of population using solid fuels6 Urban: 96.5% Total: 99.5%
sustainability Rural: 99.9%
Proportion of population with sustainable access to an Urban: 92.7% Total: 60.0%
improved water source, urban and rural7 Rural: 55.5%
Proportion of population with access to improved sanitation, Urban: 22.6% Total: 7.4%
urban and rural8 Rural: 5.4%
1
Excludes children with parental status missing
2
Refers to respondents who attended secondary school or higher and women who can read a whole sentence
3
Wage employment includes respondents who receive wages in cash or in cash and kind.
4
High risk refers to sexual intercourse with a partner who neither was a spouse nor who lived with the respondent; time frame is
12 months preceding the survey.
5
A person is considered to have a comprehensive knowledge about AIDS when they say that use of condoms for every sexual intercourse
and having just one uninfected and faithful partner can reduce the chance of getting the AIDS virus, that a healthy-looking person can
have the AIDS virus, and when they reject the two most common local misconceptions. The most common misconceptions in Ethiopia
are that AIDS can be transmitted through mosquito bites and that a person can become infected with the AIDS virus by sharing food or
utensils with someone who is infected.
6
Charcoal, firewood, straw, dung, or crop waste
7
Improved water sources are: household connection (piped), public standpipe, borehole, protected dug well, protected spring, or
rainwater collection.
8
Improved sanitation technologies are: connection to a public sewer, connection to septic system, pour-flush latrine, simple pit latrine, or
ventilated improved pit latrine.

Millennium Development Goal Indicators | xxix


INTRODUCTION 1
1.1 HISTORY, GEOGRAPHY, AND ECONOMY

History

Ethiopia is an ancient country with a rich diversity of peoples and cultures and a unique
alphabet that has existed for more than 3,000 years. Palaeontological studies identify Ethiopia as one
of the cradles of mankind. “Dinknesh” or “Lucy,” one of the earliest and most complete hominoids
discovered through archaeological excavations, dates back to 3.5 million years. Ethiopia’s geo-
graphical and historical factors have had a great influence on the distribution of its peoples and
languages. The country is situated at the cross roads between the Middle East and Africa. Through its
long history, Ethiopia has become a melting pot of diverse customs and varied cultures, some of
which are extremely ancient. Ethiopia embraces a complex variety of nations, nationalities and
peoples, and linguistic groups. Its peoples altogether speak over 80 different languages constituting 12
Semitic, 22 Cushitic, 18 Omotic and 18 Nilo-Saharan languages (MOI, 2004).

The country has always maintained its independence, even during the colonial era in Africa.
Ethiopia is one of the founding members of the United Nations. Ethiopia has been playing an active
role in African affairs, specifically played a pioneering role in the formation of the Organization of
African Unity (OAU). In fact, the capital city, Addis Ababa, has been a seat for the OAU since its
establishment and continues serving as the seat for the African Union (AU) today.

Ethiopia was ruled by successive emperors and kings with a feudal system of government
until 1974. In 1974, the military took over the reign of rule by force and administered the country
until May 1991. Currently, a federal system of government exists, and political leaders are elected
every five years. The government is made up of two tiers of parliament, the House of Peoples’
Representatives and the House of the Federation. Major changes in the administrative boundaries
within the country have been made three times since the mid-1970s, and at present Ethiopia is
administratively structured into nine regional states, namely, Tigray, Affar, Amhara, Oromiya,
Somali, Benishangul-Gumuz, Southern Nations, Nationalities and Peoples, Gambela and Harari
regional states and two city administrations, that is, Addis Ababa and Dire Dawa Administration
Council.

Geography

Ethiopia is situated in the Horn of Africa between 3 and 15 degrees north latitude and 33 and
48 degrees east longitude. It is a country with great geographical diversity; its topographic features
range from the highest peak at Ras Dashen, which is 4,550 metres above sea level, down to the Affar
Depression at 110 metres below sea level (CSA, 2000). The climatic condition of the country varies
with the topography, with temperatures as high as 47 degrees Celsius in the Affar Depression and as
low as 10 degrees Celsius in the highlands. The total area of the country is about 1.1 million square
kilometres and Djibouti, Eritrea, Sudan, Kenya, and Somalia border it. A large part of the country is
high plateaux and mountain ranges, with precipitous edges dissected by rushing streams of tributaries
of famous rivers like the Abay (The Blue Nile), Tekeze, Awash, Omo, the Wabe Shebelie and the
Baro-Akobo (MOI, 2004).

As the country is located within the tropics, its physical conditions and variations in altitude
have resulted in great diversity of terrain, climate, soil, flora, and fauna. Ethiopia’s major physical
features are the result of extensive and spectacular faulting that cracked the old crystalline block of the
African continent along the eastern side, producing the Great Rift Valley that stretches from the

Introduction |1
eastern end of the Mediterranean Basin down to Mozambique in the southeastern part of our continent
(MOI, 2004).

There are three principal climatic groups in Ethiopia, namely the tropical rainy, dry, and
warm temperate climates. In Ethiopia the mean maximum and minimum temperatures vary spatially
and temporally. Generally, the mean maximum temperature is higher from March to May and the
mean minimum temperature is lower from November to December as compared to the other months
(MOI, 2004). Ethiopia’s mean annual distribution of rainfall is influenced by the direction of both
westerly and southeasterly winds. Thus, in Ethiopia the general pattern of annual rainfall distribution
remains seasonal, varying in amount, space, and time, as the rain moves from the southwest to the
northeast of the country (MOI, 2004).

Economy

Ethiopia is an agrarian country and agriculture accounts for 54 percent of the gross domestic
product (GDP). Agriculture employs about 80 percent of the population and accounts for about 90
percent of the exports (CSA, 2000). The country is one of the least developed in the world, with a per
capita gross national income (GNI) in 2004 of US$110 (World Bank, 2006). Coffee has remained the
main export of the country; however, other agricultural products are currently being introduced on the
international market. The Ethiopian currency is the Birr, and at present, 1 US dollar is equivalent to
about 8.60 Birr. Between 1974 and 1991, the country operated a central command economy under the
socialist banner of the Derg regime. However, since their overthrow, Ethiopia has moved toward a
market-oriented economy. At present, the country has one commercial and two specialized
government-owned banks and also six privately owned commercial banks; one government-owned
insurance company and seven private insurance companies (NBE, 2000). There are also 15
microfinancing institutions established by private organizations.

For the past three years the Ethiopian economy has shown mixed performance, with negative
real GDP growth rate of 3.8 percent in 2002/03 as a result of drought, followed by strong positive
performance of 11.3 percent and 8.9 percent during the past two years. Accordingly, during 2001/02-
2004/05 the annual real GDP growth averaged 5 percent. As usual, variability of growth was mostly a
result of the variability in the output of the agricultural sector. Agricultural value-added declined by
about 12 percent in 2002/03 and rebounded by 18 percent in the following year. Inflation stood at 15.1
percent in 2002/03, but declined to 9 percent in 2003/04 and 6.8 percent in 2004/05. Exports
registered substantial growth in recent years, owing to both increases in volume and revival in the
prices of major exports in the international market. In 2003/04 and 2004/05 the total value of exports
grew by 25.0 and 36.0 percent, respectively (MoFED, 2005).

Despite improvements in the past few years, sustaining long-term growth remains a challenge.
Economic growth averaged about 5 percent per annum over the period 1999/2000 to 2004/05.
Adjusting for population growth, the average per capita income rose by about 2.1 percent per annum.
Major disruptions and shocks in the 1970s and 1980s resulted in economic decline, and the relatively
good performance of the 1990s and early 2000s has only recently helped to reverse and raise incomes
(MoFED, 2005). Ethiopia is one of the seven priority countries selected by the Millennium Project to
prepare a scaled-up investment plan that would allow the country to meet the Millennium
Development Goal (MDG) targets in 2005. Ethiopia is on the verge of embarking on the second
poverty reduction strategy, which is referred to as the ”Plan for Accelerated and Sustained
Development to End Poverty (PASDEP)” that supersedes the first strategy “Sustainable Development
and Poverty Reduction Program (SDPRP). The PASDEP carries forward important strategic
directions pursued under the SDPRP—related to human development, rural development, food
security and capacity building—but also embodies some bold new directions (MoFED, 2005). The
PASDEP, which is the government’s national development plan for the five years covering 2005/06-
2009/10, consists of eight strategic elements, namely: a massive push to accelerated growth, a
geographically differentiated strategy, addressing the population challenge, unleashing the potential of

2 | Introduction
Ethiopia’s women, strengthening the infrastructural backbone, managing risk and volatility, scaling-
up to reach the MDG, and creating jobs.

1.2 POPULATION

Despite its long history, there were no estimates of the total population of Ethiopia prior to the
1930s. However, population estimates for some towns like Axum, Lalibela and Debre Berhan are
available from the 16th century onwards. Many of the estimates were made by travellers and were
based on a general observation. The first ever population and housing census was conducted in 1984.
The 1984 Census covered about 81 percent of the population of the country and official estimates
were given for the remaining 19 percent that were not enumerated in the census. The second
population and housing census was conducted in 1994. Unlike the first census, the second census
covered the entire population. Table 1.1 provides a summary of the basic demographic indicators for
Ethiopia from data collected in the two population and housing censuses. The population increased
over the decade from 42.6 million in 1984 to 53.5 million in 1994. There was a slight decline in the
population growth rate over the decade, from 3.1 percent in 1984 to 2.9 percent in 1994. Ethiopia is
one of the least urbanized countries in the world, with less than 14 percent of the country urbanized in
1994. Female life expectancy is about two years higher than male life expectancy. Over the decade,
life expectancy for both males and females did not improve.

Table 1.1 Basic demographic indicators


1984 1994
Indicator Census1 Census2
Population (millions) 42.6 53.5
Intercensal grown rate (percent) 3.1 2.9
Density (pop./km2.) 34.0 48.6
Percent urban 11.4 13.7
Life expectancy
Male 51.1 50.9
Female 53.4 53.5
1
Including Eritrea; CSA, 1991
2
CSA, 1998

The majority of the population lives in the highland areas of the country. The main occupation
of the settled population is farming, while in the lowland areas, the mostly pastoral population moves
from place to place with their livestock in search of grass and water. Among the nine regional states,
Amhara, Oromiya and SNNP comprised about 80 percent of the total population of the country. Affar,
Somali, Benishangul-Gumuz and Gambela regions are relatively underdeveloped. Christianity and
Islam are the main religions; 51 percent of the population are Orthodox Christians, 33 percent are
Muslims, and 10 percent are Protestants. The rest follow a diversity of other faiths. The country is
home to about 80 ethnic groups that vary in population size from more than 18 million people to less
than 100 (CSA, 1998).

Efforts were made to generate reliable demographic data by conducting a number of


demographic surveys. These include the 1981 Demographic Survey, the 1990 National Family and
Fertility Survey, the 1995 Fertility Survey of Urban Addis Ababa, and the 2000 Ethiopia
Demographic and Health Survey (EDHS). The 1990 National Family and Fertility Survey (NFFS)
was the first nationally representative survey that incorporated wider information on fertility, family
planning, contraceptive use and other related topics. In addition to the topics covered by the NFFS,
the 2000 EDHS collected information on maternal and child health, nutrition and breastfeeding
practices, HIV and other sexually transmitted diseases.

Introduction |3
Population Policy

Population policies had been accorded a low priority in Ethiopia prior to the early 1990s.
After the end of the Derg regime, the Transitional Government adopted a national population policy
in 1993 (TGE, 1993b). The primary objective of the population policy was to harmonize the rate of
population growth with socio-economic development to achieve a high level of welfare. The main
long-term objective was to close the gap between high population growth and low economic
productivity and to expedite socio-economic development through holistic integrated programs. Other
objectives included preserving the environment and reducing rural-urban migration and reducing
morbidity and mortality, particularly infant and child mortality. More specifically, the population
policy was targeted to:

i. Reduce the total fertility rate from 7.7 children per woman in 1990 to 4.0 children per
woman in 2015;
ii. Increase the prevalence of contraceptives from 4 percent in 1990 to 44 percent in 2015;
iii. Reduce maternal, infant and child morbidity and mortality rates as well as promote the
level of general welfare of the population;
iv. Significantly increase female participation at all levels of the educational system;
v. Remove all legal and customary practices that prevent women from the full enjoyment of
economic and social rights, including the full enjoyment of property rights and access to
gainful employment;
vi. Ensure spatially balanced population distribution patterns with a view to maintaining
environmental security and extending the scope of development activities;
vii. Improve productivity in agriculture and introduce off-farm and non-agricultural activities
for the purpose of employment diversification;
viii.Mount an effective countrywide population information and education programme
addressing issues pertaining to small family size and its relationship with human welfare
and environmental security (TGE, 1993b).

The policy indicated that population activities will be undertaken in Ethiopia under the
framework that would be defined in the technical and programmatic guidelines to be developed by the
Office of Population in consultation with the National Population Council. The policy also proposed
the establishment of certain institutional structures for its implementation. In general, the national
population policy covered all the major grounds that need to be covered in providing directives on the
management of population dynamics in the interest of sustainable development.

1.3 HEALTH PRIORITIES AND PROGRAMMING

The health system in Ethiopia is underdeveloped, and transportation problems are severe. The
majority of the population resides in the rural areas and has little access to any type of modern health
institution. It is estimated that about 75 percent of the population suffers from some type of
communicable disease and malnutrition, which are potentially preventable (TGE, 1995). There was no
health policy up through the 1950s; however, in the early 1960s, a health policy initiated by the World
Health Organization (WHO) was adopted. In the mid-1970s, during the Derg regime, an elaborate
health policy with emphasis on disease prevention and control was formulated. This policy gave
priority to rural areas and advocated community involvement (TGE, 1993a). At present, the
government health policy takes into account population dynamics, food availability, acceptable living
conditions, and other requisites essential for health improvements (TGE, 1993a). The present health
policy arises from the fundamental principle that health constitutes physical, mental, and social well-
being for the enjoyment of life and for optimal productivity. To realize this objective, the government
has established the Health Sector Development Programme (HSDP), which incorporates a 20-year
health development strategy, through a series of five-year investment programmes (MOH, 1999). This
programme calls for the democratisation and decentralization of health services; development of
preventive health care; capacity building within the health service system; equitable access to health
services; self-reliance; promotion of intersectoral activities and participation of the private sector,

4 | Introduction
including non-governmental organizations (NGOs); and cooperation and collaboration with all
countries in general and neighbouring countries in particular and between regional and international
organizations (TGE, 1993a).

The HSDP was implemented in two cycles, currently extending into the third programme
(HSDP III). The focus of HSDP III will be on poverty-related health conditions, communicable
diseases such as malaria and diarrhoea, and health problems that affect mothers and children. Efforts
will be concentrated on rural areas and on extending services outwards from static facilities to reach
villages and households. In addition, and more importantly, gender will be mainstreamed at all levels
of the health system (MoFED, 2005). The main implementation modalities identified were:

i. The Health Service Extension Programme (HSEP)—which involves the use of female
workers to deliver 16 health care packages in four main areas, i.e., hygiene and
environmental sanitation, disease prevention and control, family health services, and
health education and communication on outreach basis.
ii. The Accelerated Expansion of Primary Health Care Coverage—which has already been
developed and endorsed by the government, with a view to achieving universal coverage
of primary health care in the rural population by 2008.
iii. A Health Care Financing Strategy—which aims at increasing resource flow to the health
sector, improving efficiency of resource utilization, and ensuring sustainability of
financing to improve the coverage and quality of health service;
iv. The Health Sector Human Resource Development Plan—which aims at overcoming
problems related to the absolute shortage, maldistribution and productivity of workforce.

Despite the progress to date, coverage of the system remains inadequate, and the quality of
services available, especially in rural areas, is variable. In line with the government’s current five-year
national plan, the health sector will continue to emphasize primary health care and preventive
services; with a big focus on extending these services to those who have not been reached, and
improving the effectiveness of services, especially addressing difficulties in staffing and the flow of
drugs. The major health outcome objectives envisaged in the five-year period include (MoFED,
2005):

i. To cover all rural localities with the HSEP to achieve universal primary health care
coverage by the year 2008;
ii. To reduce the maternal mortality ratio from 871/100,000 to 600 per 100,000 live births;
iii. To reduce under-five mortality from 140 to 85 per 1000 population, and the infant
mortality rate from 97 to 45 per 1000 populations;
iv. To reduce total fertility rate from 5.9 to 4.0 children per woman;
v. To reduce the adult incidence of HIV from 0.68 to 0.65 and maintain the prevalence of
HIV at 4.4 percent;
vi. To reduce morbidity attributed to malaria from 22 percent to 10 percent;
vii. To reduce the case fatality rate of malaria in age groups five years and above from 4.5
percent to 2 percent and the rate in children under five from 5 percent to 2 percent; and
viii. To reduce mortality attributed to tuberculosis (TB) from 7 percent to 4 percent of all
treated cases.

1.4 OBJECTIVES OF THE SURVEY

The principal objective of the 2005 Ethiopia Demographic and Health Survey (DHS) is to
provide current and reliable data on fertility and family planning behaviour, child mortality, adult and
maternal mortality, children’s nutritional status, the utilization of maternal and child health services,
knowledge of HIV/AIDS and prevalence of HIV/AIDS and anaemia. The specific objectives are to:

• collect data at the national level which will allow the calculation of key demographic
rates;G

Introduction |5
• analyze the direct and indirect factors which determine the level and trends of fertility;
• measure the level of contraceptive knowledge and practice of women and men by
method, urban-rural residence, and region;G
• collect high quality data on family health including immunization coverage among
children, prevalence and treatment of diarrhoea and other diseases among children under
five, and maternity care indicators including antenatal visits and assistance at delivery;
• collect data on infant and child mortality and maternal and adult mortality; G
• obtain data on child feeding practices including breastfeeding and collect anthropometric
measures to use in assessing the nutritional status of women and children;
• collect data on knowledge and attitudes of women and men about sexually transmitted
diseases and HIV/AIDS and evaluate patterns of recent behaviour regarding condom use;G
• conduct haemoglobin testing on women age 15-49 and children under age five years in a
subsample of the households selected for the survey to provide information on the
prevalence of anaemia among women in the reproductive ages and young children;
• collect samples for anonymous HIV testing from women and men in the reproductive
ages to provide information on the prevalence of HIV among the adult population.

This information is essential for informed policy decisions, planning, monitoring, and
evaluation of programs on health in general and reproductive health in particular at both the national
and regional levels. A long-term objective of the survey is to strengthen the technical capacity of the
Central Statistical Agency to plan, conduct, process, and analyse data from complex national
population and health surveys. Moreover, the 2005 Ethiopia DHS provides national and regional
estimates on population and health that are comparable to data collected in similar surveys in other
developing countries. The first ever Demographic and Health Survey (DHS) in Ethiopia was
conducted in the year 2000 as part of the worldwide DHS programme. Data from the 2005 Ethiopia
DHS survey, the second such survey, add to the vast and growing international database on
demographic and health variables.

Wherever possible, the 2005 EDHS data is compared with data from the 2000 EDHS. In
addition, where applicable, the 2005 EDHS is compared with the 1990 NFFS, which also sampled
women age 15-49. Husbands of currently married women were also covered in this survey. However,
for security and other reasons, the NFFS excluded from its coverage Eritrea, Tigray, Asseb, and
Ogaden autonomous regions. In addition, fieldwork could not be carried out for Northern Gondar,
Southern Gondar, Northern Wello, and Southern Wello due to security reasons. Thus, any comparison
between the EDHS and the NFFS has to be interpreted with caution.

1.5 ORGANIZATION OF THE SURVEY

The 2005 EDHS was carried out under the aegis of the Ministry of Health and was
implemented by the then Population and Housing Census Commission Office (PHCCO), now merged
with the Central Statistical Agency (CSA). The testing of the blood samples for HIV status was
handled by the Ethiopia Health and Nutrition Research Institute (EHNRI). ORC Macro provided
technical assistance through its MEASURE DHS project. The resources for the conduct of the survey
were committed by the Government of Ethiopia, and various international donor organizations and
governments, namely, the United States Agency for International Development (USAID), the
President’s Emergency Plan for AIDS Relief (PEPFAR), the Dutch and Irish Governments, and the
United Nations Population Fund (UNFPA).

A steering committee composed of major stakeholders drawn from the government,


international organizations and NGOs was formed. The steering committee was responsible for
coordination, oversight, advice and decision-making on all major aspects of the survey undertaking.

6 | Introduction
Members of the steering committee include the Ministry of Health (MOH), PHCCO, EHNRI, the
HIV/AIDS Prevention and Control Office (HAPCO), the National Office of Population (NOP), the
Ethiopian Science and Technology Agency, the Consortium of Reproductive Health Associations
(CORHA), USAID, UNFPA, UNICEF, and WHO. A technical committee was also formed from
among the steering committee institutions.

1.6 SAMPLE DESIGN

The 2005 EDHS sample was designed to provide estimates for the health and demographic
variables of interest for the following domains: Ethiopia as a whole; urban and rural areas of Ethiopia
(each as a separate domain); and 11 geographic areas (9 regions and 2 city administrations), namely:
Tigray; Affar; Amhara; Oromiya; Somali; Benishangul-Gumuz; Southern Nations, Nationalities and
Peoples (SNNP); Gambela; Harari; Addis Ababa and Dire Dawa. In general, a DHS sample is
stratified, clustered and selected in two stages. In the 2005 EDHS a representative sample of
approximately 14,500 households from 540 clusters was selected. The sample was selected in two
stages. In the first stage, 540 clusters (145 urban and 395 rural) were selected from the list of
enumeration areas (EA) from the 1994 Population and Housing Census sample frame.

In the census frame, each of the 11 administrative areas is subdivided into zones and each
zone into weredas. In addition to these administrative units, each wereda was subdivided into
convenient areas called census EAs. Each EA was either totally urban or rural and the EAs were
grouped by administrative wereda. Demarcated cartographic maps as well as census household and
population data were also available for each census EA. The 1994 Census provided an adequate frame
for drawing the sample for the 2005 EDHS. As in the 2000 EDHS, the 2005 EDHS sampled three of
seven zones in the Somali Region (namely, Jijiga, Shinile and Liben). In the Affar Region the
incomplete frame used in 2000 was improved adding a list of villages not previously included, to
improve the region’s representativeness in the survey. However, despite efforts to cover the settled
population, there may be some bias in the representativeness of the regional estimates for both the
Somali and Affar regions, primarily because the census frame excluded some areas in these regions
that had a predominantly nomadic population.

The 540 EAs selected for the EDHS are not distributed by region proportionally to the census
population. Thus, the sample for the 2005 EDHS must be weighted to produce national estimates. As
part of the second stage, a complete household listing was carried out in each selected cluster. The
listing operation lasted for three months from November 2004 to January 2005. Between 24 and 32
households from each cluster were then systematically selected for participation in the survey.

Because of the way the sample was designed, the number of cases in some regions appear
small since they are weighted to make the regional distribution nationally representative. Throughout
this report, numbers in the tables reflect weighted numbers. To ensure statistical reliability,
percentages based on 25 to 49 unweighted cases are shown in parentheses and percentages based on
fewer than 25 unweighted cases are suppressed.

1.7 QUESTIONNAIRES

In order to adapt the standard DHS core questionnaires to the specific socio-cultural settings
and needs in Ethiopia, its contents were revised through a technical committee composed of senior
and experienced demographers of PHCCO. After the draft questionnaires were prepared in English,
copies of the household, women’s and men’s questionnaires were distributed to relevant institutions
and individual researchers for comments. A one-day workshop was organized on November 22, 2004
at the Ghion Hotel in Addis Ababa to discuss the contents of the questionnaire. Over 50 participants
attended the national workshop and their comments and suggestions collected. Based on these
comments, further revisions were made on the contents of the questionnaires. Some additional
questions were included at the request of MOH, the Fistula Hospital, and USAID. The questionnaires
were finalized in English and translated into the three main local languages: Amharic, Oromiffa and

Introduction |7
Tigrigna. In addition, the DHS core interviewer’s manual for the Women’s and Men’s Questionnaires,
the supervisor’s and editor’s manual, and the HIV and anaemia field manual were modified and
translated into Amharic.

The Household Questionnaire was used to list all the usual members and visitors in the
selected households. Some basic information was collected on the characteristics of each person
listed, including age, sex, education, and relationship to the head of the household. The main purpose
of the Household Questionnaire was to identify women and men who were eligible for the individual
interview. The Household Questionnaire also collected information on characteristics of the
household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the
floor and roof of the house, ownership of various durable goods, and ownership and use of mosquito
nets. In addition, this questionnaire was used to record height and weight measurements of women
age 15-49 and children under the age of five, households eligible for collection of blood samples, and
the respondents’ consent to voluntarily give blood samples.

The Women’s Questionnaire was used to collect information from all women age 15-49 years
and covered the following topics.

• Household and respondent characteristics


• Fertility levels and preferences
• Knowledge and use of family planning
• Childhood mortality
• Maternity care
• Childhood illness, treatment, and preventative actions
• Anaemia levels among women and children
• Breastfeeding practices
• Nutritional status of women and young children
• Malaria prevention and treatment
• Marriage and sexual activity
• Awareness and behaviour regarding AIDS and STIs
• Harmful traditional practices
• Maternal mortality

The Men’s Questionnaire was administered to all men age 15-59 years living in every second
household in the sample. The Men’s Questionnaire collected similar information contained in the
Women’s Questionnaire, but was shorter because it did not contain questions on reproductive history,
maternal and child health, nutrition and maternal mortality.

1.8 HAEMOGLOBIN AND HIV TESTING

In one in two households selected for the 2005 EDHS, women age 15-49 and children age 6-
59 months were tested for anaemia. In addition, all eligible women and men in this subsample of
households were tested for HIV. Anaemia and HIV testing were only carried out if consent was
provided by the respondents and in the case of a minor, by the parent or guardian. Consent for HIV
and anaemia was obtained separately. The protocol for haemoglobin and HIV testing was approved by
the National Ethics Review Committee of the Ethiopia Science and Technology Commission in Addis
Ababa, Ethiopia and the ORC Macro Institutional Review Board in Calverton, USA.

1.8.1 HAEMOGLOBIN TESTING

Haemoglobin testing is the primary method of anaemia diagnosis. In the EDHS, testing was
done using the HemoCue system. A consent statement was read to the eligible woman and to the
parent or responsible adult of young children and women age 15-17. This statement explained the
purpose of the test, informed prospective subjects tested and/or their caretakers that the results would

8 | Introduction
be made available as soon as the test was completed, and requested permission for the test to be
carried out, as well as consent to report their names to health personnel in the local health facility if
their haemoglobin level was severe.

Before the blood was taken, the finger was wiped with an alcohol prep swab and allowed to
air-dry. Then the palm side of the end of a finger was punctured with a sterile, non-reusable, self-
retractable lancet and a drop of blood collected on a HemoCue microcuvette and placed in a
HemoCue photometer which displays the result. For children 6-11 months who were particularly
undernourished and bony, a heel puncture was made to draw a drop of blood. The results were
recorded in the Household Questionnaire, as well as on a brochure given to each woman, parent, or
responsible adult, explaining what the results meant. For each person whose haemoglobin level was
severe, and who agreed to have the condition reported, a referral was given to the respondent to be
taken to a health facility.

1.8.2 HIV/AIDS TESTING

Eligible women and men in the subsample of households selected for HIV testing who were
interviewed were asked to voluntarily provide a few drops of blood for HIV testing. The protocol for
the blood specimen collection and analysis was based on the anonymous linked protocol developed
for DHS. The protocol allows for the merging of the HIV results to the socio-demographic data
collected in the individual questionnaires, provided that information that could potentially identify an
individual is destroyed before the linking takes place. This required that identification codes be
deleted from the data file and that the back page of the Household Questionnaires that contain the bar
code labels and names of respondents be destroyed prior to merging the HIV results with the
individual data file.

If, after explaining the procedure, the confidentiality of the data, and the fact that the test
results would not be made available to the subject, a respondent consented to the HIV testing, a
minimum of three blood spots was obtained from a finger prick and collected on a filter paper to
which was affixed a bar code label unique to the respondent, but with no other identifying information
attached. Each respondent who consented to being tested for HIV was given an information brochure
on AIDS, a list of fixed sites providing voluntary counselling and testing (VCT) services throughout
the country, and a voucher to access free VCT services at any of these sites for the respondent and/or
the partner.

Each dried blood spot (DBS) sample was given a bar code label, with a duplicate label
attached to the Household Questionnaire on the line showing consent for that respondent. A third
copy of the same bar code label was affixed to a Blood Sample Transmittal Form to track the blood
samples from the field to the laboratory. Filter papers were dried overnight in a plastic drying box,
after which the biomarker interviewer packed them in individual Ziploc bags for that particular
sample point. Blood samples were periodically collected in the field along with the completed
questionnaires and transported to the PHCCO headquarters in Addis Ababa for logging in, after which
they were taken to EHNRI for HIV testing.

In preparation for carrying out the HIV testing, an assessment was conducted jointly by
EHNRI staff and Macro consultants (from the Zambia Tropical Disease Research Centre) of the
equipment and staff training required for the testing of the DBS samples. In addition, the consultants
together with a biomarker specialist from ORC Macro worked with laboratory scientists at EHNRI to
conduct a validation study and set up the dried blood spot methodology to test for HIV using two
Enzyme-Linked Immunosorbent Assay (ELISA) tests from different manufacturers. Several meetings
with ORC Macro staff, EHNRI staff, and staff of PHCCO, were held to discuss the monitoring of
sample collection in the field, the collection of samples from the field, and the delivery of the samples
to the laboratory, with built-in checks to verify the samples collected and delivered. It was
emphasized at the meeting that the period between the collecting of blood samples in the field and the
time of refrigeration should not exceed 14 days. The DBS filter paper samples with barcodes were

Introduction |9
received by EHNRI. Upon receipt, the samples were counted and checked against the transmittal sheet
to verify the barcode identifications and kept frozen until testing was started in September.

All specimens were tested with a screening test, Vironostika HIV Uni-Form Plus O
manufactured by BioMerieux (ELISA I). All samples positive on the first screening test as well as 10
percent of the negatives were further tested with Enzygnost Anti HIV-1/2 Plus manufactured by Dade
Behring (ELISA 2). According to the testing algorithm, samples positive on both ELISAs were
regarded as positive and samples negative for both ELISAs were regarded as negative.

Samples that had discordant results on ELISA I and ELISA II were subject to a retest with
both ELISAs. The results were obtained and interpreted in the same manner as indicated above for the
repeat ELISA testing. Discordant samples from the repeat ELISAs, were tested with a confirmatory
test, Genetic Systems HIV-1 Western Blot manufactured by Bio-Rad. The result on immunoblotting
(Western Blot) was regarded as the final result.

1.9 LISTING, PRETEST, TRAINING AND FIELDWORK

1.9.1 Listing

After the selection of the 540 clusters throughout the 11 administrative areas, a listing
operation in the selected clusters starting from the month of October 2004 was conducted. For this
purpose, training was conducted for 46 listers who had been recruited from all the regions to do the
listing of households and delineation of EAs. A manual that described the listing procedure was
prepared as a guideline and the training was conducted using classroom demonstrations and field
practices. Instructions were given on the use of Global Positioning System (GPS) units to obtain
locational coordinates for selected EAs. The listing was performed by organizing the listers into
teams, with two listers per team. Seven field coordinators were also assigned from the head office to
perform quality checks and handle all the administrative and financial issues of the listing staff.
Supervision was carried out by the cartographic division of PHCCO to assess the quality of the field
operation and the level of the accuracy of the GPS readings. Though the listing operation was aimed
to be completed in three months, it was extended up to five months in some parts of the country,
primarily because of a shortage of vehicles.

1.9.2 Pretest

Prior to the start of the fieldwork, the questionnaires were pretested in all the three local
languages, to make sure that the questions were clear and could be understood by the respondents. In
order to conduct the pilot survey, 12 interviewers were recruited from the Amhara, Oromiya and
Tigray regions. In addition to the new recruits, 14 senior staff members of PHCCO were trained for a
period of three weeks to conduct the pilot fieldwork and serve as trainers for the main fieldwork. The
pilot training which was conducted from January 24 to February 11, 2005, included training in blood
sample collection for the anaemia and HIV testing. The pilot survey was conducted from 11-25
February 2005 in four selected sites. The areas selected for the pretest were urban Addis Ababa and
both urban and rural parts of Mekele, Ambo and Debre Birhan areas. Based on the findings of the
pretest, the household, the women’s and men’s questionnaires were further refined in all the three
local languages.

1.9.3 Training and Fieldwork

The recruitment of interviewers, editors and supervisors was conducted in the 9 regions and 2
city administrations taking into account language skills of the specific areas. Accommodation was
arranged for the trainees as well as the trainers at a training site in Addis Ababa. The training of
interviewers, editors and supervisors was conducted from March 14 to April 20, 2005. The Amharic
questionnaires were used during the training, while the Tigrigna and Oromiffa versions were
simultaneously checked against the Amharic questionnaires to ensure accurate translation. In addition

10 | Introduction
to classroom training, trainees did several days of field practice to gain more experience on
interviewing in the three local languages and fieldwork logistics.

A total of 271 trainees were trained in five classrooms. In each class the training was
conducted by two senior staff members of PHCCO. The Family Guidance Association of Ethiopia
conducted a session demonstrating and explaining the different family planning methods, while
UNFPA and CDC conducted a session on HIV/AIDS. After the training on how to complete the
household, women’s and men’s questionnaires was completed, an exam was given to all trainees. On
the basis of the scores on the exam and overall performances in the classroom, 240 trainees were
selected to participate in the main fieldwork. From the group 30 of the best male trainees were
selected as supervisors and 30 of the best female interviewers were identified as field editors. The
remaining 180 trainees were selected to be interviewers. The trainees not selected to participate in the
fieldwork were kept as reserve.

After completing the interviewers’ training, the field editors and supervisors were trained for
an additional three days on how to supervise the fieldwork and edit questionnaires in the field to
ensure data quality.

Thirty male interviewers and 30 female interviewers were selected to attend the biomarker
training. In addition, the 30 field editors also attended the training, as a backup to the biomarker
interviewers. Thirteen regional laboratory technicians who were recruited from Private Laboratory
Consortium Unit (PLCU) to serve as regional coordinators for the HIV testing were also trained, of
whom 11 were eventually selected to supervise the blood collection. During the one-week biomarker
training, six experienced experts from ORC Macro and EHNRI provided theoretical training followed
by practical classroom demonstrations of the techniques for testing of haemoglobin and collection of
dried blood spots from a finger prick for HIV testing. In addition to the classroom training, trainees
did several days of field practice to gain more experience on blood collection.

A total of 30 data collection teams, each composed of four female interviewers, two male
interviewers, one female editor, and a male team supervisor, were organized for the main fieldwork.
Furthermore, the 30 field teams were organized into 11 regional groups, each headed by an
experienced senior staff of PHCCO and accompanied by a regional coordinator from PLCU. The
survey was fielded from April 27 to August 30, 2005. The fieldwork was closely monitored for data
quality through regular field visits by senior staff from PHCCO, ORC Macro, and other member
organizations of the Steering Committee. Data quality was also monitored through field check tables
generated from completed clusters simultaneously data entered and produced during the fieldwork.
Five senior experts from PHCCO were permanently assigned to monitor the fieldwork throughout the
survey period by moving from one region to another. Continuous communication was maintained
between the field staff and the headquarters through cell phones.

Fieldwork was successfully completed in 535 of the 540 clusters, with the 5 clusters not
covered primarily due to reasons of inaccessibility. Two of these clusters were located in rural
Oromiya, one in rural Somali, one in rural SNNP and one in urban Gambela. DBS samples were
collected in 534 out of the 535 clusters and delivered to EHNRI for analysis. In one cluster in the
Gambela Region, households refused to be finger-pricked for cultural and traditional reasons.

1.10 DATA PROCESSING

The processing of the 2005 EDHS results began soon after the start of fieldwork. Completed
questionnaires were returned periodically from the field to the data processing department at the
PHCCO headquarters. A total of 17 new recruits had been trained for office editing/coding and data
entry of the questionnaires. Guidelines for the editing/coding procedures had been issued and
questions, which needed coding, were identified and a list of codes prepared. After the actual entry of
the data began, additional data entry operators were recruited and entry was performed in two shifts.
A total of 22 data entry operators and 4 office editors carried out data entry and primary office editing

Introduction | 11
activities. Each of the questionnaires was keyed twice by two separate entry clerks. Consistency
checks were made and entry errors were manually checked by going back to the questionnaires. A
secondary editing program was then run on the data to indicate questions that showed inconsistency
and these were also corrected by secondary editors. The data entry for the 535 clusters that started on
9 May 2005 was completed on 24 September 2005.

1.11 RESPONSE RATES

Table 1.2 shows the household and individual interview response rates for the survey. A total
of 14,645 households were selected, of which 13,928 were occupied. The total number of households
interviewed was 13,721, yielding a household response rate of 99 percent.

A total of 14,717 eligible women were identified in these households and interviews were
completed for 14,070 women, yielding a response rate of 96 percent. One in two households were
selected for the male survey and 6,778 eligible men were identified in this subsample of households,
of whom 6,033 were successfully interviewed, yielding a response rate of 89 percent. The response
rates are higher in rural areas than urban areas for both males and females.

Table 1.2 Results of the household and individual interviews

Number of households, number of interviews, and response rates,


according to residence, Ethiopia 2005

Residence
Result Urban Rural Total
Household interviews
Households selected 3,989 10,656 14,645
Households occupied 3,762 10,166 13,928
Households interviewed 3,666 10,055 13,721
Household response rate 97.4 98.9 98.5

Interviews with women


Number of eligible women 4,686 10,031 14,717
Number of eligible women
interviewed 4,423 9,647 14,070
Eligible woman response rate 94.4 96.2 95.6

Household interviews for men


Households selected 1,947 5,213 7,160
Households occupied 1,828 4,959 6,787
Households interviewed 1,785 4,904 6,689
Household response rate 97.6 98.9 98.6

Interviews with men


Number of eligible men 1,948 4,830 6,778
Number of eligible men
interviewed 1,628 4,405 6,033
Eligible man response rate 83.6 91.2 89.0

12 | Introduction
HOUSEHOLD POPULATION AND HOUSING
CHARACTERISTICS 2
This chapter provides a summary of the socioeconomic characteristics of households and
respondents surveyed, including age, sex, place of residence, educational status, household facilities,
and household characteristics. Information collected on the characteristics of the households and
respondents is important in understanding and interpreting the findings of the survey and also
provides indicators of the representativeness of the survey. The information is also useful in
understanding and identifying the major factors that determine or influence the basic demographic
indicators of the population.

The 2005 EDHS collected information from all usual residents of a selected household (the de
jure population) and persons who had stayed in the selected household the night before the interview
(the de facto population). Since the difference between these two populations is very small and to
maintain comparability with other DHS reports, all tables in this report refer to the de facto population
unless otherwise specified. A household was defined as a person or group of related and unrelated
persons who live together in the same dwelling unit(s) or in connected premises, who acknowledge
one adult member as head of the household, and who have common arrangements for cooking and
eating.

2.1 HOUSEHOLD POPULATION BY AGE AND SEX

Age and sex are important demographic variables and are the primary basis of demographic
classification in vital statistics, censuses, and surveys. They are also very important variables in the
study of mortality, fertility, and nuptiality. In general, a cross-classification with sex is useful for the
effective analysis of all forms of data obtained in surveys.

The distribution of the household population in the 2005 EDHS is shown in Table 2.1 by five-
year age groups, according to urban-rural residence and sex. The total population counted in the
survey was 67,556, with females slightly outnumbering males. The results indicate an overall sex ratio
of 99 males per 100 females. The sex ratio is higher in rural areas (101 males per 100 females) than in
urban areas (85 males per 100 females).

Table 2.1 Household population by age, sex, and residence

Percent distribution of the de facto household population by five-year age groups, according to sex and
residence, Ethiopia 2005

Urban Rural Total


Age Male Female Total Male Female Total Male Female Total
<5 10.3 8.9 9.5 16.9 16.5 16.7 16.1 15.5 15.8
5-9 11.5 10.6 11.0 17.9 17.5 17.7 17.2 16.6 16.9
10-14 13.7 12.0 12.8 15.8 14.7 15.3 15.6 14.3 15.0
15-19 14.3 16.2 15.3 10.0 9.1 9.5 10.4 10.1 10.2
20-24 12.0 12.7 12.4 6.9 7.1 7.0 7.5 7.8 7.7
25-29 8.4 10.2 9.4 5.7 7.3 6.5 6.0 7.7 6.9
30-34 6.1 5.8 5.9 5.2 5.3 5.3 5.3 5.4 5.3
35-39 5.4 5.4 5.4 4.4 4.8 4.6 4.5 4.8 4.7
40-44 4.3 3.8 4.0 3.4 3.5 3.4 3.5 3.5 3.5
45-49 4.1 3.9 4.0 3.0 3.3 3.1 3.1 3.4 3.3
50-54 2.6 3.2 2.9 2.5 2.8 2.7 2.5 2.9 2.7
55-59 1.7 2.2 2.0 1.7 2.6 2.1 1.7 2.5 2.1
60-64 2.2 2.0 2.1 2.3 2.2 2.3 2.3 2.2 2.2
65-69 1.2 1.1 1.2 1.6 1.1 1.4 1.6 1.1 1.3
70-74 1.2 0.7 0.9 1.2 1.1 1.1 1.2 1.0 1.1
75-79 0.4 0.5 0.5 0.6 0.4 0.5 0.6 0.4 0.5
80 + 0.6 0.8 0.7 0.9 0.7 0.8 0.9 0.7 0.8
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number 3,752 4,425 8,177 29,903 29,475 59,378 33,656 33,900 67,556

Household Population and Housing Characteristics | 13


The age structure of the household population is typical of a society with a youthful
population. The sex and age distribution of the population is shown in the population pyramid in
Figure 2.1. Ethiopia has a pyramidal age structure due to the large number of children under 15 years
of age. Children under 15 years of age account for 48 percent of the population, a feature of
populations with high fertility levels. Forty-nine percent of the population is in the age group 15-64
and about 4 percent are over 65.

Figure 2.1 Population Pyramid


Age
80+
75-79
70-74
65-69
60-64 Female
Male
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4

10 8 6 4 2 0 2 4 6 8 10
Percent

EDHS 2005

2.2 HOUSEHOLD COMPOSITION

Table 2.2 shows the distribution of Table 2.2 Household composition


households in the survey by the sex of the head
Percent distribution of households by sex of head of household
of the household and by the number of and by household size, according to residence, Ethiopia 2005
household members in urban and rural areas.
Households in Ethiopia are predominantly male Residence
Characteristic Urban Rural Total
headed, a common feature of most African
countries. More than one in five households are Household headship
Male 61.4 79.9 77.2
headed by women with the proportion of Female 38.6 20.1 22.8
female-headed households much higher in urban Total 100.0 100.0 100.0
than in rural areas. Number of usual members
1 13.0 3.7 5.0
2 13.0 8.4 9.0
The average household size observed in 3 16.4 13.4 13.8
the survey is 5 persons, which is slightly higher 4 17.6 15.3 15.7
5 14.4 17.2 16.8
than the 2000 EDHS (4.8 persons). Rural 6 10.5 14.6 14.0
households have 5.2 persons per household and 7 6.4 11.9 11.1
8 3.9 7.7 7.2
are larger than urban households (4.2 persons). 9+ 4.8 7.8 7.4
Single-person households are more common in
Total 100.0 100.0 100.0
urban areas (13 percent) than in rural areas (4 Number of households 1,974 11,747 13,721
percent). Only 7 percent of households have Mean size 4.2 5.2 5.0
nine or more members. Note: Table is based on de jure members, i.e., usual residents.

Detailed information on children’s liv-


ing arrangements and orphanhood is presented in Table 2.3. In Ethiopia, 73 percent of children under
18 live with both parents, 12 percent live with only their mother, 4 percent live with only their father,

14 | Household Population and Housing Characteristics


and 10 percent live with neither parent. Seven percent of children live with their mother even though
their father is alive, 2 percent of children live with their father even though their mother is alive, and 6
percent live with neither parent even though both of them are alive. Eight percent of children do not
have a father alive and 4 percent do not have a mother alive. The percentage of children not living
with their parents increases with age of the child. The proportion of children living with both parents
varies little by sex. However, rural children are more likely to live with both parents than urban
children. The highest proportion of children living with both parents is in Somali (79 percent), while
the lowest proportion is in Addis Ababa (49 percent).

Table 2.3 Children's living arrangements and orphanhood

Percent distribution of de jure children under age 18 by children's living arrangements and survival status of parents, according to background
characteristics, Ethiopia 2005

Living with Living with


mother but father but not Missing Percentage
Living not father mother Not living with either parent informa- with one
with Only Only tion on or both Number
Background both Father Father Mother Mother Both father mother Both father or parents of
characteristic parents alive dead alive dead alive alive alive dead mother Total dead children

Age
<2 88.6 8.7 1.2 0.3 0.2 0.7 0.1 0.0 0.0 0.2 100.0 1.6 4,287
2-4 84.6 6.5 2.4 1.2 0.9 3.3 0.3 0.3 0.2 0.2 100.0 4.2 6,545
5-9 74.9 5.9 5.0 2.6 1.9 6.4 0.8 1.0 1.0 0.5 100.0 9.8 11,579
10-14 65.2 6.5 7.8 2.9 3.2 8.5 1.3 2.2 1.9 0.5 100.0 16.5 10,284
15-17 52.0 7.1 9.9 3.2 4.2 11.7 2.2 3.9 3.5 2.3 100.0 23.7 4,308

Sex
Male 73.6 6.2 5.7 2.5 2.3 5.7 0.8 1.4 1.3 0.6 100.0 11.5 18,950
Female 72.1 7.1 5.3 1.9 2.0 7.1 1.1 1.4 1.3 0.7 100.0 11.2 18,052

Residence
Urban 52.6 12.7 8.6 3.4 1.7 12.1 1.9 2.5 3.5 0.9 100.0 18.4 3,455
Rural 74.9 6.0 5.1 2.1 2.2 5.8 0.9 1.3 1.1 0.6 100.0 10.6 33,547

Region
Tigray 70.0 12.9 5.0 2.1 1.8 4.5 1.0 0.9 1.4 0.5 100.0 10.1 2,344
Affar 75.2 7.1 5.8 2.1 3.1 3.3 1.3 0.7 1.2 0.3 100.0 12.0 408
Amhara 71.5 6.9 5.4 2.9 2.0 6.6 1.4 1.6 1.2 0.6 100.0 11.7 8,835
Oromiya 73.8 5.8 5.4 2.0 2.6 6.8 0.7 1.1 1.4 0.5 100.0 11.2 13,918
Somali 79.4 5.9 4.7 1.0 2.6 3.4 0.4 0.5 1.5 0.8 100.0 9.7 1,643
Benishangul-Gumuz 72.5 8.7 7.2 1.5 2.1 4.0 1.1 1.3 1.1 0.4 100.0 13.0 327
SNNP 74.8 5.7 5.5 2.1 1.6 6.0 1.0 1.8 0.9 0.7 100.0 10.8 8,449
Gambela 63.9 10.3 8.1 2.5 0.9 8.5 0.9 2.3 1.1 1.5 100.0 13.2 101
Harari 67.1 7.5 5.2 1.4 1.3 10.3 1.4 1.8 1.7 2.2 100.0 11.6 74
Addis Ababa 48.5 10.1 8.7 3.6 1.7 15.5 2.0 4.2 4.2 1.6 100.0 21.0 773
Dire Dawa 62.0 10.1 7.8 2.3 1.7 10.0 0.6 2.1 2.5 0.7 100.0 14.8 130

Wealth quintile
Lowest 73.5 7.5 6.6 2.3 1.7 4.7 0.8 1.0 1.3 0.6 100.0 11.6 7,758
Second 73.9 6.9 5.6 1.8 2.4 4.9 1.3 1.4 0.9 0.8 100.0 11.6 7,534
Middle 74.7 5.7 4.8 2.2 2.5 6.2 0.9 1.5 1.1 0.4 100.0 10.8 7,574
Fourth 76.6 4.5 4.5 2.1 2.2 6.5 0.6 1.3 1.1 0.6 100.0 9.8 7,605
Highest 64.4 8.8 5.8 2.9 1.8 10.2 1.3 1.9 2.2 0.7 100.0 13.1 6,531

Total age <18 72.8 6.6 5.5 2.2 2.1 6.4 1.0 1.4 1.3 0.6 100.0 11.3 37,002
Total age <15 75.6 6.6 4.9 2.1 1.9 5.7 0.8 1.1 1.0 0.4 100.0 9.7 32,694

Household Population and Housing Characteristics | 15


The EDHS administered three questions on succession planning to women and men. Women
and men were first asked if they were primary caregivers to children under the age of 18, and if they
were, an additional question was administered to ascertain if they had made any arrangements for
someone to care for these children in the event of their illness or inability to care for their young
children themselves. Information on succession planning is shown in Table 2.4.

Three-fifths of women and men are primary caregivers to their children. Among primary
caregivers, just under half (46 percent) had made provisions for someone else to take care of their
children in case of their illness or inability to care for their own children. As the data show, younger,
male, urban, highly educated and wealthy respondents are more likely than other respondents to make
arrangements in the case of an eventuality. Succession planning varies markedly by region, with
respondents residing in Harari (68 percent) most likely and respondents residing in Dire Dawa (34
percent) least likely to make plans in the case of an eventuality.

Table 2.4 Succession planning

Percentage of de facto women and men age 15-49 who are the primary caregivers
of children under age 18 years, and among the primary caregivers, the percentage
who have made arrangements for someone else to care for the children in the event
of their own inability to do so because of illness or death, by background
characteristics, Ethiopia 2005

Percentage
Percentage of caregivers
of women Number of who have
and men who women and made Number of
Background are primary men age succession primary
Characteristics caregivers 15-49 arrangements caregivers
Age
15-19 17.0 4,601 52.8 783
20-29 60.3 6,869 48.0 4,143
30-39 83.2 4,815 45.3 4,006
40-49 81.3 3,249 43.0 2,642
Sex
Women 66.1 14,070 42.5 9,306
Men 41.5 5,464 61.7 2,268
Residence
Urban 45.1 3,353 50.8 1,513
Rural 62.2 16,181 45.5 10,061
Region
Tigray 61.4 1,235 55.8 758
Affar 60.6 205 45.7 124
Amhara 63.8 4,828 39.3 3,082
Oromiya 52.8 7,051 37.4 3,725
Somali 68.8 666 59.4 459
Benishangul-Gumuz 63.7 174 35.7 111
SNNP 67.0 4,138 60.2 2,774
Gambela 64.1 63 58.7 41
Harari 59.2 54 67.7 32
Addis Ababa 40.7 1,023 53.5 416
Dire Dawa 54.9 97 33.5 53
Education
No education 71.9 11,436 42.4 8,217
Primary 44.1 5,263 52.8 2,322
Secondary and higher 35.7 2,641 61.5 943
Wealth quintile
Lowest 65.9 3,373 45.2 2,225
Second 64.1 3,670 42.9 2,354
Middle 61.6 3,767 43.9 2,321
Fourth 60.2 3,727 45.3 2,245
Highest 48.6 4,996 53.4 2,429

Total 59.3 19,534 46.2 11,574

16 | Household Population and Housing Characteristics


2.3 HOUSEHOLD EDUCATION

Studies show that education is one of the major socioeconomic factors that influence a
person’s behaviour and attitude. In general, the higher the level of education of a woman, the more
knowledgeable she is about the use of health facilities, family planning methods, and the health of her
children. Ethiopia’s education system has been stable for a long time; however, recently a major
restructuring and expansion programme was undertaken by the government. Following the free
market oriented economic policy the education sector was opened to private investment. The current
system of formal education is based on a three-tier system: eight years of primary education, followed
by four years of secondary school and tertiary education. Prior to the change in the education policy,
the education system was based on six years of primary education, followed by two years of junior
secondary and four years of senior secondary education and tertiary education. Currently, several pre-
university collages and various institutions operated by the government and the private sector offer
vocational, technical and professional training in different parts of the country. The number of
government universities, and private universities and vocational and technical schools has increased
tremendously in various parts of the country.

2.3.1 Educational Attainment of Household Population

Tables 2.5.1 and 2.5.2 show the percent distribution of the de facto female and male
household population age six and over by highest level of education attended or completed, according
to background characteristics. Survey results show that the majority of Ethiopians have little or no
education, with females much less educated than males. Fifty-two percent of males and 67 percent of
females have never attended school, and 32 percent of males and 25 percent of females have only
some primary education. Four percent of males and 2 percent of females have completed primary
education only, and 8 percent of males and 5 percent of females have attended, but not completed
secondary education.1 Only 3 percent of males and 2 percent of females have completed secondary
school or higher. Nevertheless, improvements in the education sector were observed since the 2000
EDHS, with the proportions of males and females with no education declining by 9 and 10 percentage
points, respectively. The improvement is observed across all education categories. The male-female
gap in education is more obvious at lower levels of education primarily because the proportion of
males and females attending higher levels of education is so small.

An investigation of the changes in educational attainment by successive age groups indicates


the long-term trend of the country’s educational achievement. Survey results show that there has been
a marked improvement in the educational attainment of women. For example, the proportion of
women with no education has declined significantly from 99 percent among women age 65 and over
to 41 percent among women age 10-14. A similar trend is noticeable among men, with the proportion
of men with no education declining from 94 percent among those age 65 and over to 37 percent
among those age 10-14.

As expected, educational attainment is much higher among the urban than the rural
population. For example, 83 percent of males and 69 percent of females in urban areas have some
education, compared with only 42 percent of males and 27 percent of females in rural areas.
Regarding regional variation, the proportion of men and women with no education is highest in the
Somali Region (82 percent and 89 percent, respectively), followed by the Affar Region (80 percent
and 87 percent, respectively), and is lowest in the capital city, Addis Ababa (13 percent and 25
percent, respectively). It is noticeable that in the majority of the regions (Affar, Amhara, Oromiya,
Somali, Benishangul-Gumuz, SNNP, and Gambela) about 2 percent or less of women and 3 percent
or less of men have completed secondary and higher education. In the most urbanized regions, Harari,
Addis Ababa, and Dire Dawa, much higher proportions of women and men have secondary education.

1
Secondary education refers to both junior secondary (grades 7-8) and senior secondary (grades 9-12).

Household Population and Housing Characteristics | 17


Table 2.5.1 Educational attainment of household population: female

Percent distribution of the de facto female household population age six and over by highest level of education attended or
completed, according to background characteristics, Ethiopia 2005

Don't
Background No Some Completed Some Completed More than know/
characteristic education primary primary1 secondary secondary2 secondary missing Total Number
Age
6-9 73.3 26.1 0.0 0.0 0.0 0.0 0.5 100.0 4,704
10-14 41.1 54.9 2.0 1.7 0.0 0.0 0.3 100.0 4,861
15-19 40.4 37.0 6.6 15.1 0.5 0.2 0.1 100.0 3,409
20-24 60.4 19.6 2.6 11.5 4.0 1.8 0.1 100.0 2,652
25-29 67.6 18.2 1.7 6.5 4.0 1.9 0.0 100.0 2,609
30-34 73.7 14.6 1.6 5.0 3.1 1.8 0.2 100.0 1,825
35-39 79.8 11.5 1.4 3.2 2.7 1.4 0.0 100.0 1,642
40-44 87.0 5.7 1.1 2.6 1.4 1.6 0.6 100.0 1,190
45-49 92.9 3.5 0.7 1.4 0.5 0.7 0.2 100.0 1,156
50-54 95.3 2.9 0.1 0.7 0.2 0.2 0.7 100.0 975
55-59 96.1 2.1 0.3 0.6 0.4 0.1 0.4 100.0 859
60-64 98.2 0.9 0.0 0.2 0.1 0.1 0.5 100.0 735
65+ 98.9 0.7 0.1 0.2 0.0 0.0 0.0 100.0 1,075

Residence
Urban 30.7 28.6 5.5 22.1 8.7 4.3 0.1 100.0 3,951
Rural 72.8 23.8 1.3 1.7 0.1 0.1 0.3 100.0 23,750

Region
Tigray 63.0 24.6 2.6 7.1 1.4 0.8 0.3 100.0 1,795
Affar 87.0 8.0 0.9 3.2 0.4 0.0 0.4 100.0 286
Amhara 69.5 24.2 1.4 3.3 0.9 0.5 0.2 100.0 6,937
Oromiya 66.1 26.5 1.8 4.3 0.9 0.3 0.2 100.0 9,919
Somali 88.8 6.6 0.5 1.5 0.9 0.3 1.5 100.0 1,063
Benishangul-Gumuz 67.9 26.7 1.6 2.4 0.5 0.7 0.3 100.0 240
SNNP 69.6 24.8 1.8 2.9 0.4 0.2 0.3 100.0 6,051
Gambela 58.6 32.4 3.2 4.4 0.5 0.2 0.7 100.0 79
Harari 49.4 21.5 2.9 15.6 8.0 2.2 0.4 100.0 69
Addis Ababa 24.6 26.8 5.5 22.9 11.9 8.0 0.2 100.0 1,143
Dire Dawa 52.9 22.4 3.9 14.0 5.3 1.4 0.1 100.0 119

Wealth quintile
Lowest 84.1 14.7 0.3 0.5 0.0 0.0 0.4 100.0 5,426
Second 78.5 19.8 0.5 0.7 0.0 0.0 0.4 100.0 5,412
Middle 71.9 25.0 1.4 1.4 0.0 0.0 0.3 100.0 5,440
Fourth 65.0 30.4 1.9 2.4 0.0 0.0 0.2 100.0 5,334
Highest 38.0 31.6 4.7 16.6 5.8 3.1 0.2 100.0 6,088

Total 66.8 24.5 1.9 4.6 1.3 0.7 0.3 100.0 27,701

Note: Total includes 5 women missing information on age and not shown separately.
1
Completed grade 6 at the primary level
2
Completed grade 12 at the secondary level

The proportion of female and male household members who have never attended school
decreases with wealth. Seventy-three percent of men in the lowest wealth quintile have no education
compared with only 24 percent in the highest quintile. Similarly, 84 percent of women in the lowest
quintile have no education compared with 38 percent in the highest quintile.

18 | Household Population and Housing Characteristics


Table 2.5.2 Educational attainment of household population: male

Percent distribution of the de facto male household population age six and over by highest level of education attended or
completed, according to background characteristics, Ethiopia 2005

Don't
Background No Some Completed Some Completed More than know/
characteristic education primary primary1 secondary secondary2 secondary missing Total Number
Age
6-9 73.7 25.6 0.0 0.0 0.0 0.0 0.7 100.0 4,865
10-14 37.0 57.7 3.1 2.1 0.0 0.0 0.2 100.0 5,247
15-19 26.8 42.4 9.0 20.7 0.7 0.2 0.2 100.0 3,512
20-24 35.5 30.4 6.3 21.2 4.1 2.3 0.2 100.0 2,527
25-29 43.0 31.3 5.0 12.5 5.0 2.7 0.6 100.0 2,019
30-34 46.9 29.1 6.7 9.7 5.4 2.1 0.0 100.0 1,789
35-39 49.4 27.6 6.3 9.1 4.1 3.2 0.3 100.0 1,527
40-44 59.5 21.0 3.2 8.0 4.1 4.0 0.3 100.0 1,179
45-49 65.4 16.8 3.8 7.4 2.7 3.7 0.2 100.0 1,041
50-54 74.7 14.7 2.9 3.2 2.2 1.7 0.6 100.0 838
55-59 78.9 14.8 1.7 2.5 0.8 1.3 0.0 100.0 567
60-64 88.2 8.3 0.4 1.3 0.5 1.0 0.4 100.0 781
65+ 93.8 3.7 0.4 0.6 0.4 0.4 0.7 100.0 1,406
Residence
Urban 16.3 27.1 6.7 29.2 11.9 8.4 0.4 100.0 3,289
Rural 57.3 33.1 3.5 5.0 0.4 0.2 0.4 100.0 24,019
Region
Tigray 53.7 30.3 3.3 9.3 1.6 1.6 0.2 100.0 1,669
Affar 80.0 13.7 1.3 3.3 1.2 0.2 0.3 100.0 303
Amhara 62.2 27.5 2.5 5.6 1.1 0.7 0.4 100.0 7,004
Oromiya 48.0 37.2 4.5 8.0 1.3 0.7 0.3 100.0 9,921
Somali 82.4 10.1 1.0 3.6 1.1 0.4 1.5 100.0 1,165
Benishangul-Gumuz 52.6 36.2 3.6 4.9 0.8 0.9 1.0 100.0 230
SNNP 47.3 38.0 4.9 7.9 1.1 0.5 0.3 100.0 5,798
Gambela 40.1 33.0 7.2 15.5 2.0 1.0 1.2 100.0 85
Harari 31.1 28.4 5.5 20.4 9.6 4.6 0.4 100.0 63
Addis Ababa 13.1 21.6 7.3 27.2 16.6 14.0 0.2 100.0 955
Dire Dawa 33.6 25.5 7.3 21.2 9.3 3.0 0.2 100.0 116
Wealth quintile
Lowest 73.3 22.8 1.5 2.0 0.0 0.0 0.4 100.0 5,261
Second 61.8 31.9 2.9 2.9 0.1 0.0 0.4 100.0 5,387
Middle 56.0 35.5 3.3 4.6 0.2 0.0 0.3 100.0 5,447
Fourth 48.2 38.6 5.2 6.9 0.5 0.1 0.5 100.0 5,612
Highest 24.2 32.7 6.5 22.6 8.0 5.8 0.2 100.0 5,601

Total 52.4 32.4 3.9 7.9 1.8 1.2 0.4 100.0 27,308

Note: Total includes 8 men with missing information on age and not shown separately.
1
Completed grade 6 at the primary level
2
Completed grade 12 at the secondary level

2.3.2 School Attendance Ratios

Data on net attendance ratios (NARs) and gross attendance ratios (GARs) for the de facto
household population by school level, sex, residence, region and wealth index are shown in Table 2.6.
The NAR indicates participation in primary schooling for the population age 7-12 and secondary
schooling for the population age 13-18. The GAR measures participation at each level of schooling
among those of any age. The GAR is nearly always higher than the NAR for the same level because
the GAR includes participation by those who may be older or younger than the official age range for
that level.2 An NAR of 100 percent would indicate that all those in the official age range for the level
are attending at that level. The GAR can exceed 100 percent if there is significant overage or underage
participation at a given level of schooling.

2
Students who are overage for a given level of schooling may have started school overage, may have repeated
one or more grades in school, or may have dropped out of school and later returned.

Household Population and Housing Characteristics | 19


Table 2.6 School attendance ratios

Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de facto household population by level
of schooling and sex, according to background characteristics, Ethiopia 2005
Gender
Net attendance ratio1 Gross attendance ratio2
Background parity
characteristic Male Female Total Male Female Total index3
PRIMARY SCHOOL

Residence
Urban 77.8 79.6 78.8 117.2 122.4 120.0 1.04
Rural 39.1 38.5 38.8 77.7 68.0 73.0 0.88
Region
Tigray 48.6 52.7 50.6 78.3 84.1 81.1 1.07
Affar 19.1 11.0 15.3 34.9 21.0 28.5 0.60
Amhara 46.3 54.5 50.4 85.9 82.3 84.1 0.96
Oromiya 43.9 41.4 42.7 88.2 75.7 82.1 0.86
Somali 15.5 11.6 13.8 24.4 17.2 21.2 0.71
Benishangul-Gumuz 49.7 47.1 48.4 90.5 69.6 79.6 0.77
SNNP 37.2 31.8 34.5 76.3 63.7 70.0 0.84
Gambela 39.2 45.9 42.2 81.4 84.7 82.9 1.04
Harari 54.0 54.6 54.3 85.2 80.8 83.1 0.95
Addis Ababa 83.0 78.8 80.6 124.9 137.0 131.8 1.10
Dire Dawa 60.6 48.7 54.8 93.6 74.8 84.4 0.80
Wealth quintile
Lowest 26.0 24.9 25.4 52.2 41.4 46.9 0.79
Second 35.9 34.7 35.3 71.8 60.8 66.6 0.85
Middle 42.8 40.2 41.5 83.9 76.0 80.1 0.91
Fourth 46.2 47.0 46.6 92.8 82.8 87.9 0.89
Highest 66.9 69.4 68.2 112.7 111.1 111.9 0.99

Total 42.2 42.4 42.3 80.9 73.3 77.1 0.91

SECONDARY SCHOOL

Residence
Urban 55.3 42.3 48.2 79.9 57.2 67.6 0.72
Rural 11.9 7.3 9.7 20.3 10.3 15.6 0.51
Region
Tigray 19.6 17.6 18.6 32.8 26.1 29.3 0.80
Affar 6.7 4.1 5.3 12.6 7.9 10.2 0.62
Amhara 15.6 15.2 15.4 23.1 17.3 20.4 0.75
Oromiya 18.0 10.5 14.5 29.9 15.4 23.0 0.51
Somali 9.4 4.1 7.0 12.2 6.3 9.6 0.51
Benishangul-Gumuz 17.9 12.6 15.3 28.1 17.8 23.1 0.63
SNNP 14.2 9.6 11.9 25.0 15.1 20.2 0.60
Gambela 30.0 15.9 24.0 52.2 24.4 40.3 0.47
Harari 39.6 33.1 36.1 56.0 40.7 47.8 0.73
Addis Ababa 58.8 38.9 46.7 81.4 53.8 64.7 0.66
Dire Dawa 45.4 31.4 38.2 66.9 38.0 52.1 0.57
Wealth quintile
Lowest 5.8 2.3 4.1 10.4 3.1 7.0 0.30
Second 8.3 3.3 5.8 15.2 4.9 10.1 0.32
Middle 9.4 7.0 8.2 18.8 9.3 14.1 0.49
Fourth 15.0 11.4 13.4 24.8 14.7 20.4 0.59
Highest 42.6 33.5 38.0 62.1 47.0 54.5 0.76

Total 17.7 13.3 15.6 28.2 18.3 23.5 0.65


1
The NAR for primary school is the percentage of the primary-school-age (7-12 years) population that is
attending primary school. The NAR for secondary school is the percentage of the secondary-school-age (13-
18 years) population that is attending secondary school. By definition the NAR cannot exceed 100 percent.
2
The GAR for primary school is the total number of primary school students, expressed as a percentage of the
official primary-school-age population. The GAR for secondary school is the total number of secondary school
students, expressed as a percentage of the official secondary-school-age population. If there are significant
numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent.
3
The gender parity index for primary school is the ratio of the primary school GAR for females to the GAR for
males. The gender parity index for secondary school is the ratio of the secondary school GAR for females to
the GAR for males.

20 | Household Population and Housing Characteristics


Forty-two percent of children who should be attending primary school are currently doing so.
At the same time, only 16 percent of secondary-school-age youths are in school. Nevertheless, marked
improvements in NAR are observed since the 2000 EDHS, with 12 and 4 percentage point
improvements in the NARs for the primary and secondary levels, respectively. The NAR is higher
among males than among females at the secondary level. Attendance ratios are much lower in rural
areas than in urban areas and are the lowest in the Affar and Somali regions.

The GAR is higher among males than females at both the primary and secondary levels, at 81
and 73 at the primary-school level, respectively, and 28 and 18 at the secondary-school level,
respectively, indicating higher attendance among males than among females. Although the overall
GAR at the primary-school level is 77, there are significant levels of overage and/or underage
participation in the urban areas among both males (117) and females (122) and also in Addis Ababa
(132), the highest among the regions.

There is a strong relationship between household economic status and schooling that can be
seen at both the primary and secondary levels and among males and females. For example, the NAR
increases from 25 percent among students from poorer households (lowest wealth quintile) in primary
school to 68 percent among students from richer households (highest wealth quintile). Similarly, the
NAR rises from 4 percent among secondary attendees in the lowest wealth quintile to 38 percent
among those in the highest wealth quintile.

The Gender Parity Index (GPI) represents the ratio of the GAR for females to the GAR for
males. It is presented at both the primary and secondary levels and offers a summary measure of
gender differences in school attendance rates. A GPI less than one indicates that a smaller proportion
of females than males attend school. In Ethiopia, the GPI is slightly less than one (0.9) for primary
school attendance, but 0.7 for secondary school attendance, indicating that the gender gap is smaller at
the primary than the secondary level. There are also marked differences in the GPI by place of
residence and by region. The primary school GPI is markedly lower in Affar, Somali and
Benishangul-Gumuz than in other regions, while a higher female to male index is observed in Tigray,
Gambela and Addis Ababa. The Tigray Region has the highest secondary school GPI (0.8) and
Gambela, Oromiya and Somali regions the lowest.

Grade repetition and dropout rates for the de facto household population age 5-24 years who
attended school in the previous school year is shown in Table 2.7. The repetition rate is defined as the
percentage of students in a given grade in the previous school year who are repeating that grade in the
current school year. Dropout rate refers to the percentage of students in a given grade in the previous
school year who are not attending school in the current school year.

School attendance ratios in combination with repetition and dropout rates fully describe the
flow of students through the school system. In countries with an automatic promotion policy, where
students are nearly always promoted to the next grade at the end of the school year, repetition rates
may approach zero. However, in Ethiopia the school system does not support automatic promotion of
students. Therefore, repetition and dropout rates measure and show current educational problems and
impacts of education policies and programmes. Repetition rates are higher in lower grades,
specifically highest in grade one (6 percent). Males have higher repetition rates up to grade three
compared with female children. However, more female than male children repeat in grades 4 and 5.
Dropout rates are higher for males than females in all grade categories. Rural children are more
disadvantaged than their urban counterparts; in all grade levels dropout rates are much higher for rural
than urban children.

Household Population and Housing Characteristics | 21


Table 2.7 Grade repetition and dropout rates

Repetition and dropout rates for the de facto household population


age 5-24 years who attended school in the previous school year by
school grade, according to background characteristics, Ethiopia 2005

Background School grade


characteristic 1 2 3 4 5 6
REPETITION RATE

Sex
Male 6.5 2.1 1.8 1.1 1.3 2.2
Female 4.7 1.2 1.1 2.5 2.0 1.5
Residence
Urban 4.3 1.1 1.3 2.5 0.7 2.4
Rural 5.8 1.8 1.5 1.5 1.9 1.8
Region
Tigray 1.8 2.1 1.0 0.8 1.7 0.0
Affar 2.1 (0.0) * * * *
Amhara 6.6 1.2 1.8 0.6 2.2 0.0
Oromiya 6.5 2.2 0.6 2.4 1.4 3.2
Somali 1.6 (0.0) (0.0) (8.0) * *
Benishangul-Gumuz 13.2 1.6 2.0 0.0 (2.3) 0.0
SNNP 3.8 1.4 2.7 1.5 0.8 0.0
Gambela 7.5 0.7 1.8 5.4 3.6 5.3
Harari 6.1 4.6 2.5 3.1 2.8 1.4
Addis Ababa 9.5 0.7 2.1 2.6 2.3 3.3
Dire Dawa 0.0 0.0 0.0 0.0 2.7 2.3
Wealth quintile
Lowest 7.8 2.7 1.2 0.5 3.6 0.1
Second 5.2 3.0 4.0 1.6 3.5 4.9
Middle 6.3 1.3 0.0 1.3 0.1 3.1
Fourth 4.5 1.4 1.5 2.3 2.4 1.4
Highest 5.1 1.0 1.1 2.0 0.7 1.5

Total 5.7 1.7 1.5 1.7 1.6 2.0

DROPOUT RATE

Sex
Male 5.5 5.7 7.7 9.3 9.7 6.2
Female 3.6 5.4 3.9 4.0 5.2 4.8
Residence
Urban 1.1 3.1 2.8 3.6 4.7 2.4
Rural 5.0 6.1 6.6 7.9 8.9 6.9
Region
Tigray 2.5 4.1 7.0 8.1 6.8 5.0
Affar 2.3 4.8 * * * *
Amhara 2.4 2.1 3.0 4.0 6.0 1.8
Oromiya 6.7 9.3 7.2 10.0 8.9 5.1
Somali 2.9 (1.4) (0.0) (6.8) * *
Benishangul-Gumuz 2.6 8.2 6.6 8.9 8.0 7.9
SNNP 5.0 4.1 7.1 5.5 9.8 11.3
Gambela 5.8 10.1 10.8 11.1 6.9 14.1
Harari 5.6 8.1 2.2 8.7 7.9 4.7
Addis Ababa 1.4 2.1 3.9 2.8 7.4 4.6
Dire Dawa 5.3 0.0 4.7 6.6 3.2 3.9
Wealth quintile
Lowest 5.7 8.7 5.7 10.1 6.6 15.2
Second 4.2 7.1 7.6 6.1 15.1 9.6
Middle 5.1 3.8 2.8 11.1 7.8 6.7
Fourth 4.9 5.4 9.2 4.9 8.9 5.2
Highest 3.3 4.8 4.1 6.0 4.6 3.1

Total 4.6 5.6 6.0 7.1 7.9 5.6

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


An asterisk indicates that a figure is based on fewer than 25
unweighted cases and has been suppressed.

22 | Household Population and Housing Characteristics


The age-specific attendance rates (ASARs) for the population age five and over by sex are
shown in Figure 2.2. The ASAR indicates participation in schooling at any level, from primary to
higher levels of education. Although the minimum age for schooling in Ethiopia is seven, there are
some children enrolled prior to this age. Nevertheless, only 21 percent of children age seven are
attending school, indicating that a large majority of children that age in Ethiopia have not entered the
school system. However, a marked improvement in enrolment at age seven was observed since 2000
when 15 percent were attending school. There is little difference in the proportion of males and
females attending school up to age 12; thereafter, a significantly higher proportion of males than
females attends school.

Figure 2.2 Age-Specific Attendance Rates

Percent
70
Male
60 Female

50

40

30

20

10

0
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Age

EDHS 2005

2.4 HOUSEHOLD CHARACTERISTICS

The physical characteristics and availability and accessibility of basic household facilities are
important in assessing the general welfare and socioeconomic condition of the population. In the 2005
EDHS respondents to the household questionnaire were asked about household drinking water and
household sanitation facilities that included questions on the source of drinking water, time taken to
the nearest source, and the person that usually collects drinking water, water treatment prior to
drinking and questions on sanitation facilities.

Table 2.8 presents information on household drinking water. The majority (61 percent) of
households in Ethiopia have access to an improved source of drinking water with access in urban
areas much higher than in rural areas (94 percent and 56 percent, respectively). The most common
source of improved drinking water in urban areas is piped water with 90 percent of households having
access to this source. On the other hand, only 13 percent of rural households have access to piped
water. The major source of improved drinking water in rural areas is a protected spring (39 percent).
The proportion of households with access to piped water has increased from about 14 percent in 1994
(CSA, 1999) to 18 percent in 2000 and 24 percent in 2005.

Household Population and Housing Characteristics | 23


Table 2.8 Household drinking water

Percent distribution of households by source, time to collect, person who usually collects
drinking water, and treatment of water, according to residence, and percent distribution of
the de jure population by source, time to collect, person who usually collects drinking
water, and treatment of drinking water, Ethiopia 2005

Characteristics of household Households De jure


drinking water Urban Rural Total population
Source of drinking water
Improved source 93.7 56.0 61.4 60.0
Piped into dwelling 2.5 0.0 0.4 0.3
Piped into compound 45.0 0.2 6.6 5.7
Piped outside compound 42.6 12.3 16.7 15.8
Tube well or borehole 0.0 0.1 0.1 0.1
Protected dug well 1.2 4.5 4.0 4.1
Protected spring 2.3 38.7 33.5 33.7
Rainwater 0.0 0.2 0.2 0.2
Non-improved source 6.1 43.8 38.4 39.9
Unprotected dug well 0.8 6.0 5.3 5.4
Unprotected spring 4.1 7.5 7.0 7.3
Tanker truck 0.5 0.2 0.2 0.2
Surface water 0.8 30.1 25.9 26.9
Other 0.2 0.2 0.2 0.2
Total 100.0 100.0 100.0 100.0

Time to obtain drinking water


(round trip)
Water on premises 48.4 1.6 8.4 7.4
Less than 30 minutes 36.4 45.6 44.3 44.1
30 minutes or longer 14.6 52.1 46.7 47.9
Missing 0.6 0.7 0.6 0.6
Total 100.0 100.0 100.0 100.0

Person who usually collects


drinking water
Adult male age 15+ 7.1 5.7 5.9 4.8
Adult female age 15+ 38.6 80.5 74.4 75.0
Male child under age 15 1.8 2.5 2.4 2.7
Female child under age 15 3.0 9.0 8.1 9.6
Water on premises 48.4 1.6 8.4 7.4
Other 1.0 0.6 0.6 0.4
Missing 0.1 0.2 0.2 0.1
Total 100.0 100.0 100.0 100.0

Water treatment prior to drinking


Boiled 2.9 2.4 2.4 2.5
Bleach/chlorine added 0.6 0.2 0.2 0.2
Strained through cloth 0.6 5.2 4.6 4.9
Ceramic, sand or other filter 0.6 0.3 0.3 0.4
Let it stand and settle 0.1 0.2 0.2 0.1
Other 0.3 0.3 0.3 0.3
No treatment 94.7 91.4 91.9 91.6
Don't know/missing 0.5 0.9 0.9 0.9

Total 100.0 100.0 100.0 100.0


Number 1,974 11,747 13,721 68,981

Only 8 percent of households reported having water on their premises. Households not having
access on their premises were asked for the time taken to fetch water. Forty-four percent of all
households (36 percent urban and 46 percent rural) take less than 30 minutes to fetch drinking water.
In the majority (74 percent) of households, an adult female usually collects drinking water. Female
children under age 15 are over three times more likely than male children the same age to fetch
drinking water.

24 | Household Population and Housing Characteristics


In the survey all households were asked whether they treat water prior to drinking. An
overwhelming majority of households (92 percent) do not treat drinking water. Rural households are
somewhat more likely than urban households to treat drinking water and this is mostly done by
straining water through cloth.

Table 2.9 presents information on household sanitation facilities by type of toilet/latrine.


Sixty-two percent of Ethiopian households do not have a toilet facility. Overall a small proportion (7
percent) of households use improved toilets that are not shared. Urban households are more than three
times as likely as rural households to have access to improved toilet facilities. In urban areas, a pit
latrine with a slab (12 percent) is the major type of improved toilet facility. There has been a decline
recently in the proportion of households with no toilet facilities from 82 percent in 2000 to 62 percent
in 2005. The decline was observed in both urban and rural areas (from 30 percent to 12 percent in
urban areas and from 92 percent to 70 percent in rural areas).

Table 2.9 Household sanitation facilities

Percent distribution of households by type of toilet/latrine facilities, according to residence


and the percent distribution of the de jure population by toilet/latrine facilities, Ethiopia
2005

Type of toilet/ Households De jure


latrine facility Urban Rural Total population

Improved, not shared 18.0 4.9 6.8 7.4


Flush/pour flush to piped sewer system 1.1 0.0 0.2 0.1
Flush/pour flush to septic tank 1.3 0.0 0.2 0.2
Flush/pour flush to pit latrine 1.9 0.8 1.0 1.2
Ventilated improved pit (VIP) latrine 1.1 0.3 0.4 0.5
Pit latrine with a slab 11.5 0.8 2.3 2.5
Composting toilet 1.0 3.0 2.7 3.0
Not improved 81.9 95.0 93.1 92.5
Any facility shared with other
households 51.1 5.9 12.4 9.8
Flush/pour flush not to sewer/septic
tank/pit latrine 0.2 0.1 0.1 0.1
Pit latrine without slab/ open pit 18.1 18.6 18.5 20.3
Bucket 0.1 0.0 0.0 0.0
Hanging toilet/hanging latrine 0.1 0.0 0.1 0.0
No facility/bush/field 12.2 70.3 61.9 62.2
Other/missing 0.1 0.1 0.1 0.1

Total 100.0 100.0 100.0 100.0


Number 1,974 11,747 13,721 68,981

Information on household characteristics such as availability of electricity, type of flooring


material, number of rooms for sleeping, type of fuel used for cooking, place for cooking and type of
fire/stove among households using biomass are shown in Table 2.10. Fourteen percent of households
have electricity, but this varies widely by place of residence. Two percent of households in rural areas
have access to electricity, compared with 86 percent of urban households. The proportion of
households with electricity rose from 76 percent to 86 percent in urban areas between 2000 and 2005
and from 0.4 percent to 1.9 percent in rural areas. Sixty-five percent of households have earth or sand
floors and 25 percent have dung floors. Rural houses are more likely than urban houses to have earth,
sand, or dung floors, while urban houses are more likely than rural houses to have floors made with
cement/bricks.

Household Population and Housing Characteristics | 25


Table 2.10 Household characteristics

Percent distribution of households by household characteristics, according to residence,


Ethiopia 2005

Household Households De jure


characteristic Urban Rural Total population
Electricity
Yes 85.7 1.9 14.0 12.0
No 14.3 98.0 85.9 87.9
Missing 0.0 0.1 0.1 0.1
Total 100.0 100.0 100.0 100.0
Flooring material
Earth/sand 32.8 70.6 65.2 65.7
Dung 12.8 27.5 25.4 25.7
Wood planks 1.1 0.1 0.3 0.3
Reed/bamboo 1.9 0.4 0.7 0.7
Parquet or polished wood 4.7 0.0 0.7 0.6
Vinyl 17.7 0.1 2.7 2.4
Ceramic tiles 1.8 0.0 0.3 0.2
Cement/bricks 23.3 0.5 3.8 3.5
Carpet 3.6 0.6 1.0 0.8
Other/missing 0.2 0.1 0.1 0.2
Total 100.0 100.0 100.0 100.0
Rooms for sleeping
No bedrooms or only one 67.4 78.4 76.8 71.5
Two 25.3 18.2 19.2 22.8
Three or more 7.1 2.7 3.4 5.0
Missing 0.1 0.7 0.6 0.7
Total 100.0 100.0 100.0 100.0
Cooking fuel
Electricity 1.0 0.0 0.2 0.2
LPG 0.4 0.0 0.1 0.0
Natural gas 0.6 0.0 0.1 0.1
Biogas 0.3 0.0 0.0 0.0
Kerosene 25.9 0.2 3.9 3.0
Charcoal 18.1 0.2 2.8 2.2
Wood 48.5 89.9 83.9 85.7
Straw/shrubs/grass 0.2 1.2 1.1 1.1
Animal dung 2.1 8.3 7.4 7.5
Other/missing 3.0 0.2 0.6 0.2
Total 100.0 100.0 100.0 100.0
Place for cooking
In the house 31.1 74.1 67.9 66.4
In a separate building 53.5 21.0 25.7 27.6
Outdoors 12.4 4.8 5.9 5.8
Other/missing 2.8 0.1 0.5 0.2
Total 100.0 100.0 100.0 100.0
Number of households 1,974 11,747 13,721 68,981
Type of fire/stove among
households using biomass fuel1
Open fire or stove whithout a
chimney/hood 91.5 97.5 96.6 96.8
Open fire or stove with
chimney/hood 5.9 2.1 2.6 2.6
Closed stove with chimney 1.7 0.1 0.4 0.3
Other 0.8 0.1 0.2 0.2
Missing 0.1 0.1 0.1 0.1
Total 100.0 100.0 100.0 100.0
Number of households using
biomass fuel 1,871 11,722 13,593 68,605
1
Biomass fuel includes kerosene, coal/lignite, charcoal, wood/straw/shrubs, and animal
dung.

26 | Household Population and Housing Characteristics


Data were collected on the number of sleeping rooms per household. Slightly over three-
fourths of households have no bedrooms or have only one room for sleeping. Nineteen percent of
households have two rooms and only 3 percent have three or more rooms for sleeping. Urban
households are more likely than rural households to have two or more rooms for sleeping.

The overwhelming majority of households (84 percent) use wood for cooking. Wood is the
most common form of cooking fuel in rural areas (90 percent). In urban areas nearly half of the
households use wood for cooking (49 percent), followed by kerosene (26 percent) and charcoal (18
percent). Slightly over two-thirds of households (68 percent) cook their meals in the house, while over
a quarter use a separate building for cooking (26 percent). Slightly over half the households in urban
areas (54 percent) use a separate building for cooking. Almost all households (99 percent) use a
biomass fuel for cooking, that is, kerosene, charcoal, dung and wood/straw/shrubs, which generate
smoke that is unhealthy when inhaled. In these households, almost all cooking is done over an open
fire or stove with no chimney or hood to channel the smoke outside the house.

2.5 HOUSEHOLD POSSESSIONS

Information on ownership of durable goods and other possessions is presented in Table 2.11.
In general, ownership of household effects, means of transportation and agricultural land and farm
animals is indicative of a household’s social and economic well-being. The survey results show that
one-third of all households have a radio, about 5 percent have a television, 4 percent have a non-
mobile telephone, 2 percent have a mobile telephone and 2 percent have a refrigerator. In general,
households in rural Ethiopia are much less likely to possess consumer items like televisions,
telephones, or refrigerators. Ethiopians in general are not very likely to own a means of transport,
although urban households are more likely than rural households to own a means of transportation.
Bicycles owned by 1 percent of households are the most commonly owned means of transportation.
Most rural households in contrast to urban households own agricultural land (92 percent versus 11
percent) or farm animals (90 percent versus 24 percent).

Table 2.11 Household possessions

Percentage of households possessing various household effects, means of


transportation, agricultural land, and farm animals, by residence, Ethiopia 2005

Households De jure
Possessions Urban Rural Total population

Household effects
Radio 75.6 26.6 33.7 35.6
Television 33.1 0.1 4.9 4.9
Mobile telephone 11.4 0.0 1.7 1.8
Non-mobile telephone 28.2 0.1 4.2 4.4
Refrigerator 11.9 0.2 1.9 1.9

Means of transport
Bicycle 5.5 0.5 1.2 1.5
Animal drawn cart 0.8 0.5 0.6 0.8
Motorcycle/scooter 0.2 0.0 0.0 0.1
Car/truck 3.0 0.0 0.5 0.6
Boat with a motor 0.2 0.0 0.0 0.0

Ownership of agricultural land 11.3 92.0 80.4 84.3

Ownership of farm animals1 23.8 89.5 80.1 85.4

Number of households 1,974 11,747 13,721 68,981


1
Cattle, cows, bulls, horses, donkeys, goats, sheep or chicken.

Household Population and Housing Characteristics | 27


2.6 SOCIOECONOMIC STATUS INDEX

One of the background characteristics used throughout this report is an index of socio-
economic status. The economic index used here was recently developed and tested in a large number
of countries in relation to inequalities in household income, use of health services and health
outcomes (Rutstein et al., 2000). It is an indicator of the level of wealth that is consistent with
expenditure and income measures (Rutstein, 1999). The economic index was constructed using
household asset data including ownership of a number of consumer items ranging from a television to
a bicycle or car, as well as dwelling characteristics, such as source of drinking water, sanitation
facilities and type of material used for flooring.

Each asset was assigned a weight (factor score) generated through principal components
analysis, and the resulting asset scores were standardized in relation to a normal distribution with a
mean of zero and standard deviation of one (Gwatkin et al., 2000). Each household was then assigned
a score for each asset, and the scores were summed for each household; individuals were ranked
according to the score of the household in which they resided. The sample was then divided into
quintiles from one (lowest) to five (highest). A single asset index was developed for the whole
sample; separate indices were not prepared for the urban and rural population.

Table 2.12 presents the wealth quintiles by residence and administrative regions. Ninety-three
percent of the population in urban areas is in the highest wealth quintile in contrast to the rural areas
where only 10 percent are in this category. The wealth quintile distribution among regions shows
large variations, with a relatively high percentage of the population in the most urbanized regions in
the highest wealth quintile—Addis Ababa (99 percent), Dire Dawa (66 percent), and Harari (65
percent). On the other hand, a significant proportion of the population in the more rural areas of the
country such as in Somali (72 percent), Affar (67 percent) and Gambela (44 percent) are in the lowest
wealth quintile.

Table 2.12 Wealth quintiles

Percent distribution of the de jure population by wealth quintiles, according to residence and region, Ethiopia
2005

Background Wealth quintile De jure


characteristic Lowest Second Middle Fourth Highest Total population

Residence
Urban 0.3 0.7 1.3 5.1 92.6 100.0 8,260
Rural 22.7 22.6 22.5 22.0 10.1 100.0 60,721

Region
Tigray 31.6 23.5 17.5 10.2 17.2 100.0 4,410
Affar 67.3 8.2 7.8 3.3 13.5 100.0 738
Amhara 17.5 21.4 22.1 23.5 15.5 100.0 17,081
Oromiya 19.9 22.0 20.6 19.7 17.9 100.0 25,278
Somali 71.8 11.1 4.4 3.2 9.6 100.0 2,835
Benishangul-Gumuz 19.1 21.9 24.6 18.5 15.9 100.0 600
SNNP 10.7 19.5 24.2 26.9 18.6 100.0 15,110
Gambela 44.0 15.1 7.9 13.6 19.4 100.0 202
Harari 5.7 6.7 10.3 12.7 64.6 100.0 163
Addis Ababa 0.1 0.3 0.3 0.6 98.7 100.0 2,280
Dire Dawa 11.4 11.2 8.3 3.2 65.8 100.0 285

Total 20.0 20.0 20.0 20.0 20.0 100.0 68,981

28 | Household Population and Housing Characteristics


The registration of births is the inscription of the facts of the birth into an official log kept at
the registrar’s office. A birth certificate is issued at the time of registration or later as proof of the
registration of the birth. Although Ethiopia does not have a legal and administrative structure that
performs official registration of births according to standard procedures, there exists in the urban parts
of the country a practice where certificates of birth are issued without the event being officially
registered. Birth certificates may also be issued by hospitals where the birth occurred, but this event
again may not be officially recorded in a civil registry. In addition, some regional capitals in the
country may also issue birth certificates that are not officially recorded by a civil registry. Thus the
information in Table 2.13 should be interpreted in the light of the situation in Ethiopia. Information on
the registration of births was collected in the household interview where respondents were asked if
their child under age five had a birth certificate. If they responded that the child did not have a birth
certificate, an additional question was posed to ascertain if the child’s birth had ever been registered
with the municipal or local authorities. Seven percent of Ethiopian children under age five have had
their births registered. However, most of these children (5 percent) did not have a birth certificate.

Table 2.13 Birth registration of children under age five

Percentage of de jure children under five years of age whose births are
registered with the civil authorities, by background characteristics, Ethiopia
2005

Percentage of children whose births


are registered:
Did not
Background Had a birth have a birth Total Number of
characteristic certificate certificate registered children
Age
<2 1.5 5.6 7.2 4,287
2-4 1.1 5.2 6.3 6,545

Sex
Male 1.4 5.0 6.4 5,486
Female 1.2 5.7 6.9 5,345

Residence
Urban 10.1 18.9 28.9 783
Rural 0.6 4.3 4.9 10,048

Region
Tigray 3.4 4.1 7.5 694
Affar 1.5 2.8 4.3 102
Amhara 0.6 3.6 4.2 2,479
Oromiya 1.0 3.9 4.9 4,285
Somali 0.9 2.7 3.6 460
Benishangul-Gumuz 0.6 3.2 3.8 104
SNNP 0.9 9.1 10.0 2,467
Gambela 0.9 5.2 6.1 30
Harari 10.6 6.6 17.3 23
Addis Ababa 16.6 28.9 45.5 150
Dire Dawa 7.5 16.3 23.8 38

Wealth quintile
Lowest 0.3 2.2 2.6 2,366
Second 0.1 3.6 3.8 2,308
Middle 0.6 5.2 5.7 2,356
Fourth 0.9 5.7 6.6 2,184
Highest 5.9 12.2 18.1 1,617

Total 1.3 5.4 6.6 10,831

Household Population and Housing Characteristics | 29


 
CHARACTERISTICS OF RESPONDENTS 3
This chapter provides a demographic and socioeconomic profile of respondents interviewed
in the 2005 EDHS. Such background information is essential to the interpretation of findings and for
understanding the results presented later in the report. Basic characteristics collected include age,
level of education, marital status, religion, ethnicity, and wealth status. Exposure to mass media and
literacy status was examined and detailed information was collected on employment status, occu-
pation, and earnings.

3.1 CHARACTERISTICS OF SURVEY RESPONDENTS

The background characteristics of the 14,070 women age 15-49 and the 6,033 men age 15-59
interviewed in the 2005 EDHS are shown in Table 3.1. This table is important in that it provides the
background for interpreting findings presented later in the report.

Three in five women (59 percent) and one in two men (52 percent) are under age 30. In
general, the proportion of women and men in each age group declines as age increases, reflecting the
comparatively young age structure of the population in Ethiopia as a result of past high fertility levels.

The majority of surveyed respondents (65 percent of women and 57 percent of men) are
married or living together. The proportion not currently married varies by gender. One in four women
has never married compared with two in five men. On the other hand, women are much more likely to
be divorced, separated, or widowed (11 percent) than men (3 percent).

Place of residence is another characteristic that determines access to services and exposure to
information pertaining to reproductive health and other aspects of life. As expected, the majority of
respondents reside in rural areas, with only 18 percent of women and 15 percent of men residing in
urban areas.

More than 80 percent of the respondents live in three major regions, namely: Amhara,
Oromiya, and SNNP. Respondents from Tigray, Addis Ababa, and Somali constitute about 7 percent,
5 percent, and 3 percent, respectively, of the sample. One percent or less of respondents reside in
other regions.

Education is an important factor influencing an individual’s attitude and outlook on various


aspects of life. Generally, educational attainment in Ethiopia is very low among both men and
women, with women much more disadvantaged than men. Two-thirds of women compared with two-
fifths of men do not have any formal education. The corresponding figures in the 2000 EDHS were 75
percent and 52 percent, respectively, indicating that the proportion of persons with no education has
declined over the past five years. Nearly twice as many men as women have primary (37 percent of
men compared with 22 percent of women) or secondary education (20 percent of men compared with
12 percent of women).

The distribution of respondents by religious affiliation shows that half are Orthodox
Christians and nearly 30 percent are Muslims. Protestant women and men account for about 19
percent and 17 percent, respectively. The ethnic composition of respondents indicates that a third of
respondents belong to the Oromo ethnic group and about three out of ten are Amharas. Tigraways
constitute 7 percent of the population. While there are more than 80 ethnic groups in Ethiopia, most
are small in number and, therefore, are not shown separately. They are grouped under the category
“Other.”

Characteristics of Respondents | 31
Table 3.1 Background characteristics of respondents

Percent distribution of women and men by selected background characteristics, Ethiopia 2005

Women Men
Background Weighted Weighted
characteristic percent Weighted Unweighted percent Weighted Unweighted
Age
15-19 23.2 3,266 3,252 22.1 1,335 1,278
20-24 18.1 2,547 2,617 17.6 1,064 1,039
25-29 17.9 2,517 2,557 12.3 741 830
30-34 12.8 1,808 1,754 12.5 754 759
35-39 11.4 1,602 1,629 10.8 651 650
40-44 8.4 1,187 1,181 8.2 497 496
45-49 8.1 1,143 1,080 7.0 422 420
50-54 na na na 5.5 335 339
55-59 na na na 3.9 235 222
Marital status
Never married 25.0 3,516 3,830 40.1 2,419 2,460
Married 63.4 8,914 8,438 56.2 3,393 3,295
Living together 1.1 152 206 0.5 31 37
Divorced/separated 6.6 932 989 2.5 153 182
Widowed 4.0 556 607 0.6 37 59
Residence
Urban 17.8 2,499 4,423 15.2 916 1,628
Rural 82.2 11,571 9,647 84.8 5,117 4,405
Region
Tigray 6.5 919 1,257 6.1 366 512
Affar 1.0 146 789 1.1 65 314
Amhara 24.7 3,482 1,943 25.2 1,521 897
Oromiya 35.6 5,010 2,230 36.8 2,222 1,041
Somali 3.5 486 669 3.4 202 281
Benishangul-Gumuz 0.9 124 846 0.9 54 382
SNNP 21.3 2,995 2,087 20.6 1,244 880
Gambela 0.3 44 729 0.3 21 339
Harari 0.3 39 844 0.3 16 359
Addis Ababa 5.4 756 1,869 4.8 292 698
Dire Dawa 0.5 69 807 0.5 30 330
Education
No education 65.9 9,271 8,454 42.9 2,589 2,434
Primary 22.2 3,123 2,966 37.3 2,252 1,946
Secondary 10.5 1,481 2,292 17.3 1,045 1,394
Higher 1.4 194 358 2.4 147 259
Religion
Orthodox 49.2 6,920 6,809 49.3 2,974 2,916
Catholic 1.2 173 143 1.0 61 56
Protestant 18.9 2,654 2,301 17.2 1,038 876
Muslim 28.5 4,009 4,522 29.6 1,788 2,030
Other 2.2 313 295 2.9 172 155
Ethnicity
Affar 0.7 104 603 0.8 46 249
Amhara 31.5 4,434 4,165 30.8 1,861 1,707
Guragie 4.6 648 786 4.4 268 343
Oromo 32.4 4,556 3,387 33.2 2,005 1,499
Sidamo 4.0 561 345 4.5 270 168
Somali 3.0 421 690 3.1 188 299
Tigraway 6.9 971 1,398 6.5 394 588
Welaita 2.6 361 266 2.2 132 103
Other 14.3 2,015 2,430 14.4 869 1,077

Total 100.0 14,070 14,070 100.0 6,033 6,033

Note: Education categories refer to the highest level of education attended, whether or not that level
was completed.
na = Not applicable

32 | Characteristics of Respondents
3.2 EDUCATIONAL ATTAINMENT AND LITERACY

Tables 3.2.1 and 3.2.2 present detailed distribution of educational attainment, according to
background characteristics. As can be seen from the table, most women with no education are older
and reside primarily in rural areas. The urban-rural difference in level of education is pronounced at
secondary or higher levels. For example, only 3 percent of women in rural areas have some secondary
education, compared with nearly a third of their counterparts in urban areas. Regarding regional
differentials in educational attainment, the highest proportions of women with no education are
observed in the Somali and Affar regions (91 percent and 85 percent, respectively). The lowest
proportion is observed in Addis Ababa, where only 18 percent of women have never attended formal
education.

Table 3.2.1 Educational attainment by background characteristics: women

Percent distribution of women by highest level of schooling attained, and median number of years of schooling, according to background
characteristics, Ethiopia 2005

Highest level of schooling attended or completed


Number
Background No Some Completed Some Completed More than of Median years
characteristic education primary primary1 secondary secondary2 secondary Total women of schooling
Age
15-19 40.1 36.4 7.2 15.5 0.4 0.5 100.0 3,266 1.2
20-24 60.2 19.8 2.7 11.4 3.8 2.1 100.0 2,547 0.0
25-29 68.9 17.4 1.6 6.6 3.8 1.7 100.0 2,517 0.0
30-34 73.0 15.5 1.7 5.0 3.2 1.6 100.0 1,808 0.0
35-39 80.1 11.3 1.5 3.4 2.3 1.5 100.0 1,602 0.0
40-44 87.0 6.0 1.1 2.6 1.8 1.6 100.0 1,187 0.0
45-49 92.8 3.5 0.9 1.5 0.5 0.8 100.0 1,143 0.0

Residence
Urban 24.7 17.8 6.7 31.5 12.5 6.9 100.0 2,499 6.2
Rural 74.8 19.5 2.2 3.2 0.1 0.2 100.0 11,571 0.0

Region
Tigray 63.5 16.4 3.7 12.0 2.0 2.4 100.0 919 0.0
Affar 84.8 6.7 1.7 6.1 0.7 0.0 100.0 146 0.0
Amhara 75.6 13.7 2.1 5.7 1.7 1.1 100.0 3,482 0.0
Oromiya 64.4 22.4 3.3 8.0 1.5 0.5 100.0 5,010 0.0
Somali 90.6 3.3 1.0 2.4 2.2 0.6 100.0 486 0.0
Benishangul-Gumuz 73.2 17.6 2.8 4.2 0.8 1.4 100.0 124 0.0
SNNP 65.7 24.6 3.0 5.6 0.7 0.3 100.0 2,995 0.0
Gambela 59.5 27.4 4.7 6.9 1.4 0.1 100.0 44 0.0
Harari 39.9 14.4 3.0 25.1 13.0 4.6 100.0 39 3.8
Addis Ababa 17.6 18.6 5.7 29.8 16.7 11.6 100.0 756 7.3
Dire Dawa 46.7 15.0 4.5 22.3 9.1 2.4 100.0 69 2.1

Wealth quintile
Lowest 88.2 10.2 0.4 1.2 0.0 0.0 100.0 2,428 0.0
Second 83.5 14.3 1.0 1.2 0.0 0.0 100.0 2,643 0.0
Middle 73.2 21.8 2.4 2.5 0.0 0.0 100.0 2,732 0.0
Fourth 66.2 25.6 3.5 4.5 0.1 0.1 100.0 2,647 0.0
Highest 32.4 22.1 6.2 25.1 8.9 5.3 100.0 3,621 4.2

Total 65.9 19.2 3.0 8.2 2.3 1.4 100.0 14,070 0.0
1
Completed grade 6 at the primary level
2
Completed grade 12 at the secondary level

Characteristics of Respondents | 33
Table 3.2.2 Educational attainment by background characteristics: men

Percent distribution of men by highest level of schooling attained, and median number of years of schooling, according to background
characteristics, Ethiopia 2005

Highest level of schooling attended or completed


Background No Some Completed Some Completed More than Number Median years
characteristic education primary primary1 secondary secondary2 secondary Total of men of schooling
Age
15-19 21.2 43.3 11.4 22.9 0.6 0.7 100.0 1,335 3.5
20-24 32.7 30.4 7.7 22.0 4.4 2.8 100.0 1,064 3.1
25-29 42.2 31.4 5.2 12.5 5.2 3.5 100.0 741 1.4
30-34 44.6 32.1 7.4 9.5 4.8 1.6 100.0 754 1.3
35-39 49.1 28.1 6.3 8.8 5.0 2.7 100.0 651 0.2
40-44 57.0 22.2 3.6 8.6 3.2 5.3 100.0 497 0.0
45-49 66.9 16.8 3.1 6.6 2.5 4.1 100.0 422 0.0
50-54 73.0 16.8 2.7 3.3 2.1 2.1 100.0 335 0.0
55-59 77.0 19.7 0.3 1.7 0.7 0.6 100.0 235 0.0

Residence
Urban 7.9 14.6 5.8 40.3 18.1 13.4 100.0 916 8.5
Rural 49.2 33.4 7.0 9.3 0.6 0.5 100.0 5,117 0.0

Region
Tigray 46.9 24.0 6.1 14.2 4.2 4.7 100.0 366 0.7
Affar 71.4 14.2 2.9 6.4 4.0 1.2 100.0 65 0.0
Amhara 60.5 23.8 3.1 9.4 2.0 1.2 100.0 1,521 0.0
Oromiya 36.7 34.5 8.5 16.1 2.6 1.6 100.0 2,222 1.9
Somali 81.9 7.7 2.5 5.3 1.7 0.9 100.0 202 0.0
Benishangul-Gumuz 49.9 30.6 6.9 10.3 0.4 1.9 100.0 54 0.0
SNNP 32.6 42.7 9.4 12.5 1.6 1.2 100.0 1,244 2.3
Gambela 27.5 32.5 8.2 26.8 3.6 1.3 100.0 21 3.7
Harari 20.5 21.7 6.2 31.8 12.2 7.6 100.0 16 6.3
Addis Ababa 7.2 12.7 6.9 33.0 21.5 18.7 100.0 292 9.2
Dire Dawa 22.8 18.0 6.7 33.9 11.8 6.8 100.0 30 6.3

Wealth quintile
Lowest 69.6 21.9 4.3 4.2 0.0 0.0 100.0 1,100 0.0
Second 55.4 34.2 4.8 5.4 0.2 0.1 100.0 1,184 0.0
Middle 47.4 35.9 7.2 9.4 0.1 0.1 100.0 1,081 0.3
Fourth 37.0 39.2 9.7 13.0 1.0 0.1 100.0 1,200 2.1
Highest 14.5 22.9 7.7 32.6 12.5 9.8 100.0 1,469 6.7

Total 42.9 30.5 6.8 14.0 3.3 2.4 100.0 6,033 1.3
1
Completed grade 6 at the primary level
2
Completed grade 12 at the secondary level

Not surprisingly, access to wealth equates with access to education. An analysis of the
variation in the level of education by wealth quintile indicates that only those in the highest wealth
quintile have the opportunity to complete secondary or higher levels of education. Likewise, only a
third of the women in the highest quintile have never attended school, compared with 88 percent of
women in the lowest quintile.

The pattern of educational attainment among men is similar to that of women. However, men
are more educated than women at every level. This gender disparity is more marked at higher than at
lower levels, indicating the government’s recognition and successful intervention to address gender
disparity in recent years.

34 | Characteristics of Respondents
Literacy is widely acknowledged as benefiting the individual and the society and is associated
with a number of positive outcomes for health and nutrition. In the 2005 EDHS, literacy status was
determined based on the respondents’ ability to read all or part of a sentence. During data collection,
interviewers carried a set of cards on which simple sentences were printed in five of the major
languages for testing a respondent’s reading ability. Only those who had never been to school and
those who had not completed primary level were asked to read the cards in the language they were
most likely able to read; those who had attained middle school or above were assumed to be literate.

Table 3.3.1 indicates that only 3 of 10 women in Ethiopia are literate and that literacy status
varies greatly by place of residence. Three-fourths of women residing in urban areas are literate
compared with only a fifth of their rural counterparts. The level of literacy by age exhibits a consistent
decrease with increasing age, suggesting that the younger generation has had more opportunity for
learning than the older generation. Half of the women age 15-19 are literate compared with only 8
percent of the women age 45-49.

Table 3.3.1 Literacy: women

Percent distribution of women by level of schooling attended and level of literacy, and percent literate, according to background
characteristics, Ethiopia 2005

No schooling or primary school


No card
Secondary Can read Can read Cannot with Blind/ Number
Background school or a whole part of a read required visually of Percent
characteristic higher sentence sentence at all language impaired Missing Total women literate1
Age
15-19 16.4 22.4 10.7 47.5 2.7 0.0 0.2 100.0 3,266 49.5
20-24 17.3 7.8 6.4 66.1 2.3 0.0 0.1 100.0 2,547 31.5
25-29 12.1 7.1 6.9 73.2 0.5 0.1 0.1 100.0 2,517 26.1
30-34 9.8 6.1 8.9 74.2 1.0 0.1 0.0 100.0 1,808 24.8
35-39 7.2 5.2 7.3 78.8 1.6 0.0 0.0 100.0 1,602 19.6
40-44 5.9 2.7 5.7 84.0 1.6 0.0 0.0 100.0 1,187 14.4
45-49 2.8 1.2 4.0 90.9 1.1 0.0 0.0 100.0 1,143 8.0

Residence
Urban 50.9 14.3 8.3 26.0 0.3 0.0 0.1 100.0 2,499 73.6
Rural 3.5 8.6 7.5 78.4 2.0 0.0 0.1 100.0 11,571 19.6

Region
Tigray 16.5 10.0 7.2 66.3 0.0 0.0 0.0 100.0 919 33.7
Affar 6.8 4.6 4.1 84.3 0.1 0.0 0.0 100.0 146 15.6
Amhara 8.5 9.6 6.9 74.8 0.0 0.0 0.1 100.0 3,482 25.1
Oromiya 10.0 10.7 8.8 68.6 1.9 0.1 0.0 100.0 5,010 29.5
Somali 5.2 1.8 2.8 89.5 0.2 0.0 0.5 100.0 486 9.8
Benishangul-Gumuz 6.4 9.2 7.6 74.7 1.9 0.0 0.2 100.0 124 23.2
SNNP 6.7 8.4 7.3 73.0 4.5 0.1 0.0 100.0 2,995 22.4
Gambela 8.4 5.4 9.1 73.2 3.8 0.0 0.1 100.0 44 22.8
Harari 42.7 6.6 5.7 44.4 0.1 0.0 0.5 100.0 39 54.9
Addis Ababa 58.1 12.7 9.0 19.8 0.2 0.0 0.2 100.0 756 79.9
Dire Dawa 33.7 9.9 9.4 46.7 0.0 0.2 0.0 100.0 69 53.0

Wealth quintile
Lowest 1.2 3.1 5.2 88.7 1.7 0.1 0.0 100.0 2,428 9.5
Second 1.2 5.7 5.2 85.3 2.5 0.0 0.0 100.0 2,643 12.1
Middle 2.6 9.3 8.8 77.8 1.5 0.1 0.0 100.0 2,732 20.6
Fourth 4.6 12.5 9.4 71.5 1.9 0.0 0.1 100.0 2,647 26.5
Highest 39.3 14.9 8.9 35.7 1.0 0.0 0.2 100.0 3,621 63.1

Total 11.9 9.6 7.6 69.1 1.7 0.0 0.1 100.0 14,070 29.2
1
Refers to women who attended secondary school or higher and women who can read a whole sentence or part of a sentence

Characteristics of Respondents | 35
Regional differences in literacy are marked, with literacy being highest among women in
predominantly urban Addis Ababa, (80 percent) and lowest in the predominantly rural Somali Region
(10 percent). There is also a marked difference in literacy levels by women’s wealth status, ranging
from a low of 10 percent among women in the lowest wealth quintile to a high of 63 percent among
women in the highest wealth quintile.

In general, men are more likely to be literate than women (Table 3.3.2). The urban-rural
differential in literacy among men is smaller compared with women, suggesting that men in the rural
areas have much greater opportunity for learning than women.

Table 3.3.2 Literacy: men

Percent distribution of men by level of schooling attended and level of literacy, and percent literate, according to background
characteristics, Ethiopia 2005

No schooling or primary school


No card
Secondary Can read Can read Cannot with Blind/
Background school or a whole part of a read at required visually Number Percent
characteristic higher sentence sentence all language impaired Missing Total of men literate1
Age
15-19 24.2 33.8 12.9 25.4 3.7 0.0 0.0 100.0 1,335 70.9
20-24 29.3 22.4 11.0 35.3 1.7 0.2 0.1 100.0 1,064 62.7
25-29 21.2 22.0 13.9 41.6 1.4 0.0 0.0 100.0 741 57.0
30-34 15.9 30.0 14.4 38.5 1.0 0.2 0.0 100.0 754 60.3
35-39 16.5 25.7 20.5 36.7 0.6 0.0 0.0 100.0 651 62.7
40-44 17.2 21.9 13.2 47.1 0.6 0.0 0.0 100.0 497 52.3
45-49 13.2 16.7 17.0 52.3 0.8 0.0 0.0 100.0 422 46.9
50-54 7.5 20.9 9.3 61.9 0.4 0.1 0.0 100.0 335 37.7
55-59 3.0 11.8 15.6 67.9 0.7 1.0 0.0 100.0 235 30.4

Residence
Urban 71.8 15.7 6.2 6.0 0.2 0.0 0.1 100.0 916 93.7
Rural 10.4 27.0 15.3 45.3 1.9 0.1 0.0 100.0 5,117 52.7

Region
Tigray 23.1 31.4 13.0 32.5 0.0 0.0 0.0 100.0 366 67.5
Affar 11.5 8.1 7.4 71.2 1.2 0.5 0.0 100.0 65 27.0
Amhara 12.6 30.0 11.5 45.6 0.2 0.1 0.0 100.0 1,521 54.0
Oromiya 20.3 22.7 18.6 37.8 0.6 0.1 0.0 100.0 2,222 61.5
Somali 7.9 7.8 6.3 77.1 0.9 0.0 0.0 100.0 202 22.0
Benishangul-Gumuz 12.6 25.6 9.2 51.5 0.8 0.0 0.3 100.0 54 47.4
SNNP 15.3 28.6 13.2 36.5 6.4 0.1 0.0 100.0 1,244 57.0
Gambela 31.7 15.9 9.8 41.3 1.2 0.0 0.0 100.0 21 57.5
Harari 51.6 22.5 4.3 20.6 0.6 0.0 0.3 100.0 16 78.4
Addis Ababa 73.2 16.5 3.9 6.1 0.0 0.0 0.3 100.0 292 93.6
Dire Dawa 52.5 13.4 10.6 22.7 0.4 0.4 0.0 100.0 30 76.6

Wealth quintile
Lowest 4.2 16.2 13.5 64.9 0.9 0.3 0.0 100.0 1,100 33.9
Second 5.7 21.2 17.7 53.1 2.3 0.0 0.0 100.0 1,184 44.5
Middle 9.5 30.8 14.1 43.3 2.2 0.0 0.0 100.0 1,081 54.5
Fourth 14.1 37.1 15.1 31.5 2.0 0.2 0.0 100.0 1,200 66.3
Highest 54.9 21.5 9.9 12.5 1.0 0.0 0.1 100.0 1,469 86.4

Total 19.8 25.3 13.9 39.3 1.7 0.1 0.0 100.0 6,033 58.9
1
Refers to men who attended secondary school or higher and men who can read a whole sentence or part of a sentence

36 | Characteristics of Respondents
3.3 ACCESS TO MASS MEDIA

Exposure to mass media provides the opportunity to be acquainted with new ideas and
knowledge that is useful in various aspects of everyday life. In the 2005 EDHS, exposure to media
was assessed by asking respondents how often they listened to a radio, watched television, or read
newspapers or magazines. This information is useful in determining which media may be more
effective for disseminating health information to targeted audiences. The results are presented in
Tables 3.4.1 and 3.4.2 by background characteristics.

Table 3.4.1 Exposure to mass media: women

Percentage of women who are exposed to specific media on a weekly basis, according to background
characteristics, Ethiopia 2005

Reads a Watches Listens to All three No media


newspaper television the radio media at at least
Background at least once at least once at least once least once once Number of
characteristic a week a week a week a week a week women
Age
15-19 5.3 11.0 19.9 1.3 72.6 3,266
20-24 2.7 10.3 19.6 1.1 76.2 2,547
25-29 1.9 6.8 15.2 0.7 81.2 2,517
30-34 1.4 5.4 13.0 0.7 84.3 1,808
35-39 0.9 4.8 13.4 0.3 84.4 1,602
40-44 1.3 5.0 11.2 0.7 86.6 1,187
45-49 0.7 5.7 11.6 0.6 85.3 1,143

Residence
Urban 8.8 39.5 40.4 4.6 41.9 2,499
Rural 1.2 0.9 10.7 0.0 88.1 11,571

Region
Tigray 2.8 7.3 13.4 0.9 82.2 919
Affar 0.5 4.4 8.3 0.0 88.4 146
Amhara 1.2 3.5 14.6 0.4 83.8 3,482
Oromiya 2.3 6.5 16.6 0.6 79.4 5,010
Somali 0.6 6.5 5.0 0.3 90.9 486
Benishangul-Gumuz 1.6 1.4 13.2 0.3 86.1 124
SNNP 1.6 2.5 11.3 0.2 86.6 2,995
Gambela 1.7 3.6 7.6 0.0 89.1 44
Harari 6.1 42.2 39.1 4.0 46.3 39
Addis Ababa 14.1 55.8 45.9 7.4 29.2 756
Dire Dawa 4.1 37.2 38.3 3.0 53.1 69

Education
No education 0.0 1.5 8.1 0.0 91.0 9,271
Primary 3.6 7.4 21.2 0.3 72.8 3,123
Secondary and higher 14.3 43.5 50.1 6.6 31.6 1,675

Wealth quintile
Lowest 0.3 0.2 2.2 0.0 97.2 2,428
Second 0.5 0.3 5.1 0.1 94.4 2,643
Middle 1.5 0.4 10.1 0.0 88.6 2,732
Fourth 1.5 1.1 15.6 0.0 82.8 2,647
Highest 6.9 28.7 37.9 3.3 48.9 3,621

Total 2.5 7.8 16.0 0.9 79.9 14,070

Characteristics of Respondents | 37
Table 3.4.2 Exposure to mass media: men

Percentage of men who are exposed to specific media on a weekly basis, according to background
characteristics, Ethiopia 2005

Reads a Watches Listens to All three


newspaper television the radio media at No media at
Background at least once at least once at least once least once least once Number of
characteristic a week a week a week a week a week men
Age
15-19 8.6 13.3 26.5 2.9 65.6 1,335
20-24 9.9 14.9 37.1 4.0 57.0 1,064
25-29 7.8 12.4 33.5 3.8 61.7 741
30-34 6.2 8.2 34.0 3.2 63.8 754
35-39 6.2 8.2 30.1 2.4 66.6 651
40-44 6.6 7.8 33.4 3.1 64.0 497
45-49 5.6 8.0 31.4 2.3 65.4 422
50-54 5.3 6.4 23.3 2.1 73.9 335
55-59 3.4 4.3 27.6 1.2 71.0 235
Residence
Urban 27.3 49.9 62.8 17.6 21.9 916
Rural 3.9 3.7 25.7 0.5 71.6 5,117
Region
Tigray 13.7 18.4 37.0 4.1 54.1 366
Affar 1.4 13.1 29.1 1.2 67.1 65
Amhara 4.6 5.7 24.9 1.4 71.4 1,521
Oromiya 6.5 10.2 35.6 2.9 61.0 2,222
Somali 2.0 3.4 22.0 1.2 77.0 202
Benishangul-Gumuz 1.9 6.8 35.0 0.3 61.9 54
SNNP 4.6 5.6 24.6 1.2 72.3 1,244
Gambela 5.4 8.4 33.4 1.6 62.6 21
Harari 22.2 41.8 70.9 15.0 22.1 16
Addis Ababa 37.5 54.7 55.7 20.7 21.4 292
Dire Dawa 17.5 34.2 51.9 9.7 38.9 30
Education
No education 0.6 1.4 16.1 0.0 82.9 2,589
Primary 5.5 7.7 33.4 0.9 61.8 2,252
Secondary and higher 25.8 36.5 60.5 13.9 27.2 1,192
Wealth quintile
Lowest 2.8 1.0 10.4 0.2 87.8 1,100
Second 1.7 2.9 18.6 0.4 79.5 1,184
Middle 6.3 3.6 25.0 0.3 70.3 1,081
Fourth 4.1 4.4 35.9 0.5 61.5 1,200
Highest 19.0 34.6 58.1 11.4 31.2 1,469

Total 7.4 10.7 31.3 3.1 64.0 6,033

The survey shows that exposure to media in Ethiopia is low, especially with regards to the
print media. Respondents are more likely to be exposed to the radio than any other media. Men have
greater access to mass media, particularly radio, than women. Specifically, men are twice as likely to
listen to the radio as women (31 percent and 16 percent, respectively).

Young women under 25 years of age are more likely to be exposed to mass media than older
women, primarily because of their higher level of education. There is also a wide gap in exposure to
mass media by place of residence. For example, the proportion of newspaper readers is highest among
urban residents and those with some secondary or higher levels of education. When looking into the
regional variation, women in Addis Ababa are more likely to read newspapers or magazines on a
weekly basis than other women.

38 | Characteristics of Respondents
There has been an increase in exposure to the media since 2000. The proportion of women
who listen to the radio at least once a week has increased by 43 percent, from 11 percent in 2000 to 16
percent in 2005, while the proportion among men rose from 24 percent to 31 percent. There was also
an increase in exposure to television, from 4 to 8 percent among women and from 8 to 11 percent
among men.

3.4 EMPLOYMENT

3.4.1 Employment Status

In the 2005 EDHS, respondents were asked a number of questions regarding their
employment status, including whether they were working in the seven days preceding the survey and,
if not, whether they had worked in the 12 months before the survey. The results for women and men
are presented in Tables 3.5.1 and 3.5.2. At the time of the survey, about 3 of 10 women were currently
employed and an additional 5 percent were not employed but had worked sometime during the
preceding 12 months.

Current employment generally increases with increasing age and women who are divorced,
separated, or widowed are more likely to be employed than other women. Women who have four or
less children are more likely to be employed than those with five or more children.

There are notable variations in the proportion currently employed by place of residence and
region. Urban women are more likely to be currently employed than rural women (40 percent
compared with 27 percent).Women in Addis Ababa and Harari are most likely to be employed (44
percent and 41 percent, respectively), while Affar and Somali regions have the lowest proportions of
employed women (11 percent each).

Current employment increases with an increase in level of education; the proportion of


employed women increases from 27 percent among uneducated women to 38 percent among those
with some secondary education. There is also an increase in the percentage of employed persons by
wealth quintile, with those in the highest quintile much more likely to be employed than those in the
other four quintiles.

A marked difference was observed in the level of employment by gender. The proportion
currently employed is much higher among men than women. As can be seen from Table 3.5.2, the
majority of men (86 percent) were employed at the time of survey. The majority of employed men are
in rural areas and have little or no education. This is probably because the EDHS data collection took
place during the peak agricultural season when most men in rural areas are likely to be engaged in
farm work.

Although the level of female employment is lower in 2005 than in 2000, the patterns for men
are very similar. The marked difference in the percentage of women currently employed between
2000 (57 percent) and 2005 (29 percent) can be attributed to the difference in the way the data on
current employment were collected for women in the two DHS surveys. There was no difference in
the wording of the question on current employment for men between the two surveys.

Characteristics of Respondents | 39
Table 3.5.1 Employment status: women

Percent distribution of women by employment status, according to background characteristics, Ethiopia 2005

Employed in the Not employed


12 months preceding in the
the survey 12 months
Background Currently Not currently preceding Number of
characteristic employed1 employed the survey Missing Total women
Age
15-19 24.0 4.2 65.8 6.0 100.0 3,266
20-24 29.6 5.9 60.5 3.9 100.0 2,547
25-29 28.8 6.1 60.5 4.6 100.0 2,517
30-34 30.2 5.7 60.6 3.5 100.0 1,808
35-39 31.2 4.6 59.2 4.9 100.0 1,602
40-44 33.0 6.6 56.0 4.4 100.0 1,187
45-49 31.6 5.1 60.6 2.8 100.0 1,143

Marital status
Never married 31.2 3.4 60.2 5.2 100.0 3,516
Married or living together 25.5 6.0 63.9 4.6 100.0 9,066
Divorced/separated/widowed 44.3 6.0 47.2 2.5 100.0 1,488

Number of living children


0 30.4 4.7 60.0 4.9 100.0 4,554
1-2 29.5 6.4 60.1 4.0 100.0 3,226
3-4 29.7 5.7 60.2 4.4 100.0 2,981
5+ 25.5 5.0 64.8 4.6 100.0 3,309

Residence
Urban 39.6 3.8 53.5 3.1 100.0 2,499
Rural 26.6 5.7 62.9 4.8 100.0 11,571

Region
Tigray 27.6 16.8 51.5 4.1 100.0 919
Affar 11.3 0.6 82.5 5.6 100.0 146
Amhara 27.9 8.4 59.9 3.8 100.0 3,482
Oromiya 32.0 3.3 59.9 4.7 100.0 5,010
Somali 11.4 0.1 73.1 15.4 100.0 486
Benishangul-Gumuz 34.3 9.1 51.1 5.5 100.0 124
SNNP 24.5 3.0 68.3 4.2 100.0 2,995
Gambela 26.7 6.2 59.8 7.3 100.0 44
Harari 41.1 1.0 53.5 4.4 100.0 39
Addis Ababa 44.2 4.7 49.4 1.7 100.0 756
Dire Dawa 33.7 0.9 64.5 0.9 100.0 69

Education
No education 27.2 5.6 62.5 4.6 100.0 9,271
Primary 29.1 4.9 60.9 5.1 100.0 3,123
Secondary and higher 38.0 4.6 54.5 2.9 100.0 1,675

Wealth quintile
Lowest 23.5 5.7 64.4 6.4 100.0 2,428
Second 26.6 6.3 62.0 5.1 100.0 2,643
Middle 25.9 5.2 64.0 4.8 100.0 2,732
Fourth 29.6 5.3 61.9 3.2 100.0 2,647
Highest 35.9 4.6 55.9 3.7 100.0 3,621

Total 28.9 5.4 61.2 4.5 100.0 14,070


1
"Currently employed" is defined as having done work in the last seven days. Includes persons who did not work in
the last seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any
other such reason.

40 | Characteristics of Respondents
Table 3.5.2 Employment status: men

Percent distribution of men by employment status, according to background characteristics, Ethiopia 2005

Employed in the 12 months Not employed


in the
preceding the survey
12 months
Background Currently Not currently preceding Number of
characteristic employed1 employed the survey Missing Total men
Age
15-19 63.0 2.0 34.3 0.6 100.0 1,335
20-24 79.8 3.4 16.5 0.4 100.0 1,064
25-29 91.9 2.8 5.3 0.0 100.0 741
30-34 97.6 0.7 1.5 0.2 100.0 754
35-39 97.3 0.6 2.1 0.0 100.0 651
40-44 96.3 1.6 2.0 0.0 100.0 497
45-49 95.5 0.9 3.5 0.0 100.0 422
50-54 96.6 0.8 2.5 0.0 100.0 335
55-59 93.4 0.8 5.8 0.0 100.0 235
Marital status
Never married 69.0 3.1 27.4 0.5 100.0 2,419
Married or living together 97.0 0.9 2.1 0.0 100.0 3,424
Divorced/separated/widowed 92.0 1.0 7.1 0.0 100.0 190
Number of living children
0 72.5 2.9 24.2 0.4 100.0 2,766
1-2 95.8 1.1 2.9 0.1 100.0 993
3-4 97.6 0.4 1.9 0.0 100.0 967
5+ 96.7 1.1 2.1 0.0 100.0 1,307
Residence
Urban 62.1 5.5 32.0 0.4 100.0 916
Rural 89.8 1.2 8.8 0.2 100.0 5,117
Region
Tigray 80.5 6.2 13.2 0.2 100.0 366
Affar 92.0 2.1 5.9 0.0 100.0 65
Amhara 91.3 0.7 8.0 0.0 100.0 1,521
Oromiya 84.1 1.2 14.5 0.1 100.0 2,222
Somali 87.2 1.9 10.5 0.3 100.0 202
Benishangul-Gumuz 91.0 1.6 7.5 0.0 100.0 54
SNNP 86.4 1.5 11.5 0.7 100.0 1,244
Gambela 82.1 6.1 11.8 0.0 100.0 21
Harari 81.0 3.1 15.7 0.2 100.0 16
Addis Ababa 68.9 7.3 23.6 0.1 100.0 292
Dire Dawa 68.8 6.1 25.2 0.0 100.0 30
Education
No education 97.4 1.0 1.6 0.0 100.0 2,589
Primary 83.9 1.4 14.5 0.2 100.0 2,252
Secondary and higher 63.2 4.4 31.8 0.6 100.0 1,192
Wealth quintile
Lowest 92.8 1.4 5.6 0.1 100.0 1,100
Second 91.8 1.2 6.9 0.1 100.0 1,184
Middle 90.7 0.9 7.9 0.5 100.0 1,081
Fourth 86.4 1.6 11.9 0.1 100.0 1,200
Highest 70.8 3.5 25.4 0.3 100.0 1,469

Total 85.6 1.8 12.4 0.2 100.0 6,033


1
"Currently employed" is defined as having done work in the last seven days. Includes persons who did not work in
the last seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any
other such reason.

Characteristics of Respondents | 41
3.4.2 OCCUPATION

Respondents who were currently employed or had worked in the 12 months preceding the
survey were further asked to specify their occupation. Tables 3.6.1 and 3.6.2 show data on employed
women and men, respectively, by occupation according to background characteristics. Most employed
persons are engaged in the agricultural sector. Specifically, more than half of employed women and
84 percent of employed men are engaged in agricultural jobs. Sales and service is an important
occupation category, especially for women, employing nearly a third of the women and about 7
percent of the men.

Table 3.6.1 Occupation: women

Percent distribution of women employed in the 12 months preceding the survey by occupation, according to background characteristics,
Ethiopia 2005

Profes-
sional/
Background technical/ Sales and Manual labour Agricul- Number
characteristic managerial Clerical services Skilled Unskilled ture Missing Total of women
Age
15-19 0.3 0.3 35.6 4.9 5.0 52.2 1.6 100.0 922
20-24 3.9 2.0 35.4 4.6 6.4 45.6 2.1 100.0 905
25-29 6.1 1.1 33.6 5.7 6.1 47.0 0.5 100.0 879
30-34 5.8 1.8 28.3 6.3 4.8 51.8 1.3 100.0 648
35-39 4.6 1.1 28.2 7.6 3.8 54.1 0.6 100.0 574
40-44 3.4 1.2 24.7 8.1 2.4 58.4 1.6 100.0 470
45-49 2.1 0.4 24.7 7.2 3.6 61.0 1.0 100.0 419
Marital status
Never married 5.1 2.7 43.6 5.5 6.9 35.0 1.3 100.0 1,217
Married or living together 3.6 0.6 24.8 5.0 3.1 61.8 1.2 100.0 2,854
Divorced/separated/widowed 2.2 1.0 36.3 10.8 8.8 39.5 1.5 100.0 748
Number of living children
0 4.4 2.1 40.6 5.9 6.2 39.3 1.5 100.0 1,596
1-2 5.8 1.4 29.1 5.6 6.2 50.6 1.2 100.0 1,157
3-4 3.2 0.3 25.5 6.5 3.8 59.8 0.9 100.0 1,056
5+ 1.0 0.3 25.2 6.2 2.6 63.4 1.3 100.0 1,010
Residence
Urban 14.2 5.0 57.5 12.2 9.0 1.2 1.0 100.0 1,084
Rural 0.7 0.1 23.7 4.2 3.8 66.2 1.3 100.0 3,734
Region
Tigray 5.5 1.6 15.3 4.5 20.1 52.1 0.9 100.0 408
Affar 8.1 3.5 37.0 10.3 19.7 20.8 0.5 100.0 17
Amhara 3.4 0.5 15.3 6.5 4.7 68.4 1.2 100.0 1,265
Oromiya 2.3 0.7 25.2 4.1 2.5 63.7 1.5 100.0 1,771
Somali 14.9 2.8 74.8 2.4 0.0 4.0 1.2 100.0 56
Benishangul-Gumuz 4.2 0.7 18.0 2.8 0.3 73.2 0.8 100.0 54
SNNP 1.0 0.4 58.8 9.5 2.0 27.5 0.8 100.0 824
Gambela 3.0 1.9 31.9 17.5 7.2 38.2 0.3 100.0 15
Harari 14.4 5.5 64.9 5.7 5.1 2.6 1.8 100.0 16
Addis Ababa 13.7 6.0 62.7 7.9 7.4 0.3 2.1 100.0 370
Dire Dawa 7.0 4.0 73.9 3.3 11.1 0.0 0.7 100.0 24
Education
No education 0.1 0.0 25.8 5.6 4.4 62.8 1.3 100.0 3,042
Primary 0.0 0.4 37.8 6.4 6.0 48.1 1.4 100.0 1,063
Secondary and higher 25.0 7.3 45.1 7.3 5.7 8.5 1.2 100.0 714
Wealth quintile
Lowest 0.0 0.0 19.0 3.0 5.3 70.3 2.3 100.0 709
Second 0.2 0.0 18.9 6.3 5.0 68.3 1.3 100.0 870
Middle 0.0 0.0 22.8 5.0 3.3 68.1 0.9 100.0 851
Fourth 0.0 0.2 28.8 3.7 3.7 62.4 1.2 100.0 924
Highest 12.2 3.7 51.2 9.3 6.5 16.0 1.1 100.0 1,465

Total 3.8 1.2 31.3 6.0 4.9 51.5 1.3 100.0 4,819

42 | Characteristics of Respondents
Table 3.6.2 Occupation: men

Percent distribution of men employed in the 12 months preceding the survey by occupation, according to background characteristics,
Ethiopia 2005

Profes-
sional/
Background technical/ Sales and Manual labour Agricul- Number
characteristic managerial Clerical services Skilled Unskilled ture Missing Total of men
Age
15-19 0.1 0.1 6.4 2.0 2.6 88.3 0.6 100.0 869
20-24 1.9 0.2 9.8 4.2 3.8 79.6 0.6 100.0 884
25-29 2.7 0.3 8.0 4.3 3.6 80.3 0.7 100.0 702
30-34 1.8 0.0 5.1 5.7 1.9 84.5 0.9 100.0 741
35-39 3.9 0.4 7.5 2.1 1.4 84.0 0.6 100.0 637
40-44 5.8 0.1 5.9 3.2 1.5 82.1 1.4 100.0 487
45-49 4.7 0.1 4.4 2.2 2.0 85.8 0.7 100.0 407
50-54 3.2 0.1 2.8 1.4 1.7 90.3 0.6 100.0 326
55-59 1.7 0.2 7.2 1.3 2.5 87.1 0.0 100.0 221

Marital status
Never married 1.9 0.2 9.2 5.0 3.9 79.3 0.5 100.0 1,745
Married or living together 2.9 0.2 5.5 2.2 1.7 86.7 0.8 100.0 3,353
Divorced/separated/widowed 4.4 0.0 5.6 5.6 4.0 79.9 0.5 100.0 177

Number of living children


0 1.8 0.2 8.6 4.6 3.6 80.9 0.4 100.0 2,084
1-2 3.9 0.2 8.9 4.9 2.5 78.3 1.3 100.0 963
3-4 4.1 0.3 5.0 1.2 2.0 86.5 1.0 100.0 948
5+ 1.8 0.1 3.5 1.5 1.0 91.7 0.5 100.0 1,279

Residence
Urban 15.8 1.4 37.0 24.4 14.5 6.3 0.7 100.0 620
Rural 0.8 0.0 2.7 0.5 0.9 94.4 0.7 100.0 4,655

Region
Tigray 4.0 0.8 8.0 3.3 5.1 78.4 0.5 100.0 317
Affar 4.6 1.1 15.2 4.7 4.4 67.9 2.2 100.0 61
Amhara 1.1 0.0 3.5 2.0 1.1 91.7 0.6 100.0 1,400
Oromiya 2.2 0.1 5.3 1.9 2.5 87.2 0.7 100.0 1,896
Somali 3.8 0.0 6.7 0.4 2.0 86.9 0.2 100.0 180
Benishangul-Gumuz 2.0 0.0 3.3 1.8 0.8 91.3 0.7 100.0 50
SNNP 1.6 0.0 5.4 1.5 1.7 89.0 0.9 100.0 1,093
Gambela 5.3 0.4 10.5 2.0 6.8 74.4 0.5 100.0 18
Harari 11.5 0.4 23.7 9.7 10.3 42.2 2.2 100.0 14
Addis Ababa 14.9 1.5 39.0 32.5 10.1 1.2 0.9 100.0 222
Dire Dawa 9.4 1.3 29.3 13.2 11.6 34.7 0.5 100.0 22

Education
No education 0.1 0.0 3.0 0.5 1.1 94.8 0.6 100.0 2,547
Primary 0.3 0.0 6.1 2.0 2.6 88.2 0.7 100.0 1,922
Secondary and higher 15.9 1.1 20.1 15.1 6.6 40.1 1.1 100.0 806

Wealth quintile
Lowest 0.0 0.0 1.9 0.0 0.7 96.8 0.5 100.0 1,037
Second 0.3 0.0 2.0 0.4 0.5 96.3 0.5 100.0 1,101
Middle 0.0 0.0 1.9 0.4 0.2 96.4 0.9 100.0 991
Fourth 0.7 0.0 3.2 0.7 1.7 93.2 0.5 100.0 1,055
Highest 11.4 0.8 24.0 14.4 8.9 39.4 1.0 100.0 1,091

Total 2.6 0.2 6.8 3.3 2.5 84.0 0.7 100.0 5,274

Characteristics of Respondents | 43
Six percent of employed women are skilled manual workers, while 5 percent are engaged as
unskilled manual workers. Only 4 percent of employed women work in the professional, technical,
and managerial fields. Women are less likely to be highly educated and less likely to have attended
vocational or technical schools. Therefore, their employment in the professional, technical, and
managerial sector is somewhat low compared with men.

The analysis of occupation by background characteristics suggests that the proportion of


women with jobs in sales and services decreases as age increases and that married women are more
likely to be employed in agricultural work than other women. Never-married women, on the other
hand, are more likely to be employed in sales and services and in clerical work.

Residence has a significant effect on the type of occupation. As expected, two-thirds of


employed women and 94 percent of employed men in rural areas are engaged in agricultural work.
Most educated women are employed in sales and services and professional, technical, and managerial
occupations, whereas women with little or no education tend to be employed in the agricultural sector.
Agriculture is by far the most important occupation for working women in the lower wealth quintiles.
Employment outside the agricultural sector is greatest among men with secondary or higher education
and men in the highest wealth quintile.

3.4.3 Earnings, Employers and Continuity of Employment

Table 3.7.1 shows the percent Table 3.7.1 Type of employment: women
distribution of employed women by
Percent distribution of women employed in the 12 months preceding the
type of earnings and employment
survey by type of earnings, type of employer, and continuity of employment,
characteristics. The table takes into according to type of employment (agricultural or nonagricultural), Ethiopia
account whether women are involved 2005
in agricultural or nonagricultural oc-
Employment Agricultural Nonagricultural
cupations, because all of the employ- characteristic work work Total
ment variables in the table are strong-
Type of earnings
ly influenced by the sector in which a Cash only 2.5 73.8 36.4
woman is employed. Cash and in-kind 3.6 2.7 3.1
In-kind only 12.6 2.7 7.8
An overwhelming majority Not paid 81.1 20.6 52.3
(81 percent) of women engaged in Missing 0.1 0.2 0.4
agricultural work are unpaid workers
most likely employed by family Total 100.0 100.0 100.0
members at the peak of the agri-
Type of employer
cultural season. Women are more
Employed by family member 75.4 42.5 59.5
likely to be paid in cash if they are Employed by nonfamily member 3.1 25.0 13.6
employed in the nonagricultural Self-employed 21.5 32.4 26.7
sector; about three-fourths of the Missing 0.0 0.1 0.2
women employed in this sector are
paid in cash. Overall, more than half Total 100.0 100.0 100.0
(52 percent) of employed women are
Continuity of employment
not paid at all and only 40 percent
All year 5.8 63.0 33.2
earn cash for their work. Seasonal 88.5 14.1 52.6
Occasional 5.5 22.9 13.9
Six out of 10 employed Missing 0.2 0.0 0.3
women work for a family member,
and about 27 percent are self- Total 100.0 100.0 100.0
employed. Only 14 percent of em- Number of women 2,484 2,273 4,819
ployed women work for someone Note: Total includes women with missing information on type of employment
outside the family. who are not shown separately.

44 | Characteristics of Respondents
Three-quarters of women working in the agricultural sector are working for a family member
compared with 43 percent working in the nonagricultural sector. In addition, the proportion of women
employed by someone outside the family is higher among those working in the nonagricultural sector
than those in the agricultural sector (25 percent versus 3 percent).

Generally, a third of employed women work all year round while 53 percent work seasonally.
Those who work occasionally account for 14 percent. As in the case of type of earning and employer,
continuity of employment also varies by sector of employment. Around 9 in 10 women employed in
the agricultural sector are seasonal workers compared with only 14 percent among those working in
the nonagricultural sector. On the other hand,
Table 3.7.2 Type of employment: men
continuity of employment is more assured for
women engaged in nonagricultural work than Percent distribution of men employed in the 12 months preceding
those in agricultural work. For example, 63 the survey by type of earnings, according to type of employment
percent of women working in the nonagri- (agricultural or nonagricultural), Ethiopia 2005
cultural sector work all year compared with Agricultural Nonagricultural
only 6 percent of women engaged in agri- Type of earnings work work Total
cultural work. Cash only 7.7 82.4 19.3
Cash and in-kind 10.5 1.9 9.2
In-kind only 23.6 1.1 20.1
Male respondents were only asked
Not paid 58.2 14.4 51.4
questions on type of earning. Table 3.7.2
Missing 0.0 0.2 0.0
shows that only 3 in 10 employed men are paid
in cash. Eighty-four percent of men employed Total 100.0 100.0 100.0
in nonagricultural work are paid in cash Number of men 4,432 806 5,274
compared with 18 percent among those
Note: Total includes men with missing information on type of
engaged in agricultural work. employment who are not shown separately.

Characteristics of Respondents | 45
 
FERTILITY 4
Fertility is one of the three principal components of population dynamics that determine the
size and structure of the population of a country. This chapter presents the 2005 EDHS results on the
levels, trends, and differentials in fertility. The analysis is based on birth history information collected
from women age 15-49 interviewed during the survey. Each eligible woman was asked a series of
questions on the number of sons and daughters who were living with her, the number living
elsewhere, and the number who had died, in order to obtain the total number of live births she had had
in her lifetime. For each live birth, information was also collected on the name, sex, age and survival
status of the child. For dead children, age at death was recorded. Information from the birth history is
then used to assess current and completed fertility and factors related to fertility such as age at first
birth, birth intervals, and adolescent childbearing.

4.1 CURRENT FERTILITY

Measures of current fertility are presented in Table 4.1 Current fertility


Table 4.1 for the three-year period preceding the
Age-specific and total fertility rate, the general fertility
survey, corresponding to the calendar period 2003-
rate and the crude birth rate for the three years
2005. A three-year period was chosen because it preceding the survey, by residence, Ethiopia 2005
reflects the most current information, while also
allowing the rates to be calculated on a sufficient Residence

number of cases so as not to compromise the statistical Age group Urban Rural Total

precision of the estimate. 15-19 35 122 104


20-24 105 260 228
Several measures of current fertility are 25-29 133 261 241
shown. Age-specific fertility rates (ASFRs), expressed 30-34 101 253 231
35-39 58 178 160
as the number of births per thousand women in a
40-44 28 94 84
specified age group, are calculated by dividing the 45-49 14 38 34
number of live births to women in a specific age group
by the number of woman-years lived in that age group TFR (15-49) 2.4 6.0 5.4
The total fertility rate (TFR) is a common measure of GFR 77 200 179
current fertility and is defined as the total number of CBR 23.4 37.3 35.7
births a woman would have by the end of her Note: Age-specific fertility rates are per 1,000 women.
childbearing period if she were to pass through those Rates for age group 45-49 may be slightly biased due to
years bearing children at the currently observed age- truncation.
TFR: Total fertility rate for ages 15-49, expressed per
specific fertility rates. The general fertility rate (GFR) woman
is the number of live births occurring during a GFR: General fertility rate (births divided by the number
specified period per 1,000 women age 15-44. The of women age 15-44), expressed per 1,000 women
crude birth rate (CBR) is the number of births per CBR: Crude birth rate, expressed per 1,000 population
1,000 population during a specified period.

Table 4.1 shows current fertility levels for Ethiopia as a whole, and for urban and rural areas.
The total fertility rate for Ethiopia is 5.4 births per woman. As expected, fertility is considerably
higher in the rural areas than urban areas. The TFR in the rural areas is 6.0, two and half times higher
than the TFR in the urban areas (2.4). As the ASFRs show, this pattern of higher rural fertility is
prevalent in all age groups (Figure 4.1). The urban-rural difference in fertility is especially
pronounced among women age 20-34.

The overall age pattern of fertility as reflected in the ASFRs indicates that childbearing begins
early. Fertility is low among adolescents and increases to a peak of 241 births per 1,000 among
women age 25-29 and declines thereafter.

Fertility | 47
Figure 4.1 Age-specific Fertility Rates by Urban-Rural Residence

Births per 1,000 Women


300


250

200

150


100  

50 



0
15-19 20-24 25-29 30-34 35-39 40-44 45-49

Age Group
 Urban Rural Total EDHS 2005

4.2 FERTILITY DIFFERENTIALS

Table 4.2 and Figure 4.2 present differentials in the total fertility rates, the percentage of
women who are currently pregnant and the mean number of children ever born (CEB) to women age
40-49, by residence, region, education and wealth quintile.

There are substantial differentials in fertility among regions, ranging from a low of 1.4
children per woman in Addis Ababa to a high of 6.2 children per woman in Oromiya. With the
exception of Oromiya, Somali and SNNP, fertility levels in the other 8 regions are less than the
national average. The level of fertility is inversely related to women’s educational attainment,
decreasing rapidly from 6.1 children among women with no education to 2.0 children among women
who have at least some secondary education. Fertility is also associated with wealth quintile. Women
in the lowest wealth quintile have a TFR of 6.6, twice as high as that of women in the highest quintile
(3.2).

Table 4.2 also presents a crude assessment of trends in the various subgroups by comparing
current fertility with a measure of completed fertility: the mean number of children ever born to
women age 40-49. The mean number of children ever born to older women who are nearing the end
of their reproductive period is an indicator of average completed fertility of women who began
childbearing during the three decades preceding the survey. If fertility remained constant over time
and the reported data on both children ever born and births during the three years preceding the survey
are reasonably accurate, the TFR and the mean number of children ever born for women 40-49 are
expected to be similar. When fertility levels have been falling, the TFR will be substantially lower
than the mean number of children ever born among women age 40-49. The comparison suggests that
fertility has fallen by more than one child during the past few decades, from 6.9 children per woman
to 5.4. Fertility has declined in both rural and urban areas, in all regions, at all educational levels, and
for all wealth quintiles. The difference between the level of current and completed fertility is highest
in Addis Ababa (3 children), in all urban areas (2.7 children), and among women in the highest wealth
quintile (2.7 children).

48 | Fertility
Table 4.2 Fertility by background characteristics

Total fertility rate for the three years preceding the survey, percentage
of women currently pregnant, and mean number of children ever
born to women age 40-49 years, by background characteristics,
Ethiopia 2005

Mean number
Total Percentage of children ever
Background fertility currently born to women
characteristic rate pregnant1 age 40-49
Residence
Urban 2.4 2.5 5.1
Rural 6.0 9.7 7.3
Region
Tigray 5.1 8.6 6.8
Affar 4.9 8.9 5.8
Amhara 5.1 7.2 7.0
Oromiya 6.2 9.0 7.1
Somali 6.0 10.0 6.7
Benishangul-Gumuz 5.2 10.2 6.7
SNNP 5.6 10.2 7.5
Gambela 4.0 8.3 5.3
Harari 3.8 6.7 5.2
Addis Ababa 1.4 1.5 4.4
Dire Dawa 3.6 3.9 5.6
Education
No education 6.1 10.1 7.1
Primary 5.1 6.7 5.8
Secondary and higher 2.0 2.2 4.2
Wealth quintile
Lowest 6.6 10.2 6.9
Second 6.0 11.0 7.0
Middle 6.2 10.5 7.4
Fourth 5.7 8.3 7.6
Highest 3.2 3.8 5.9

Total 5.4 8.4 6.9


1
Women age 15-49 years

Figure 4.2 Total Fertility Rates by


Background Characteristics

ETHIOPIA 5.4
RESIDENCE
Urban 2.4
Rural 6.0
REGION
Tigray 5.1
Affar 4.9
Amhara 5.1
Oromiya 6.2
Somali 6.0
Benishangul-Gumuz 5.2
SNNP 5.6
Gambela 4.0
Harari 3.8
Addis Ababa 1.4
Dire Dawa 3.6
EDUCATION
No education 6.1
Primary 5.1
Secondary and higher 2.0
0.0 2.0 4.0 6.0 8.0
Number of Children
EDHS 2005

Fertility | 49
Table 4.2 shows the percentage of women who reported being pregnant at the time of the
survey. This percentage may be underreported since women may not be aware of a pregnancy,
especially at the very early stages, and some women who are early in their pregnancy may not want to
reveal that they are pregnant. Eight percent of women were pregnant at the time of the survey. Rural
women were almost four times as likely to be pregnant as urban women. The proportion of women
currently pregnant declines as the level of education rises. Current pregnancy is highest in
Benishangul-Gumuz, SNNP and Somali and lowest in Addis Ababa.

Table 4.3 Trends in age-specific fertility rates


4.3 FERTILITY TRENDS

Age-specific fertility rates for five-year periods In addition to comparison of current and
preceding the survey, by mother's age at the time of completed fertility, trends in fertility can be assessed in
the birth, Ethiopia 2005
two other ways. First, the TFR from the 2005 EDHS
Number of years can be compared with estimates obtained in earlier
Mother's age preceding survey surveys. Second, fertility trends can be investigated
at birth 0-4 5-9 10-14 15-19 using retrospective data from the birth histories
15-19 109 160 186 168 collected in the same survey.
20-24 242 304 311 288
25-29 253 321 309 298 One way of examining trends in fertility over
30-34 240 281 290 [288]time is to compare age-specific fertility rates from the
35-39 166 220 [244] 2005 EDHS for successive five-year periods preceding
40-44 96 [141]
the survey, as presented in Table 4.3. The numerators
45-49 [35]
of the rates are classified by five-year segments of time
Note: Age-specific fertility rates are per 1,000 women. preceding the survey and the mother’s age at the time
Estimates in brackets are truncated.
of survey. Because women 50 years and over were not
interviewed in the survey, the rates for older age groups
become progressively more truncated for periods more distant from the survey date. For example,
rates cannot be calculated for women age 35-39 for the period 15-19 years before the survey because
these women would have been over age 50 at the time of the survey and were not interviewed.

Fertility has fallen substantially among all age groups over the past two decades. This decline
is most obvious in the 15 years preceding the survey, with the largest decline observed between the
two most recent five-year periods. Fertility decline is steepest among the youngest cohort, with a 35
percent decline between the period 15-19 years before the survey and the period 0-4 years before the
survey. The decline in fertility observed in Ethiopia
can be attributed in part to increasing use of contracep- Table 4.4 Trends in age-specific and total fertility rates
tion, which will be discussed in the next chapter. Trends in age-specific and total fertility rates, Ethiopia

Another way to assess fertility trends is to NFFS EDHS EDHS


compare estimates obtained in earlier surveys. Table Age group 19901 20002 2005

4.4 presents the ASFRs and TFRs from the 1990 15-19 95 100 104
NFFS, the 2000 EDHS, and the 2005 EDHS. 20-24 275 235 228
25-29 289 251 241
There has been a decline in fertility from 6.4 30-34 257 243 231
35-39 199 168 160
births per woman in the 1990 NFFS to 5.4 births in the
40-44 105 89 84
2005 EDHS, a one-child drop in the past 15 years. The 45-49 56 19 34
decline in fertility was more pronounced in the 10
years between 1990 and 2000 than in the five years TFR 6.4 5.5 5.4
between 2000 and 2005 and more pronounced in
Note: Rates for NFFS 1990 are for the 12 months
urban than rural areas. A comparison of the three-year preceding the survey; rates for EDHS 2000 and EDHS
TFR calculated from the 2000 EDHS and the 2005 2005 are for the three years prior to the survey.
1
EDHS shows little change for the country as a whole CSA, 1993
2
CSA and ORC Macro, 2001

50 | Fertility
(5.5 births in 2000 versus 5.4 births in 2005).1 With the exception of the 15-19 age group, fertility has
declined in every age group over the past 15 years, with the largest decline—nearly 40 percent—
among the oldest cohort (age 45-49).

4.4 CHILDREN EVER BORN AND SURVIVING

Data on the number of children ever born reflect the accumulation of births over the past 30
years and therefore have limited relevance to current fertility levels, particularly when the country has
experienced a decline in fertility. Moreover, the data are subject to recall error, which is typically
greater for older than younger women. Nevertheless, the information on children ever born (or parity)
is useful in looking at a number of issues. The parity data show how average family size varies across
age groups. The percentage of women in their forties who have never had children also provides an
indicator of the level of primary infertility or the inability to bear children.2 Voluntary childlessness is
rare in developing countries like Ethiopia, so that married women in their late forties with no live
births are predominantly those involuntarily so. Comparison of the differences in the mean number of
children ever born and surviving reflects the cumulative effects of mortality levels during the period
in which women have been bearing children.

Table 4.5 shows the percent distribution of all women and currently married women by
number of children ever born and mean number of children surviving. More than four-fifths of
women age 15-19 (86 percent) have never given birth. However, this proportion declines to 13
percent for women age 25-29 and to 6 percent or less among women age 30 and above, indicating that
childbearing among Ethiopian women is nearly universal. On the average, Ethiopian women nearing
the end of their reproductive years have attained a parity of 7.3 children. This is 1.9 children more
than the total fertility rate, a difference brought about by the dramatic decline in fertility during the
1980s and 1990s.

Table 4.5 Children ever born and living

Percent distribution of all women and currently married women by number of children ever born, and mean number of children ever born and
mean number of living children, according to age group, Ethiopia 2005
Mean Mean
Number number of number of
Number of children ever born of children children
Age 0 1 2 3 4 5 6 7 8 9 10+ Total women ever born living
ALL WOMEN

15-19 86.4 9.9 3.1 0.4 0.1 0.0 0.0 0.0 0.0 0.0 0.0 100.0 3,266 0.18 0.15
20-24 39.7 26.2 19.6 9.6 3.8 0.8 0.3 0.0 0.0 0.0 0.0 100.0 2,547 1.15 1.01
25-29 12.8 11.4 17.2 22.5 18.7 10.5 4.6 1.5 0.6 0.1 0.0 100.0 2,517 2.85 2.50
30-34 5.9 4.7 7.8 12.6 16.8 18.9 16.5 9.3 4.4 2.2 0.8 100.0 1,808 4.48 3.81
35-39 2.7 3.0 4.8 7.3 11.4 13.0 17.9 13.9 14.2 6.0 5.7 100.0 1,602 5.78 4.74
40-44 2.7 2.3 4.5 4.6 6.0 9.3 13.4 17.7 14.9 11.5 13.0 100.0 1,187 6.63 5.25
45-49 1.6 2.5 4.0 3.6 5.2 9.8 11.3 12.4 13.9 12.2 23.6 100.0 1,143 7.25 5.50
Total 31.0 10.4 9.6 9.0 8.5 7.5 7.1 5.5 4.7 3.0 3.8 100.0 14,070 3.14 2.59

CURRENTLY MARRIED WOMEN

15-19 45.1 38.4 13.9 1.9 0.6 0.0 0.0 0.0 0.0 0.0 0.0 100.0 711 0.75 0.64
20-24 12.7 35.0 29.5 15.1 5.9 1.3 0.4 0.0 0.0 0.0 0.0 100.0 1,574 1.72 1.52
25-29 3.1 10.0 18.4 25.7 21.9 12.6 5.6 1.8 0.8 0.1 0.0 100.0 2,066 3.28 2.90
30-34 2.2 3.3 7.1 12.2 17.5 20.2 18.3 10.7 5.0 2.5 1.0 100.0 1,551 4.82 4.13
35-39 1.0 1.4 2.9 6.7 10.5 13.2 19.6 15.8 15.8 6.4 6.7 100.0 1,343 6.18 5.10
40-44 2.5 2.3 3.9 3.4 4.7 8.1 12.6 18.7 15.8 12.4 15.6 100.0 960 6.92 5.54
45-49 1.3 2.3 3.8 2.5 4.3 8.6 11.4 11.6 14.8 13.0 26.6 100.0 862 7.54 5.81
Total 7.3 12.6 12.8 12.3 11.5 10.2 9.8 7.7 6.4 3.9 5.3 100.0 9,066 4.29 3.57

1
A comparison of the five-year TFR shows a similar pattern. For the country as a whole (5.9 births in 2000
versus 5.7 births in 2005), there has been little change over the past five years.
2
The data does not address the level of secondary infertility which refers to women who may have had one or
more births but are unable to have more children.

Fertility | 51
The same pattern is replicated for currently married women, except that the mean number of
children ever born is higher for currently married women (4.3 children) than for all women (3.1
children). The difference between all women and currently married women in the mean number of
children ever born is due to a substantial proportion of young and unmarried women in the former
category who exhibit lower fertility.

Consistent with expectations, the mean number of children ever born and mean number of
children surviving rise monotonically with increasing age of women. Comparison of the mean
children ever born with the mean number of living children reveals the experience of child loss among
Ethiopian women. By the end of their reproductive years (age 45-49), women in Ethiopia have given
birth, on average, to 7.3 children, with 5.5 surviving.

Voluntary childlessness is uncommon in Ethiopia and currently married women with no


children are likely to be those who are unable to bear children. The level of childlessness among
married women at the end of their reproductive period can be used as an indicator of the level of
primary sterility. In Ethiopia, primary sterility among older currently married women is less than 2
percent.

4.5 BIRTH INTERVALS

Birth interval is the length of time between two successive live births. Information on birth
intervals provides insight into birth spacing patterns, which affect fertility as well as infant and
childhood mortality. Studies have shown that children born too soon after a previous birth are at
increased risk of dying at an early age, particularly when the interval between births is less than 24
months.

Table 4.6 shows the percent distribution of non-first births in the five years preceding the
survey by number of months since the preceding birth, according to background characteristics. The
median birth interval in Ethiopia is 33.8 months. The median number of months since a preceding
birth increases significantly with age, from a low of 26.1 months among mothers age 15-19 to a high
of 38.8 months among mothers age 40-49.

There is no substantial difference in the length of the median birth interval by birth order and
sex of the preceding birth.

Studies have shown that the death of a preceding child leads to a shorter birth interval than
when the preceding child survived. The median birth interval is more than eight months shorter for
children whose previous sibling is dead than for children whose previous sibling is alive (26.1 months
and 34.6 months, respectively). It is presumed that the difference in the birth intervals is related to the
desire of parents to replace a dead child, as well as to the loss of the fertility-delaying effects of
breastfeeding.

According to the 2005 EDHS data, urban women have slightly longer intervals between births
(39.1 months) compared with rural women (33.6 months).

Regional variations in birth intervals range from a low of 29 months in Affar to a high of 45.2
months in Addis Ababa. The median birth interval is longer among births to women with at least
some secondary education than among births to women with lower levels of education. The birth
interval does not vary consistently by wealth quintile.

52 | Fertility
Table 4.6 Birth intervals

Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, according to background
characteristics, Ethiopia 2005
Median
number of
months
Number since
Background Months since preceding birth of non- preceding
characteristic 7-17 18-23 24-35 36-47 48-54 55-59 60+ Total first births birth
Age
15-19 21.4 18.8 44.5 10.7 4.6 0.0 0.0 100.0 144 26.1
20-29 10.1 15.3 36.6 23.2 6.6 2.7 5.4 100.0 4,002 31.6
30-39 6.7 11.8 34.6 25.4 7.2 3.9 10.5 100.0 3,930 35.0
40-49 5.3 9.7 27.5 25.7 9.5 4.8 17.4 100.0 1,150 38.8
Birth order
2-3 8.7 13.8 34.3 24.1 6.8 3.2 9.1 100.0 3,347 33.5
4-6 8.3 12.8 35.3 24.0 7.2 3.7 8.6 100.0 3,659 33.6
7+ 7.5 12.6 34.4 25.0 7.7 3.4 9.5 100.0 2,220 34.3
Sex of preceding birth
Male 8.2 13.0 34.9 24.4 7.4 3.2 8.9 100.0 4,711 33.7
Female 8.3 13.3 34.6 24.2 6.9 3.7 9.1 100.0 4,515 33.8
Survival of preceding birth
Living 6.1 12.2 35.7 25.6 7.5 3.6 9.3 100.0 8,026 34.6
Dead 22.3 19.4 28.5 15.4 5.1 2.1 7.2 100.0 1,201 26.1
Residence
Urban 9.0 11.5 24.6 16.9 8.9 2.7 26.5 100.0 551 39.1
Rural 8.2 13.2 35.4 24.8 7.1 3.5 7.9 100.0 8,675 33.6
Region
Tigray 4.0 9.2 38.8 25.7 8.5 3.0 10.9 100.0 578 35.2
Affar 14.3 17.2 33.9 17.3 6.4 1.3 9.6 100.0 87 29.0
Amhara 5.4 8.5 31.5 30.4 8.4 4.0 11.7 100.0 2,109 37.0
Oromiya 9.3 16.3 37.4 21.7 5.5 2.9 7.0 100.0 3,719 31.0
Somali 13.4 19.0 31.4 18.5 6.7 2.3 8.8 100.0 402 29.6
Benishangul-Gumuz 9.8 14.2 35.8 22.7 6.2 3.1 8.2 100.0 83 32.2
SNNP 9.3 11.9 33.5 24.2 8.6 4.3 8.2 100.0 2,093 34.5
Gambela 6.0 10.1 27.4 23.6 11.1 5.6 16.2 100.0 25 38.2
Harari 10.8 17.1 31.4 18.9 5.4 2.1 14.2 100.0 16 31.4
Addis Ababa 5.0 12.3 19.4 17.3 10.4 3.6 32.1 100.0 86 45.2
Dire Dawa 8.9 17.0 32.5 20.9 6.3 0.3 14.0 100.0 28 31.5
Education
No education 7.9 13.3 34.8 24.9 7.1 3.4 8.5 100.0 7,459 33.8
Primary 9.3 12.6 36.3 22.7 7.1 3.6 8.4 100.0 1,462 32.8
Secondary and higher 10.5 11.5 24.9 17.1 8.6 3.0 24.5 100.0 305 38.7
Wealth quintile
Lowest 9.2 14.9 36.1 23.0 7.5 3.0 6.4 100.0 2,079 32.3
Second 7.4 12.1 35.7 25.2 6.7 3.7 9.2 100.0 1,956 34.0
Middle 7.8 13.3 34.1 24.8 7.2 4.4 8.3 100.0 2,070 34.1
Fourth 8.4 12.8 35.8 24.9 6.8 3.5 7.8 100.0 1,850 33.7
Highest 8.3 12.2 30.6 23.4 7.9 2.0 15.6 100.0 1,272 35.5

Total 8.2 13.1 34.7 24.3 7.2 3.4 9.0 100.0 9,226 33.8

Note: First-order births are excluded from this table. The interval for multiple births is the number of months since the preceding pregnancy that
ended in a live birth.

4.6 AGE AT FIRST BIRTH

Early age at initiation of childbearing has a detrimental effect on the health of both mother
and child. It also lengthens the reproductive period, thereby increasing the level of fertility. Table 4.7
shows the median age at first birth and the percentage of women who first gave birth by specific exact
ages, by five-year age groups.

Fertility | 53
Table 4.7 Age at first birth

Percentage of women who gave birth by specific exact ages, and median age at first birth, by current age,
Ethiopia 2005
Percentage
who have
Percentage who gave birth by exact age
Current never given Number of Median age
age 15 18 20 22 25 birth women at first birth

15-19 1.7 na na na na 86.4 3,266 a


20-24 5.4 28.4 46.1 na na 39.7 2,547 a
25-29 8.5 38.0 58.1 73.0 83.3 12.8 2,517 19.2
30-34 10.0 40.9 59.7 74.9 87.6 5.9 1,808 18.9
35-39 9.9 40.3 58.3 75.2 89.1 2.7 1,602 19.0
40-44 11.2 41.2 60.3 74.7 86.8 2.7 1,187 19.0
10.5 45.4 60.3 73.4 86.7 1.6 1,143 18.7
45-49
na = Not applicable
a = Omitted because less than 50 percent of women had a birth before reaching the beginning of the age group

Childbearing begins early in Ethiopia. The median age at first birth is 19.2 years for the
younger cohort (age 25-29) of women for whom a median age can be computed and varies between
18.7 and 19.0 years for the older cohorts. This suggests a small, recent rise in the median age at first
birth. An examination of the percentage of women in various age groups who had a first birth by
specific exact age indicates that the percentage increases as the exact age increases, as expected. The
proportion of women in the age group 20-24 who had their first birth by exact age 20 (46 percent), for
instance, is higher than by exact age 15 (5 percent) and 18 (28 percent). The data also show some
evidence of a trend toward delayed onset of childbearing among younger women; for example, 41
percent of women age 30 and above had their first birth by exact age 18 while 28 percent and 38
percent of women in the age groups 20-24 and 25-29, respectively, had started childbearing at the
same age.

Table 4.8 shows median age at first birth by background characteristics and age at the time of
the survey. The median age at first birth is higher in urban areas than in rural areas, with a difference
of almost two years among women age 25-49. According to the data the urban-rural difference in
median age at first birth is much wider among younger (25-29) than older women. Among regions,
Addis Ababa has the highest median age at first birth (23.5 years) for women age 25-49, followed by
Harari (21.0 years), while the Amhara Region has the lowest median age at first birth (18 years). This
indicates that women in the Amhara Region initiated childbearing more than five years earlier on
average than women in Addis Ababa.

There is a positive relationship between educational attainment and median age at first birth,
but the impact seems more significant at secondary and higher levels of education. Women with at
least secondary education begin their childbearing more than four years (22.9 years) later than women
with no education (18.7 years). Although the median age at first birth is consistently the highest
among the wealthiest women, there is no clear pattern between the onset of childbearing and women’s
wealth across age groups except among the younger cohort (25-29).

54 | Fertility
Table 4.8 Median age at first birth by background characteristics

Median age at first birth among women age 25-49 years, by current age and back-
ground characteristics, Ethiopia 2005

Current age Women


Background age
characteristic 25-29 30-34 35-39 40-44 45-49 25-49
Residence
Urban 23.6 21.0 20.0 18.8 19.3 20.7
Rural 18.8 18.7 18.9 19.0 18.5 18.8

Region
Tigray 19.5 19.0 18.6 18.7 18.9 19.0
Affar 18.8 17.9 19.2 21.1 20.3 19.5
Amhara 18.1 18.3 18.0 18.1 17.6 18.0
Oromiya 19.1 18.9 19.7 19.3 18.9 19.2
Somali 18.8 18.6 20.8 21.1 22.8 20.0
Benishangul-Gumuz 17.9 18.0 18.5 18.2 17.1 18.1
SNNP 19.6 19.2 19.0 19.1 19.2 19.3
Gambela 17.8 18.2 18.8 17.9 17.3 18.1
Harari 22.9 20.7 20.0 19.6 20.4 21.0
Addis Ababa a 25.8 22.3 19.3 19.5 23.5
Dire Dawa 21.5 20.1 19.1 19.1 19.3 19.9

Education
No education 18.8 18.6 18.7 18.9 18.6 18.7
Primary 18.7 18.6 19.9 19.9 18.8 18.9
Secondary and higher a 22.2 22.1 19.8 20.5 22.9

Wealth quintile
Lowest 18.7 18.7 18.9 19.6 20.5 19.0
Second 18.3 18.5 19.1 19.3 18.4 18.6
Middle 19.0 18.9 19.5 19.1 19.0 19.1
Fourth 19.0 18.7 18.0 18.4 17.8 18.5
Highest 21.5 19.8 19.2 18.7 18.7 19.8

Total 19.2 18.9 19.0 19.0 18.7 19.0

a = Omitted because less than 50 percent of the women had a birth before reaching
the beginning of the age group

4.7 TEENAGE PREGNANCY AND MOTHERHOOD

In addition to the relatively high level of pregnancy complications among young mothers
because of physiological immaturity, inexperience associated with child care practices also influences
maternal and infant health. Moreover, an early start to childbearing greatly reduces the educational
and employment opportunities of women and is associated with higher levels of fertility. Table 4.9
shows the proportion of women age 15-19 (teenagers) who are mothers or pregnant with their first
child, by background characteristics.

Fertility | 55
Table 4.9 Teenage pregnancy and motherhood

Percentage of women age 15-19 who have had a live birth or who are
pregnant with their first child, by background characteristics, Ethiopia 2005

Percentage who:
Are Percentage
pregnant who have
Background Have had with first begun Number
characteristic a live birth child childbearing of women

Age
15 1.5 0.4 1.9 729
16 4.9 3.2 8.1 667
17 10.9 3.1 14.0 556
18 20.4 4.3 24.7 862
19 36.1 4.7 40.8 451

Residence
Urban 6.0 0.6 6.6 703
Rural 15.6 3.7 19.4 2,562

Region
Tigray 12.9 1.8 14.7 229
Affar 14.6 5.7 20.3 31
Amhara 16.7 3.6 20.3 811
Oromiya 15.8 3.2 19.0 1,206
Somali 16.8 2.6 19.5 78
Benishangul-Gumuz 20.8 6.4 27.1 27
SNNP 8.1 2.9 11.0 652
Gambela 24.8 6.0 30.8 8
Harari 18.2 3.7 21.9 11
Addis Ababa 3.4 0.9 4.3 199
Dire Dawa 11.9 1.8 13.7 16

Education
No education 24.9 4.0 28.9 1,308
Primary 7.4 3.1 10.4 1,423
Secondary and higher 2.3 0.7 3.0 535

Wealth quintile
Lowest 19.7 4.1 23.8 448
Second 17.3 3.5 20.8 566
Middle 15.9 4.0 19.8 627
Fourth 13.9 4.5 18.3 603
Highest 7.2 1.0 8.2 1,022

Total 13.6 3.1 16.6 3,266

Seventeen percent of women age 15-19 have already become mothers or are currently
pregnant with their first child, which is similar to the pattern seen from data collected in the 2000
EDHS (16 percent). The percentage of women who have begun childbearing increases rapidly with
age, from 2 percent among women age 15, to 41 percent among women age 19. Nearly three times as
many teenagers residing in rural areas as in urban areas have begun childbearing. Childbearing among
teenagers is lowest in Addis Ababa (4 percent) and highest in the Gambela Region (31 percent). The
level of teenage parenthood among teenagers with no education is nearly three times that among
teenagers with primary education, while it is nearly ten times that of teenagers with secondary and
higher education. The percentage of teenagers who have begun childbearing is three times higher
among those in the poorest households (24 percent) compared with those in the wealthiest households
(8 percent).

56 | Fertility
FAMILY PLANNING 5
This chapter presents information from the 2005 EDHS on contraceptive knowledge, attitudes
and behaviour. Although the focus is on women, some results from the male survey are also presented
because men play an important role in the realization of reproductive goals. Comparisons are also
made, where appropriate, with findings from the 2000 EDHS to evaluate changes over the past five
years.

5.1 KNOWLEDGE OF CONTRACEPTIVE METHODS

Acquiring knowledge about family planning is an important step towards gaining access to
and using a suitable contraceptive method in a timely and effective manner. Individuals who have
adequate information about the available methods of contraception are better able to make choices
about planning their families. Thus, one of the main objectives of the 2005 EDHS was to obtain
information on knowledge of family planning methods among women and men in the reproductive
age. Data on knowledge of contraception was collected in two ways. First, respondents were asked to
mention all the methods of contraception that they had heard of spontaneously. For methods not
mentioned spontaneously, the interviewer described and probed for whether the respondent
recognized it.

Information was collected for 10 modern contraceptive methods: female and male
sterilization, the pill, the IUD, injectables, implants, condoms, diaphragm/foam/jelly, standard days
method and lactational amenorrhoea method (LAM), and two traditional methods (periodic abstinence
and withdrawal). In addition, provision was made in the questionnaire to record any other method
named spontaneously by the respondents.

Table 5.1 shows knowledge of contraception among all women age 15-49 and men age 15-59,
as well as among those who are currently married and those unmarried and sexually active.
Knowledge of contraceptive methods is high with 88 percent of currently married women and 93
percent of currently married men knowing at least one method of contraception. Modern methods are
more widely known than traditional methods. For example, 87 percent of currently married women
know of a modern method, and only 17 percent know of a traditional method. The pill is the most
widely known method (84 percent), followed closely by injectables (83 percent). Currently married
men are more than twice as likely to recognize the condom as a method of family planning as
currently married women (41 percent versus 84 percent).

The mean number of methods known is a rough indicator of the breadth of knowledge of
family planning methods. Using this as a measure, contraceptive knowledge is highest among
sexually active unmarried men (5.6 methods) and women (4.7 methods).

Overall, knowledge of contraception has remained high in Ethiopia over the past five years.
For example, knowledge of any modern method among currently married women was 85 percent in
2000 and 87 percent in 2005. Similarly, knowledge of any modern method among currently married
men was 90 percent in 2000 and 91 percent in 2005. The most notable increases in knowledge of
specific methods among currently married women are with respect to injectables and condoms—from
70 percent to 83 percent for injectables and from 29 percent to 41 percent for condoms between 2000
and 2005. Men also had significant gains in knowledge for these two methods.

Family Planning | 57
Table 5.1 Knowledge of contraceptive methods

Percentage of all women and men, currently married women and men, and sexually active unmarried women and
men who know any contraceptive method, by specific method, Ethiopia 2005
Women Men
Sexually Sexually
Currently active Currently active
All married unmarried All married unmarried
Method women women women1 men men men1
Any method 86.1 87.5 91.2 91.0 93.0 95.3

Any modern method 86.0 87.4 91.2 90.7 92.6 93.1


Female sterilisation 18.4 17.2 30.4 26.4 28.2 45.7
Male sterilisation 6.6 5.5 12.5 15.3 14.0 24.1
Pill 82.6 84.2 86.8 81.2 84.7 87.4
IUD 14.8 12.2 33.0 14.3 12.0 22.0
Injectables 80.9 82.6 87.4 79.0 82.9 89.5
Implants 22.4 20.0 47.3 23.0 22.3 40.0
Condom 46.1 40.6 69.8 84.2 84.2 90.1
Diaphragm/foam/jelly 5.9 4.4 4.5 8.8 6.3 16.3
Standard days method 4.3 3.4 4.7 6.3 5.3 11.6
Lactational amenorrhoea method
(LAM) 9.2 8.9 20.9 7.9 8.2 14.6

Any traditional method 20.6 17.0 53.2 39.2 39.3 70.6


Rhythm 18.0 14.4 48.2 34.9 34.2 69.9
Withdrawal 11.8 9.3 28.6 21.3 19.8 50.9
Folk method 0.6 0.6 0.0 1.5 1.9 0.7

Mean number of methods known 3.2 3.0 4.7 4.0 4.0 5.6

Number 14,070 9,066 52 6,033 3,424 72


1
Had sexual intercourse in the month preceding the survey

Table 5.2 shows the correspondence between the contraceptive knowledge of husbands and
wives among the 2,972 couples interviewed in the 2005 EDHS. Knowledge of at least one method of
contraception by both spouses is relatively high (84 percent). Among couples in which only one
partner knows of a method, husbands are more likely to know the method than their wives. The
discordance in knowledge with respect to specific modern methods is most noticeable for the
condom—which is twice as likely to be known by men as women—and sterilization, especially male
sterilization. Among married couples, men are also more likely to mention knowing a traditional
method than women (38 percent and 17 percent, respectively).

58 | Family Planning
Table 5.2 Couples' knowledge of contraceptive methods
Percent distribution of couples by contraceptive knowledge, according to specific methods,
Ethiopia 2005

Husband Wife
knows knows
method, method, Neither
Both know wife husband knows
Method method doesn't doesn't method Total
Any method 84.3 8.6 4.5 2.6 100.0

Any modern method 84.0 8.5 4.6 3.0 100.0


Female sterilisation 6.9 20.5 11.1 61.5 100.0
Male sterilisation 1.7 11.3 3.2 83.9 100.0
Pill 75.4 9.1 9.9 5.6 100.0
IUD 4.3 7.2 7.6 81.0 100.0
Injectables 73.6 9.2 10.5 6.8 100.0
Implants 7.6 14.1 13.0 65.4 100.0
Condom 41.9 42.2 4.0 11.8 100.0
Diaphragm/foam/jelly 0.6 5.4 3.4 90.7 100.0
Standard days method 0.3 4.6 2.7 92.5 100.0
Lactational amenorrhoea method
(LAM) 2.0 5.9 6.5 85.6 100.0

Any traditional method 10.6 27.8 6.2 55.5 100.0


Rhythm 8.0 25.3 6.3 60.4 100.0
Withdrawal 4.8 14.3 3.5 77.3 100.0

Other methods 0.0 1.5 0.7 97.8 100.0

Note: Table is based on 2,972 couples.

5.2 EVER USE OF CONTRACEPTIVE METHODS

Ever use of contraception provides a measure of the cumulative experience of a population


with family planning. The EDHS 2005 collected data on ever use of family planning methods from
women by asking respondents whether they had ever used each of the methods that they have heard
about.

Table 5.3.1 presents ever use of contraception among three groups of women: all women;
currently married women, and unmarried, sexually active women, by current age. The data indicate
that 18 percent of all women and 24 percent of currently married women have used a method at some
time. Women are much more likely to have used a modern method than a traditional method. For
example, 23 percent of currently married women have used a modern method at some time compared
with 2 percent who have used a traditional method. Injectables have been the most commonly used
modern method (18 percent) among currently married women. Rhythm has been the most widely
employed traditional method.

Among currently married women ever use of any method rises from 16 percent among those
age 15-19, peaks at 27 percent among those age 25-29, and remains consistently high until age 40-44,
before falling markedly to 14 percent among the oldest age group.

Although based on a small number of cases, ever use of any method is highest among
sexually active unmarried women. Sixty-five percent of sexually active unmarried women have used a
contraceptive method at some time in the past.

Family Planning | 59
Table 5.3.1 Ever use of contraception: women

Percentage of all women, currently married women, and sexually active unmarried women who have ever used any contraceptive method, by
specific method and age, Ethiopia 2005

Modern method Any Traditional method


Any Female Standard tradi-
Any modern sterili- Inject- days tional With- Folk Number
Age method method sation Pill IUD ables Implants Condom method LAM method Rhythm drawal method of women
ALL WOMEN

15-19 4.7 4.5 0.0 1.4 0.0 3.2 0.0 0.7 0.0 0.0 0.5 0.4 0.1 0.0 3,266
20-24 18.9 17.7 0.0 9.3 0.2 13.2 0.3 1.5 0.0 0.0 2.7 2.4 0.6 0.0 2,547
25-29 25.6 24.4 0.1 11.7 0.2 18.7 0.4 0.9 0.0 0.6 2.8 2.1 1.0 0.2 2,517
30-34 24.7 23.9 0.2 12.4 0.6 18.1 0.2 1.4 0.0 0.6 2.3 1.7 0.8 0.1 1,808
35-39 24.5 23.9 0.2 13.9 1.0 16.7 0.6 0.5 0.0 0.5 1.8 1.2 0.7 0.1 1,602
40-44 23.9 23.2 0.6 12.6 0.9 16.3 0.3 0.8 0.0 0.6 2.1 1.5 0.7 0.2 1,187
45-49 13.8 12.6 0.5 7.2 0.9 7.7 0.1 0.4 0.0 0.1 1.9 1.1 0.7 0.4 1,143

Total 18.2 17.4 0.2 8.9 0.4 12.7 0.2 0.9 0.0 0.3 1.9 1.5 0.6 0.1 14,070

CURRENTLY MARRIED WOMEN

15-19 16.1 15.6 0.0 5.4 0.0 11.6 0.0 1.0 0.0 0.0 1.3 0.9 0.4 0.0 711
20-24 25.7 24.3 0.0 13.3 0.3 19.1 0.2 0.9 0.1 0.0 3.7 3.3 0.9 0.0 1,574
25-29 27.1 26.1 0.0 12.7 0.2 20.6 0.4 0.4 0.0 0.7 2.4 1.8 0.9 0.2 2,066
30-34 25.4 24.8 0.0 12.9 0.7 18.8 0.2 1.1 0.0 0.6 2.3 1.7 0.9 0.1 1,551
35-39 25.2 24.8 0.2 14.1 1.2 18.0 0.6 0.5 0.0 0.5 1.6 1.0 0.8 0.1 1,343
40-44 26.5 25.8 0.6 13.6 0.9 19.2 0.4 0.6 0.0 0.5 2.1 1.5 0.6 0.2 960
45-49 13.8 12.8 0.6 6.8 1.0 8.8 0.2 0.3 0.0 0.1 1.7 1.1 0.7 0.2 862

Total 24.1 23.2 0.2 12.0 0.6 17.7 0.3 0.7 0.0 0.4 2.3 1.7 0.8 0.1 9,066

SEXUALLY ACTIVE UNMARRIED WOMEN1

15-24 62.2 51.7 0.0 16.8 0.0 12.9 0.0 42.3 0.0 0.0 15.0 13.5 1.5 0.0 28
25-49 68.7 55.5 0.0 25.8 0.0 37.7 0.4 29.7 0.0 0.0 16.7 16.7 0.4 0.0 25

Total 65.3 53.5 0.0 21.1 0.0 24.6 0.2 36.4 0.0 0.0 15.8 15.0 1.0 0.0 52

LAM = Lactational amenorrhoea method


1
Had sexual intercourse in the month preceding the survey

The 2005 EDHS collected information on ever use of contraception from men as well as
women, but with respect to the four male methods only, namely male sterilization, condoms, the
rhythm method, and withdrawal. Table 5.3.2 shows that 19 percent of currently married men have
used a male method of contraception at some time. Men have been more likely to use a traditional
method, particularly rhythm (14 percent), than a modern method. Five percent of currently married
men have used a condom at some time. Ever use of any method among currently married men rises
from 14 percent among the youngest men to a peak of 23 percent among men 25-29 and then falls
steadily to a low of 10 percent among those in the oldest cohort.

60 | Family Planning
Table 5.3.2 Ever use of contraception: men

Percentage of all men, currently married men, and sexually active unmarried men who have ever used
any contraceptive method, by specific method and age, Ethiopia 2005

Ever used Traditional


Ever used condom Modern method Ever used method
any of or male Male rhythm or
four male sterili- sterili- with- With- Number
Age methods sation sation Condom drawal Rhythm drawal of men
ALL MEN

15-19 3.1 2.3 0.1 2.2 1.2 0.9 0.3 1,335


20-24 13.3 9.7 0.2 9.5 7.2 5.7 2.8 1,064
25-29 21.9 10.8 0.2 10.6 16.2 14.5 6.2 741
30-34 23.9 10.0 0.1 9.9 18.7 15.6 7.5 754
35-39 20.7 7.0 0.6 6.6 16.7 14.7 3.9 651
40-44 20.2 6.9 0.4 6.5 17.3 14.6 4.8 497
45-49 15.2 4.1 0.3 3.8 13.1 11.8 2.5 422
50-54 10.9 1.9 0.5 1.3 10.6 8.8 4.1 335
55-59 9.9 1.9 0.8 1.1 8.1 6.7 2.1 235

Total 14.7 6.6 0.3 6.3 10.9 9.3 3.6 6,033

CURRENTLY MARRIED MEN

15-19 13.5 3.5 0.0 3.5 11.7 10.2 6.7 28


20-24 19.6 7.8 0.0 7.7 16.3 13.2 5.6 255
25-29 23.2 7.7 0.2 7.5 20.2 18.4 7.5 482
30-34 22.6 7.1 0.0 7.1 19.3 16.6 7.1 646
35-39 20.1 5.7 0.4 5.3 17.0 15.0 3.8 610
40-44 19.3 5.2 0.4 4.8 16.7 13.9 4.3 468
45-49 14.8 3.7 0.3 3.4 12.8 11.6 2.2 399
50-54 11.1 1.6 0.6 1.1 11.0 9.4 4.2 310
55-59 9.6 2.0 0.8 1.2 7.8 6.3 2.2 225

Total 18.7 5.5 0.3 5.2 16.1 14.0 4.9 3,424

SEXUALLY ACTIVE UNMARRIED MEN1

15-24 46.6 34.3 0.9 34.3 21.0 18.4 7.6 46


25-59 72.9 68.0 0.2 68.0 42.8 23.2 33.3 26

Total 56.2 46.5 0.6 46.5 28.9 20.2 16.9 72


1
Had sexual intercourse in the month preceding the survey

5.3 CURRENT USE OF CONTRACEPTIVE METHODS

The current level of contraceptive use is a measure of actual contraceptive practice at the time
of the survey. It takes into account all use of contraception, whether the concern of the user is
permanent cessation of childbearing or a desire to space births. Current use of family planning
services provides insight into one of the principal determinants of fertility. It also serves to assess the
success of family planning programmes. This section focuses on the levels, differentials, and trends in
current use of family planning methods in Ethiopia.

Contraceptive use among all women, currently married women, and sexually active
unmarried women, is presented in Table 5.4 by age group. The contraceptive prevalence rate for
married Ethiopian women who are currently using a method of family planning is 15 percent. Almost
all of these users are using modern methods. The most widely used method is injectables (10 percent)
followed by the pill (3 percent).

Family Planning | 61
Table 5.4 Current use of contraception

Percent distribution of all women, currently married women, and sexually active unmarried women by contraceptive method currently used, according
to age, Ethiopia 2005

Traditional
Modern method Any method
Any Female tradi- Not
Any modern sterili- Inject- tional With- currently Number of
Age method method sation Pill IUD ables Implants Condom LAM method Rhythm drawal using Total women
ALL WOMEN

15-19 2.5 2.5 0.0 0.3 0.0 1.8 0.0 0.3 0.0 0.1 0.0 0.1 97.5 100.0 3,266
20-24 11.4 10.4 0.0 2.3 0.1 7.3 0.1 0.5 0.0 1.1 0.9 0.2 88.6 100.0 2,547
25-29 15.2 14.4 0.1 3.3 0.1 10.0 0.2 0.3 0.4 0.8 0.6 0.2 84.8 100.0 2,517
30-34 13.2 12.6 0.2 2.4 0.1 9.4 0.2 0.2 0.0 0.7 0.5 0.1 86.8 100.0 1,808
35-39 15.3 14.4 0.2 3.9 0.5 9.1 0.4 0.2 0.2 0.9 0.6 0.3 84.7 100.0 1,602
40-44 11.9 11.1 0.6 1.9 0.3 8.0 0.1 0.2 0.0 0.8 0.6 0.2 88.1 100.0 1,187
45-49 6.3 5.7 0.5 1.0 0.3 3.9 0.0 0.0 0.0 0.5 0.5 0.0 93.7 100.0 1,143

Total 10.3 9.7 0.2 2.1 0.1 6.8 0.1 0.3 0.1 0.7 0.5 0.2 89.7 100.0 14,070

CURRENTLY MARRIED WOMEN

15-19 8.9 8.6 0.0 1.3 0.0 7.0 0.0 0.3 0.0 0.3 0.0 0.3 91.1 100.0 711
20-24 16.7 15.4 0.0 3.7 0.1 11.2 0.2 0.1 0.0 1.3 1.0 0.3 83.3 100.0 1,574
25-29 16.9 16.2 0.0 3.9 0.1 11.3 0.2 0.2 0.5 0.7 0.4 0.3 83.1 100.0 2,066
30-34 14.4 13.7 0.0 2.8 0.1 10.3 0.2 0.2 0.0 0.7 0.5 0.2 85.6 100.0 1,551
35-39 17.2 16.4 0.2 4.3 0.5 10.5 0.4 0.1 0.3 0.9 0.5 0.4 82.8 100.0 1,343
40-44 14.2 13.2 0.6 2.1 0.4 9.8 0.2 0.1 0.0 1.0 0.7 0.3 85.8 100.0 960
45-49 8.1 7.4 0.6 1.3 0.4 5.0 0.0 0.0 0.0 0.7 0.7 0.0 91.9 100.0 862

Total 14.7 13.9 0.2 3.1 0.2 9.9 0.2 0.2 0.2 0.8 0.6 0.3 85.3 100.0 9,066

SEXUALLY ACTIVE UNMARRIED WOMEN1

15-24 60.7 48.9 0.0 4.4 0.0 8.4 0.0 36.1 0.0 11.8 11.8 0.0 39.3 100.0 28
25-49 48.3 36.9 0.0 1.7 0.0 26.4 0.0 8.8 0.0 11.4 11.4 0.0 51.7 100.0 25

Total 54.9 43.3 0.0 3.1 0.0 16.9 0.0 23.3 0.0 11.6 11.6 0.0 45.1 100.0 52

Note: If more than one method is used, only the most effective method is considered in this tabulation.
LAM = Lactational amenorrhoea method
1
Had sexual intercourse in the month preceding the survey

Use of contraception among the small number of sexually active unmarried women is higher
than among all women and currently married women. Fifty-five percent of sexually active unmarried
women are currently using contraception, with 43 percent using modern methods and 12 percent using
traditional methods. The difference in use of modern methods among unmarried sexually active
women and all other women may be attributed primarily to the greater use of condoms and
injectables.

As shown in Table 5.5, there are marked differences in the contraceptive prevalence rate
among currently married women by background characteristics. Contraceptive use is associated with
the number of living children a woman has; it is highest among currently married women with one or
two children (17 percent) and lowest among women with no children (12 percent).

As expected, contraceptive prevalence is more than four times higher in urban than in rural
areas (47 percent versus 11 percent). There is also substantial variation in current use by region.
Current use is highest in Addis Ababa (57 percent) and lowest in the Somali Region (3 percent).
Urbanized areas like Dire Dawa and Harari also have much higher levels of current use (34 percent
each) than the other regions.

62 | Family Planning
Table 5.5 Current use of contraception by background characteristics

Percent distribution of currently married women by contraceptive method currently used, according to background characteristics, Ethiopia 2005

Traditional
Modern method Any method
Any Female Male tradi- Not Number
Background Any modern sterili- Inject- Im- con- tional With- currently of
characteristic method method sation Pill IUD ables plants dom LAM method Rhythm drawal using Total women
Number of living
children
0 11.7 10.1 0.0 3.5 0.0 5.5 0.0 1.1 0.0 1.6 1.6 0.0 88.3 100.0 600
1-2 16.5 15.4 0.2 3.7 0.3 10.8 0.2 0.2 0.1 1.0 0.7 0.4 83.5 100.0 2,662
3-4 14.8 14.1 0.1 3.4 0.2 10.1 0.1 0.0 0.2 0.8 0.6 0.2 85.2 100.0 2,645
5+ 13.7 13.2 0.3 2.3 0.2 9.8 0.3 0.1 0.3 0.5 0.3 0.3 86.3 100.0 3,159

Residence
Urban 46.7 42.2 1.3 10.7 1.8 25.9 0.7 1.4 0.4 4.5 3.7 0.8 53.3 100.0 959
Rural 10.9 10.6 0.0 2.2 0.0 8.0 0.1 0.0 0.1 0.4 0.2 0.2 89.1 100.0 8,107

Region
Tigray 16.5 16.2 0.0 2.9 0.0 13.1 0.1 0.1 0.0 0.3 0.3 0.0 83.5 100.0 570
Affar 6.6 6.0 0.0 1.3 0.0 4.5 0.0 0.2 0.0 0.6 0.6 0.0 93.4 100.0 109
Amhara 16.1 15.7 0.1 3.6 0.2 11.6 0.1 0.1 0.0 0.4 0.3 0.1 83.9 100.0 2,330
Oromiya 13.6 12.9 0.2 3.4 0.2 8.6 0.1 0.1 0.3 0.7 0.4 0.4 86.4 100.0 3,300
Somali 3.1 2.7 0.0 0.0 0.0 2.7 0.0 0.0 0.0 0.4 0.4 0.0 96.9 100.0 363
Benishangul-
Gumuz 11.1 10.4 0.3 1.3 0.0 8.5 0.0 0.1 0.0 0.7 0.6 0.1 88.9 100.0 92
SNNP 11.9 11.4 0.0 1.9 0.0 8.9 0.3 0.1 0.2 0.4 0.3 0.2 88.1 100.0 1,988
Gambela 15.9 15.8 0.0 2.5 0.0 12.9 0.0 0.5 0.0 0.1 0.1 0.0 84.1 100.0 31
Harari 33.5 29.1 0.0 5.8 1.6 20.1 0.0 0.8 0.8 4.4 4.2 0.2 66.5 100.0 22
Addis Ababa 56.9 45.2 1.8 10.6 3.9 23.5 2.0 2.1 1.3 11.7 9.2 2.5 43.1 100.0 224
Dire Dawa 34.0 31.5 0.3 6.7 0.6 21.4 1.0 1.5 0.0 2.4 2.2 0.2 66.0 100.0 37

Education
No education 10.0 9.8 0.1 2.0 0.0 7.3 0.1 0.0 0.1 0.2 0.1 0.1 90.0 100.0 7,094
Primary 23.4 21.9 0.0 5.7 0.5 15.1 0.2 0.1 0.2 1.5 0.8 0.7 76.6 100.0 1,402
Secondary and
higher 52.6 45.9 0.7 11.0 1.7 28.7 1.0 2.2 0.6 6.7 5.9 0.8 47.4 100.0 570

Wealth quintile
Lowest 4.2 4.0 0.0 0.8 0.0 3.0 0.1 0.0 0.1 0.1 0.0 0.1 95.8 100.0 1,759
Second 6.6 6.5 0.0 1.1 0.0 5.4 0.0 0.0 0.0 0.1 0.1 0.0 93.4 100.0 1,892
Middle 12.0 11.6 0.1 2.7 0.0 8.5 0.1 0.0 0.2 0.4 0.3 0.1 88.0 100.0 1,903
Fourth 15.5 15.2 0.0 3.1 0.0 11.7 0.2 0.0 0.1 0.3 0.1 0.2 84.5 100.0 1,823
Highest 37.0 33.7 0.8 8.2 1.2 21.7 0.5 0.9 0.4 3.3 2.4 0.9 63.0 100.0 1,689

Total 14.7 13.9 0.2 3.1 0.2 9.9 0.2 0.2 0.2 0.8 0.6 0.3 85.3 100.0 9,066

Note: If more than one method is used, only the most effective method is considered in this tabulation.
LAM = Lactational amenorrhoea method

Contraceptive use differs significantly across educational categories. Current use increases
five-fold from 10 percent among women with no education to 53 percent among those with secondary
and higher levels of education.

Wealth has a positive effect on women’s contraceptive use, with use increasing markedly as
wealth increases, from 4 percent among married women in the lowest wealth quintile to 37 percent
among those in the highest wealth quintile.

Family Planning | 63
5.3.1 Trends in Contraceptive Use Table 5.6 Trends in current use of contraception
Percentage of currently married women who are currently using a
Results on contraceptive use from contraceptive method, Ethiopia 2005
the 2005 EDHS are compared with similar
1990 2000 2005
surveys in Table 5.6 and Figure 5.1. Use Method NFFS1 EDHS2 EDHS
of contraceptive methods tripled in the 15-
Any method 4.8 8.1 14.7
year period between the 1990 NFFS and
the 2005 EDHS from 5 percent to 15 Any modern method 2.9 6.3 13.9
percent. The increase is especially marked Pill 2.2 2.5 3.1
IUD 0.3 0.1 0.2
for modern methods in the five years Injectables 0.0 3.1 9.9
between 2000 and 2005. This increase is Condom 0.1 0.3 0.2
attributed primarily to the rapid rise in the Implants na 0.0 0.2
use of injectables from 3 percent in 2000 Lactational amenorrhoea (LAM) na na 0.2
to 10 percent in 2005. Any traditional method 1.9 1.7 0.8
Rhythm 0.5 1.5 0.6
5.3.2 Number of Children at First Withdrawal 0.1 0.2 0.3
Sexual abstinence3 1.2 na na
Use of Contraception
Number 5,048 9,789 9,066
Family planning may be used to
either limit family size or delay the next na 1
= Not applicable
CSA, 1993
birth. Couples using family planning to 2 CSA and ORC Macro, 2001
limit family size adopt contraception 3 Sexual abstinence was included as a method of contraception in the
when they have already had the number of 1990 NFFS.
children they want. When contraception is
used to space births, couples may start using family planning earlier, with the intention of delaying a
possible pregnancy. This may be done even before a couple has had their desired number of children.

Figure 5.1 Trends in Current Use of Contraception,


Ethiopia 1990-2005

Percent
20

15
15 14

10
10
8
6
5
5
3 3 3
2 3 2 2
1
0
Any Any Pill Injectables
Injectables Any
method modern traditional
method method
1990 NFFS 2000 EDHS 2005 EDHS

Women interviewed in the 2005 EDHS were asked how many children they had at the time
they first used a contraceptive method. Table 5.7 shows the percent distribution of women by the
number of living children at the time of first use of contraception, according to current age.

64 | Family Planning
The data show that one-third of users (6 percent of all women) first used a method of family
planning when they had four or more children. Nearly one-fifth of users (3 percent of all the women)
first used at the time they had no children, and 4 percent first used after the birth of their first child.

The age pattern of first use of contraception shows that younger women are more likely to
start using contraception at lower parities than older women. For example, most women below age 30
started using contraception after they had one child, suggesting the intention of younger women to
space births at earlier parities than older women.

Table 5.7 Number of living children at first use of contraception

Percent distribution of women by number of living children at time of first use of contraception, Ethiopia 2005

Current Never Number of living children at time of first use of contraception Number of
age used 0 1 2 3 4+ Missing Total women

15-19 95.3 3.1 1.4 0.1 0.0 0.0 0.1 100.0 3,266
20-24 81.1 6.5 7.1 3.9 1.3 0.0 0.0 100.0 2,547
25-29 74.4 3.8 6.9 6.2 4.2 4.5 0.1 100.0 2,517
30-34 75.3 2.6 4.1 3.1 4.3 10.4 0.1 100.0 1,808
35-39 75.5 1.9 2.8 3.3 2.4 14.2 0.0 100.0 1,602
40-44 76.1 1.2 2.1 2.4 1.2 17.0 0.0 100.0 1,187
45-49 86.2 0.3 1.0 1.2 0.6 10.7 0.0 100.0 1,143

Total 81.8 3.3 3.9 2.9 2.0 6.1 0.1 100.0 14,070

5.4 USE OF SOCIAL MARKETING BRANDS

Current users of the pills and condoms were asked for the brand name of the pills and
condoms they last used. This information is useful in monitoring the success of social marketing
programmes that promote a specific brand. In Ethiopia, “Prudence” and “Choice” are the two brands
of pills that are socially marketed, and “Hiwot” and “Sensation” are two brands of condoms that are
socially marketed.

Table 5.8.1 indicates that nearly one-third (29 percent) of users said that they use Prudence.
This is much higher than the level reported in the 2000 EDHS (13 percent). Forty-one percent of pill
users reported that they did not know the brand of pills they were using.

Table 5.8.2 shows the percentage of men currently using condoms by brand used. About 39
percent of men use Hiwot, and 19 percent use Sensation. Nearly, one-third of condom users (30
percent) do not know the brand of condoms they are using.

Table 5.8.1 Pill brands Table 5.8.2 Condom brands

Percent distribution of Percent distribution of men


women currently using the currently using condoms by
pill by brand used, Ethiopia brand used, Ethiopia 2005
2005
Condom
Pill Condom brand users
Pill brand users
Hiwot 38.7
Microgynon 7.2 Sensation 18.7
Lo-Feminol 1.7 Durex 0.2
Prudence 29.1 Other 0.1
Choice 0.5
Other 2.6 Don't know 30.2
Missing 12.0
Don't know 40.6
Missing 18.2
Total 100.0
Total 100.0 Number 40
Number 292

Family Planning | 65
5.5 KNOWLEDGE OF FERTILE PERIOD

A basic knowledge of the physiology of reproduction is especially useful for the successful
practice of coitus-related methods such as periodic abstinence. The successful use of such methods
depends in part on an understanding of when during the ovulatory cycle a woman is most likely to
conceive. All women and men in the survey were asked about their knowledge of a woman’s fertile
period. Specifically, they were asked whether there are certain days between two menstrual periods
when a woman is more likely to become pregnant if she has sexual intercourse. Those who answered
in the affirmative were further asked if this time is just before the period begins, during the period,
right after the period ends, or halfway between the two periods.

Table 5.9 shows that only 11 percent of women and 8 percent of men, interviewed in the
EDHS, know that a woman is most likely to conceive halfway between her menstrual periods.
Slightly over one-fifth of all women (22 percent) wrongly believe that the fertile period is just before
her period begins or during her period or right after her period has ended. However, the great majority
of women either do not know when the fertile period falls (35 percent) or believe that there is no
specific time (32 percent). Regarding men, 43 percent say that they do not know when the fertile
period falls and 27 percent believe that there is no specific time when a woman is more likely to
conceive.

As expected, users of the rhythm method are more likely than nonusers to know that the
fertile time in a women’s menstrual cycle is halfway between periods. In addition, there has been a
slight increase in knowledge of the fertile period over the past five years among users of the rhythm
method (from 53 percent in 2000 to 62 percent in 2005).

Table 5.9 Knowledge of fertile period

Percent distribution of women currently using periodic abstinence, women not


using periodic abstinence, and all women and all men by knowledge of the
fertile period during the ovulatory cycle, Ethiopia 2005

Users of Nonusers
rhythm of rhythm All All
Perceived fertile period method method women men
Just before her period begins 5.6 2.2 2.2 3.5
During her period 0.7 1.8 1.8 1.9
Right after her period has ended 20.1 17.8 17.8 16.2
Halfway between two periods 61.8 11.1 11.4 8.1
Other 3.2 32.0 31.9 27.1
Don't know 6.4 35.1 34.9 43.0
Missing 2.2 0.1 0.1 0.1

Total 100.0 100.0 100.0 100.0


Number 69 14,001 14,070 6,033

5.6 SOURCE OF FAMILY PLANNING METHODS

Information on sources of modern contraceptives is useful for family planning managers and
implementers. Women who reported using a modern method of contraception at the time of the
survey were asked where they obtained the method the last time and interviewers recorded the name
and location of the source. To ensure accuracy in reporting, supervisors and editors were asked to
verify the type of source from the written response.

Table 5.10 shows that four-fifths of current users (80 percent) obtain methods from the public
sector, 17 percent from the private medical sector, and 3 percent from other sources. The most
important source of contraceptives in the public sector is the government health centre, providing
methods to 37 percent of current users. Government health stations or clinics and government health

66 | Family Planning
posts also play a major role in distributing contraceptives, being the source of 19 percent and 16
percent, of modern methods, respectively. The public sector is the leading source of injectables and
the pill, distributed mainly through government health centres (39 percent and 36 percent,
respectively). More than half of condom users get their supply from other sources, predominantly
shops (42 percent).

Over the years, the public sector has been the major source of family planning methods,
particularly for injectables and the pill. While the overall contribution from other private sources has
declined from 6 percent in 2000 to 3 percent in 2005, the contribution of shops in supplying condoms
has increased substantially, from 23 percent in 2000 to 42 percent in 2005.

The 2005 EDHS also gathered information on the cost of modern contraceptive methods. The
data show that the majority of users who obtained a method from the public sector obtained it for free
compared with 16 percent of users who obtained their method from the private medical sector (data
not shown).

Table 5.10 Source of modern contraceptive methods

Percent distribution of users of modern contraceptive methods by most recent source of the method,
Ethiopia 2005
Most recent
source of method Pill IUD Injectables Condom Total
Public sector 70.5 (64.9) 85.2 17.3 79.5
Government hospital 3.2 (47.1) 5.2 5.4 5.8
Government health centre 36.0 (14.1) 39.3 10.0 36.8
Government health post 11.8 (0.0) 18.6 0.1 16.1
Government health station/clinic 15.7 (0.0) 20.6 0.2 18.6
CBD worker 3.1 (3.6) 1.3 1.6 1.7
Other public 0.6 (0.0) 0.2 0.0 0.4
Private medical sector 27.0 (35.1) 13.5 20.3 17.1
Private hospital/clinic/doctor 6.4 (17.7) 5.0 0.4 5.5
Pharmacy 12.7 (0.0) 3.3 16.8 5.7
NGO Health facility 4.8 (6.8) 3.6 2.7 3.9
CBD worker/CBRHA 2.1 (10.6) 1.0 0.3 1.4
Other NGO 1.0 (0.0) 0.0 0.0 0.2
Other private medical 0.0 (0.0) 0.6 0.0 0.4
Other source 2.5 (0.0) 1.0 51.7 2.8
Drug vendor 0.8 (0.0) 0.5 0.0 0.5
Shop 1.3 (0.0) 0.4 42.4 1.9
Friends relatives 0.3 (0.0) 0.0 9.3 0.4
Other 0.0 (0.0) 0.3 10.7 0.6

Total 100.0 100.0 100.0 100.0 100.0


Number of women 292 20 954 40 1,324

Note: Table excludes female sterilisation and lactational amenorrhoea method (LAM). Total includes 24
users of implants who are not shown separately. Figures in parentheses are based on 25-49 unweighted
cases.
CBD = Community-based distribution
CBRHA = Community-based reproductive health agent

5.7 INFORMED CHOICE

Current users of modern methods who are well informed about the side effects and problems
associated with methods and know of a range of method options are in a better position to make an
informed choice about the method they would like to use. Current users of various modern
contraceptive methods were asked whether, at the time they were adopting a particular method, they
were informed about the possible side effects or problems they might have with the method and what
to do if they experienced side effects. Table 5.11 shows the percentage of current users of modern
methods who were informed about the side effects or problems with the method used, informed about
what to do if they experienced side effects, and informed of other methods they could use, according
to the type of method used and initial source of the method.

Family Planning | 67
Four percent of users were informed about the side effects or problems associated with the
method, 30 percent were informed about what to do if they experienced side effects, and 7 percent
were informed of the availability of other methods.

Table 5.11 Informed choice

Among current users of modern contraceptive methods who started the last episode of use
within the five years preceding the survey, the percentage who were informed about possible
side effects or problems of that method, about what to do if they experienced side effects,
and about other methods they could use, by method and initial source, Ethiopia 2005

Percentage Percentage Percentage who


who were who were were informed
informed informed by a health or
about side about what family planning
Method/source/ effects or to do if worker of other
background problems of experienced methods that Number of
characteristic method used side effects could be used women
Method
Female sterilisation (2.8) (84.7) (42.8) 6
Pill 1.9 31.5 2.8 265
IUD (0.0) (90.1) (4.0) 10
Injectables 3.9 28.1 7.7 914
Implants * * * 16
Total1 3.5 30.1 6.7 1,249
Initial source of method2
Public sector 3.7 30.0 7.0 972
Government hospital 7.2 41.6 13.2 65
Government health centre 2.6 33.2 8.0 452
Family planning clinic 2.8 28.2 5.2 209
Mobile clinic 5.7 21.2 5.4 231
Fieldworker * * * 14
Private medical sector 4.4 27.8 7.3 102
Private doctor 1.7 26.0 6.4 47
Private hospital or clinic (17.9) (59.8) (4.3) 16
Pharmacy * * * 3
Shop * * * 7
Church (0.0) (0.0) (0.0) 24
Friends relatives * * * 5
Other * * * 9
Missing 0.0 24.1 12.4 24

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that
a figure is based on fewer than 25 unweighted cases and has been suppressed.
na = Not applicable
1
Among users of female sterilisation, pill, IUD, injectables and implants
2
Source at start of current episode of use

68 | Family Planning
5.8 CONTRACEPTIVE DISCONTINUATION

Couples can realize their reproductive goals only when they use contraceptive methods
continuously. A major concern for family planning programme managers is discontinuation of
methods. In the 2005 EDHS “calendar” section, all segments of contraceptive use between September
2000 and the date of the interview were recorded, along with the reasons for any discontinuation.
One-year contraceptive discontinuation rates based on the data from the calendar are presented in
Table 5.12.1

Table 5.12 First-year contraceptive discontinuation rates

Percentage of contraceptive users who discontinued use of a method within 12


months after beginning its use, by reason for discontinuation and specific method,
Ethiopia 2005

Reason for discontinuation


Desire to Switched
Method become to another Other
Method failure pregnant method reason Total
Pill 2.4 11.6 21.8 25.1 60.9
Injectables 0.3 8.6 7.1 15.9 32.0
Male condom 1.3 9.5 13.7 17.3 41.8
Periodic abstinence 5.4 18.8 8.0 7.0 39.2

All methods 1.2 10.2 11.9 17.6 40.9

Note: Table is based on episodes of contraceptive use that began 3-59 months prior
to the survey.
LAM = Lactational amenorrhoea method
1
Used a different method in the month following discontinuation or said they
wanted a more effective method and started another method within two months of
discontinuation

It can be seen from the table that four in ten contraceptive users discontinue using a method
within 12 months of starting its use. About 10 percent of users discontinued to become pregnant and
12 percent switched to other methods. Just 1 percent of users stopped as a result of method failure,
suggesting that this is not a major problem in Ethiopia. The discontinuation rate is highest among pill
users (61 percent) and lowest among users of injectables (32 percent).

Table 5.13 also presents reasons for contraceptive discontinuation, but from a different
perspective. All of the 1,686 contraceptive discontinuations occurring in the five years preceding the
survey, regardless of duration of use, are distributed by the main reason for discontinuation, according
to method. The desire to become pregnant is the most prominent reason for contraceptive
discontinuation (30 percent), followed by health concerns (26 percent).

1
The discontinuation rates presented here include only those segments of contraceptive use that began since
September 2000. The rates apply to the period 3-59 months preceding the survey; exposure during the month of
interview and the two months before the interview are excluded to avoid the biases that may be introduced by
unrecognized pregnancies. These cumulative discontinuation rates represent the proportion of users
discontinuing a method within 12 months after the start of use. The rates are calculated by dividing the number
of women discontinuing a method by the number exposed at that duration. The single-month rates are then
cumulated to produce a one-year rate. In calculating the rate, the various reasons for discontinuation are treated
as competing risks.

Family Planning | 69
Table 5.13 Reasons for discontinuation

Percent distribution of discontinuations of contraceptive methods in the five years preceding the survey by
main reason for discontinuation, according to specific method, Ethiopia 2005 FINAL

With- All
Reason Pill IUD Injection Condom Rhythm drawal methods
Became pregnant while using 5.6 0.0 2.2 14.7 16.8 10.4 5.0
Wanted to become pregnant 23.8 14.2 33.1 25.4 47.6 46.6 30.2
Husband/partner disapproved 2.9 0.0 2.6 2.5 0.1 0.0 2.6
Side effects 3.4 4.2 4.5 3.8 0.9 0.0 3.7
Health concerns 33.2 51.7 25.3 2.1 2.0 0.0 26.0
Lack of access/too far 0.0 0.0 0.0 1.6 0.4 0.0 0.1
Wanted more effective method 6.9 11.9 2.3 6.7 14.7 32.3 5.6
Inconvenient to use 6.1 0.0 4.2 6.4 7.8 1.8 5.1
Infrequent sex/husband away 3.9 8.8 2.3 14.7 5.1 0.2 3.6
Cost too much 0.2 0.0 0.9 0.0 0.0 0.0 0.5
Fatalistic 0.1 0.0 0.2 0.0 1.0 0.0 0.2
Method not available 2.5 0.0 6.2 0.0 0.0 0.0 3.9
Difficult to get pregnant/menopausal 0.5 7.3 0.3 0.0 0.0 0.0 0.4
Marital dissolution/separation 2.7 2.0 4.1 3.1 0.0 0.0 3.2
Other 8.2 0.0 11.8 18.1 3.6 8.6 9.8
Missing 0.0 0.0 0.0 0.7 0.0 0.0 0.0

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0


Number of discontinuations 680 17 786 60 89 23 1,686

5.9 FUTURE USE OF CONTRACEPTION

Intention to use a method of contraception is an important indicator of the potential demand


for family planning services. Currently married women who were not using contraception at the time
of the survey were asked about their intention to use family planning methods in the future. The
results are presented in Table 5.14.

Table 5.14 Future use of contraception

Percent distribution of currently married women who are not using a contraceptive
method by intention to use in the future, according to number of living children, Ethiopia
2005

Intention to use Number of living children1


in the future 0 1 2 3 4+ Total
Intends to use 44.0 60.0 56.4 51.8 49.5 52.0
Unsure 5.6 1.9 4.4 5.1 3.9 4.0
Does not intend to use 50.4 37.8 38.9 43.0 46.4 43.9
Missing 0.0 0.3 0.3 0.0 0.1 0.1

Total 100.0 100.0 100.0 99.9 100.0 100.0


Number of women 530 1,091 1,133 1,098 3,880 7,732
1
Includes current pregnancy

70 | Family Planning
More than half (52 percent) of currently married women who were not using any
contraception at the time of the survey say that they intend to use a family planning method some time
in the future. Forty-four percent do not intend to use any method, while 4 percent are unsure of their
intention. The proportion of women who intend to use in the future varies by the number of living
children, increasing from 44 percent for those with no living children to a peak at 60 percent among
those with one child. These women are likely interested in spacing subsequent births. Over the past
five years, there has been an increase in the proportion of married women not using at the time of the
survey but who intend to use in the future (from 46 percent in 2000 to 52 percent in 2005).

5.10 REASONS FOR NOT INTENDING TO USE A CONTRACEPTIVE METHOD IN THE FUTURE

An understanding of the reasons why people do not use family planning methods is critical in
designing programmes that are effective in reaching women with unmet need and to improve the
quality of family planning services. Table 5.15 shows currently married nonusers who do not intend to
use a contraceptive method in the future by the main reasons for not intending to use family planning.
Around 40 percent cited fertility-related reasons for not intending to use contraception. In particular,
18 percent cited the desire for as many children as possible as the main reason for not intending to
use. The proportion of women who cited a desire for more children has dropped markedly from 42
percent in 2000 to 18 percent in 2005, suggesting that women are realizing the disadvantages of large
family sizes.

Table 5.15 Reason for not intending to use contraception


in the future

Percent of currently married women who are not using


contraception and who do not intend to use in the future
by main reason for not intending to use, Ethiopia 2005

Nonusers who
do not intend
to use
Reason contraception
Fertility-related reasons 37.5
Infrequent sex/no sex 2.9
Menopausal/had hysterectomy 6.3
Subfecund/infecund 10.4
Wants as many children as possible 17.8

Opposition to use 23.6


Respondent opposed 5.5
Husband/partner opposed 4.1
Others opposed 0.1
Religious prohibition 13.8

Lack of knowledge 11.2


Knows no method 8.6
Knows no source 2.6

Method-related reasons 13.6


Health concerns 10.2
Fear of side effects 2.6
Lack of access/too far 0.1
Costs too much 0.2
Inconvenient to use 0.1
Interferes with body's normal processes 0.2
Method not available 0.3

Other 11.1

Don’t know/missing 3.0

Total 100.0
Number of women 3,394

Family Planning | 71
Nearly a quarter of women reported disapproval or opposition to use as the reason for not
intending to use in the future. The majority of these women specifically cited religious prohibition as
the main reason for not using in the future. Method-related reasons, largely health concerns, was cited
by about 14 percent of nonusers not intending to use in the future, and lack of knowledge of method
or source was cited by 11 percent.

5.11 PREFERRED METHOD OF CONTRACEPTION FOR FUTURE USE

Demand for specific methods can be assessed by asking Table 5.16 Preferred method of contra-
nonusers which methods they intend to use in the future. Table ception for future use
5.16 presents information on method preference among currently
Percent distribution of currently married
married women who are not using a contraceptive method but say women who are not using a contra-
they intend to use in the future. The majority (72 percent) of ceptive method but who intend to use in
prospective users prefer to use injectables, while a sizable propor- the future by preferred method, Ethiopia
2005
tion (19 percent) cite the pill as their preferred method. In the
2000 EDHS, the corresponding figures for injectables and pills are Nonusers
46 percent and 38 percent, respectively. The data indicates a con- who intend
to use
vergence in preference of methods to injectables, largely because Preferred contraception
of the convenience of use and duration of effectiveness. method in future
Modern method
5.12 EXPOSURE TO FAMILY PLANNING MESSAGES Female sterilisation 0.2
Pill 18.7
Exposure to family planning messages widens the horizon IUD 0.3
Injectables 71.9
of understanding on issues related to contraceptive use and helps Implants 1.7
in the realization of its importance in achieving desired family Condom 0.1
size. Additionally, it contributes to the enhancement of the health Lactation amenorrhoea
method (LAM) 0.1
of both children and mothers. Measuring the extent of exposure to
such information helps programme managers and planners to Traditional method
effectively target population subgroups for information, education, Rhythm 0.5
and communication (IEC) activities. In the 2005 EDHS, both Withdrawal 0.1
Folk method 3.3
women and men were asked if they have heard or seen family
planning messages on the radio or television or read about family Unsure of method 3.0
planning in a newspaper or magazine in the few months prior to
the survey. Total 100.0
Number of women 4,017

Family planning information is largely disseminated


through radio with limited dissemination through television or the print media. For example, 29
percent of women heard about family planning on the radio compared with only 11 percent of women
who got family planning information from the television and 8 percent who got such information from
newspapers or magazines (Table 5.17).

Consistent with the level of exposure to mass media, exposure to family planning messages
varies by the gender of respondents. As can be seen from Table 5.17, men are more likely to be
exposed to family planning messages than women for all media types. Nearly 4 out of 10 men
compared with 3 out of 10 women heard family planning messages on the radio or seen them on
television or read about family planning in newspapers or magazines.

Significant variation is also observed in exposure to family planning messages by other


characteristics. Younger women are more likely to be exposed to family planning messages than older
women. Because of the limited infrastructural development in most rural communities, women and
men in these parts of the country have little opportunity to be exposed to essential information on
health and family planning. For example, women in urban areas are three times more likely to have
heard family planning messages on the radio than their rural counterparts. The regional differential
also suggests that women and men in relatively urbanized areas, namely, Addis Ababa, Dire Dawa
and Harari, are more likely than other women and men to have been exposed to family planning

72 | Family Planning
messages from all three media sources. Interestingly, women in these three urbanized areas are more
likely than men to be exposed to family planning messages on the radio and television. Women in
Somali and Gambela regions have the lowest level of exposure to family planning messages.

There is a marked difference in exposure to family planning messages by level of education.


Three-quarters of men and 84 percent of women with some secondary education were exposed to
family planning messages in at least one of the three media compared with only one-fourth of men
and 18 percent of women with no education. The results also show that exposure to family planning
messages varies by wealth quintile and is greatest among respondents in the wealthiest quintile.

Table 5.17 Exposure to family planning messages

Percentage of women who heard or saw a family planning message on the radio or television, or in a newspaper or magazine in the past few
months, according to background characteristics, Ethiopia 2005

Women Men
None of
the None of
three the three
Background Newspaper/ media Number of Newspaper/ media Number
characteristic Radio Television magazine sources women Radio Television magazine sources of men
Age
15-19 34.5 15.0 13.6 61.4 3,266 32.3 14.4 16.0 64.1 1,335
20-24 33.0 15.1 11.5 65.1 2,547 42.9 21.1 19.4 54.4 1,064
25-29 28.9 10.8 7.5 70.0 2,517 40.0 14.8 15.3 58.4 741
30-34 25.2 8.8 5.4 73.8 1,808 46.5 15.3 14.2 51.8 754
35-39 25.5 8.3 4.8 73.2 1,602 39.6 12.5 14.1 59.1 651
40-44 25.4 7.5 3.9 73.7 1,187 36.8 13.9 14.8 61.5 497
45-49 24.2 6.2 2.3 75.3 1,143 36.8 11.2 8.0 61.3 422
50-54 na na na na na 31.8 8.1 11.5 66.8 335
55-59 na na na na na 32.0 4.5 6.3 67.8 235
Residence
Urban 66.7 54.6 32.6 26.2 2,499 67.8 57.8 42.1 25.9 916
Rural 21.3 2.0 3.1 77.9 11,571 33.0 6.8 9.9 65.5 5,117
Region
Tigray 34.8 13.9 11.5 63.1 919 36.9 17.6 18.9 60.1 366
Affar 20.2 11.3 4.7 78.9 146 35.4 18.0 10.3 63.1 65
Amhara 24.9 6.2 6.3 73.7 3,482 34.6 8.1 15.8 63.8 1,521
Oromiya 34.5 11.1 8.0 63.9 5,010 42.7 13.7 12.0 55.0 2,222
Somali 10.2 6.3 4.8 89.1 486 29.6 3.7 3.1 70.4 202
Benishangul-Gumuz 15.8 2.7 3.2 83.8 124 33.0 10.3 11.2 64.5 54
SNNP 18.2 3.7 4.5 80.6 2,995 30.0 13.0 12.1 68.8 1,244
Gambela 11.7 4.5 3.7 87.1 44 42.4 17.1 13.3 55.3 21
Harari 70.6 53.3 36.2 27.9 39 65.0 48.1 37.8 30.7 16
Addis Ababa 67.4 63.4 32.2 23.8 756 65.2 60.2 44.4 26.2 292
Dire Dawa 58.2 53.6 26.0 38.0 69 56.1 43.4 29.9 36.9 30
Education
No education 17.9 2.4 0.4 81.6 9,271 23.3 1.9 2.3 76.3 2,589
Primary 38.1 12.3 11.5 58.5 3,123 39.0 10.9 14.5 58.4 2,252
Secondary and higher 76.6 59.3 46.4 16.3 1,675 69.6 48.8 42.5 25.1 1,192
Wealth quintile
Lowest 10.2 0.5 0.7 89.7 2,428 17.0 2.0 4.1 81.5 1,100
Second 15.4 1.0 1.4 84.0 2,643 28.7 4.2 8.0 70.2 1,184
Middle 20.5 1.4 2.9 78.8 2,732 34.3 6.9 10.9 63.9 1,081
Fourth 27.9 1.8 4.2 70.9 2,647 41.3 8.4 12.6 57.0 1,200
Highest 60.4 40.7 25.6 34.2 3,621 62.6 42.9 33.0 33.3 1,469

Total 29.4 11.4 8.3 68.7 14,070 38.3 14.5 14.8 59.5 6,033

na = Not applicable

5.13 CONTACT OF NONUSERS WITH FAMILY PLANNING PROVIDERS

Given the importance of family planning services to the improvement of mother’s and
children’s health, it is critical that every opportunity be fully exploited to inform potential users. In
reality, however, even though there is ample opportunity to inform nonusers there are also many
“missed opportunities.” Information on missed opportunities was gathered by asking female nonusers

Family Planning | 73
if they had visited a health facility in the 12 months preceding the survey. Those who visited a health
facility were asked whether anyone at the facility had discussed family planning with them during any
of their visits. Women who were not using a family planning method were also asked whether they
had been visited by a fieldworker who talked with them about family planning in the 12 months
preceding the survey.

The results are presented in Table 5.18. The majority of nonusers (90 percent) did not have
any contact with health providers or fieldworkers with whom family planning was discussed. Only 6
percent of nonusers reported being visited by fieldworkers who discussed family planning issues.
Though this seems low, it is still an improvement over the 2000 level which was practically nil. Only
5 percent of nonusers who visited a facility discussed family planning with a health worker, compared
with 16 percent who visited a facility but did not discuss family planning. Variations across subgroups
in the proportions of nonusers who had some contact with family planning providers are minor.

Table 5.18 Contact of nonusers with family planning providers

Percentage who were visited by a fieldworker who discussed family planning, the percentage who
visited a health facility and discussed family planning, the percentage who visited a health facility but
did not discuss family planning, and the percentage who did not discuss family planning with a
fieldworker or with someone at a health facility in the 12 months preceding the survey, by
background characteristics, Ethiopia 2005

Women who visited a


health facility and: Women who
Women who did not discuss
were visited by Did not family planning
a fieldworker Discussed discuss with a field-
Background who discussed family family worker or at a Number of
characteristic family planning planning planning health facility women
Age
15-19 3.3 2.1 11.9 95.2 3,182
20-24 6.1 5.4 19.1 89.9 2,256
25-29 7.8 5.9 19.6 87.7 2,135
30-34 9.2 8.2 17.6 85.3 1,569
35-39 7.4 6.6 17.1 87.3 1,357
40-44 7.4 6.2 17.4 88.3 1,046
45-49 5.4 4.9 13.8 91.1 1,071
Residence
Urban 4.9 8.1 24.1 88.7 1,968
Rural 6.5 4.6 14.9 90.2 10,648
Region
Tigray 6.7 9.5 13.8 86.5 816
Affar 3.9 1.7 22.3 95.0 137
Amhara 6.6 5.4 17.5 90.1 3,080
Oromiya 6.0 4.6 16.0 90.5 4,520
Somali 1.0 0.3 5.6 98.7 475
Benishangul-Gumuz 3.3 3.7 17.2 93.6 113
SNNP 7.9 5.3 14.2 88.2 2,750
Gambela 1.8 2.7 10.1 96.0 39
Harari 8.8 4.5 17.4 88.7 31
Addis Ababa 4.1 7.2 34.2 89.2 601
Dire Dawa 2.5 4.3 12.4 94.5 55
Education
No education 6.1 4.4 15.5 90.7 8,526
Primary 7.0 6.1 14.8 88.2 2,769
Secondary and higher 5.4 7.8 25.1 88.8 1,321
Wealth quintile
Lowest 6.2 3.8 11.9 91.2 2,352
Second 5.1 3.7 15.1 91.8 2,514
Middle 6.8 4.9 15.9 90.0 2,492
Fourth 7.4 5.0 15.6 89.3 2,351
Highest 5.9 7.9 22.1 88.0 2,907

Total 6.2 5.2 16.4 90.0 12,616

74 | Family Planning
5.14 HUSBAND'S KNOWLEDGE OF WIFE'S USE OF CONTRACEPTION

Concealment of use of contraception is an indication of absence of communication or


disagreement on use of family planning. To shed light on the extent of communication on the use of
contraception among married couples, married women who were using contraception at the time of
the survey were asked whether their husband knew of their use. An overwhelming majority (87
percent) of users reported that their husbands know about their use of contraception (Table 5.19). On
the other hand, 8 percent of women mentioned that their husband did not know of their use of family
planning.

Husbands’ lack of knowledge of wives’ family planning use is relatively higher in Tigray,
SNNP and Benishangul-Gumuz regions. Uneducated women are three times as likely to conceal the
use of a method of family planning as women with secondary or higher levels of education.
Concealment of use is also higher among women in the two lowest wealth quintiles and among those
residing in rural areas.

Table 5.19 Husbands/partners knowledge of women's use of contraception

Percent distribution of currently married women who are using a contraceptive method by
whether their husband/partner knows about their use of contraception, according to background
characteristics, Ethiopia 2005

Husband/ Unsure
Husband/ partner whether
partner does not husband/
Background knows know partner Number of
characteristic about use about use knows Missing Total women
Age
15-19 88.0 8.7 0.0 3.3 100.0 63
20-24 85.9 7.3 0.0 6.8 100.0 262
25-29 89.0 6.0 0.2 4.9 100.0 348
30-34 87.3 7.8 0.0 4.9 100.0 223
35-39 89.2 6.8 0.3 3.7 100.0 231
40-44 79.5 12.9 0.0 7.7 100.0 136
45-49 81.6 13.8 0.0 4.5 100.0 70
Education
No education 83.2 9.9 0.2 6.7 100.0 706
Primary 86.5 8.5 0.0 5.0 100.0 328
Secondary and higher 95.2 2.6 0.0 2.2 100.0 300
Wealth quintile
Lowest 84.0 10.8 0.0 5.2 100.0 73
Second 81.2 14.0 0.0 4.9 100.0 126
Middle 84.8 8.0 0.3 6.9 100.0 228
Fourth 86.8 8.1 0.0 5.1 100.0 283
Highest 88.9 6.3 0.1 4.8 100.0 625
Residence
Urban 91.8 4.7 0.2 3.3 100.0 448
Rural 84.2 9.5 0.1 6.2 100.0 887
Region
Tigray 81.8 13.8 0.7 3.7 100.0 94
Affar (88.7) (0.0) (0.0) (11.3) (100.0) 7
Amhara 86.7 7.4 0.0 5.9 100.0 374
Oromiya 87.6 6.1 0.0 6.3 100.0 450
Somali * * * * * 11
Benishangul-Gumuz 80.2 10.0 0.0 9.8 100.0 10
SNNP 82.8 12.3 0.0 4.9 100.0 236
Gambela 92.3 1.5 0.0 6.2 100.0 5
Harari 83.0 2.5 0.5 14.0 100.0 7
Addis Ababa 94.2 5.1 0.0 0.7 100.0 127
Dire Dawa 90.6 7.0 0.0 2.4 100.0 12

Total 86.7 7.9 0.1 5.2 100.0 1,334

Note: Women who report use of male sterilisation, condoms, or withdrawal are included in the
column, husband/partner knows about use. Figures in parentheses are based on 25-49 unweighted
cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.

Family Planning | 75
5.15 MEN'S ATTITUDE ABOUT CONTRACEPTION

Men’s attitude towards contraceptive use exerts an important influence on their partner’s
attitude and eventual adoption of a method. In the 2005 EDHS men were asked if they agreed or
disagreed with three stereotypical statements about contraceptive use in general.

As shown in Table 5.20 nearly 15 percent of men who know about contraception think that
contraception is women’s business and that it does not concern them. A similar proportion of men
also believe that women should be the ones to get sterilized, as they are the ones who get pregnant.
Thirteen percent of men believe that women who use contraception may become promiscuous.

Table 5.20 Men's attitude about contraception

Among men who know a family planning method, percentage who agree with three
stereotypical statements about contraceptive use, by background characteristics, Ethiopia 2005

Women The woman is the


who use one who becomes
Contraception contraception pregnant, so she
Background is women's may become should be the one Number of
characteristic business promiscuous to get sterilised men
Age
15-19 12.6 13.0 14.0 1,149
20-24 14.7 14.0 16.0 988
25-29 15.9 13.1 12.5 687
30-34 18.0 12.5 18.1 720
35-39 17.3 10.2 14.2 609
40-44 14.1 11.5 14.3 454
45-49 15.4 14.6 16.1 378
50-54 19.4 10.7 17.6 296
55-59 14.9 13.3 14.9 209
Marital status
Never married 12.0 13.4 13.5 2,133
Married or living together 17.8 12.1 16.3 3,185
Divorced/separated/
widowed 13.0 15.7 14.4 172
Residence
Urban 7.6 9.0 7.3 910
Rural 16.9 13.4 16.7 4,580
Region
Tigray 7.3 6.9 8.6 359
Affar 8.5 7.9 6.8 58
Amhara 14.4 13.4 24.4 1,408
Oromiya 19.4 16.9 16.1 2,072
Somali 9.5 6.5 6.2 109
Benishangul-Gumuz 19.1 12.0 23.5 44
SNNP 14.9 7.3 7.0 1,089
Gambela 10.2 12.4 14.4 18
Harari 16.9 10.4 25.2 16
Addis Ababa 6.2 10.5 5.1 288
Dire Dawa 19.6 8.8 11.1 29
Education
No education 17.2 13.2 18.3 2,195
Primary 16.9 13.3 15.7 2,104
Secondary and higher 9.3 10.5 8.3 1,191
Wealth quintile
Lowest 15.9 11.0 13.2 895
Second 16.9 13.3 17.9 1,063
Middle 17.1 15.1 17.4 987
Fourth 17.8 14.0 18.3 1,118
Highest 10.8 10.7 10.2 1,427

Total 15.4 12.7 15.1 5,490

76 | Family Planning
Misconceptions about contraceptive use are relatively more widespread among men with little
or no education and men residing in rural areas. Men in Dire Dawa, Oromiya and Benishangul-
Gumuz are most likely to think that contraception is women’s business, men in Oromiya are also most
likely to believe that using contraception might make a woman promiscuous, and men in Harari,
Amhara and Benishangul-Gumuz are more likely than those in other regions to believe that women
should be the ones to get sterilized, since they are the ones who get pregnant.

Family Planning | 77
 
OTHER PROXIMATE DETERMINANTS OF FERTILITY 6
This chapter addresses the principal factors other than contraception, that influence fertility.
Marriage is the principal indicator of women’s exposure to the risk of pregnancy in Ethiopia. Early
age at marriage in a population is usually associated with a longer period of exposure to the risk of
pregnancy and higher fertility levels. The early initiation of childbearing associated with early
marriage may also adversely affect the health of both women and children. The duration of
postpartum amenorrhoea and postpartum abstinence affect the length of time a woman is insusceptible
to pregnancy and thus, determine the interval between births. The onset of menopause marks the end
of a woman’s reproductive life cycle. These factors taken together determine the duration of a
woman’s reproductive life and the pace of childbearing, making them important in understanding
fertility levels and differentials.

6.1 CURRENT MARITAL STATUS

Table 6.1 shows the percent distribution of women and men by current marital status. The
term “married” refers to both legal or formal marriage, while “living together” refers to informal
unions in which a man and a woman live together, even if a formal civil or religious ceremony has not
taken place. In later tables in this report, the term “currently married” includes those living together, if
it is not listed as a separate category. Respondents who are widowed, divorced or separated are
referred to as “formerly married.” The term “ever married” refers to respondents who are currently
married or formerly married.

The data indicate that 25 percent of Ethiopian women age 15-49 have never been married.
Sixty-three percent are married, 1 percent live together, and 11 percent are separated, divorced or
widowed. The low proportion (less than half a percent) of women age 45-49 that have never been
married indicates that marriage is universal in Ethiopia.

Compared with women, the proportion of men who have never been married is considerably
higher (40 percent). Fifty-six percent of men are formally married, less than 1 percent are living
together with a woman, and 3 percent are either divorced, separated or widowed. A significant
proportion of men marry when they are age 25 or older, unlike women who tend to marry at younger
ages.

There has been little change over the past five years in the proportions of Ethiopian women
and men who have never married, who are married, who are living together, or who are widowed.
However, the proportion divorced among both women and men has nearly doubled, and there has
been a substantial decline in the proportion separated. The increase in the proportion divorced may be
attributed somewhat to greater urbanization and its effects on support from the extended family. The
anomaly in the proportion divorced and the proportion separated may be due to larger proportions of
women and men formalizing their separation and obtaining a divorce.

Other Proximate Determinants of Fertility | 79


Table 6.1 Current marital status

Percent distribution of women and men by current marital status, according to age, Ethiopia 2005
Never Living
Age married Married together Divorced Separated Widowed Total Number
WOMEN

15-19 73.3 21.1 0.7 4.0 0.6 0.2 100.0 3,266


20-24 30.3 60.1 1.7 5.6 1.8 0.6 100.0 2,547
25-29 9.7 81.0 1.0 4.1 2.1 2.0 100.0 2,517
30-34 3.5 84.6 1.2 4.7 2.2 3.8 100.0 1,808
35-39 1.9 82.8 1.0 5.0 2.3 7.0 100.0 1,602
40-44 0.8 79.4 1.4 4.0 3.0 11.4 100.0 1,187
45-49 0.4 74.9 0.6 7.3 2.4 14.5 100.0 1,143

Total 25.0 63.4 1.1 4.8 1.8 4.0 100.0 14,070

MEN

15-19 97.6 2.0 0.1 0.3 0.0 0.0 100.0 1,335


20-24 73.1 23.4 0.6 1.9 0.7 0.3 100.0 1,064
25-29 31.2 64.2 0.9 2.5 0.8 0.4 100.0 741
30-34 10.2 85.0 0.6 1.9 1.6 0.7 100.0 754
35-39 2.2 93.4 0.4 3.1 0.8 0.0 100.0 651
40-44 2.1 93.1 1.0 3.0 0.2 0.6 100.0 497
45-49 0.8 94.7 0.0 1.6 1.5 1.4 100.0 422
50-54 0.6 91.4 1.1 2.2 1.8 2.9 100.0 335
55-59 0.0 95.8 0.0 1.0 0.4 2.8 100.0 235

Total 40.1 56.2 0.5 1.8 0.8 0.6 100.0 6,033

6.2 POLYGYNY

Polygyny (the practice of having more than one wife) has implications for the frequency of
exposure to sexual activity and therefore fertility. The extent of polygyny is ascertained from
responses of currently married women to questions on whether their husband or partner has other
wives and if so how many. Similarly, currently married men are asked for the number of wives or
partners they have.

Table 6.2 shows the proportion of currently married women and men who are in polygynous
unions by background characteristics. The data show that 12 percent of married women in Ethiopia
are in polygynous unions. Seven percent say they have only one co-wife, while 5 percent say they
have 2 or more co-wives. The percentage of women in polygynous unions tends to increase with age,
from 4 percent among women age 15-19 to 17 percent among women age 45-49. Rural women are
more likely to be in polygynous unions (13 percent) than urban women (7 percent).

The regional distribution shows substantial variation. The prevalence of polygyny is highest
in Gambela (27 percent) and lowest in Amhara and Addis Ababa (3 percent each). Polygyny is also
high in Affar, Somali and Benishangul-Gumuz (21 percent each). The extent of polygyny has
declined slightly over the past five years, from 14 percent to 12 percent.

80 | Other Proximate Determinants of Fertility


Table 6.2 Number of co-wives and wives

Percent distribution of currently married women by number of co-wives and percent distribution of currently married men by
number of wives, according to background characteristics, Ethiopia 2005
Number of
Background Number of co-wives Number wives Number
characteristic 0 1 2+ Missing Total of women 1 2+ Total of men

Age
15-19 96.0 2.5 1.4 0.1 100.0 711 (100.0) (0.0) (100.0) 28
20-24 93.7 3.8 2.1 0.4 100.0 1,574 99.9 0.1 100.0 255
25-29 90.6 5.6 3.6 0.2 100.0 2,066 98.5 1.5 100.0 482
30-34 83.9 8.7 7.1 0.3 100.0 1,551 95.2 4.8 100.0 646
35-39 82.4 9.9 7.5 0.2 100.0 1,343 94.0 6.0 100.0 610
40-44 83.0 9.5 7.4 0.0 100.0 960 87.2 12.8 100.0 468
45-49 83.0 9.9 7.2 0.0 100.0 862 90.8 9.2 100.0 399
50-54 na na na na na na 91.7 8.3 100.0 310
55-59 na na na na na na 89.8 10.2 100.0 225
Residence
Urban 92.4 2.8 4.6 0.2 100.0 959 97.4 2.6 100.0 344
Rural 87.1 7.5 5.2 0.2 100.0 8,107 93.1 6.9 100.0 3,080
Region
Tigray 95.9 2.2 1.6 0.2 100.0 570 98.8 1.2 100.0 206
Affar 78.3 8.8 12.2 0.6 100.0 109 84.2 15.8 100.0 42
Amhara 97.2 1.4 1.2 0.2 100.0 2,330 99.2 0.8 100.0 913
Oromiya 84.1 9.8 6.0 0.1 100.0 3,300 90.8 9.2 100.0 1,228
Somali 78.4 10.3 10.8 0.5 100.0 363 89.9 10.1 100.0 137
Benishangul-Gumuz 78.7 12.2 8.9 0.1 100.0 92 86.2 13.8 100.0 37
SNNP 81.8 9.9 7.9 0.4 100.0 1,988 90.5 9.5 100.0 730
Gambela 72.0 12.0 15.3 0.6 100.0 31 90.9 9.1 100.0 12
Harari 94.6 2.9 2.3 0.2 100.0 22 97.9 2.1 100.0 9
Addis Ababa 96.4 2.0 1.1 0.5 100.0 224 98.4 1.6 100.0 97
Dire Dawa 91.1 5.9 2.7 0.3 100.0 37 94.8 5.2 100.0 14
Education
No education 86.6 7.5 5.7 0.2 100.0 7,094 93.8 6.2 100.0 1,912
Primary 89.8 7.0 3.2 0.0 100.0 1,402 91.4 8.6 100.0 1,099
Secondary and higher 96.3 0.7 2.4 0.6 100.0 570 97.8 2.2 100.0 413
Wealth quintile
Lowest 83.7 8.4 7.5 0.4 100.0 1,759 94.1 5.9 100.0 659
Second 86.5 7.3 5.9 0.3 100.0 1,892 93.1 6.9 100.0 745
Middle 87.7 7.5 4.7 0.1 100.0 1,903 91.9 8.1 100.0 715
Fourth 88.7 7.6 3.5 0.2 100.0 1,823 93.2 6.8 100.0 669
Highest 91.9 4.0 4.0 0.1 100.0 1,689 95.5 4.5 100.0 637

Total 87.7 7.0 5.1 0.2 100.0 9,066 93.5 6.5 100.0 3,424

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


na = Not applicable

There is an inverse relationship between education and polygyny. The proportion of currently
married women in a polygynous union decreases from 13 percent among women with no education to
3 percent among women with some secondary or higher education. Substantial differences are
observed in the prevalence of polygyny among women in different wealth quintiles. Women in the
lowest wealth quintile are twice as likely to be in a polygynous union as women in the highest wealth
quintile. Data on polygynous unions among currently married men is also shown in Table 6.2. The
data indicate that 7 percent of men report having two or more wives; however, this figure varies
widely by region and urban-rural residence. The level of polygyny as reported by men has declined
slightly over the past five years, from 9 percent in the 2000 EDHS to 7 percent in the 2005 EDHS.

Other Proximate Determinants of Fertility | 81


6.3 AGE AT FIRST MARRIAGE

In Ethiopia, marriage marks the point in a woman’s life when childbearing becomes socially
acceptable. Age at first marriage has a major effect on childbearing because women who marry early
have on average a longer period of exposure to pregnancy and a greater number of lifetime births.
Information on age at first marriage was obtained by asking respondents the month and year, or age,
at which they started living with their first partner.

Table 6.3 shows the percentage of women and men who have married by specific exact ages,
according to current age. Marriage occurs relatively early in Ethiopia. Among women age 25-49, 66
percent married by age 18 and 79 percent married by age 20. The median age at first marriage among
women age 25-49 is 16.1 years. The proportion of women married by age 15 has declined from 38
percent among women age 45-49 to 13 percent among women age 15-19, but there has been little
change in the median age at marriage among women age 25-49 in the past five years.

Table 6.3 Age at first marriage

Percentage of women and men who were first married by specific exact ages and median age at first marriage,
according to current age, Ethiopia 2005
Percentage Median
Percentage first married by exact age:
Current never age at first
age 15 18 20 22 25 married Number marriage
WOMEN

15-19 12.7 na na na na 73.3 3,266 a


20-24 23.9 49.2 62.4 na na 30.3 2,547 18.1
25-29 31.9 61.7 74.3 82.6 89.1 9.7 2,517 16.6
30-34 31.9 64.3 77.7 85.9 92.6 3.5 1,808 16.2
35-39 33.3 67.4 81.4 88.3 93.3 1.9 1,602 16.0
40-44 36.7 68.6 81.1 89.8 94.5 0.8 1,187 15.8
45-49 38.0 70.8 83.0 90.4 94.8 0.4 1,143 15.8

Women age 20-49 31.4 61.8 74.8 na na 10.4 10,804 16.5

Women age 25-49 33.7 65.6 78.6 86.6 92.2 4.2 8,257 16.1

MEN

15-19 na na na na na 97.6 1,335 a


20-24 na 5.7 13.6 na na 73.1 1,064 a
25-29 na 7.8 18.8 32.0 54.2 31.2 741 24.2
30-34 na 10.3 24.1 38.4 61.0 10.2 754 23.5
35-39 na 10.5 21.5 42.2 62.1 2.2 651 23.0
40-44 na 12.5 25.1 38.1 57.8 2.1 497 23.8
45-49 na 10.4 25.6 42.7 61.0 0.8 422 23.2
50-54 na 6.8 17.6 28.8 46.2 0.6 335 25.7
55-59 na 7.8 17.1 25.0 44.9 0.0 235 25.5

Men age 25-59 na 9.7 21.8 36.5 57.0 9.3 3,634 23.8

Note: The age at first marriage is defined as the age at which the respondent began living with her/his first
spouse/partner.
na = Not applicable due to censoring
a = Omitted because less than 50 percent of the women or men began living with their spouse/partner for the
first time before reaching the beginning of the age group.

Men tend to marry at much older ages than women. Among men age 25-59, only 10 percent
were married by age 18 and 22 percent by age 20. The median age at marriage for men age 25-29 is
24.2 years, nearly eight years older than for women in the same age group.

82 | Other Proximate Determinants of Fertility


Table 6.4 shows the median age at first marriage for women age 20-49 by current age and
background characteristics; summary data are also given for men age 25-59. Data for women age 15-
19 and men age 15-24 have been omitted because fewer than 50 percent of respondents in these age
groups were married.

Urban women age 25-49 marry more than two years later than rural women. Women with at
least some secondary education marry 5 years later than women with no education and women in the
highest wealth quintile marry a year later than women in the lowest wealth quintile. The median age
at marriage is highest in Addis Ababa (21.9 years) and lowest in Amhara (14.2 years). Similar
differences by background characteristics are also observed among men.

Table 6.4 Median age at first marriage

Median age at first marriage among women age 20 (25)-49 and among men 25-49, by current age and
background characteristics, Ethiopia 2005

Current age Women Women Men


Background age age age
characteristic 20-24 25-29 30-34 35-39 40-44 45-49 20-49 25-49 25-59
Residence
Urban 3.3 21.6 18.7 17.2 15.8 16.1 19.4 18.2 a
Rural 17.3 16.1 16.0 15.9 15.7 15.7 16.1 15.9 23.4
Region
Tigray 16.9 16.0 15.7 15.3 15.0 15.5 15.7 15.6 24.7
Affar 17.4 16.9 16.0 15.7 15.9 17.8 16.7 16.4 23.9
Amhara 15.2 14.5 14.3 14.2 14.1 13.6 14.4 14.2 22.3
Oromiya 18.7 16.8 17.0 16.7 16.5 16.7 17.1 16.7 24.4
Somali 17.3 17.6 17.2 19.1 18.3 19.6 17.9 18.0 24.3
Benishangul-Gumuz 16.6 15.5 15.3 15.4 15.2 15.1 15.6 15.3 22.7
SNNP 19.5 17.5 17.2 16.9 16.8 16.6 17.6 17.2 23.2
Gambela 15.8 15.7 15.8 15.9 15.8 15.4 15.8 15.7 23.0
Harari 19.6 20.0 18.3 17.9 17.4 18.6 18.9 18.6 a
Addis Ababa 8.5 2.5 23.8 21.2 16.9 16.8 a 21.9 a
Dire Dawa a 19.3 17.3 16.8 17.0 17.1 18.3 17.8 a
Education
No education 16.5 16.0 15.9 15.7 15.6 15.7 15.9 15.8 23.5
Primary 20.0 16.6 15.9 17.1 17.1 16.0 17.4 16.5 23.3
Secondary and higher 6.4 24.1 20.7 19.8 18.3 19.1 a 21.2 a
Wealth quintile
Lowest 16.6 16.2 16.0 15.9 16.1 16.7 16.2 16.1 24.0
Second 16.7 15.6 15.8 15.8 16.0 15.4 15.9 15.7 23.4
Middle 17.2 16.4 16.3 16.1 15.6 15.9 16.4 16.1 23.1
Fourth 17.7 16.4 16.3 15.9 15.5 15.5 16.2 15.9 23.2
Highest a 19.4 17.0 16.3 15.7 15.9 18.2 17.0 a

Total 18.1 16.6 16.2 16.0 15.8 15.8 16.5 16.1 23.8

Note: The age at first marriage is defined as the age at which the respondent began living with her/his first
spouse/partner.
a = Omitted because less than 50 percent of the women/men began living with their spouse/partner for
the first time before reaching the beginning of the age group.

6.4 AGE AT FIRST SEXUAL INTERCOURSE

Age at first marriage is often used as a proxy for first exposure to intercourse and risk of
pregnancy. But the two events may not occur at the same time because some women may engage in
sexual activity before marriage. In the 2005 EDHS, women and men were asked how old they were
when they first had sexual intercourse.

Other Proximate Determinants of Fertility | 83


Table 6.5 shows the percentage of women and men who first had sexual intercourse by
specific exact ages. Among women age 25-49, 32 percent had sexual intercourse before age 15,
65 percent before age 18, and by age 25 most Ethiopian women have had sexual intercourse. The
median age at first sexual intercourse for women age 25-49 years is 16.1 years, which is identical to
the median age at first marriage. This suggests that Ethiopian women generally begin sexual
intercourse at the time of their first marriage. The median age at first sexual intercourse has increased
over the past two decades, from 15.7 years for women age 45-49 to 18.2 years for women age 20-24.

Table 6.5 Age at first sexual intercourse

Percentage of women and men who had first sexual intercourse by specific exact ages and median age at
first sexual intercourse, according to current age, Ethiopia 2005

Percentage
Percentage who had first sexual intercourse who never Median
Current by exact age: had age at first
age 15 18 20 22 25 intercourse Number intercourse

WOMEN

15-19 11.1 na na na na 72.3 3,266 a


20-24 21.9 48.6 62.3 na na 27.4 2,547 18.2
25-29 29.3 61.2 72.5 81.1 87.0 8.1 2,517 16.6
30-34 29.9 63.3 74.4 82.1 86.8 2.4 1,808 16.4
35-39 30.1 65.9 79.1 84.7 89.4 0.6 1,602 16.1
40-44 35.7 69.8 80.3 87.9 90.2 0.3 1,187 15.7
45-49 37.4 71.0 83.1 88.4 91.1 0.3 1,143 15.7

Women age 20-49 29.3 61.3 73.4 na na 8.9 10,804 16.5

Women age 25-49 31.6 65.2 76.8 84.0 88.4 3.2 8,257 16.1

MEN

15-19 1.7 na na na na 92.7 1,335 a


20-24 1.7 14.1 29.3 na na 55.9 1,064 a
25-29 1.5 16.3 35.3 50.2 73.0 18.9 741 22.0
30-34 1.4 15.0 37.5 57.7 77.7 4.1 754 21.0
35-39 1.0 16.9 34.1 55.9 75.8 1.0 651 21.3
40-44 0.7 17.6 38.4 58.2 76.8 0.6 497 20.8
45-49 0.5 15.8 40.7 59.1 73.8 0.0 422 20.8
50-54 0.0 11.3 32.4 49.9 70.3 0.0 335 22.0
55-59 1.1 16.0 36.5 51.4 64.8 0.0 235 21.0

Men age 25-59 1.0 15.8 36.4 55.0 74.3 5.0 3,634 21.2

na = Not applicable due to censoring


a = Omitted because less than 50 percent of the women had intercourse for the first time before reaching
the beginning of the age group

The data show that men initiate sex at a later age than women. The median age at first
intercourse for men age 25-59 is 21.2 years. An assessment of the median age at first intercourse
across the different age cohorts indicates that there has not been any significant change in age at first
sexual intercourse for men over the past 20 years.

Table 6.6 presents differentials in the median age at first sexual intercourse by background
characteristics for women and men. Urban women have their first sexual intercourse about two years
later than rural women, while urban men have their first intercourse about a year earlier than rural
men. Women with at least some secondary education have their first intercourse about five years later
than women with no education. On the other hand, highly educated men initiate sex a year earlier than
men with no education. Among women, age at first sexual intercourse is lowest in Amhara and
highest in Addis Ababa; among men, it is lowest in Gambela and highest in Somali.

84 | Other Proximate Determinants of Fertility


Table 6.6 Median age at first intercourse

Median age at first sexual intercourse among women age 20-49 and men age 25-59, by current age and
background characteristics, Ethiopia 2005

Current age Women Women Men


Background age age age
characteristic 20-24 25-29 30-34 35-39 40-44 45-49 20-49 25-49 25-59
Residence
Urban a 20.7 18.5 17.4 16.1 15.8 18.7 18.0 20.4
Rural 17.5 16.1 16.1 15.9 15.7 15.7 16.2 15.9 21.4

Region
Tigray 17.0 15.9 15.6 15.5 14.7 15.3 15.6 15.5 22.3
Affar 17.8 17.2 15.9 15.8 15.8 16.5 16.5 16.1 19.9
Amhara 15.5 14.7 14.7 14.6 14.5 14.1 14.7 14.6 20.3
Oromiya 18.7 17.1 17.1 17.3 16.4 16.3 17.3 16.9 21.6
Somali 17.9 18.2 17.1 19.3 18.4 19.0 18.3 18.4 23.9
Benishangul-Gumuz 16.6 15.8 15.8 15.6 15.3 15.2 15.8 15.6 20.8
SNNP 19.6 17.6 17.7 16.8 16.8 16.8 17.8 17.3 22.0
Gambela 15.9 15.8 15.7 15.7 15.7 15.6 15.8 15.7 18.3
Harari 19.4 19.6 18.4 18.0 18.0 18.5 18.8 18.6 21.0
Addis Ababa a 22.7 21.0 18.9 16.7 16.6 a 20.0 20.5
Dire Dawa 19.3 18.8 17.1 16.6 17.0 17.0 18.0 17.5 21.0

Education
No education 16.7 16.0 16.0 15.8 15.6 15.7 15.9 15.8 21.3
Primary 19.6 16.7 16.5 17.4 16.7 16.1 17.5 16.8 21.6
Secondary and higher a 21.9 19.9 18.8 18.4 18.4 a 20.4 20.4

Wealth quintile
Lowest 17.2 16.0 16.0 15.9 15.9 16.1 16.1 15.9 21.9
Second 17.0 15.7 16.0 15.8 15.7 15.4 15.9 15.7 21.5
Middle 17.3 16.4 16.6 16.3 15.6 15.9 16.4 16.1 21.5
Fourth 17.8 16.2 16.6 15.9 15.6 15.5 16.2 15.9 20.9
Highest a 19.6 17.0 17.1 15.9 15.7 18.1 17.2 20.6

Total 18.2 16.6 16.4 16.1 15.7 15.7 16.5 16.1 21.2

a = Omitted because less than 50 percent of the women had intercourse for the first time before reaching
the beginning of the age group

6.5 RECENT SEXUAL ACTIVITY

In the absence of contraception, the probability of pregnancy is related to the frequency of


intercourse. Therefore, information on sexual activity can be used to refine measures of exposure to
pregnancy. Women and men were asked how long ago their last sexual activity occurred to assess
whether they had a sexual encounter in the past four weeks.

Tables 6.7.1 and 6.7.2 show the percent distribution of women and men by recent sexual
activity.1 Half of women age 15-49 were sexually activity in the four weeks before the survey, 15
percent had been sexually active in the 12-month period before the survey but not in the month prior
to the interview, and 11 percent had not been sexually active for one or more years. Twenty-four
percent of the women had never had sexual intercourse.

1
Questions on recent sexual activity were only administered to the subsample of women who were in house-
holds selected for the male survey.

Other Proximate Determinants of Fertility | 85


Table 6.7.1 Recent sexual activity: women

Percent distribution of women by timing of last sexual intercourse, according to background characteristics, Ethiopia
2005

Timing of last sexual intercourse Never had


Background Within the Within One or sexual Number of
characteristic last 4 weeks 1 year1 more years Missing intercourse Total women
Age
15-19 17.5 7.6 3.7 0.2 71.1 100.0 1,645
20-24 50.7 14.5 7.8 0.0 27.0 100.0 1,228
25-29 68.0 15.7 9.0 0.0 7.3 100.0 1,167
30-34 68.2 16.6 12.0 0.3 3.0 100.0 845
35-39 63.5 19.3 16.3 0.4 0.5 100.0 776
40-44 60.0 18.3 21.4 0.3 0.1 100.0 570
45-49 50.2 18.9 30.7 0.1 0.2 100.0 520
Marital status
Never married 1.6 2.1 2.4 0.0 93.9 100.0 1,703
Married or living together 77.0 19.0 3.8 0.1 0.1 100.0 4,317
Divorced/separated/widowed 3.4 16.9 77.2 0.6 2.0 100.0 731
Marital duration2
Married only once
0-4 years 75.8 20.3 3.1 0.3 0.6 100.0 670
5-9 years 78.6 19.4 2.1 0.0 0.0 100.0 705
10-14 years 79.5 17.9 2.4 0.1 0.0 100.0 666
15-19 years 78.8 18.8 2.1 0.4 0.0 100.0 495
20-24 years 75.2 20.1 4.8 0.0 0.0 100.0 341
25+ years 67.8 20.4 11.8 0.0 0.0 100.0 413
Married more than once 78.5 17.7 3.7 0.2 0.0 100.0 1,026
Current contraceptive method
Female sterilisation * * * * * 100.0 5
Pill 89.0 10.6 0.4 0.0 0.0 100.0 144
IUD * * * 8 * 100.0 6
Condom (76.3) (23.7) (0.0) (0.0) (0.0) 100.0 19
Periodic abstinence 85.0 14.5 0.5 0.0 0.0 100.0 30
Other method 86.3 10.3 2.6 0.8 0.0 100.0 505
No method 45.8 14.9 12.4 0.1 26.8 100.0 6,042
Residence
Urban 30.6 11.3 18.7 0.5 38.8 100.0 1,173
Rural 54.1 15.2 9.9 0.1 20.8 100.0 5,579
Region
Tigray 48.6 16.3 13.0 0.1 22.0 100.0 448
Affar 57.2 19.2 11.5 0.0 12.1 100.0 72
Amhara 53.3 16.2 14.4 0.0 16.1 100.0 1,640
Oromiya 51.0 14.8 9.2 0.1 24.9 100.0 2,368
Somali 52.0 14.2 14.5 1.4 18.0 100.0 243
Benishangul-Gumuz 59.0 16.2 8.7 0.1 16.0 100.0 62
SNNP 49.9 12.8 8.5 0.2 28.6 100.0 1,504
Gambela 38.7 20.7 24.9 1.0 14.7 100.0 23
Harari 39.4 18.7 13.3 0.0 28.6 100.0 20
Addis Ababa 26.6 8.0 19.4 0.3 45.7 100.0 339
Dire Dawa 42.0 11.2 20.7 0.0 26.1 100.0 33
Education
No education 57.6 17.5 12.9 0.1 11.9 100.0 4,419
Primary 39.1 8.6 7.6 0.1 44.5 100.0 1,552
Secondary and higher 28.7 9.2 10.3 0.3 51.6 100.0 781
Wealth quintile
Lowest 55.5 15.4 13.1 0.1 15.9 100.0 1,251
Second 53.5 17.3 10.0 0.0 19.2 100.0 1,321
Middle 52.6 16.3 8.9 0.3 21.9 100.0 1,273
Fourth 54.1 12.9 9.4 0.0 23.6 100.0 1,234
Highest 38.1 11.4 14.6 0.4 35.6 100.0 1,672

Total 50.0 14.5 11.4 0.2 24.0 100.0 6,751

Note: Only women in the subsample of households selected for the male survey were administered this question.
Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer
than 25 unweighted cases and has been suppressed.
1
Excludes women who had sexual intercourse within the last 4 weeks
2
Excludes women who are not currently married

86 | Other Proximate Determinants of Fertility


Table 6.7.2 Recent sexual activity: men

Percent distribution of men by timing of last sexual intercourse, according to background characteristics, Ethiopia 2005

Timing of last sexual intercourse Never had


Background Within the Within One or sexual Number of
characteristic last 4 weeks 1 year1 more years Missing intercourse Total men
Age
15-19 2.1 3.8 1.4 0.0 92.7 100.0 1,335
20-24 22.6 12.1 9.3 0.2 55.9 100.0 1,064
25-29 56.8 14.8 9.5 0.0 18.9 100.0 741
30-34 73.3 16.5 6.1 0.0 4.1 100.0 754
35-39 78.4 15.9 4.6 0.1 1.0 100.0 651
40-44 73.6 20.5 4.8 0.4 0.6 100.0 497
45-49 75.1 16.2 8.1 0.6 0.0 100.0 422
50-54 70.8 19.7 9.1 0.4 0.0 100.0 335
55-59 67.8 20.0 12.3 0.0 0.0 100.0 235

Marital status
Never married 2.6 6.8 7.7 0.0 82.9 100.0 2,419
Married or living together 80.6 17.1 2.0 0.2 0.1 100.0 3,424
Divorced/separated/widowed 4.3 26.7 65.9 0.0 3.1 100.0 190

Marital duration2
Married only once
0-4 years 82.3 16.7 0.2 0.3 0.5 100.0 610
5-9 years 82.0 16.8 1.1 0.1 0.0 100.0 650
10-14 years 84.1 14.8 1.1 0.0 0.0 100.0 654
15-19 years 79.5 17.9 2.0 0.6 0.0 100.0 528
20-24 years 79.8 17.1 2.4 0.6 0.0 100.0 372
25+ years 74.8 19.5 5.6 0.1 0.0 100.0 611

Residence
Urban 32.5 15.9 12.9 0.7 37.9 100.0 916
Rural 49.5 12.8 5.1 0.0 32.6 100.0 5,117

Region
Tigray 47.6 16.4 4.0 0.0 32.1 100.0 366
Affar 50.3 26.0 7.8 0.0 16.0 100.0 65
Amhara 50.6 10.6 5.9 0.1 32.8 100.0 1,521
Oromiya 45.0 13.9 6.2 0.2 34.7 100.0 2,222
Somali 53.5 12.4 7.2 0.0 26.9 100.0 202
Benishangul-Gumuz 56.6 13.4 3.2 0.0 26.7 100.0 54
SNNP 47.9 12.3 4.6 0.1 35.1 100.0 1,244
Gambela 45.7 19.8 16.2 0.0 18.3 100.0 21
Harari 41.7 24.3 11.2 0.0 22.8 100.0 16
Addis Ababa 31.2 18.0 18.6 0.3 31.9 100.0 292
Dire Dawa 42.2 16.0 9.2 0.0 32.6 100.0 30

Education
No education 59.4 14.4 6.4 0.1 19.8 100.0 2,589
Primary 40.8 11.6 4.3 0.0 43.4 100.0 2,252
Secondary and higher 31.4 14.0 10.0 0.5 44.1 100.0 1,192

Wealth quintile
Lowest 48.6 12.8 5.5 0.2 33.0 100.0 1,100
Second 48.7 15.2 5.4 0.0 30.7 100.0 1,184
Middle 56.0 12.4 4.1 0.0 27.5 100.0 1,081
Fourth 47.2 12.0 4.4 0.0 36.4 100.0 1,200
Highest 37.3 13.7 10.9 0.4 37.8 100.0 1,469

Total 46.9 13.3 6.3 0.1 33.4 100.0 6,033


1
Excludes men who had sexual intercourse within the last 4 weeks
2
Excludes men who are not currently married

Other Proximate Determinants of Fertility | 87


The proportion of women who were sexually active during the four weeks before the survey
increases with age, from 18 percent at age 15-19 to 68 percent by age 25-34 and decreases thereafter
until it reaches 50 percent at age 45-49. Women who are currently in union are much more likely to
be sexually active in the four weeks preceding the survey than women who were formerly married or
had never been married. Those married 25 years or more are less likely to be sexually active in the
recent past than women married for shorter durations. In general, women using contraception are
more likely to be sexually active than those not using contraception. Rural women are more likely to
be sexually active (54 percent) than urban women (31 percent). Among the regions, women residing
in Benishangul-Gumuz (59 percent) and Affar (57 percent) are proportionately more likely to be
sexually active than women residing in Addis Ababa (27 percent). Women with no education (58
percent) are twice as likely to be sexually active in the recent past as women with some secondary
education (29 percent). Women in the highest wealth quintile are much less likely to report being
sexually active in the past four weeks than their counterparts.

Among men, 47 percent were sexually active in the four weeks preceding the survey, 13
percent had had sexual intercourse in the year before the survey but not in the month prior to the
survey, while 6 percent had not been sexually active for one year or more. Thirty-three percent of men
said they had never had sex. As with women, sexual activity among men increases with age and peaks
in the late thirties. Men in union are much more likely to be sexually active than those not in union.
Men in urban areas are less likely (33 percent) to be sexually active in the recent past than those in
rural areas (50 percent).

Regional variation shows similar patterns with women. Recent sexual activity is highest
among men living in Benishangul-Gumuz (57 percent) and lowest in Addis Ababa (31 percent).
Comparison of data between the 2005 EDHS and the 2000 EDHS shows that there has been virtually
no change in the level of recent sexual activity among women or men over the past five years.

As with women, recent sexual activity is inversely related with men’s level of education.
Recent sexual activity decreases from 59 percent among men with no education to 41 percent among
men with some primary education, and decreases further to 31 percent among those with some
secondary education. Recent sexual activity is lowest among the wealthiest men.

6.6 POSTPARTUM AMENORRHOEA, ABSTINENCE AND INSUSCEPTIBILITY

Postpartum amenorrhoea is the interval between the birth of a child and the resumption of
menstruation. It is the period following childbirth during which a woman becomes temporarily and
involuntarily infecund. Postpartum protection from conception can be prolonged by the intensity and
length of breastfeeding. Postpartum abstinence refers to the period of voluntary sexual inactivity after
childbirth. A woman is considered insusceptible if she is not exposed to the risk of pregnancy, either
because she is amenorrhoeic or because she is abstaining from sexual intercourse following a birth.
Information was obtained about the duration of amenorrhoea and the duration of sexual abstinence
following childbirth for births in the three years preceding the survey.

88 | Other Proximate Determinants of Fertility


Table 6.8 shows the percentage of births in the three years preceding the survey for which
mothers were postpartum amenorrhoeic, abstaining, and insusceptible, by number of months since
birth. The results show that Ethiopian women are amenorrhoeic for a median of 15.8 months, abstain
for a median of 2.4 months, and are insusceptible to pregnancy for a median of 16.7 months. In
general, the proportion of women who are amenorrhoeic or abstaining decreases with increasing
months after delivery. The proportion amenorrhoeic drops from 96 percent in the first two months
following a birth to 63 percent at 12-13 months and 17 percent at 24-25 months after birth. The
majority of Ethiopian women (85 percent) abstain from sex during the first two months following
birth. A comparison of data from the 2000 and 2005 EDHS surveys indicates that there has been a
decline in the median duration of postpartum amenorrhoea from 19 months to around 16 months
while there has been no change in the median duration of postpartum abstinence. The reduction in the
duration of postpartum amenorrhoea is probably due to the shorter duration of breastfeeding (see
chapter 11).

Table 6.8 Postpartum amenorrhoea, abstinence and insusceptibility

Percentage of births in the three years preceding the survey for which mothers
are postpartum amenorrhoeic, abstaining, and insusceptible, by number of
months since birth, and median and mean durations, Ethiopia 2005

Months Percentage of births for which the mother is: Number of


since birth Amenorrhoeic Abstaining Insusceptible births

<2 95.5 85.2 96.2 344


2-3 85.6 43.7 88.8 493
4-5 81.2 22.5 86.0 380
6-7 77.2 13.3 78.3 435
8-9 78.0 12.1 78.7 404
10-11 70.1 8.8 72.4 291
12-13 63.2 7.2 65.1 482
14-15 54.2 9.9 57.7 382
16-17 45.7 6.0 47.6 357
18-19 41.6 5.2 45.2 336
20-21 43.0 8.7 45.8 288
22-23 28.9 11.2 34.6 234
24-25 17.2 4.9 20.2 388
26-27 15.0 2.7 17.1 427
28-29 9.5 3.5 12.0 330
30-31 12.8 2.8 14.5 345
32-33 12.3 3.2 13.1 329
34-35 5.2 2.3 7.5 255

Total 48.9 14.7 51.3 6,497


Median 15.8 2.4 16.7 na
Mean 17.0 5.4 17.9 na

Note: Estimates are based on status at the time of the survey.


na = Not applicable

Table 6.9 shows the median duration of postpartum amenorrhoea, abstinence, and
insusceptibility by background characteristics. The duration of amenorrhoea is much shorter among
urban women than among rural women, and is lower among women age 15-29, women with
secondary and higher education, women in the highest wealth quintile and women residing in Addis
Ababa.

Other Proximate Determinants of Fertility | 89


Table 6.9 Median duration of postpartum insusceptibility by background charac-
teristics

Median number of months of postpartum amenorrhoea, postpartum abstinence,


and postpartum insusceptibility following births in the three years preceding the
survey, by background characteristics, Ethiopia 2005

Background Postpartum Postpartum Postpartum Number of


characteristic amenorrhoea abstinence insusceptibility births
Age
15-29 15.1 2.4 15.8 3,761
30-49 18.0 2.5 19.9 2,736
Residence
Urban 9.1 2.4 10.0 489
Rural 16.4 2.4 17.7 6,008
Region
Tigray 20.0 2.0 21.2 395
Affar 13.4 2.4 14.2 64
Amhara 20.8 2.4 21.4 1,519
Oromiya 14.5 2.5 15.0 2,612
Somali 15.5 3.2 16.3 276
Benishangul-Gumuz 14.4 2.5 14.5 60
SNNP 17.0 2.5 17.8 1,432
Gambela 17.1 11.1 22.9 17
Harari 10.1 2.4 10.2 14
Addis Ababa 9.3 2.1 10.7 85
Dire Dawa 10.8 2.5 11.4 22
Education
No education 16.2 2.7 18.1 5,070
Primary 14.2 1.8 15.3 1,138
Secondary and higher 10.3 2.1 10.4 289
Wealth quintile
Lowest 17.0 2.7 18.2 1,384
Second 20.9 3.0 21.2 1,382
Middle 16.4 2.8 18.5 1,456
Fourth 14.3 2.1 14.4 1,306
Highest 11.4 2.1 12.5 970

Total 15.8 2.4 16.7 6,497

Note: Medians are based on current status.

6.7 MENOPAUSE

The risk of childbearing declines as age increases. The Table 6.10 Menopause
term infecundity denotes a process rather than a well-defined
Percentage of women age 30-49 who are
event. Although the onset of infecundity is difficult to determine menopausal, by age, Ethiopia 2005
for an individual woman, there are ways of estimating it for a
Percentage Number of
group of women. Table 6.10 presents data on menopause, an Age menopausal1 women
indicator of decreasing exposure to the risk of pregnancy 30-34 2.4 1,808
(infecundity) for women age 30 and over. 35-39 5.4 1,602
40-41 14.4 697
In the context of the available survey data, women are 42-43 22.5 356
considered menopausal if they are neither pregnant nor post- 44-45 31.9 557
46-47 51.0 329
partum amenorrhoeic and have not had a menstrual period for at 48-49 60.3 393
least six months preceding the survey. The proportion of women
who are menopausal increases with age from 2 percent for Total 15.5 5,740
women age 30-34 to 60 percent for women age 48-49. Overall, 1
Percentage of all women who are not
16 percent of women age 30-49 are menopausal. pregnant and not postpartum amenor-
rhoeic whose last menstrual period
occurred six or more months preceding the
survey

90 | Other Proximate Determinants of Fertility


FERTILITY PREFERENCES 7
Information on fertility preference provides insight into a couple’s attitude towards future
childbearing, desired completed family size, the extent of unwanted and mistimed pregnancies, and
the prevailing demand for contraception.

In the 2005 EDHS, women and men were asked a series of questions to ascertain their fertility
preferences, including their desire to have another child, the length of time they would like to wait
before having another child, and what they consider to be the ideal number of children. These data
make it possible to quantify fertility preferences and, coupled with the data on contraceptive use allow
estimation of the unmet need for family planning, for both spacing and limiting births. Nevertheless,
interpretation of the results of fertility preferences is controversial since respondents’ reported
preferences are, in most cases, hypothetical and thus subject to change and rationalization.

7.1 DESIRE FOR MORE CHILDREN

In the 2005 EDHS currently married women and men were asked whether they want to have
another child, and if so how soon. The wording of the question varied slightly if the female
respondent or the wife or partner of a male respondent was pregnant to ensure that pregnant women
(and men with pregnant partners) were not asked about the wantedness of the current pregnancy but
the desire for subsequent children.

Table 7.1 shows future reproductive intentions of currently married women and men by the
number of living children. Sixteen percent of women want to have another child soon while 35
percent want another child two or more years later (Figure 7.1). Forty-two percent want no more
children or have been sterilized. In general 78 percent of currently married women want to either stop
or postpone childbearing. This implies that around four out of five currently married women are in
need of family planning services. A similar pattern is observed for men, except that a relatively higher
percentage of men want to have another child, either sooner or later.

The desire to stop childbearing increases with the number of living children from 9 percent
among women with no children to 72 percent among women with 6 or more children. Comparison
between the two EDHS surveys show that the proportion of currently married women who want to
stop childbearing has increased in the past five years for all categories of living children, with an
overall increase from 32 percent in 2000 to 42 percent in 2005 (Figure 7.2).

Tables 7.2.1 and 7.2.2 show that the desire to limit childbearing is higher among women and
men in urban than rural areas, with the urban-rural difference higher overall among men than women.
Regional differences are notable. Currently married women living in Addis Ababa, Oromia and
Amhara are more likely to want to stop childbearing than women living in the other regions. A similar
pattern is seen for currently married men as well. The percentage of currently married men who want
to stop childbearing is lower than the percentage among women in all regions except Addis Ababa
and Dire Dawa. The male-female difference in the desire to limit childbearing is especially
pronounced in Gambela where only 24 percent of currently married men want to stop childbearing
compared with 44 percent of women. Women and men living in the Somali Region are least likely to
want to limit childbearing (10 percent and 4 percent, respectively).

Fertility Preferences | 91
Table 7.1 Fertility preferences by number of living children

Percent distribution of currently married women and currently married men by desire for children, according to number of
living children, Ethiopia 2005

Number of living children1


Desire for children 0 1 2 3 4 5 6+ Total
WOMEN
2
Have another soon 57.9 23.3 16.4 15.1 10.0 8.6 8.0 16.1
Have another later3 24.5 58.3 50.9 47.7 33.4 24.4 13.3 35.4
Have another, undecided when 3.0 2.5 3.5 3.7 3.3 2.7 2.4 3.0
Undecided 1.4 0.6 1.2 1.3 1.2 2.6 1.1 1.3
Want no more 8.5 14.2 26.5 31.3 49.7 57.9 72.1 41.9
Sterilised4 0.0 0.1 0.2 0.1 0.0 0.2 0.3 0.2
Declared infecund 4.8 0.9 1.2 0.7 2.2 3.6 2.8 2.1
Missing 0.0 0.0 0.1 0.0 0.1 0.0 0.1 0.1

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0


Number of women 600 1,293 1,370 1,312 1,333 1,066 2,093 9,066

MEN
2
Have another soon 43.3 27.4 17.8 15.7 14.9 14.3 12.4 18.7
Have another later3 43.6 59.5 59.4 47.9 45.8 30.5 21.6 41.5
Have another, undecided when 2.5 2.3 2.2 2.4 2.1 2.4 3.4 2.6
Undecided 3.6 2.6 1.8 3.6 1.5 1.7 1.5 2.1
Want no more 5.8 8.2 18.0 28.6 35.4 49.9 59.6 34.1
Declared infecund 0.7 0.0 0.3 1.8 0.4 1.1 1.3 0.9
Missing 0.5 0.1 0.5 0.0 0.0 0.0 0.2 0.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0


Number of men 298 419 489 456 479 390 893 3,424
1
Includes current pregnancy
2
Wants next birth within 2 years
3
Wants to delay next birth for 2 or more years
4
Includes both female and male sterilisation

Figure 7.1 Fertility Preferences of Currently Married Women


Age 15-49

Wants a child later Wants a child,


(after 2 years) 35% unsure of timing 3%

Wants a child soon


(within 2 years) 16%

Declared
infecund 2%
Undecided 1%

Wants no more
children/sterilised 42%

Note: Percentages add to less than 100 due to rounding. EDHS 2005

92 | Fertility Preferences
Among women, the desire to limit childbearing decreases as the respondent’s education
increases. The percentage of currently married women who want no more children decreases from 43
percent among women with no education to 37 percent among women with secondary and higher
education. In contrast, the percentage of currently married men who want no more children increases
from 33 percent among men with no education to 46 percent among men with secondary and higher
education. The desire to limit childbearing rises with increasing access to resources. Both women and
men in the highest wealth quintiles are more likely to want to limit childbearing than those living in
poorer households.

Table 7.2.1 Desire to limit childbearing: women

Percentage of currently married women who want no more children, by number of living children by background
characteristics, Ethiopia 2005

Background Number of living children1


characteristic 0 1 2 3 4 5 6+ Total

Residence
Urban 7.8 18.1 45.8 51.3 72.9 74.9 83.4 47.8
Rural 8.6 13.7 23.5 29.2 47.5 56.5 71.8 41.4

Region
Tigray 2.2 3.1 9.7 11.6 30.0 41.1 70.1 28.5
Affar 13.3 16.9 16.6 29.0 33.6 17.0 16.1 19.8
Amhara 15.2 18.1 32.0 39.2 60.5 65.9 80.4 47.5
Oromiya 5.3 13.7 31.7 33.5 54.0 65.1 78.7 47.1
Somali 0.0 1.1 10.0 7.8 8.2 15.3 14.9 10.3
Benishangul-Gumuz 10.6 14.6 28.8 41.5 56.0 61.0 71.1 40.8
SNNP 5.2 15.1 17.2 25.8 38.4 54.5 67.6 37.8
Gambela 14.2 32.8 36.9 47.5 62.7 68.5 59.3 43.5
Harari 4.9 15.6 35.7 52.7 58.5 73.8 75.4 40.8
Addis Ababa 0.0 14.2 48.4 54.8 70.6 92.3 95.6 47.7
Dire Dawa 2.1 10.2 28.1 42.6 62.5 57.6 65.2 36.0

Education
No education 9.5 14.2 25.7 27.6 48.0 57.5 73.0 43.0
Primary 9.6 16.2 24.3 41.2 52.9 56.3 67.4 39.5
Secondary and higher 1.6 11.9 36.9 51.6 68.0 86.0 75.4 36.9

Wealth quintile
Lowest 11.2 9.3 19.2 26.6 37.4 40.1 56.4 33.3
Second 6.0 15.4 24.9 22.1 47.7 56.3 70.4 39.0
Middle 10.2 15.0 23.4 34.3 46.1 66.5 78.5 43.7
Fourth 6.8 15.6 26.0 33.6 55.1 59.5 77.0 46.9
Highest 8.5 15.4 38.4 42.1 66.1 70.4 81.4 47.6

Total 8.5 14.3 26.7 31.4 49.8 58.1 72.4 42.1

Note: Women who have been sterilised are considered to want no more children.
1
Includes current pregnancy

Fertility Preferences | 93
Table 7.2.2 Desire to limit childbearing: men

Percentage of currently married men who want no more children, by number of living children by background
characteristics, Ethiopia 2005

Background Number of living children


characteristic 0 1 2 3 4 5 6+ Total
Residence
Urban 9.0 20.8 29.2 59.9 64.1 69.1 73.1 45.5
Rural 5.6 5.7 15.9 25.6 32.3 47.9 58.8 32.8
Region
Tigray 0.0 0.0 5.3 20.4 27.5 49.2 57.1 28.0
Affar 2.5 21.0 24.8 13.3 26.6 3.9 13.5 15.1
Amhara 4.1 12.9 18.4 29.3 40.1 63.1 67.3 35.6
Oromiya 7.6 5.3 19.6 30.3 40.7 52.8 66.8 39.5
Somali 0.0 0.0 0.0 4.4 0.0 6.4 7.8 4.0
Benishangul-Gumuz 0.0 6.1 10.2 17.1 35.3 54.7 55.7 24.5
SNNP 9.9 7.0 14.9 28.3 21.1 34.6 54.2 29.5
Gambela 12.1 13.3 24.5 18.3 28.2 30.7 41.7 23.9
Harari 0.0 2.4 22.9 51.7 40.0 49.8 69.7 30.4
Addis Ababa 12.1 21.1 41.0 69.0 82.9 88.2 84.6 53.3
Dire Dawa 0.0 11.5 36.6 30.2 62.7 38.8 58.8 36.4
Education
No education 3.5 5.1 18.0 22.0 33.3 48.5 56.5 33.3
Primary 8.5 9.7 15.7 27.3 29.1 42.8 61.4 31.0
Secondary and higher 9.4 15.0 22.3 55.2 59.4 70.8 82.4 45.8
Wealth quintile
Lowest 9.0 3.6 15.1 19.5 23.7 32.4 43.7 25.1
Second 10.3 4.7 17.5 24.4 27.6 47.2 59.0 32.2
Middle 2.0 10.3 15.0 27.3 32.2 48.1 68.7 33.0
Fourth 0.0 3.9 12.9 26.8 42.3 56.5 58.5 37.0
Highest 6.2 15.6 27.1 46.9 54.7 66.6 72.0 43.7

Total 5.8 8.2 18.0 28.6 35.4 49.9 59.6 34.1

Note: Men who have been sterilised are considered to want no more children.

Figure 7.2 Desire to Limit Childbearing Among Currently


Married Women, by Number of Living Children, 2000 and 2005
Percent
80
72
65
60 58
50
47
39
40
31
27 26
20 18
14
9 9
5
0
0 1 2 3 4 5 6+
Number of Living Children
2000 2005

Note: Desire to limit childbearing includes respondents who


stated that they did not want any more children and those
who have been sterilised. Number of living children includes EDHS 2005
current pregnancy.

94 | Fertility Preferences
7.2 NEED FOR FAMILY PLANNING SERVICES

This section discusses the extent of need and the potential demand for family planning
services. Currently married women who want to postpone their next birth for two or more years or
who want to stop childbearing all together but are not using a contraceptive method are said to have
an unmet need for family planning. Pregnant women are considered to have an unmet need for
spacing or limiting if their pregnancy was mistimed or unwanted. Similarly, amenorrhoeic women are
categorized as having unmet need if their last birth was mistimed or unwanted. Women who are
currently using a family planning method are said to have a met need for family planning. The total
demand for family planning services comprises those who fall in the met need and unmet need
categories.

Table 7.3 shows the need for family planning among currently married women by select
background characteristics. Thirty-four percent of currently married women have an unmet need for
family planning, with 20 percent having an unmet need for spacing and 14 percent having an unmet
need for limiting. Only 15 percent of women have a met need for family planning. If all currently
married women who say that they want to space or limit their children were to use a family planning
method, the contraceptive prevalence rate would increase three-fold to 49 percent. Currently, only 31
percent of the family planning needs of currently married women are being met.

There has been little change in unmet need for family planning over the past five years, with
unmet need in 2005 only slightly lower than it was in 2000 when it was 36 percent. On the other hand,
met need has nearly doubled over the same period from 8 percent in 2000 to 15 percent in 2005,
resulting in a concomitant rise in demand satisfied from 18 percent to 31 percent.

Unmet need for spacing decreases with age while the opposite is true for unmet need for
limiting, with the exception of women age 45-49. Overall, unmet need remains relatively high at all
ages but falls sharply at age 45-49. Rural women have twice the unmet need of urban women and less
than one in four rural women have the demand for family planning satisfied, compared with three in
four urban women. Unmet need is lowest in Addis Ababa (10 percent) and highest in Oromiya (41
percent). Women with no education are twice as likely to have an unmet need for family planning as
women with secondary or higher levels of education. Unmet need ranges from a low of 24 percent
among women in the highest wealth quintile to a high of 38 percent among women in the second
wealth quintile.

Fertility Preferences | 95
Table 7.3 Need for family planning

Percentage of currently married women with unmet need for family planning, and with met need for family planning, and the total
demand for family planning, by background characteristics, Ethiopia 2005

Unmet need for Met need for family Total demand for Percent-
family planning1 planning (currently using)2 family planning3 age of
Background For For For For For For demand Number
characteristic spacing limiting Total spacing limiting Total spacing limiting Total satisfied of women

Age
15-19 30.1 8.0 38.0 7.1 1.8 8.9 37.3 10.0 47.2 19.4 711
20-24 28.8 5.6 34.4 12.6 4.0 16.7 41.6 9.7 51.3 32.9 1,574
25-29 25.3 10.5 35.8 9.9 7.0 16.9 35.4 17.6 53.0 32.4 2,066
30-34 20.9 15.0 35.9 5.9 8.4 14.4 27.0 23.5 50.6 29.0 1,551
35-39 16.8 20.6 37.4 4.1 13.1 17.2 21.1 33.7 54.8 31.7 1,343
40-44 6.9 25.6 32.4 0.9 13.3 14.2 7.9 39.1 47.1 31.0 960
45-49 1.5 14.9 16.3 0.1 8.0 8.1 1.6 22.9 24.5 33.2 862

Residence
Urban 7.8 9.1 17.0 23.4 23.3 46.7 31.4 32.7 64.1 73.5 959
Rural 21.5 14.3 35.8 4.8 6.2 10.9 26.4 20.5 46.9 23.7 8,107

Region
Tigray 16.4 7.6 24.1 9.3 7.2 16.5 25.9 14.8 40.7 40.9 570
Affar 8.8 4.6 13.4 2.3 4.3 6.6 11.1 8.9 20.0 33.0 109
Amhara 14.8 14.9 29.7 7.0 9.1 16.1 21.9 24.1 46.0 35.4 2,330
Oromiya 24.9 16.5 41.4 5.6 8.0 13.6 30.6 24.6 55.2 25.0 3,300
Somali 8.8 2.8 11.6 1.7 1.5 3.1 10.5 4.3 14.8 21.3 363
Benishangul-Gumuz 16.8 13.0 29.7 4.3 6.8 11.1 21.1 20.0 41.1 27.7 92
SNNP 24.0 13.4 37.4 5.8 6.1 11.9 30.0 19.6 49.6 24.6 1,988
Gambela 10.5 13.0 23.5 6.2 9.7 15.9 17.0 22.7 39.6 40.7 31
Harari 16.0 6.4 22.4 18.4 15.1 33.5 34.6 21.7 56.2 60.2 22
Addis Ababa 5.8 4.5 10.3 30.4 26.4 56.9 37.1 31.1 68.2 84.8 224
Dire Dawa 9.5 5.3 14.8 21.3 12.7 34.0 30.9 18.0 48.9 69.8 37

Education
No education 19.7 14.8 34.5 3.8 6.1 10.0 23.7 21.0 44.7 22.8 7,094
Primary 25.7 11.3 37.0 11.0 12.4 23.4 36.8 23.7 60.5 38.8 1,402
Secondary and higher 10.3 6.7 16.9 32.4 20.2 52.6 43.2 27.1 70.2 75.9 570

Wealth quintile
Lowest 20.1 13.0 33.1 1.6 2.6 4.2 21.7 15.7 37.3 11.3 1,759
Second 24.3 13.5 37.9 3.3 3.4 6.6 27.7 16.9 44.6 15.1 1,892
Middle 21.5 15.3 36.8 5.3 6.7 12.0 26.9 22.2 49.1 25.1 1,903
Fourth 21.2 15.0 36.2 5.7 9.8 15.5 27.2 24.8 52.0 30.4 1,823
Highest 12.5 11.5 24.0 18.7 18.3 37.0 31.4 30.0 61.3 60.9 1,689

Total 20.1 13.7 33.8 6.7 8.0 14.7 26.9 21.8 48.7 30.7 9,066
1
Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrhoeic women who are not using family
planning and whose last birth was mistimed or whose last birth was unwanted but now say they want more children, and fecund women
who are neither pregnant nor amenorrhoeic, who are not using any method of family planning and say they want to wait 2 or more years
for their next birth. Also included in unmet need for spacing are fecund women who are not using any method of family planning and say
they are unsure whether they want another child or who want another child.
Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrhoeic women who are not using family
planning, whose last child was unwanted and who do not want any more children, and fecund women who are neither pregnant nor
amenorrhoeic, who are not using any method of family planning, and who want no more children. Excluded from the unmet need
category are pregnant and amenorrhoeic women who became pregnant while using a method (these women are in need of a better
method of contraception).
2
Using for spacing is defined as women who are using some method of family planning and say they want to have another child or are
undecided whether to have another.
Using for limiting is defined as women who are using and who want no more children. Note that the specific methods used are not taken
into account here.
3
Nonusers who are pregnant or amenorrhoeic and women whose pregnancy was the result of a contraceptive failure are not included in
the category of unmet need, but are included in total demand for contraception (since they would have been using had their method not
failed).

96 | Fertility Preferences
7.3 IDEAL FAMILY SIZE

Information on ideal family size was collected in two ways: respondents who did not have
any children were asked how many children they would like to have if they could choose the number
of children to have. Respondents with children were asked how many children they would like to have
if they could go back to the time when they did not have any children and choose exactly the number
of children to have. Even though these questions are based on hypothetical situations they provide an
idea of the total number of children women who have not started childbearing will have in the future.
For older and high parity women, this information provides a measure of unwanted fertility.

Responses to these questions are summarized in Table 7.4 for both women and men. The
majority of women and men were able to provide a numeric response to these questions. However, 10
percent of women and 7 percent of men gave non-numeric responses such as “it is up to God,” “any
number” or “do not know.” The proportion unable to specify an ideal number of children has declined
since the 2000 EDHS in which 18 percent of women and 11 percent of men failed to provide a
numeric response.

Table 7.4 Ideal number of children

Percent distribution of all women and all men by ideal number of children, and mean ideal numbers of children for all women,
for currently married women, for all men and for currently married men, according to number of living children, Ethiopia 2005

Number of living children1


Desire for children 0 1 2 3 4 5 6+ Total
WOMEN

0 11.2 7.7 10.1 8.1 11.4 12.8 14.6 11.0


1 1.1 1.8 0.7 0.2 0.1 0.2 0.1 0.7
2 23.2 11.2 6.9 3.0 3.2 2.1 1.4 10.3
3 12.6 10.4 5.4 3.6 1.5 2.0 1.9 6.7
4 29.0 31.6 31.8 26.9 24.3 16.7 14.4 25.5
5 7.4 9.8 11.6 12.7 7.6 6.8 5.4 8.4
6+ 10.3 17.8 23.0 35.2 39.7 45.4 44.4 26.9
Non-numeric responses 5.3 9.6 10.4 10.3 12.1 14.1 17.8 10.4
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of respondents 4,336 1,633 1,645 1,475 1,521 1,186 2,274 14,070
Mean ideal number children for:2
All women 3.3 4.1 4.5 5.1 5.2 5.6 5.9 4.5
Number 4,107 1,475 1,474 1,323 1,336 1,019 1,869 12,602
Currently married women 3.9 4.3 4.6 5.2 5.3 5.6 5.9 5.1
Number 556 1,160 1,234 1,174 1,166 908 1,728 7,928

MEN

0 2.8 1.2 1.9 2.7 2.1 3.8 4.4 2.8


1 0.8 1.8 0.1 0.3 0.0 0.0 0.0 0.6
2 23.6 9.0 4.5 2.5 3.8 2.2 0.8 12.7
3 19.8 18.8 8.4 6.4 2.4 4.7 1.7 12.6
4 29.4 31.5 34.1 22.8 17.9 10.8 12.3 24.7
5 8.1 12.4 15.5 17.9 13.6 9.6 7.1 10.3
6+ 11.4 20.4 29.6 37.9 48.7 60.9 60.6 29.5
Non-numeric responses 4.1 4.8 5.9 9.5 11.5 8.1 13.1 6.9
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of men 2,766 477 516 478 489 401 906 6,033
Mean ideal number children for:2
All men 3.8 4.7 5.1 5.9 6.5 6.8 8.5 5.2
Number 2,654 454 485 433 433 368 787 5,615
Currently married men 4.4 4.8 5.2 5.9 6.5 6.9 8.5 6.4
Number 291 399 460 414 424 359 776 3,123
1
Includes current pregnancy
2
Means are calculated excluding the respondents giving non-numeric responses.

Fertility Preferences | 97
Three out of five women preferred an ideal family size of four or more children with only
three in ten favouring less than four children. More than one in ten women did not want any children
at all. The mean ideal number of children is 4.5 among all women who gave a numeric response, and
it is half a child more among currently married women (5.1). The mean ideal number of children is
5.2 among all men and 6.4 among currently married men. As can be observed, the mean ideal number
of children among currently married men is more than one child higher than that among currently
married women. The survey shows that ideal family size has declined over the past five years by
nearly a child among women (all women and currently married) and by more than a child among all
men and currently married men.

The mean ideal family size increases Table 7.5 Mean ideal number of children
with the number of living children among both
women and men, rising from 3.3 among child- Mean ideal number of children for all women and men, by age
and background characteristics, Ethiopia 2005
less women to 5.9 among women with six or
more children and from 3.8 among childless Number Number
men to 8.5 among men with six or more Background of of
characteristic Mean women Mean men
children. This positive association between
actual and ideal number of children could be Age
due to two principal reasons. First, to the 15-19 3.3 3,069 3.8 1,287
20-24 4.1 2,343 4.0 1,014
extent that women are able to implement their
25-29 4.7 2,292 4.8 700
fertility desires, women who want smaller 30-34 5.2 1,619 5.1 695
families will tend to achieve smaller families. 35-39 5.2 1,355 6.6 588
Second, some women may have difficulty 40-44 5.5 998 6.7 456
admitting their desire for fewer children if they 45-49 5.7 927 6.8 380
could begin childbearing again and may in fact 50-54 na na 7.4 277
report their actual number as their preferred 55-59 na na 9.0 218
number. Despite this tendency to rationalize, Residence
the 2005 EDHS data provide evidence of Urban 3.4 2,387 3.6 895
unwanted fertility with more than a third of Rural 4.7 10,215 5.6 4,720

women (38 percent) with six or more children Region


wanting an ideal family size of fewer than six Tigray 4.7 886 4.8 346
Affar 7.8 137 11.3 62
children.
Amhara 4.1 3,206 4.9 1,470
Oromiya 4.2 4,338 4.8 2,057
Table 7.5 shows the mean ideal num- Somali 9.8 400 12.9 166
ber of children for all women and men by Benishangul-Gumuz 5.0 119 6.7 51
select background variables. The mean ideal SNNP 4.7 2,655 5.7 1,116
number of children increases with age, for Gambela 4.7 40 6.0 20
both men and women. It ranges from a low of Harari 4.2 31 4.2 15
3.3 children among women age 15-19 to a Addis Ababa 3.3 727 3.3 283
high of 5.7 among women age 45-49, and Dire Dawa 5.3 63 4.0 28

from 3.8 to 6.8 among men in the same age Education


groups. An interesting finding is that women No education 5.1 7,998 6.6 2,347
Primary 3.6 2,966 4.7 2,112
and men age 20-34 have nearly identical ideals
Secondary and higher 3.3 1,638 3.5 1,156
for the number of children they desire, indi-
cating a narrowing of the male-female gap in Wealth quintile
Lowest 6.0 2,055 6.9 999
ideal family size for this group. Fertility is
Second 4.7 2,305 5.5 1,094
highest among women in this age group and Middle 4.4 2,467 5.3 1,002
the similar fertility intentions of women and Fourth 4.5 2,368 5.1 1,114
men in this age group may have the desired Highest 3.6 3,407 4.0 1,406
effect of lowering fertility in the long run.
Total 4.5 12,602 5.2 5,615

na = Not applicable

98 | Fertility Preferences
The mean ideal number of children is higher in rural than in urban areas for both women and
men. There is a wide variation among regions. As was the case in the 2000 EDHS, women and men
living in the nomadic regions of Somali and Affar have a relatively higher mean ideal number of
children than those living in the other regions. For example, women in the Somali Region have nearly
three times the mean ideal number of children as women in Addis Ababa.

The mean ideal number of children varies inversely with education. Women with no
education have a mean ideal of 5.1 children whereas those who have at least a secondary level
education reported a mean ideal of 3.3 children. A similar pattern is seen by wealth quintile, with
women in the lowest quintile desiring a mean ideal of one and a half more children than women in the
highest wealth quintile.

7.4 FERTILITY PLANNING

Data from the EDHS can be used to estimate the level of unwanted fertility. Women age 15-
49 were asked a series of questions about each of their children born to them in the preceding five
years, as well as any current pregnancy, to determine whether the birth or pregnancy was wanted then
(planned), wanted later (mistimed), or not wanted at all (unplanned) at the time of conception. In
assessing these results, it is important to recognize that women may declare a birth or current
pregnancy as wanted once the child is born, and this rationalization of a current birth or pregnancy as
wanted may in fact result in an underestimate the true extent of unwanted births.

Table 7.6 shows the percent distribution of births (including current pregnancy) in the five
years preceding the survey by birth order and age of mothers at birth. According to the data, two-
thirds of births in the five years preceding the survey were planned, 19 percent were mistimed, and 16
percent were unplanned. One in five births of order four or higher is unplanned, twice the level among
births of order three or below. The percentage of unplanned births also increases with mother’s age at
birth. More than two in five births to mothers who were age 45-49 at the time of the birth were not
planned compared with one in ten births to mothers age 25 or younger.

Table 7.6 Fertility planning status

Percent distribution of births in the five years preceding the survey (including current
pregnancies), by planning status of the birth, according to birth order and mother's age
at birth, Ethiopia 2005

Birth order and Planning status of birth


mother's age at Wanted Wanted Wanted Number
birth then later no more Missing Total of births
Birth order
1 72.8 15.7 11.0 0.6 100.0 2,120
2 71.4 18.8 9.6 0.2 100.0 1,917
3 68.0 21.1 10.8 0.1 100.0 1,754
4+ 59.4 19.0 21.3 0.3 100.0 6,556

Age at birth
<20 68.5 20.4 10.7 0.4 100.0 1,842
20-24 68.9 20.2 10.6 0.3 100.0 3,252
25-29 66.5 20.1 13.1 0.3 100.0 3,058
30-34 62.7 17.7 19.3 0.3 100.0 2,205
35-39 56.0 14.2 29.5 0.3 100.0 1,310
40-44 51.2 13.7 34.6 0.5 100.0 581
45-49 51.1 3.6 45.3 0.0 100.0 99

Total 64.8 18.7 16.2 0.3 100.0 12,347

Fertility Preferences | 99
The extent of unplanned births can also be estimated utilizing information on ideal family size
to estimate what the total fertility rate would be if all unwanted births were avoided. This measure
may also be an underestimate to the extent that women may not report an ideal family size lower than
their actual family size. Table 7.7 shows wanted fertility rates calculated in the same way as the total
fertility rate but excluding unwanted births from the numerator. In this case, unwanted births are those
that exceed the number mentioned as ideal by the respondent. This rate represents the level of fertility
that would have prevailed in the five years preceding the survey if all unwanted births had been
avoided.

The data show that women on average have 1.4 children more than their ideal number. The
gap between wanted and observed fertility rates is greater among women living in rural than in urban
areas. The difference in the two rates is largest in Oromiya (a two-child difference) and smallest in
Addis Ababa. Women with little or no education tend to want 1.5 children less than their actual
number compared with women with at least secondary education who want just 0.5 children less than
they actually have. There is also an inverse relationship between wealth and wanted fertility. The gap
between wanted and actual fertility is from 1.5 children in the first four wealth quintiles to less than
one child in the highest wealth quintile.

Table 7.7 Wanted fertility rates

Total wanted fertility rates and total fertility rates for


the three years preceding the survey, by background
characteristics, Ethiopia 2005

Background Total wanted Total


characteristic fertility rate fertility rate
Residence
Urban 1.8 2.4
Rural 4.5 6.0

Region
Tigray 4.0 5.1
Affar 4.5 4.9
Amhara 3.7 5.1
Oromiya 4.3 6.2
Somali 5.7 6.0
Benishangul-Gumuz 4.0 5.2
SNNP 4.2 5.6
Gambela 3.2 4.0
Harari 3.4 3.8
Addis Ababa 1.2 1.4
Dire Dawa 3.2 3.6

Education
No education 4.6 6.1
Primary 3.5 5.1
Secondary and higher 1.5 2.0

Wealth quintile
Lowest 5.1 6.6
Second 4.5 6.0
Middle 4.5 6.2
Fourth 4.3 5.7
Highest 2.3 3.2

Total 4.0 5.4

Note: Rates are calculated based on births to women


age 15-49 in the period 1-36 months preceding the
survey. The total fertility rates are the same as those
presented in Table 4.2.

100 | Fertility Preferences


INFANT AND CHILD MORTALITY 8
This chapter describes levels, trends, and differentials in early childhood mortality and high-
risk fertility behaviour of women in Ethiopia. Information on infant and child mortality rates con-
tributes to a better understanding of a country’s socioeconomic situation and sheds light on the quality
of life of the population. This information is disaggregated by socioeconomic and demographic
characteristics since studies have shown the existence of differentials in mortality by these
characteristics and the disaggregation helps to identify subgroups that are at high risk. Preparation,
implementation, and monitoring and evaluation of population, health, and other socioeconomic
programmes and policies depend to a large extent on target population identification.

Childhood mortality in general and infant mortality in particular are often used as broad
indicators of social development or as specific indicators of health status. Childhood mortality
analyses are thus useful in identifying promising directions for health programmes and advancing
child survival efforts. Measures of childhood mortality are also useful for population projections.

One of the targets of the millennium development goal is a two-third reduction in infant and
child mortality by 2015, to be achieved through upgrading the proportion of births attended by skilled
health personnel, increasing immunization against the six vaccine preventable diseases, and upgrading
the status of women through education and enhancing their participation in the labour force. Results
from the 2005 EDHS are timely in evaluating the impact of some of the major national policies, such
as the National Population Policy, the National Policy on Ethiopian Women, and the National Health
Policy, on the achievement of the MDG goal.

The mortality rates presented in this chapter are computed from information gathered from
the birth history section of the Women’s Questionnaire. Women in the age group 15-49 were asked
whether they had ever given birth, and if they had, they were asked to report the number of sons and
daughters who live with them, the number who live elsewhere, and the number who have died. In
addition, they were asked to provide a detailed birth history of their children in chronological order
starting with the first child. Women were asked whether a birth was single or multiple; the sex of the
child; the date of birth (month and year); survival status; age of the child on the date of the interview
if alive; and if not alive, the age at death of each live birth. Since the primary causes of childhood
mortality change as children age, mostly biological factors to environmental factors, childhood
mortality rates are expressed by age categories and are customarily defined as follows:

• Neonatal mortality (NN): the probability of dying within the first month of life
• Postneonatal mortality (PNN): the difference between infant and neonatal mortality
• Infant mortality (1q0): the probability of dying between birth and the first birthday
• Child mortality (4q1): the probability of dying between exact ages one and five
• Under-five mortality (5q0): the probability of dying between birth and the fifth
birthday.

The rates of childhood mortality are expressed as deaths per 1,000 live births, except in the
case of child mortality, which is expressed as deaths per 1,000 children surviving to age one.

In addition to questions on live births, women were asked about pregnancies that ended in
miscarriage, abortion, or stillbirth. This information was collected for the five years preceding the
survey to minimize recall errors. Information on stillbirths and deaths that occurred within seven days

Infant and Child Mortality | 101


of birth is used to estimate perinatal mortality, which is the number of stillbirths and early neonatal
deaths per 1,000 stillbirths and live births.

8.1 ASSESSMENT OF DATA QUALITY

The accuracy of mortality estimates depends on the sampling variability of the estimates and
on nonsampling errors. Sampling variability and sampling errors are discussed in detail in Appendix
A. Nonsampling errors depend on the extent to which the date of birth and age at death are accurately
reported and recorded and the completeness with which child deaths are reported. Omission of births
and deaths affects mortality estimates, displacement of birth and death dates impacts mortality trends,
and misreporting of age at death may distort the age pattern of mortality. Typically, the most serious
source of nonsampling errors in a survey that collects retrospective information on births and deaths is
the underreporting of births and deaths of children who were dead at the time of the survey. It may be
that mothers are reluctant to talk about their dead children because of the sorrow associated with their
death, or they may live in a culture that discourages discussion of the dead. The possible occurrence
of these data problems in the 2005 EDHS is discussed with reference to the data quality tables in
Appendix C. Underreporting of births and deaths is generally more severe the further back in time an
event occurred.

An unusual pattern in the distribution of births by calendar years is an indication of omission


of children or age displacement. Table C.4 shows that the overall percentage of births for which a
month and year of birth was reported is relatively complete, with incomplete information being only
slightly higher for children who have died than those who are alive (97 percent versus 99 percent),
and slightly lower as one moves further back in time. Nevertheless, there is clear indication of
omission of deaths in the most recent period. For example, the proportion of births for which the child
was no longer alive at the time of the survey declines from 15 percent in the period 1996-2000 to 9
percent during the period 2001-2005. Some of this decline is likely due to a real decrease in mortality
in the most recent period, although some is due to the fact that younger children have been exposed to
the risk of dying for a shorter period. Nevertheless, such a sharp decline in the proportion of deaths
since 1996 may suggest some amount of underreporting in the most recent period. However, when
compared with the 2000 EDHS, underreporting in the 2005 EDHS is less of a problem.

Age displacement is common in surveys that include both demographic and health
information for children under a specified age. In the Ethiopia DHS survey, the cutoff date for asking
health questions was Meskerem 1992 in the Ethiopian calendar (which roughly corresponds to
September 1999 in the Gregorian calendar). Table C.4 shows that there is some age displacement
across this boundary for both living and dead children. The distribution of living children and the total
number of children shows a deficit in 2000 and an excess in 1999, as denoted by the calendar year
ratios. A similar excess is seen in 2001. The deficit in 2000 can be attributed to the transference of
births by interviewers out of the period for which health data were collected. Transference is
proportionally higher for dead children than living children, and this displacement may affect
mortality rates. The excess in 2001 is, however, puzzling. The transference of children and especially
deceased children out of the five-year period preceding the survey is likely to underestimate the true
level of childhood mortality for that period. The overall sex ratio of 108 is also higher than expected,
indicating that there may be some underreporting of female births, especially female children who are
no longer alive. The sex ratio for dead children is 125 compared with 104 for living children. The data
also show heaping in 2001, although this is not as severe as in 1999.

Underreporting of deaths is usually assumed to be higher for deaths that occur very early in
infancy. Omission of deaths or misclassification of deaths as stillbirths may also be more common
among women who have had several children or in cases where death took place a long time ago. In
order to assess the impact of omission on measures of child mortality, two indicators are used: the
percentage of deaths that occurred under seven days to the number that occurred under one month and
the percentage of neonatal to infant deaths. It is hypothesized that omission will be more prevalent
among those who died immediately after birth than those who lived longer and that it will be more

102 | Infant and Child Mortality


serious for events that took place in the distant past rather than those in the more recent past. Table
C.5 shows data on age at death for early infant deaths. Selective underreporting of early neonatal
deaths would result in an abnormally low ratio of deaths within the first seven days of life to all
neonatal deaths. Early infant deaths have not been severely underreported in the Ethiopia DHS survey
as suggested by the high ratio of deaths in the first seven days of life to all neonatal deaths. Table C.6
shows the percentage of neonatal to infant deaths. Neonatal deaths are slightly lower than would be
expected, suggesting that there may be some underreporting of deaths under one month but not in the
first week of life.

Heaping of the age at death on certain digits is another problem that is inherent in most
retrospective surveys. Misreporting of age at death biases age pattern estimates of mortality if the net
result is the transference of deaths between age segments for which the rates are calculated; for
example, child mortality may be overestimated relative to infant mortality if children who died in the
first year of life are reported as having died at age one or older. In an effort to minimize misreporting
of age at death, interviewers were instructed to record deaths under one month in days and under two
years in months. In addition, they were trained to probe deaths reported at exactly 1 year or 12 months
to ensure that they had actually occurred at 12 months. The distribution of deaths under 2 years during
the 20 years prior to the survey by month of death shows that there is definite heaping at 6, 12, and 18
months of age with corresponding deficits in adjacent months (Table C.6). However, heaping is less
pronounced for deaths in the five years preceding the survey, for which the most recent mortality rates
are calculated.

In addition to recall errors for the more distant retrospective periods, there are structural
reasons for limiting mortality estimation to recent periods, preferably to the 0-4, 5-9, and 10-14 years
before the survey. In fact, except for the first period, the others are slightly biased estimates because
they are based on the child mortality experience of women age 15-44 and 15-39, respectively, instead
of women age 15-49 as in the period 0-4 years prior to the survey. Therefore, estimating mortality for
the periods further than 10-15 years before the survey is not advisable.

8.2 LEVELS AND TRENDS IN INFANT AND CHILD MORTALITY

Table 8.1 presents neonatal, postneonatal, infant, child, and under-five mortality rates for the
three recent five-year periods before the survey. Neonatal mortality in the most recent period is 39 per
1,000 live births. This rate is similar to postneonatal deaths (38 per 1,000 live births) during the same
period; that is, the risk of dying for any Ethiopian child who survived the first month of life is the
same as in the remaining 11 months of the first year of life. Thus 50 percent of infant deaths in
Ethiopia occur during the first month of life. A similar pattern was observed in the 2000 EDHS. The
infant mortality rate in the five years preceding the survey is 77 and under-five mortality is 123 deaths
per 1,000 live births for the same period. This means that one in every thirteen Ethiopian children dies
before reaching age one, while one in every eight does not survive to the fifth birthday.

Table 8.1 Early childhood mortality rates

Neonatal, postneonatal, infant, child, and under-five mortality rates for five-year
periods preceding the survey, Ethiopia 2005

Years Neonatal Postneonatal Infant Child Under-five


preceding mortality mortality mortality mortality mortality
the survey (NN) (PNN)1 (1q0) (4q0) (5q0)
0-4 39 38 77 50 123
5-9 42 42 83 63 141
10-14 46 49 95 77 165
1
Computed as the difference between infant and neonatal mortality rates

Infant and Child Mortality | 103


Mortality trends can be examined in two ways: by comparing mortality rates for three five-
year periods preceding a single survey and by comparing mortality estimates obtained from various
surveys. However, these comparisons should be interpreted with caution because quality of data, time
references and sample coverage varies. In particular, sampling errors associated with mortality
estimates are large and should be taken into account when examining trends between surveys.

Data from the 2005 EDHS show that infant mortality has declined by 19 percent over the 15-
year period preceding the survey from 95 deaths per 1,000 live births to 77. Under-five mortality has
gone down by 25 percent from 165 deaths per 1,000 live births to 123. The corresponding decline in
neonatal and postneonatal mortality over the 15-year period are 15 percent and 22 percent,
respectively.

Mortality trends can also be examined by comparing data from the 2005 EDHS with data
from the 2000 EDHS. Infant and under-five mortality rates obtained for the five years preceding the
two surveys confirm a declining trend in mortality. Under-five mortality declined from 166 deaths per
1,000 live births in the 2000 survey to 123, while infant mortality declined from 97 deaths per 1,000
live births in the 2000 survey to 77 for the 2005 survey (Figure 8.1). However, data from the 2005
survey for the same period (1996-2000) show lower mortality, indicating a potential underestimate of
mortality in the 2001-2005 period. The data also show a ten-point decline in neonatal and
postneonatal mortality between the two surveys over the same period.

Figure 8.1 Early Childhood Mortality Rates for the Period


0-4 Years Preceding the Survey, 2000 and 2005

Deaths per 1,000


200

166

150
123

97
100
77 77

49 48 50
50 39 38

0
Neonatal Postneonatal Infant Child Under-five
mortality mortality mortality mortality mortality

2000 2005

8.3 SOCIOECONOMIC DIFFERENTIALS IN CHILDHOOD MORTALITY

To minimize sampling errors associated with mortality estimates and to ensure a sufficient
number of cases for statistical reliability, the mortality rates shown in Tables 8.2 and 8.3 are
calculated for a ten-year period. Table 8.2 shows differentials in childhood mortality by four
socioeconomic variables: place of residence, region, mother’s education, and wealth quintile.

From the table it is apparent that infant and child survival is influenced by the socioeconomic
characteristics of mothers. Mortality in urban areas is consistently lower than in rural areas. For
example, infant mortality in urban areas is 66 deaths per 1,000 live births compared with 81 deaths

104 | Infant and Child Mortality


per 1,000 live births in rural areas. The urban-rural difference is even more pronounced in the case of
child mortality. Wide regional differentials in infant and under-five mortality are observed. For
example, under-five mortality ranges from a low of 72 per 1,000 live births in Addis Ababa to a high
of 157 per 1,000 live births in Benishangul-Gumuz. Under-five mortality is also relatively higher in
Amhara and Gambela.

As expected, mother’s education is inversely related to a child’s risk of dying. Under-five


mortality among children born to mothers with no education (139 per 1,000 live births) is more than
twice that of children born to mothers with secondary and higher level of education (54 per 1,000 live
births). The beneficial effect of educating mothers is obvious for all childhood mortality rates. With
respect to wealth and mortality, the relationship is not consistent, although children born to mothers in
the highest wealth quintile clearly are at much lower risk of dying than children born to mothers in the
other quintiles.

Table 8.2 Early childhood mortality rates by socioeconomic characteristics

Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period
preceding the survey, by background characteristic, Ethiopia 2005

Neonatal Postneonatal Infant Child Under-five


Background mortality mortality mortality mortality mortality
characteristic (NN) (PNN)1 (1q0) (4q0) (5q0)
Residence
Urban 35 32 66 34 98
Rural 41 40 81 58 135
Region
Tigray 40 26 67 42 106
Affar 33 28 61 66 123
Amhara 50 44 94 66 154
Oromiya 40 36 76 51 122
Somali 27 30 57 39 93
Benishangul-Gumuz 44 40 84 80 157
SNNP 36 49 85 63 142
Gambela 42 51 92 70 156
Harari 35 30 66 40 103
Addis Ababa 23 22 45 28 72
Dire Dawa 29 42 71 70 136
Mother's education
No education 41 42 83 62 139
Primary 45 34 78 35 111
Secondary and higher 21 16 37 18 54
Wealth quintile
Lowest 39 41 80 54 130
Second 38 47 86 64 144
Middle 47 38 86 63 144
Fourth 45 39 84 60 139
Highest 30 30 60 34 92

Total 41 40 80 56 132
1
Computed as the difference between infant and neonatal mortality rates

8.4 DEMOGRAPHIC DIFFERENTIALS IN MORTALITY

Infant and child mortality is influenced to a considerable extent by the demographic charac-
teristics of mothers and children including the sex of the child, mother’s age at birth, birth order,
length of the previous birth interval, and the size of the child at birth. The relationship between these
demographic characteristics and mortality is shown in Table 8.3 and Figure 8.2. Male children in
general experience higher mortality than female children. The gender difference is especially
pronounced for infant mortality, where 1 in 11 boys dies before his first birthday, compared with 1 in
14 girls.

Infant and Child Mortality | 105


Table 8.3 Early childhood mortality rates by demographic characteristics

Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period
preceding the survey, by demographic characteristics, Ethiopia 2005

Neonatal Postneonatal Infant Child Under-five


Demographic mortality mortality mortality mortality mortality
characteristic (NN) (PNN)1 (1q0) (4q0) (5q0)
Child's sex
Male 48 43 91 56 142
Female 33 37 70 56 122
Mother's age at birth
<20 57 48 106 62 161
20-29 38 37 75 54 124
30-39 34 38 72 56 124
40-49 50 46 96 63 153
Birth order
1 52 45 97 50 142
2-3 32 39 71 53 120
4-6 39 37 76 57 128
7+ 47 42 89 67 149
Previous birth interval2
<2 years 68 66 134 85 208
2 years 32 30 62 53 112
3 years 24 27 51 43 92
4+ years 17 20 38 30 66
Birth size3
Small/very small 37 36 73 na na
Average or larger 39 38 78 na na
1
Computed as the difference between infant and neonatal mortality rates
2
Excludes first-order births
3
Rates for the five-year period before the survey
na = Not applicable

Figure 8.2 Under-Five Mortality by Selected


Demographic Characteristics

SEX OF CHILD
Male 142
Female 122

AGE OF MOTHER
<20 161
20-29 124
30-39 124
40-49 153

BIRTH INTERVAL
<2 Years 208
2 Years 112
3 Years 92
4+ Years 66
0 50 100 150 200 250
Deaths per 1,000 Live Births
Note: Rates are for the 10-year period
preceding the survey. EDHS 2005

106 | Infant and Child Mortality


As expected, the relationship between maternal age at birth and childhood mortality is
generally U-shaped, being relatively higher among children born to mothers under age 20 and over
age 40 than among mothers in the middle age groups. This pattern is especially obvious in the case of
infant and under-five mortality. In general, first births and births of order 7 and higher also suffer
significantly higher rates of mortality than births of orders 2 through 6. For example, 1 in 10 first
births did not survive to the first year, compared with 1 in 14 second and third order births. Short birth
intervals also significantly reduce a child’s chance of survival. For example, children born within two
years of a preceding birth are more than three times as likely to die within the first year of life as
children born three or more years after an older sibling.

Studies have shown that a child’s birth weight is an important determinant of its survival
chances. Since most births in Ethiopia occur at home where children are often not weighed at birth,
data on birth weight is available for only a few children. However, mothers in the Ethiopia DHS
survey were asked whether their child was very large, larger than average, average, smaller than
average, or small at birth since this has been found to be a good proxy for the child’s weight. The data
show little variation in mortality by size of child at birth.

8.5 PERINATAL MORTALITY

The 2005 Ethiopia DHS survey asked women to report on any pregnancy loss that occurred in
the five years preceding the survey. For each pregnancy that did not end in a live birth, the duration of
pregnancy was recorded. In this report, perinatal deaths include pregnancy losses of at least seven
months’ gestation (stillbirths) and deaths to live births within the first seven days of life (early
neonatal deaths). The perinatal mortality rate is the sum of stillbirths and early neonatal deaths
divided by the sum of all stillbirths and live births. Information on stillbirths and deaths to infants
within the first week of life are highly susceptible to omission and misreporting. Nevertheless,
retrospective surveys in developing countries provide more representative and accurate perinatal death
rates than the vital registration systems and hospital-based studies in developing countries.

Table 8.4 shows that out of the 11,280 reported pregnancies of at least seven months’
gestation reported during the five years preceding the survey, 117 were stillbirths and 303 were early
neonatal deaths, yielding an overall perinatal mortality rate of 37 per 1,000 stillbirths and live births.
Comparable data from the 2000 EDHS show that perinatal mortality has declined from 52 per 1,000
stillbirths and live births to its current level.

Perinatal mortality is significantly higher among women whose age at birth was under 20
years or 40-49 years. First pregnancies and pregnancies that occur after an interval of less than 15
months are much more likely than pregnancies that occur after longer intervals to end in a stillbirth or
early neonatal death. Rural women are more likely to experience perinatal losses than urban women,
as are women who reside in Amhara and (surprisingly) Addis Ababa. Educated mothers are less likely
to experience pregnancy losses than uneducated mothers. Perinatal mortality is highest among women
in the middle wealth quintile.

Infant and Child Mortality | 107


Table 8.4 Perinatal mortality

Number of stillbirths and early neonatal deaths, and the perinatal mortality rate
for the five-year period preceding the survey, by background characteristics,
Ethiopia 2005

Number of
Number pregnancies
of early Perinatal of 7+
Background Number of neonatal mortality months
characteristic stillbirths1 deaths2 rate3
duration
Mother's age at birth
<20 22 88 64 1,736
20-29 47 142 33 5,775
30-39 29 53 26 3,150
40-49 18 21 63 618
Previous pregnancy interval
in months
First pregnancy 29 89 62 1,896
<15 6 34 62 630
15-26 34 69 40 2,570
27-38 9 70 26 3,000
39+ 40 40 25 3,183
Residence
Urban 7 30 45 822
Rural 110 273 37 10,458
Region
Tigray 4 10 20 702
Affar 1 1 16 108
Amhara 64 85 56 2,685
Oromiya 22 130 34 4,433
Somali 2 12 30 480
Benishangul-Gumuz 2 3 42 107
SNNP 17 58 30 2,517
Gambela 0 1 24 31
Harari 0 0 25 22
Addis Ababa 5 3 48 158
Dire Dawa 0 1 24 38
Mother's education
No education 110 233 38 8,947
Primary 5 59 34 1,860
Secondary and higher 3 11 29 473
Wealth quintile
Lowest 11 43 22 2,451
Second 30 47 32 2,386
Middle 28 100 51 2,514
Fourth 29 64 42 2,251
Highest 18 48 40 1,678

Total 117 303 37 11,280


1
Foetal deaths occurring in pregnancies of seven or more months duration
2
Deaths at age 0-6 days among live-born children.
3
The number of stillbirths and early neonatal deaths divided by the number of
pregnancies of seven or more months duration.

8.6 HIGH-RISK FERTILITY BEHAVIOUR

The survival of infants and children depends in part on the demographic and biological
characteristics of their mothers. Typically, the probability of dying in infancy is much greater among
children born to mothers who are too young (under age 18) or too old (over age 34), children born
after a short birth interval (less than 24 months after the preceding birth), and children born to mothers
of high parity (more than three children). The risk is elevated when a child is born to a mother who
has a combination of these risk characteristics.

108 | Infant and Child Mortality


The first column in Table 8.5 shows the percentage of births occurring in the five years before
the survey that fall into the various risk categories. Two-thirds of births in Ethiopia are at an elevated
risk of dying that is avoidable while 22 percent are in a “risk-free” category. First births, which make
up 12 percent of births, are in the unavoidable risk category. Forty-one percent of births are in a single
high-risk category and 25 percent in a multiple high-risk category. The most common single high-risk
category is births of order 3 and higher (29 percent), while the most common multiple high-risk
category is births to mothers older than 34 years and of birth order 3 and above (13 percent).

The risk ratios displayed in the Table 8.5 High-risk fertility behaviour
second column of Table 8.5 denote the
Percent distribution of children born in the five years preceding the survey
relationship between risk factors and
by category of elevated risk of mortality and the risk ratio, and percent
mortality. In general, risk ratios are distribution of currently married women by category of risk if they were to
higher for children in a multiple high- conceive a child at the time of the survey, Ethiopia 2005
risk category than in a single high-risk
Births in the 5 years Percentage
category. The most vulnerable births are preceding the survey of currently
those to two groups of women: births to Percentage Risk married
women age 34 or older, with a birth Risk category of births ratio women1
interval less than 24 months and birth Not in any high-risk category 21.9 1.00 13.5a
order of three or higher; and births at an
interval less than 24 months and of birth Unavoidable risk category
order 3 and higher. These children are First-order births between ages
18 and 34 years 11.9 1.85 5.5
more than three times as likely to die as
children not in any high-risk category. Single high-risk category
Two percent and 9 percent of births, Mother’s age <18 6.3 2.63 1.4
respectively, fall into these two cate- Mother’s age >34 0.5 0.34 2.5
gories. Birth interval <24 months 5.9 2.41 9.5
Birth order >3 28.6 1.13 18.7
The last column of Table 8.5
shows the distribution of currently mar- Subtotal 41.4 1.53 32.0

ried women who have the potential for


Multiple high-risk category
having a high-risk birth by category. Age <18 and birth interval
This column is purely hypothetical and <24 months2 0.8 1.88 0.5
does not take into consideration the Age >34 and birth interval
<24 months 0.0 * 0.1
protection provided by family planning,
Age >34 and birth order >3 13.1 1.43 26.7
postpartum insusceptibility, and pro- Age >34 and birth interval
longed abstinence. However, it provides <24 months and birth order >3 2.0 3.21 7.1
an insight into the magnitude of high- Birth interval <24 months and
birth order >3 8.9 3.19 14.5
risk births. More than one in four births
(27 percent) is to women who are or Subtotal 24.9 2.22 49.0
would be too old, and have or would
have too many children. A substantially In any avoidable high-risk category 66.3 1.79 81.0
higher proportion of women (49 per-
cent) have the potential of having a birth Total 100.0 na 100.0
in a multiple high-risk category than in a Number 11,163 na 9,066
single high-risk category (32 percent). Note: Risk ratio is the ratio of the proportion dead among births in a
specific high-risk category to the proportion dead among births not in any
high-risk category. An asterisk indicates that a figure is based on fewer than
25 unweighted cases and has been suppressed.
1
Women are assigned to risk categories according to the status they would
have at the birth of a child if they were to conceive at the time of the
survey: current age less than 17 years and 3 months or older than 34 years
and 2 months, latest birth less than 15 months ago, or latest birth being of
order 3 or higher.
2
Includes the category age <18 and birth order >3
a
Includes sterilised women
na = Not applicable

Infant and Child Mortality | 109


 
MATERNAL HEALTH 9
The health care that a mother receives during pregnancy, at the time of delivery and soon after
delivery is important for the survival and well-being of both the mother and the child. This chapter
presents findings on several areas of importance to maternal health: antenatal, delivery, and postnatal
care; problems in accessing health care and awareness and attitudes concerning tuberculosis. These
findings are important to policymakers and programme implementers in formulating programmes and
policies and in designing appropriate strategies and interventions to improve maternal and child health
care services.

9.1 ANTENATAL CARE

Antenatal care (ANC) coverage can be described according to the type of provider, number of
ANC visits, and stage of pregnancy at the time of the first visit, as well as content of services and
information provided during ANC. In the 2005 EDHS information on ANC coverage was obtained
from women who had a birth in the five years preceding the survey. For women with two or more live
births during the five-year period, data refer to the most recent birth only.

Table 9.1 shows the percent distribution of mothers in the five years preceding the survey by
source of antenatal care received during pregnancy, according to selected characteristics. Women
were asked to report on all persons seen for antenatal care for the last birth. However, for the purpose
of presenting the results, if a woman was seen by more than one provider, only the provider with the
highest qualification is considered.

Twenty-eight percent of mothers received antenatal care from health professionals (doctor,
nurse, midwife) for their most recent birth in the five years preceding the survey, and less than 1
percent of mothers received antenatal care from a traditional birth attendant (trained or untrained).
More than seven in ten mothers (72 percent) received no antenatal care for births in the preceding five
years.

Differences in antenatal care by women’s age at birth are not large. Differences by birth order
however are more pronounced. Mothers are more likely to receive care from a health professional for
first births (34 percent) than for births of order six and higher (22 percent).

There are large differences in the use of antenatal care services between urban and rural
women. In urban areas, health professionals provide antenatal care for 69 percent of mothers, whereas
they provide care for only 24 percent of mothers in rural areas. It is important to note that three in four
mothers in rural areas, receive no antenatal care at all.

Regional differences in the source of antenatal care are quite significant; 88 percent of
mothers in Addis Ababa received antenatal care from a health professional, compared with less than
one in ten mothers in the Somali Region.

The use of antenatal care services is strongly related to the mother’s level of education.
Women with at least secondary education are more likely to receive antenatal care from a health
professional (81 percent) than women with primary education (39 percent) and those with no
education (22 percent). There is also a positive relationship between increasing wealth and receiving
antenatal care from a health professional, with women in the highest wealth quintile nearly five times
more likely to receive antenatal care from a health professional than women in the lowest wealth
quintile.

Maternal Health | 111


Table 9.1 Antenatal care

Percent distribution of women who had a live birth in the five years preceding the survey by antenatal care (ANC)
provider during pregnancy for the most recent birth, according to background characteristics, Ethiopia 2005

Trained Traditional
traditional birth
Background Health birth attendant/ No Number of
characteristic professional attendant other one Missing Total women
Age at birth
<20 27.3 0.7 0.4 71.5 0.2 100.0 994
20-34 29.1 0.2 0.6 70.1 0.0 100.0 4,923
35-49 22.7 0.0 0.5 76.6 0.2 100.0 1,391
Birth order
1 34.4 0.5 0.5 64.5 0.0 100.0 1,190
2-3 31.1 0.4 0.6 67.8 0.1 100.0 2,089
4-5 25.8 0.1 0.5 73.5 0.0 100.0 1,692
6+ 22.4 0.0 0.6 76.9 0.1 100.0 2,336
Residence
Urban 68.9 0.3 0.5 30.1 0.1 100.0 634
Rural 23.7 0.2 0.5 75.4 0.1 100.0 6,674
Region
Tigray 35.3 0.4 1.8 62.5 0.0 100.0 480
Affar 15.0 1.7 0.3 83.0 0.0 100.0 68
Amhara 26.5 0.2 0.3 73.1 0.0 100.0 1,856
Oromiya 24.8 0.2 0.4 74.5 0.2 100.0 2,723
Somali 7.4 0.0 0.4 92.0 0.2 100.0 288
Benishangul-Gumuz 24.5 0.2 0.2 74.3 0.8 100.0 69
SNNP 30.3 0.4 0.7 68.5 0.0 100.0 1,632
Gambela 36.6 0.6 1.6 61.0 0.2 100.0 23
Harari 40.7 0.9 0.4 58.0 0.0 100.0 15
Addis Ababa 88.3 0.3 0.0 11.5 0.0 100.0 129
Dire Dawa 52.9 0.0 1.4 45.7 0.0 100.0 25
Education
No education 21.7 0.3 0.6 77.3 0.1 100.0 5,734
Primary 39.4 0.1 0.4 60.0 0.0 100.0 1,205
Secondary and higher 80.9 0.1 0.4 18.5 0.2 100.0 368
Wealth quintile
Lowest 12.7 0.1 0.8 86.4 0.0 100.0 1,520
Second 18.6 0.5 0.4 80.4 0.2 100.0 1,553
Middle 25.2 0.4 0.4 74.1 0.0 100.0 1,586
Fourth 30.6 0.0 0.5 68.8 0.2 100.0 1,451
Highest 58.0 0.2 0.7 41.0 0.1 100.0 1,196

Total 27.6 0.2 0.5 71.5 0.1 100.0 7,307

Note: If more than one source of ANC was mentioned, only the provider with the highest qualifications is considered in
this tabulation.

There has been little improvement over the past five years in the proportion of mothers who
receive antenatal care from a health professional, increasing from 27 percent in 2000 to 28 percent in
2005. However, there seems to have been a shift in the regional pattern of antenatal care coverage.
The proportions of women receiving professional antenatal care increased over the past five years in
Amhara and Addis Ababa. On the other hand, use of professional antenatal care declined over the past
five years in Affar, Somali, Gambela, Harari and Dire Dawa, with the greatest decline seen in the
Somali Region. There was little change in the other regions.

Number and Timing of Antenatal Visits

Antenatal care is more beneficial in preventing adverse pregnancy outcomes when it is sought
early in the pregnancy and is continued through to delivery. Health professionals recommend that the
first antenatal visit should occur within the first three months of pregnancy and continue on a monthly
basis through the 28th week of pregnancy and fortnightly up to the 36th week (or until birth). If the

112 | Maternal Health


first antenatal visit is made at the third month of pregnancy and as regularly as recommended, there
would be a total of at least 12 to 13 antenatal visits. Under normal circumstances, WHO recommends
that a woman without complications have at least four ANC visits to provide sufficient care. It is
possible during these visits to detect health problems associated with a pregnancy. In the event of any
complications, more frequent visits are advisable and admission to a health facility may be necessary.

Table 9.2 shows that slightly more Table 9.2 Number of antenatal care visits and timing of first visit
than one in ten (12 percent) women make four
Percent distribution of women who had a live birth in the five
or more antenatal care visits during their entire
years preceding the survey by number of antenatal care (ANC)
pregnancy. There is marked variation between visits for the most recent birth, and by the timing of the first visit
women residing in urban areas (55 percent) according to residence, Ethiopia 2005
and those in rural areas (8 percent).
Residence
Number and timing of ANC visits Urban Rural Total
Only 6 percent of women make their
first antenatal care visit before the fourth Number of ANC visits
month of pregnancy. The median duration of None 30.1 75.4 71.5
1 2.9 4.8 4.6
pregnancy for the first antenatal care visit is
2-3 11.8 11.3 11.3
5.6 months. This indicates that in Ethiopia 4+ 54.5 8.1 12.2
women start antenatal care at a relatively late Don't know/missing 0.7 0.4 0.4
stage of their pregnancy. The median duration
of pregnancy for the first antenatal care visit is Total 100.0 100.0 100.0
4.2 months for urban women compared with
Number of months pregnant at
6.0 for rural women. There was little change in
time of first ANC visit
the timing of the first visit over the past five No antenatal care 30.1 75.4 71.5
years. <4 32.4 3.9 6.4
4-5 25.0 8.2 9.7
Components of Antenatal Care 6-7 10.7 8.9 9.1
8+ 1.4 3.1 3.0
The content of antenatal care is Don't know/missing 0.3 0.4 0.4
important in assessing the quality of antenatal
care services. Pregnancy complications are an Total 100.0 100.0 100.0
Median months pregnant at first
important source of maternal and child visit (for those with ANC) 4.2 6.0 5.6
morbidity and mortality, and thus teaching
pregnant women about the danger signs Number of women 634 6,674 7,307
associated with pregnancy and the appropriate
action to take are essential components of antenatal care. Table 9.3 presents information on the
percentage of women who took iron tablets and intestinal parasite drugs during their last pregnancy in
the five years preceding the survey. The table also shows the percentage of women who were
informed about the signs of pregnancy complications and the percentage who received routine
antenatal care services among women receiving ANC.

Among women with a live birth in the past five years, 10 percent took iron tablets while
pregnant with the last birth. There are few variations by age at birth and birth order. However, there
are substantial variations by place of residence, region, education and wealth quintile, with urban
women, women in Harari and Addis Ababa, and better educated and wealthier women much more
likely to have taken iron supplements.

Only 4 percent of women took intestinal parasite drugs during their pregnancy. Variations by
background characteristics are small.

Thirty-one percent of mothers who received antenatal care reported that they were informed
about pregnancy complications during their visits. Weight and blood pressure measurements were
taken on 72 percent and 62 percent of mothers, respectively. About one-quarter of mothers gave urine
and blood samples.

Maternal Health | 113


Table 9.3 Components of antenatal care

Among women with a live birth in the five years preceding the survey, the percentage who took iron tablets or syrup and drugs for
intestinal parasites during the pregnancy for the most recent birth, and among women receiving antenatal care for the most recent live
birth in the five years preceding the survey, the percentage receiving specific antenatal services, according to background characteristics,
Ethiopia 2005

Among women with a live birth


in the past five years, the Among women who received antenatal care for their
percentage who during the most recent birth in the past five years, the percentage
pregnancy for their last birth receiving specific services:
Informed
Took of signs of
intestinal pregnancy Blood Urine Blood
Background Took iron parasite Number of compli- pressure sample sample Number of
characteristic tablets drugs women cations Weighed measured taken taken women
Mother’s age at birth
<20 9.7 3.9 994 28.2 71.1 56.2 22.8 27.0 282
20-34 10.6 4.0 4,923 32.0 72.3 63.8 27.2 26.2 1,472
35-49 10.4 4.0 1,391 31.7 69.8 58.1 26.5 25.1 323
Birth order
1 9.8 3.1 1,190 34.9 73.4 61.0 32.4 30.1 422
2-3 10.6 3.4 2,089 32.8 74.2 65.8 31.8 30.3 671
4-5 9.6 5.0 1,692 28.0 69.4 60.3 19.9 21.9 448
6+ 11.3 4.3 2,336 29.8 69.1 59.0 20.7 21.5 536
Residence
Urban 20.1 5.3 634 51.8 91.4 84.8 64.6 59.0 442
Rural 9.5 3.9 6,674 25.9 66.4 55.7 16.2 17.3 1,634
Region
Tigray 12.2 1.8 480 40.8 84.1 79.9 21.4 30.8 180
Affar 9.4 5.2 68 29.7 66.7 65.3 44.5 39.9 12
Amhara 8.4 1.5 1,856 31.9 56.3 40.8 20.0 16.3 500
Oromiya 10.3 5.3 2,723 26.1 71.5 62.0 26.0 26.3 690
Somali 8.3 3.3 288 (52.8) (87.3) (86.6) (80.7) (67.4) 22
Benishangul-Gumuz 7.5 3.9 69 23.5 60.7 43.4 16.8 15.3 17
SNNP 12.0 5.0 1,632 26.8 76.0 67.6 16.0 16.1 513
Gambela 17.0 7.2 23 28.7 70.0 58.4 23.2 21.1 9
Harari 20.1 5.4 15 58.5 93.4 81.0 77.6 68.0 6
Addis Ababa 20.3 8.8 129 62.8 97.6 93.8 95.1 92.0 114
Dire Dawa 12.5 3.6 25 35.9 90.2 83.1 68.6 64.8 13
Education
No education 9.4 3.6 5,734 25.1 65.2 53.6 17.6 18.0 1,296
Primary 11.6 5.0 1,205 33.5 77.0 68.3 26.6 30.5 481
Secondary and higher 22.8 6.2 368 55.6 91.4 87.4 64.7 54.7 299
Wealth quintile
Lowest 6.1 2.7 1,520 23.5 57.3 51.9 14.4 18.0 207
Second 8.5 3.8 1,553 23.5 70.3 55.8 13.5 14.5 302
Middle 10.5 3.3 1,586 23.7 65.4 52.3 14.1 17.0 411
Fourth 11.1 5.0 1,451 27.9 65.6 54.9 16.4 14.1 451
Highest 17.4 5.7 1,196 43.9 84.1 77.5 49.3 46.7 705

Total 10.4 4.0 7,307 31.4 71.7 61.9 26.5 26.2 2,076

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

The quality of antenatal care is particularly affected by mother’s education, mother’s wealth,
residence and region. For example, women with secondary or higher education, women in the highest
wealth quintile and urban women are twice as likely as women with no education, women in the
lowest wealth quintile and rural women to be informed about pregnancy complications. Regional
variations in the proportion of women who were informed about pregnancy complications during
ANC visits are marked, ranging from a high of 63 percent among women in Addis Ababa to a low of
24 percent in Benishangul-Gumuz. Similar patterns are observed for the other routine tests and
procedures.

114 | Maternal Health


There has been a small increase in the percentage of women who have received the various
components of antenatal care over the past five years. For example, 31 percent of women with a birth
in the five years preceding the survey in 2005 were informed of the signs of pregnancy complications
compared with 27 percent in 2000.

Tetanus Toxoid Vaccination

Tetanus toxoid injections are given during pregnancy for the prevention of neonatal tetanus, a
major cause of death among infants. For full protection, a pregnant woman should receive at least two
doses during each pregnancy. If a woman has been vaccinated during a previous pregnancy, however,
she may only require one dose for the current pregnancy. Five doses are considered to provide
lifetime protection. Table 9.4 presents the percent distribution of women who had a live birth in the
five years preceding the survey by whether the last birth was protected against neonatal tetanus.

Table 9.4 Tetanus toxoid injections

Percent distribution of women who had a live birth in the five years preceding the survey by whether the last birth was protected against neonatal
tetanus and by number of injections, according to background characteristics, Ethiopia 2005

Protected Not protected


One plus one None, One and no
additional but at TT injection None, less
injection in least 5 in the 10 than 5
Two or the 10 years lifetime years prior to lifetime Don't Number
Background more prior to the TT Total the TT Total not know/ of
characteristic injections pregnancy injections protected pregnancy injections protected missing Total women
Mother’s age at birth
<20 28.1 2.0 0.5 30.6 7.3 61.3 68.6 0.8 100.0 994
20-34 29.6 2.8 1.5 33.9 6.1 58.5 64.7 1.4 100.0 4,923
35-49 22.5 3.2 1.7 27.3 4.4 65.0 69.4 3.3 100.0 1,391
Birth order
1 32.0 1.8 0.7 34.6 8.2 56.0 64.3 1.2 100.0 1,190
2-3 31.2 3.2 1.3 35.6 6.6 56.1 62.7 1.7 100.0 2,089
4-5 27.5 2.8 1.6 31.8 5.0 61.8 66.8 1.4 100.0 1,692
6+ 23.6 2.8 1.8 28.2 4.9 64.6 69.5 2.2 100.0 2,336
Residence
Urban 51.9 5.1 3.5 60.5 7.8 28.7 36.5 3.0 100.0 634
Rural 25.8 2.5 1.2 29.5 5.8 63.1 68.9 1.6 100.0 6,674
Region
Tigray 28.9 4.3 6.6 39.8 5.7 52.2 57.9 2.3 100.0 480
Affar 10.9 0.0 0.0 10.9 4.5 78.5 83.0 6.1 100.0 68
Amhara 24.6 4.0 1.2 29.8 6.6 61.1 67.7 2.5 100.0 1,856
Oromiya 28.4 2.0 0.8 31.1 5.1 62.8 67.9 1.0 100.0 2,723
Somali 9.1 0.0 0.3 9.4 1.3 87.4 88.8 1.8 100.0 288
Benishangul-Gumuz 18.2 2.0 0.3 20.5 4.7 70.8 75.5 4.0 100.0 69
SNNP 33.0 2.6 1.3 36.9 7.4 54.6 62.0 1.1 100.0 1,632
Gambela 22.7 1.0 0.5 24.2 5.8 66.4 72.1 3.7 100.0 23
Harari 33.0 2.6 2.1 37.8 3.7 55.9 59.5 2.6 100.0 15
Addis Ababa 57.7 6.3 3.8 67.7 10.0 15.9 25.9 6.4 100.0 129
Dire Dawa 49.8 1.1 0.8 51.7 3.4 42.3 45.7 2.7 100.0 25
Education
No education 23.5 2.5 1.2 27.2 5.6 65.5 71.2 1.7 100.0 5,734
Primary 40.3 2.6 1.6 44.6 6.8 47.1 53.8 1.6 100.0 1,205
Secondary and higher 58.8 7.0 4.1 70.0 8.7 18.5 27.3 2.8 100.0 368
Wealth quintile
Lowest 17.5 1.5 1.1 20.2 3.9 73.9 77.7 2.1 100.0 1,520
Second 22.2 2.3 1.3 25.8 6.6 66.2 72.8 1.4 100.0 1,553
Middle 26.3 1.9 1.1 29.4 7.0 62.5 69.4 1.2 100.0 1,586
Fourth 31.0 3.9 1.3 36.2 5.1 56.7 61.8 2.0 100.0 1,451
Highest 47.7 4.5 2.5 54.7 7.5 35.9 43.4 1.8 100.0 1,196

Total 28.0 2.7 1.4 32.2 6.0 60.1 66.1 1.7 100.0 7,307

Maternal Health | 115


Last births were protected against neonatal tetanus for only 32 percent of women. Most of
these women (28 percent) had received two or more tetanus toxoid injections while pregnant with the
last birth. This indicates that births to women in Ethiopia are not routinely protected against neonatal
tetanus.

Births to relatively younger mothers age 20-34 years and lower order births (3 and below) are
slightly more likely to be protected against tetanus than births to older mothers and higher order
births. Twice as many births in urban areas (61 percent) as in rural areas (30 percent) are protected
against tetanus. The proportion of births protected against tetanus varies substantially by region.
Tetanus toxoid coverage is highest among mothers in Addis Ababa (68 percent) and lowest among
mothers in the Somali and Affar regions (9 percent and 11 percent, respectively). There are marked
differences by education and wealth index in the proportion of births protected against tetanus.

Despite the low overall coverage, there is evidence of improvement over time. The percentage
of women who received two or more tetanus injections during the pregnancy leading to their most
recent birth increased from 17 percent in 2000 to 28 percent in 2005.

9.2 DELIVERY CARE

Proper medical attention and hygienic conditions during delivery can reduce the risk of
complications and infections that may cause the death or serious illness of the mother and the baby or
both. Hence, an important component in the effort to reduce the health risks of mothers and children is
to increase the proportion of babies delivered in a safe and clean environment and under the
supervision of health professionals. Data on delivery care were obtained for all births that occurred in
the five years preceding the survey. Table 9.5 presents the percent distribution of live births in the five
years preceding the survey by place of delivery, according to background characteristics.

An overwhelming majority of births (94 percent) in the five years before the survey were
delivered at home. Five percent of births were delivered in a public facility and less than 1 percent of
births were delivered in a private facility. Delivery in a health facility is more common among
younger mothers (age less than 35), mothers with first order births, and mothers who have had at least
4 antenatal visits. Children born in urban areas are 20 times more likely to be delivered in a health
facility than children born in rural areas. The proportion of births delivered in a health facility is
generally low in most of the regions (6 percent or less) with the exception of the Gambela and Harari
regions and in Addis Ababa and Dire Dawa. In these four areas, the proportion of births delivered in a
health facility ranges from 15 percent in the Gambela Region to 79 percent in Addis Ababa. There is
also a strong association between mother’s education and place of delivery. The proportion of births
delivered in a health facility is only 2 percent among uneducated mothers, compared with 52 percent
among mothers with secondary and higher education. Not surprisingly, deliveries in a private health
facility are most common among educated women residing in Addis Ababa.

There has been no change in the proportion of births taking place in health facilities over the
past five years. Data from the 2000 EDHS show that 5 percent of births took place in a health facility.

116 | Maternal Health


Table 9.5 Place of delivery

Percent distribution of live births in the five years preceding the survey by place of delivery, according to
background characteristics, Ethiopia 2005

Health facility
Background Public Private Number of
characteristic sector sector Home Other Missing Total births
Mother's age at birth
<20 5.9 0.4 93.1 0.4 0.2 100.0 1,715
20-34 5.0 0.4 93.9 0.4 0.2 100.0 7,702
35-49 2.5 0.9 95.6 0.5 0.4 100.0 1,746
Birth order
1 12.2 0.9 86.0 0.5 0.3 100.0 1,933
2-3 5.3 0.5 93.8 0.3 0.1 100.0 3,351
4-5 2.4 0.2 96.8 0.4 0.2 100.0 2,620
6+ 1.8 0.4 97.0 0.4 0.4 100.0 3,259
Antenatal care visits1
None 1.6 0.2 97.8 0.4 0.0 100.0 5,225
1-3 7.1 1.2 91.2 0.6 0.0 100.0 1,164
4+ 28.4 2.2 69.1 0.4 0.0 100.0 888
Residence
Urban 39.5 2.9 56.9 0.4 0.3 100.0 815
Rural 2.0 0.3 97.0 0.4 0.2 100.0 10,348
Region
Tigray 6.1 0.0 93.9 0.1 0.0 100.0 698
Affar 3.9 0.0 95.8 0.3 0.0 100.0 107
Amhara 3.5 0.0 96.3 0.0 0.1 100.0 2,621
Oromiya 3.7 0.6 95.2 0.3 0.3 100.0 4,411
Somali 4.6 0.4 93.9 0.0 1.1 100.0 477
Benishangul-Gumuz 4.7 0.0 80.7 13.7 1.0 100.0 105
SNNP 3.3 0.4 95.6 0.7 0.1 100.0 2,500
Gambela 13.2 2.0 81.1 3.4 0.2 100.0 31
Harari 31.1 0.4 66.5 0.8 1.1 100.0 22
Addis Ababa 67.5 11.0 21.0 0.5 0.0 100.0 153
Dire Dawa 24.5 1.4 74.2 0.0 0.0 100.0 37
Education
No education 2.1 0.1 97.1 0.4 0.2 100.0 8,838
Primary 6.9 1.1 91.3 0.4 0.4 100.0 1,855
Secondary and higher 47.0 4.6 47.8 0.2 0.4 100.0 470
Wealth quintile
Lowest 0.5 0.1 98.3 0.7 0.4 100.0 2,440
Second 1.2 0.0 98.3 0.3 0.2 100.0 2,356
Middle 1.8 0.1 97.8 0.1 0.2 100.0 2,486
Fourth 3.2 0.9 95.3 0.4 0.2 100.0 2,222
Highest 22.8 1.8 74.7 0.5 0.1 100.0 1,660

Total 4.8 0.5 94.1 0.4 0.2 100.0 11,163

Note: Total includes 47 births missing information on antenatal care visits not shown separately.
1
Includes only the most recent birth in the five years preceding the survey

Assistance during Delivery

Obstetric care from a trained provider during delivery is recognized as critical for the
reduction of maternal and neonatal mortality. Births delivered at home are usually more likely to be
delivered without assistance from a health professional, whereas births delivered at a health facility
are more likely to be delivered by a trained health professional. Table 9.6 shows the type of assistance
during delivery by selected background characteristics. Only 6 percent of births are delivered with the
assistance of a trained health professional, that is, a doctor, nurse, or midwife, and 28 percent are
delivered by a traditional birth attendant. The majority of births are attended by a relative or some
other person (61 percent). Five percent of all births are delivered without any type of assistance at all.

Maternal Health | 117


Table 9.6 Assistance during delivery

Percent distribution of live births in the five years preceding the survey by person providing assistance during delivery and
percent delivered by caesarean-section, according to background characteristics, Ethiopia 2005

Person providing assistance during delivery


Traditional Don't Percentage
Background Health birth Relative/ know/ delivered by Number of
characteristic professional attendant other No one missing Total C-section births
Mother's age at birth
<20 6.9 31.8 58.5 2.7 0.1 100.0 1.1 1,715
20-34 5.8 28.3 60.5 5.2 0.2 100.0 1.1 7,702
35-49 3.8 23.9 62.8 9.1 0.4 100.0 0.5 1,746
Birth order
1 13.7 27.8 55.9 2.2 0.3 100.0 3.1 1,933
2-3 6.6 26.7 62.9 3.9 0.0 100.0 1.0 3,351
4-5 2.7 29.5 61.0 6.4 0.4 100.0 0.2 2,620
6+ 2.4 28.6 60.4 8.2 0.3 100.0 0.4 3,259
Place of delivery
Health facility 97.3 1.5 0.9 0.3 0.0 100.0 18.8 589
Elsewhere 0.6 29.6 63.8 5.7 0.2 100.0 0.0 10,574
Residence
Urban 44.6 22.9 30.6 1.4 0.4 100.0 9.4 815
Rural 2.6 28.5 62.9 5.8 0.2 100.0 0.3 10,348
Region
Tigray 6.0 13.8 79.4 0.7 0.0 100.0 0.9 698
Affar 4.5 42.5 50.2 1.3 1.4 100.0 0.6 107
Amhara 3.7 29.6 64.6 1.9 0.1 100.0 0.6 2,621
Oromiya 4.8 32.5 57.7 4.7 0.3 100.0 0.7 4,411
Somali 5.2 71.6 20.9 1.2 1.1 100.0 1.0 477
Benishangul-Gumuz 5.1 20.4 49.8 23.8 1.0 100.0 0.1 105
SNNP 4.2 14.8 68.6 12.4 0.1 100.0 1.0 2,500
Gambela 15.3 19.3 54.5 10.5 0.4 100.0 1.7 31
Harari 31.4 61.5 5.3 0.9 0.9 100.0 3.3 22
Addis Ababa 78.8 4.2 16.0 0.9 0.1 100.0 16.0 153
Dire Dawa 26.7 72.4 0.5 0.3 0.1 100.0 3.5 37
Education
No education 2.3 29.4 62.0 6.0 0.2 100.0 0.4 8,838
Primary 8.5 25.5 62.1 3.7 0.2 100.0 0.9 1,855
Secondary and higher 57.7 14.2 26.3 1.4 0.5 100.0 13.1 470
Wealth quintile
Lowest 0.7 36.8 55.2 6.9 0.4 100.0 0.0 2,440
Second 1.3 27.5 64.9 6.1 0.2 100.0 0.3 2,356
Middle 1.9 26.8 66.7 4.4 0.2 100.0 0.2 2,486
Fourth 4.5 25.4 65.2 4.7 0.2 100.0 0.5 2,222
Highest 26.6 21.9 46.6 4.7 0.2 100.0 5.3 1,660

Total 5.7 28.1 60.5 5.4 0.2 100.0 1.0 11,163

Note: If the respondent mentioned more than one person attending during delivery, only the most qualified person is
considered in this tabulation.

Births to young mothers (less than 35 years) and first births are more likely to be assisted by
trained health professionals.

Nearly one in two births (45 percent) in urban areas was assisted by a trained health
professional, compared with only 3 percent of births in rural areas. Additionally, 63 percent of births
to women in rural areas were delivered with the help of a relative or some other person, compared
with 31 percent of births to women residing in urban areas. In most regions, the proportion of births
assisted by a trained health professional is quite low (less than 10 percent). However, about one in
seven births in Gambela, one in four births in Dire Dawa, one in three births in Harari, and nearly four
in five births in Addis Ababa are delivered by a trained health professional.

118 | Maternal Health


As expected, mother’s education has a positive relationship with delivery care. Births to
women with primary education are almost four times (9 percent) more likely and births to women
with secondary or higher education are 25 times (58 percent) more likely to receive delivery
assistance from a health professional than births to women with no education (2 percent). Similarly,
assistance by a trained health professional varies by economic status of women. Births to women in
the highest wealth quintile are much more likely to be assisted by a trained health professional (27
percent) than births to women in the lowest wealth quintile (1 percent).

Table 9.6 shows that deliveries by caesarean section are not common in Ethiopia. If they do
occur, they are mostly among highly educated women (13 percent), urban women (9 percent), and
women in Addis Ababa (16 percent).

9.3 POSTNATAL CARE

A large proportion of maternal and neonatal deaths occur during the 48 hours after delivery.
Thus, postnatal care is important for both the mother and the child to treat complications arising from
the delivery, as well as to provide the mother with important information on how to care for herself
and her child. Safe motherhood programmes have recently increased emphasis on the importance of
postnatal care, recommending that all women receive a check on their health within two days of
delivery. To assess the extent of postnatal care utilization, respondents were asked for the last birth in
the five years preceding the survey whether they had received a health check after the delivery, the
timing of the first check, and the type of health provider. This information is presented according to
background characteristics in Table 9.7.

According to data collected in the 2005 EDHS, postnatal care coverage is extremely low in
Ethiopia. More than nine in ten mothers received no postnatal care at all and only 5 percent received
postnatal care within the critical first two days after the delivery.

There are no marked variations by mother’s age in the utilization of postnatal care services
within the first two days of birth. A higher percentage of mothers who delivered for the first time than
mothers with two or more children received postnatal care within the first two days.

Thirty-one percent of mothers in urban areas received postnatal care within two days of the
birth compared with 2 percent of mothers in rural areas. The utilization of timely postnatal care ranges
from a low of 3 percent of mothers in the Somali Region to a high of 49 percent in Addis Ababa.

Similarly, mother’s education seems to influence the utilization of postnatal care. Two percent
of mothers with no education received timely postnatal care, compared with 41 percent of mothers
with at least some secondary education. There are significant differences between women in the
receipt of postnatal care within two days by wealth quintile, with only 1 percent of women in the
lowest wealth quintile receiving timely postnatal care compared with 20 percent of women in the
highest wealth quintile.

Table 9.7 presents information on the type of postnatal care providers by mother’s
background characteristics. Health professionals provided postnatal care for 6 percent of mothers.
About 1 percent of mothers received postnatal care from traditional birth attendants. Health
professionals are more likely to provide postnatal care to mothers of first order births, mothers with at
least some secondary education, and mothers to the wealthiest households. Likewise, mothers in
urban areas and those in Addis Ababa are more likely to have received postnatal care from a health
professional.

Maternal Health | 119


Table 9.7 Timing and type of provider of first postnatal checkup

Among women giving birth in the five years preceding the survey, the percent distribution by time after delivery and type of provider of the
mother's first postnatal health checkup for the last live birth, according to background characteristics, Ethiopia 2005

Time after delivery of mother's first Type of health provider of mother's


postnatal checkup first postnatal checkup
Less Don't Health Traditional Don't No
Background than 4 4-23 3-41 know/ profes- birth know/ check- Number
characteristic hours hours 2 days days missing sional attendant Other missing up Total of women
Mother’s age at birth
<20 3.0 1.5 0.3 1.2 0.6 5.9 0.6 0.1 0.0 93.4 100.0 994
20-34 3.1 1.4 0.6 1.4 0.3 5.9 0.7 0.1 0.1 93.2 100.0 4,923
35-49 1.4 1.0 0.3 0.8 0.7 3.8 0.2 0.3 0.0 95.7 100.0 1,391
Birth order
1 5.4 3.3 0.3 2.9 0.5 11.4 0.8 0.2 0.0 87.6 100.0 1,190
2-3 3.8 1.5 0.7 1.4 0.3 6.4 1.0 0.1 0.1 92.4 100.0 2,089
4-5 1.7 0.6 0.4 0.9 0.6 3.6 0.5 0.0 0.1 95.8 100.0 1,692
6+ 1.3 0.7 0.5 0.6 0.4 3.1 0.2 0.2 0.0 96.6 100.0 2,336
Residence
Urban 18.3 9.9 2.7 5.3 0.9 36.1 0.4 0.0 0.5 62.9 100.0 634
Rural 1.3 0.5 0.3 0.9 0.4 2.6 0.6 0.1 0.0 96.7 100.0 6,674
Region
Tigray 4.1 2.4 0.4 1.7 0.1 8.2 0.4 0.1 0.0 91.3 100.0 480
Affar 2.1 1.0 1.5 0.7 0.8 6.0 0.1 0.0 0.0 93.9 100.0 68
Amhara 2.2 0.8 0.3 1.0 0.2 3.6 0.8 0.0 0.2 95.5 100.0 1,856
Oromiya 2.6 0.5 0.6 1.1 0.6 4.5 0.6 0.2 0.0 94.7 100.0 2,723
Somali 0.4 2.3 0.5 1.4 0.2 4.7 0.0 0.0 0.2 95.1 100.0 288
Benishangul-Gumuz 2.3 0.7 0.2 0.9 0.0 4.1 0.0 0.0 0.0 95.9 100.0 69
SNNP 1.9 0.7 0.3 1.4 0.6 4.2 0.6 0.2 0.0 95.1 100.0 1,632
Gambela 7.9 0.7 1.9 2.2 0.3 12.6 0.4 0.0 0.0 87.0 100.0 23
Harari 8.5 15.0 0.2 2.9 0.7 25.9 0.7 0.7 0.0 72.7 100.0 15
Addis Ababa 23.6 22.8 3.0 6.6 0.5 55.9 0.3 0.0 0.3 43.4 100.0 129
Dire Dawa 9.9 11.6 1.1 1.0 0.3 23.0 1.0 0.0 0.0 76.1 100.0 25
Education
No education 1.1 0.5 0.2 0.8 0.4 2.4 0.4 0.1 0.0 97.0 100.0 5,734
Primary 4.1 1.6 0.9 1.9 0.4 7.7 1.2 0.0 0.1 91.0 100.0 1,205
Secondary and higher 24.2 13.4 3.2 6.4 0.9 46.4 1.2 0.0 0.4 52.0 100.0 368
Wealth quintile
Lowest 0.6 0.1 0.4 0.3 0.6 1.3 0.5 0.0 0.0 98.1 100.0 1,520
Second 0.8 0.6 0.0 0.5 0.3 1.8 0.4 0.0 0.0 97.9 100.0 1,553
Middle 0.8 0.5 0.2 1.3 0.1 2.1 0.7 0.1 0.0 97.0 100.0 1,586
Fourth 1.4 0.5 0.4 1.0 0.5 3.1 0.5 0.3 0.0 96.2 100.0 1,451
Highest 12.2 5.9 1.8 3.8 0.7 23.1 1.0 0.2 0.3 75.5 100.0 1,196

Total 2.8 1.3 0.5 1.3 0.4 5.5 0.6 0.1 0.1 93.7 100.0 7,307

9.4 PROBLEMS IN ACCESSING HEALTH CARE

Many factors can prevent women from getting medical advice or treatment for themselves
when they are sick. Information on such factors is particularly important in understanding and
addressing the barriers women may face in seeking care during pregnancy and at the time of delivery.

In the 2005 Ethiopia DHS survey, women were asked whether each of the following factors
would be a big problem or not a big problem in seeking medical care: getting permission to go for
treatment, getting money for treatment, distance to a health facility, having to take transport, not
wanting to go alone, concern that there may not be a female health provider, concern that there may
not be a health provider, and concern that there may be no one to complete the household chores. The
results are shown in Table 9.8.

120 | Maternal Health


Table 9.8 Problems in accessing health care

Percentage of women who reported they have serious problems in accessing health care for themselves when they are sick, by type of problem,
according to background characteristics, Ethiopia 2005

Problems in accessing health care


Concern
there may
Concern Concern be no
Getting Not there may there may one to
permission Getting Distance Having wanting not be a not be a complete Any of the Number
Background to go for money for to health to take to go female health household specified of
characteristic treatment treatment facility transport alone provider provider chores problems women
Age
15-19 35.0 68.9 63.4 65.7 57.5 71.0 78.9 59.2 93.8 3,266
20-29 34.5 74.6 67.9 71.0 62.4 72.6 81.3 72.5 95.7 5,064
30-39 34.9 78.9 69.4 74.6 62.1 71.9 79.2 72.2 96.1 3,410
40-49 33.4 82.4 70.9 76.6 63.6 75.1 83.0 72.2 97.4 2,330
Number of living children
0 32.9 67.3 60.5 62.4 57.5 70.0 79.3 60.7 93.8 4,554
1-2 34.1 76.8 67.5 71.3 62.9 72.7 80.2 71.6 95.5 3,226
3-4 34.3 80.0 71.4 76.6 62.6 72.6 80.2 76.0 96.9 2,981
5+ 37.5 82.0 74.5 80.0 64.1 75.5 82.7 72.7 97.2 3,309
Marital status
Never married 33.5 66.8 59.4 60.5 56.7 69.6 79.3 59.5 93.4 3,516
Married or living together 36.1 77.8 71.8 76.5 63.0 74.2 81.5 73.5 96.3 9,066
Divorced/separated/
widowed 27.7 83.1 62.2 68.0 62.2 68.9 77.2 66.8 96.8 1,488
Employment
Not employed 35.3 75.6 69.4 73.1 60.6 71.7 79.6 68.9 95.4 9,251
Working for cash 21.9 66.9 46.9 51.2 50.4 62.6 73.0 60.2 92.5 1,904
Not working for cash 40.5 81.4 75.9 80.2 70.9 81.4 88.3 76.3 98.6 2,896
Missing 35.6 76.9 77.1 77.1 62.5 71.9 76.1 82.6 94.5 19
Residence
Urban 16.0 53.4 31.1 33.5 40.7 53.7 71.2 57.2 88.6 2,499
Rural 38.5 80.4 75.6 79.8 65.8 76.5 82.5 71.9 97.2 11,571
Region
Tigray 11.5 69.3 49.8 52.9 37.6 37.8 46.9 25.1 87.1 919
Affar 24.5 72.6 81.7 83.5 56.6 66.5 70.6 44.5 97.9 146
Amhara 22.0 67.0 61.3 65.6 48.9 66.1 75.8 63.7 94.3 3,482
Oromiya 48.6 83.0 76.0 80.9 74.8 78.9 83.5 78.9 96.4 5,010
Somali 36.0 89.3 82.7 82.6 68.4 70.9 76.2 63.1 96.2 486
Benishangul-Gumuz 37.1 78.4 63.8 69.1 51.7 72.6 83.3 64.2 96.6 124
SNNP 40.1 80.6 73.7 78.7 65.4 85.0 90.2 77.7 98.3 2,995
Gambela 32.4 73.3 64.6 64.2 58.1 56.9 82.4 61.6 97.3 44
Harari 22.7 55.3 36.7 39.9 43.7 66.5 94.5 62.0 97.2 39
Addis Ababa 7.5 47.2 33.4 28.5 44.5 59.9 91.0 64.3 96.8 756
Dire Dawa 25.2 67.6 32.3 33.7 26.7 26.4 44.7 36.5 81.7 69
Education
No education 38.1 82.1 74.3 78.7 64.9 75.2 81.2 71.7 97.3 9,271
Primary 34.9 72.8 65.2 69.1 62.7 74.1 82.1 69.7 95.4 3,123
Secondary and higher 14.2 45.2 35.7 36.9 39.4 54.4 73.7 55.1 86.8 1,675
Wealth quintile
Lowest 38.0 86.0 81.9 84.2 67.9 74.2 78.5 65.0 98.0 2,428
Second 37.8 82.6 76.4 80.4 64.6 74.8 80.4 69.7 97.5 2,643
Middle 40.4 81.3 76.3 81.3 66.4 78.1 85.8 74.9 97.7 2,732
Fourth 37.8 77.8 71.8 76.7 65.6 79.2 85.4 75.8 97.3 2,647
Highest 23.1 57.7 42.3 45.6 47.7 60.5 74.3 62.8 90.0 3,621

Total 34.5 75.6 67.7 71.6 61.4 72.5 80.5 69.3 95.7 14,070

Maternal Health | 121


The most important reason for not seeking health care was concern that there may not be a
health provider (81 percent). Concern about getting money for treatment, concern that there may not
be a female health provider, concern about having to take transport, and concern that there may be no
one to complete the household chores were cited by about seven in ten women. Distance to a health
facility and not wanting to go alone are perceived as big problems by more than three in five women.
Only one in three (35 percent) women perceived getting permission to go for treatment to be a big
problem.

Older women, women with more than two living children, women who were married or living
together and women working but not for cash are more likely to cite concern that there may not be a
health provider as a big problem than their counterparts. Women in rural areas and those residing in
Harari, Addis Ababa and SNNP are also more likely than urban women and women residing in the
other regions to mention this as a big problem.

Women with no education, women who are married or living with a man, and women
working but not for cash are more likely to perceive the problem of not having a female health care
provider as a big problem than their counterparts. More than eight in ten (85 percent) women residing
in the SNNP Region also mentioned this as a big problem.

As expected, 80 percent of women in rural areas perceived having to take transport as a big
problem, compared with only 34 percent of women in urban areas.

Knowledge and Attitudes Concerning Tuberculosis

Tuberculosis (TB) is a leading cause of death in the world and a major health problem in the
developing world. TB is caused by the bacteria mycobacterium tuberculosis whose transmission is
mainly airborne through droplets coughed or sneezed out by infected persons. The infection is
primarily concentrated in the lungs but in some cases it can be transmitted to other areas of the body.
The very young and very old and persons with a suppressed immune system (brought on from HIV
infection or other causes) are especially prone to contracting the disease when exposed to it. The 2005
EDHS collected information from women and men on the level of their awareness of TB.
Specifically, respondents were asked whether they had ever heard of the illness, how it spreads from
one person to another, whether it can be cured, and whether they would want to keep the information
secret if a member of their family got TB. This information is useful in policy formulation and
implementation of programmes designed to combat and limit the spread of the disease.

Tables 9.9.1 and 9.9.2 show the percentage of women and men who have heard of TB, and
among those who have heard of it, their knowledge and attitudes concerning TB, according to
background characteristics. Three in four women and four in five men have heard of TB. Awareness
is slightly higher among women and men in the older age groups, respondents with some secondary or
higher education as well as among those in the highest wealth quintile. Ninety-four percent of women
in urban areas, compared with 71 percent of women in rural areas have heard of TB. There are marked
differences between regions in the knowledge of TB. Most women (about 95 percent) in Harari, Addis
Ababa, and Dire Dawa have heard of tuberculosis. Awareness of TB is relatively low in Benishangul-
Gumuz, Somali and Gambela, where only about one in two women are aware of TB. A similar pattern
is observed for men.

Sixty-five percent of women and 79 percent of men reported that TB is spread through the air
when coughing or sneezing. Education is strongly associated with knowledge of how TB can be
spread. Nearly all women and men with secondary and higher education know that TB is spread
through the air when coughing or sneezing. Wealthier women and women in urban areas are also
more likely to know how the disease is spread.

122 | Maternal Health


Table 9.9.1 Knowledge and attitude concerning tuberculosis among women

Percentage of women who have heard of tuberculosis, and among women who have heard of TB, the percentage
who know that TB is spread through the air by coughing or sneezing, who believe that TB can be cured, and who
would want to keep secret that a family member has TB, by background characteristics, Ethiopia 2005

Among women who have heard of TB,


the percentages who:
Report that
All women TB is spread Would want
Percentage through the air Believe that a family
Background who have Number of by coughing TB can be member's TB Number of
characteristic heard of TB women or sneezing cured kept secret women
Age
15-19 71.7 3,266 70.4 75.0 23.2 2,342
20-34 73.8 6,872 63.7 76.1 22.8 5,073
35-49 78.7 3,933 61.4 76.3 20.4 3,095

Residence
Urban 93.7 2,499 83.9 87.9 16.2 2,342
Rural 70.6 11,571 59.0 72.5 23.9 8,168

Region
Tigray 85.9 919 55.7 84.2 20.6 790
Affar 72.4 146 55.6 78.4 26.3 106
Amhara 73.1 3,482 56.1 74.6 19.5 2,545
Oromiya 78.3 5,010 68.4 75.7 21.1 3,920
Somali 52.1 486 38.2 75.2 22.0 253
Benishangul-Gumuz 48.3 124 66.2 75.5 23.2 60
SNNP 66.0 2,995 65.6 69.9 32.6 1,977
Gambela 55.7 44 63.6 82.1 28.8 25
Harari 95.8 39 84.7 90.5 8.6 37
Addis Ababa 96.6 756 87.8 86.5 11.1 731
Dire Dawa 95.1 69 81.6 92.5 10.2 66

Education
No education 68.2 9,271 52.8 71.2 23.0 6,323
Primary 81.5 3,123 76.6 76.9 23.4 2,545
Secondary and higher 98.0 1,675 91.0 92.3 16.8 1,642

Wealth quintile
Lowest 65.2 2,428 49.4 72.1 23.9 1,582
Second 69.1 2,643 55.1 69.8 24.6 1,827
Middle 69.0 2,732 59.1 70.4 25.7 1,886
Fourth 75.1 2,647 64.5 75.2 20.8 1,987
Highest 89.1 3,621 80.5 84.9 18.6 3,228

Total 74.7 14,070 64.5 75.9 22.2 10,510

Seventy-six percent of women and 85 percent of men believe that TB can be cured. Women’s
belief that TB can be cured varies by education, wealth quintile, and place of residence. Eighty-eight
percent of women in urban areas, compared with 73 percent of women in rural areas believe that TB
can be cured. About nine in ten women in Dire Dawa and Harari believe that TB can be cured,
compared with seven in ten women in SNNP. Ninety-two percent of women with some secondary
education and 85 percent of women in the highest wealth quintile believe that TB can be cured
compared with 71 percent of women with no education and 72 percent of those in the lowest wealth
quintile. A similar pattern is observed for men.

Maternal Health | 123


Table 9.9.2 Knowledge and attitude concerning tuberculosis among men

Percentage of men who have heard of tuberculosis, and among men who have heard of TB, the percentage
who know that TB is spread through the air by coughing or sneezing, who believe that TB can be cured, and
who would want to keep secret that a family member has TB, by background characteristics, Ethiopia 2005

Among men who have heard of TB,


the percentages who:
Report that
All men TB is spread Would want
Percentage through the air Believe that a family
Background who have Number of by coughing TB can be member's TB Number of
characteristic heard of TB men or sneezing cured kept secret men
Age
15-19 74.2 1,335 82.7 82.6 31.8 990
20-34 83.4 2,558 80.2 86.3 30.2 2,133
35-49 87.2 2,139 76.2 84.4 28.9 1,865

Residence
Urban 94.0 916 93.7 91.7 24.1 861
Rural 80.6 5,117 76.2 83.4 31.3 4,126

Region
Tigray 94.2 366 69.8 89.1 8.0 345
Affar 78.6 65 67.0 90.5 19.8 51
Amhara 78.5 1,521 74.3 84.6 16.5 1,194
Oromiya 83.0 2,222 83.2 84.7 37.7 1,844
Somali 78.9 202 58.2 79.6 30.2 160
Benishangul-Gumuz 70.3 54 74.7 82.4 22.0 38
SNNP 82.4 1,244 80.1 82.1 41.2 1,025
Gambela 75.7 21 72.0 87.2 22.9 16
Harari 96.5 16 92.1 93.2 40.4 16
Addis Ababa 93.6 292 96.1 92.2 25.9 273
Dire Dawa 89.8 30 89.6 95.6 31.4 27

Education
No education 77.1 2,589 65.9 79.7 31.4 1,996
Primary 81.7 2,252 83.8 84.3 30.4 1,840
Secondary and higher 96.7 1,192 94.9 94.6 27.1 1,152

Wealth quintile
Lowest 76.1 1,100 66.4 82.6 30.0 837
Second 79.6 1,184 76.0 80.6 30.5 942
Middle 78.2 1,081 75.5 81.5 28.1 846
Fourth 85.4 1,200 79.9 86.3 33.4 1,024
Highest 91.1 1,469 91.2 90.1 28.4 1,338

Total 82.7 6,033 79.2 84.8 30.0 4,988

More than a fifth of women and three-tenths of men believe that if a family member got TB
they would want to keep it a secret. Less educated respondents, women in the lower (lowest to
middle) wealth quintiles, respondents who reside in rural areas, and those who reside in SNNP are
more likely than their counterparts to want to keep secret the fact that a member of their family has
the disease.

Use of Tobacco

Smoking has a negative effect on the health of a person. Women and men interviewed in the
2005 EDHS were asked about their smoking habits. The data show that very few women in Ethiopia
(less than 2 percent) smoke (data not shown).

124 | Maternal Health


Table 9.10 shows the percentage of men who smoke cigarettes or tobacco and the percent
distribution of cigarette smokers by number of cigarettes smoked in the preceding 24 hours, according
to background characteristics.

Smoking is not common in Ethiopia. Only 9 percent of men smoke cigarettes and 5 percent
consume other forms of tobacco. Use of tobacco is more common among older men age 35 and
above, men living in rural areas, men with no education and men in the lowest wealth quintile.
Regional variations are significant, with use of tobacco being highest in Affar, where nearly one in
two men use tobacco, and lowest in Tigray, where less than 2 percent of men reported using tobacco.
The majority of men who smoked consumed as much as 3-5 or 10 or more cigarettes a day (about 30
percent each).

Table 9.10 Use of tobacco: men

Percentage of men who smoke cigarettes or a pipe or use other tobacco products and the percent distribution of cigarette smokers by number of
cigarettes smoked in preceding 24 hours, according to background characteristics, Ethiopia 2005
Number of cigarettes Number
Does Don't of
Background Other not use Number know/ cigarette
characteristic Cigarettes Pipe tobacco tobacco of men 0 1-2 3-5 6-9 10+ missing Total smokers

Age
15-19 1.0 0.0 0.6 98.3 1,335 4.3 17.3 52.9 10.5 14.6 0.3 100.0 14
20-34 7.2 0.0 3.2 90.6 2,558 4.1 14.0 29.6 16.5 33.7 2.1 100.0 185
35-49 14.7 0.1 9.4 79.3 2,139 6.6 15.2 27.3 17.7 30.1 3.0 100.0 314

Residence
Urban 8.1 0.0 0.9 91.2 916 6.0 8.7 35.2 12.0 38.0 0.1 100.0 74
Rural 8.6 0.0 5.5 87.8 5,117 5.6 15.9 27.8 17.9 29.8 3.0 100.0 439

Region
Tigray 1.4 0.0 0.0 98.6 366 0.0 0.0 31.0 14.9 37.3 16.9 100.0 5
Affar 25.4 0.0 27.8 52.0 65 0.0 7.3 41.1 23.4 28.2 0.0 100.0 17
Amhara 2.3 0.0 2.1 96.0 1,521 6.4 27.3 11.6 10.7 39.3 4.8 100.0 34
Oromiya 11.7 0.1 6.2 84.6 2,222 3.3 17.6 28.6 20.1 28.5 1.9 100.0 259
Somali 24.8 0.0 3.3 73.5 202 1.4 2.3 8.8 16.0 71.0 0.5 100.0 50
Benishangul-Gumuz 13.4 0.0 15.1 74.8 54 2.1 8.6 24.9 28.8 33.5 2.0 100.0 7
SNNP 7.9 0.0 6.5 87.7 1,244 15.2 14.0 43.7 11.2 10.4 5.5 100.0 98
Gambela 15.5 0.8 13.0 76.0 21 3.1 13.7 39.7 6.7 33.7 3.1 100.0 3
Harari 25.2 0.0 3.6 72.5 16 0.0 2.1 11.8 19.4 65.3 1.3 100.0 4
Addis Ababa 9.9 0.0 0.6 89.8 292 7.7 13.2 31.5 14.1 33.5 0.0 100.0 29
Dire Dawa 20.7 0.0 6.1 75.4 30 0.0 3.5 27.9 15.5 53.1 0.0 100.0 6

Education
No education 10.8 0.0 8.1 83.5 2,589 5.2 17.7 23.6 19.3 31.2 3.1 100.0 281
Primary 6.8 0.1 3.2 91.5 2,252 6.7 9.4 35.2 15.7 30.0 3.0 100.0 153
Secondary and higher 6.7 0.0 0.8 92.7 1,192 5.1 15.4 35.2 12.0 32.2 0.1 100.0 79

Wealth quintile
Lowest 12.5 0.0 10.4 80.2 1,100 1.7 13.4 28.6 20.4 33.2 2.7 100.0 138
Second 9.5 0.2 6.2 87.4 1,184 12.2 11.9 23.5 22.9 23.9 5.6 100.0 112
Middle 8.5 0.0 3.9 89.0 1,081 4.1 16.3 29.2 15.8 31.0 3.6 100.0 92
Fourth 6.4 0.0 3.4 91.0 1,200 4.2 26.1 23.2 13.3 33.1 0.1 100.0 77
Highest 6.4 0.0 1.4 92.3 1,469 6.3 9.8 39.8 9.6 34.4 0.1 100.0 94

Total 8.5 0.0 4.8 88.3 6,033 5.6 14.9 28.8 17.1 31.0 2.6 100.0 513

Maternal Health | 125


 
CHILD HEALTH 10
This chapter presents findings on several areas of importance to child health; characteristics
of the neonate (birth weight and size at birth), vaccination status of children and important childhood
illnesses and their treatment. The information on birth weight and birth size is important for the design
and implementation of programmes aimed at reducing neonatal and infant mortality.

Vaccination coverage information focuses on the age group 12-23 months. Overall coverage
levels at the time of the survey and by 12 months of age are shown for this age group. Additionally,
the source of the vaccination information (whether based on a written vaccination card or on the
mother’s recall) is shown. Differences in vaccination coverage between subgroups of the population
aid in programme planning.

Treatment practices and contact with health services among children with the three most
important childhood illnesses (acute respiratory infection, fever, and diarrhoea) help in the assessment
of national programmes aimed at reducing the mortality impact of these illnesses. Information is
provided on the prevalence and treatment of ARI and its treatment with antibiotics and the prevalence
of fever and its treatment with antimalarial drugs and antibiotics. The treatment of diarrhoeal disease
with oral rehydration therapy (including increased fluids) aids in the assessment of programmes that
recommend such treatment. Because appropriate sanitary practices can help prevent and reduce the
severity of diarrhoeal disease, information is also provided on the manner of disposing of children’s
faecal matter.

10.1 CHILD’S SIZE AT BIRTH

A child’s birth weight or size at birth is an important indicator of the child’s vulnerability to
the risk of childhood illnesses and the chances of survival. Children whose birth weight is less than
2.5 kilogrammes, or children reported to be ‘very small’ or ‘smaller than average’ are considered to
have a higher than average risk of early childhood death. For births in the five years preceding the
survey, birth weight was recorded in the questionnaire if available from either a written record or the
mother’s recall. Since birth weight may not be known for many babies, the mother’s estimate of the
baby’s size at birth was also obtained. Even though it is subjective, it can be a useful proxy for the
weight of the child. Table 10.1 presents information on child’s size at birth according to background
characteristics.

Only 3 percent of children in Ethiopia are weighed at birth. This is not surprising because the
majority of births do not take place in a health facility, and children are less likely to be weighed at
birth. Among children born in the five years before the survey with a reported birth weight, 14 percent
weighed less than 2.5 kg at birth. Birth weight is lower among children born to older women (age at
birth 35-49), children at higher birth orders (6 and above), and children of women with no education.
The birth weight of a child also varies by mother’s place of residence. Twenty-three percent of births
in rural areas compared with 10 percent in urban areas have a reported birth weight less than 2.5 kg.

In the absence of birth weight a mother’s subjective assessment of the size of the baby at birth
may be useful. Twenty-one percent of births were reported to be very small and 7 percent were
reported as smaller than average. Births to mothers with no education and rural births are more likely
to be reported as very small or smaller than average than births to educated mothers and births in
urban areas. Nearly two-fifths of births (37 percent) in Affar are reported to be very small or smaller
than average.

Child Health | 127


Table 10.1 Child's size at birth

Among live births in the five years preceding the survey with a reported birth weight, the percent distribution by birth weight and among
all live births in the five years preceding the survey, the percent distribution by mother's estimate of baby's size at birth, according to
background characteristics, Ethiopia 2005

Percent distribution of Percent distribution of all live births by


births with a reported size of child at birth
birth weight1 Smaller Don't
Background Less than 2.5 kg or Number Very than Average know/ Number of
characteristics 2.5 kg more Total of births small average or larger missing Total births
Mother's age at birth
<20 14.4 85.6 100.0 50 21.3 7.9 70.5 0.3 100.0 1,715
20-34 12.6 87.4 100.0 263 20.1 7.2 72.3 0.4 100.0 7,702
35-49 19.0 81.0 100.0 30 21.2 7.2 71.0 0.6 100.0 1,746
Birth order
1 10.1 89.9 100.0 135 21.9 7.8 69.7 0.7 100.0 1,933
2-3 12.9 87.1 100.0 141 20.5 7.7 71.7 0.2 100.0 3,351
4-5 14.7 85.3 100.0 37 18.9 7.4 73.3 0.4 100.0 2,620
6+ 28.6 71.4 100.0 31 20.9 6.5 72.1 0.5 100.0 3,259
Residence
Urban 10.2 89.8 100.0 255 16.7 5.0 77.9 0.4 100.0 815
Rural 23.0 77.0 100.0 88 20.8 7.5 71.4 0.4 100.0 10,348
Region
Tigray (0.0) (100.0) 100.0 27 20.1 13.5 65.8 0.6 100.0 698
Affar * * 100.0 3 27.2 9.9 62.6 0.3 100.0 107
Amhara * * 100.0 37 23.9 9.0 66.5 0.5 100.0 2,621
Oromiya (20.5) (79.5) 100.0 100 20.0 5.7 74.0 0.3 100.0 4,411
Somali * * 100.0 13 15.9 8.6 73.6 1.9 100.0 477
Benishangul-Gumuz * * 100.0 2 18.2 11.7 68.6 1.5 100.0 105
SNNP (19.7) (80.3) 100.0 39 18.9 5.9 75.0 0.2 100.0 2,500
Gambela 14.0 86.0 100.0 4 12.9 6.5 80.2 0.4 100.0 31
Harari 5.6 94.4 100.0 6 20.3 4.9 73.5 1.3 100.0 22
Addis Ababa 12.8 87.2 100.0 106 16.0 7.2 76.4 0.5 100.0 153
Dire Dawa 5.9 94.1 100.0 8 13.0 5.0 81.7 0.3 100.0 37
Mother's education
No education 24.3 75.7 100.0 76 21.1 7.7 70.8 0.4 100.0 8,838
Primary 18.4 81.6 100.0 74 19.7 5.3 74.6 0.3 100.0 1,855
Secondary and higher 7.3 92.7 100.0 193 12.0 7.5 79.8 0.6 100.0 470
Wealth quintile
Lowest * * 100.0 3 22.4 8.3 68.7 0.6 100.0 2,440
Second * * 100.0 7 21.6 7.7 70.3 0.5 100.0 2,356
Middle * * 100.0 21 22.3 7.1 70.1 0.4 100.0 2,486
Fourth (38.3) (61.7) 100.0 28 18.0 6.6 75.2 0.3 100.0 2,222
Highest 10.2 89.8 100.0 285 16.4 6.4 76.8 0.4 100.0 1,660

Total 13.5 86.5 100.0 343 20.5 7.3 71.8 0.4 100.0 11,163

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25
unweighted cases and has been suppressed.
1
Based on either a written record or the mother's recall.

The percentage of low birth weight babies has increased in the past five years from 8 percent
in 2000 to 14 percent in 2005. The percentage of babies assessed by mothers as being very small at
birth has increased over the same period from 6 percent to 21 percent.

10.2 VACCINATION COVERAGE

Universal immunisation of children against the six vaccine-preventable diseases (namely,


tuberculosis, diphtheria, whooping cough, tetanus, polio, and measles) is crucial to reducing infant
and child mortality. Differences in vaccination coverage among subgroups of the population are
useful for programme planning and targeting resources to areas most in need. Additionally,
information on immunization coverage is important for the monitoring and evaluation of the
Expanded Programmes on Immunization (EPI).

128 | Child Health


The EDHS 2005 collected information on vaccination coverage for all living children born in
the five years preceding the survey. According to the guidelines developed by the World Health
Organization, children are considered fully vaccinated when they have received a vaccination against
tuberculosis (BCG), three doses each of the DPT and polio vaccines, and a measles vaccination by the
age of 12 months. BCG should be given at birth or at first clinical contact, DPT and polio require
three vaccinations at approximately 4, 8, and 12 weeks of age, and measles should be given at or soon
after reaching 9 months of age.

Information on vaccination coverage was collected in two ways in the EDHS: from
vaccination cards shown to the interviewer and from mothers’ verbal reports. If the cards were
available, the interviewer copied the vaccination dates directly onto the questionnaire. When there
was no vaccination card for the child or if a vaccine had not been recorded on the card as being given
the respondent was asked to recall the vaccines given to her child. Table 10.2 and Figure 10.1 show
the percentage of children age 12-23 months who have received the various vaccinations by source of
information, that is, from vaccination card or mother’s report. This is the youngest cohort of children
who have reached the age by which they should be fully vaccinated.

Table 10.2 Vaccinations by source of information


Percentage of children age 12-23 months who received specific vaccines at any time before the survey, by source of information (vaccination card
or mother's report), and percentage vaccinated by 12 months of age, Ethiopia 2005

No
Source of DPT Polio vacci- Number of
information BCG 1 2 3 0 1 2 3 Measles All2 nations children
Vaccinated at any time
before survey
Vaccination card 33.4 36.5 31.3 25.1 13.2 35.8 31.0 24.9 22.2 17.3 0.0 692
Mother's report 27.0 21.7 15.7 6.7 4.2 38.5 33.7 19.8 12.6 3.0 24.0 1,185
Either source 60.4 58.2 47.0 31.9 17.4 74.3 64.6 44.7 34.9 20.4 24.0 1,877
Vaccinated by 12 months
of age3 57.4 54.9 43.9 29.0 16.9 70.0 60.2 41.0 28.5 16.7 28.0 1,877
1
Polio 0 is the polio vaccination given at birth.
2
BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth)
3
For children whose information was based on the mother's report, the proportion of vaccinations given during the first year of life was assumed
to be the same as for children with a written record of vaccination.

Figure 10.1 Percentage of Children Age 12-23 Months with


Specific Vaccinations
Percentage vaccinated at any time before the survey

100

80 74
65
60 58
60
47 45
40 35
32
24
20
20 17

0
BCG 1 2 3 0 1 2 3 Measles All
1
No vacci-
DPT Polio nations

Note: Based on health cards and mothers' reports


1
BCG, measles, and three doses each of DPT and polio vaccine
(excluding polio 0) EDHS 2005

Child Health | 129


Twenty percent of children age 12-23 months were fully vaccinated at the time of the survey,
60 percent had received the BCG vaccination, and 35 percent had been vaccinated against measles.
The coverage for the first dose of DPT is relatively high (58 percent). However, only 32 percent went
on to receive the third dose of DPT. Even though DPT and polio vaccines are often administered at
the same time, polio coverage is much higher than DPT coverage. Three in four children received the
first dose of polio, two in three received the second dose, and more than four in ten received the third
dose. This is primarily due to the success of the national immunization day campaigns during which
polio vaccines are administered. Nevertheless, the dropout between the first and third doses of polio is
marked—a 40 percent decline.

Table 10.3 shows the vaccination coverage among children age 12-23 months, according to
information from the vaccination card or mother’s report, by background characteristics. This
information may give some indication of the success of the immunization programme in reaching out
to all population subgroups. Boys are slightly more likely than girls to be fully immunized (23 percent
versus 18 percent). Birth order has a close relationship with vaccination coverage; as birth order
increases, vaccination coverage generally decreases. Twenty-seven percent of first-born children have
been fully immunized, compared with 18 percent of children of birth order six and above.

There are marked urban-rural differences in vaccination coverage. For example, children
residing in urban areas are almost three times (49 percent) as likely to be fully immunized as children
in rural areas (18 percent). Similarly, there are substantial differences in coverage among regions. The
percentage of children fully immunized ranges from a low of less than 1 percent in the Affar Region
to 70 percent in Addis Ababa.

The percentage of children fully immunized increases with mother’s education. Seventeen
percent of children whose mothers have no education are fully immunized, compared with 42 percent
of children born to mothers who have at least some secondary education. Children in households in
the lowest wealth quintile are less likely to have been fully immunized than children in households in
the highest wealth quintile.

Table 10.3 shows that a vaccination card was seen for 37 percent of children age 12-23
months. The actual percentage of children who have a vaccination card may be higher because in
some areas the cards are kept at the health centre and not by mothers. Cards were more likely to have
been shown for male children, first-order births, children living in urban areas, children in Addis
Ababa, children of mothers with at least some secondary education, and children of mothers in the
highest wealth quintile.

Data from the EDHS generally show vaccination coverage to be lower than data collected
from the 2004 Welfare Monitoring Survey and data reported in the service statistics from the Ministry
of Health. However, when comparing data from various sources, consideration should be given to
differences in the sampling frame, design, sample size, representativeness of the sample, and selection
methodology, as well as differences in the source of information, phrasing of questions, and reporting
of data that could explain these differences.

130 | Child Health


Table 10.3 Vaccinations by background characteristics

Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the
mother's report), and percentage with a vaccination card, by background characteristics, Ethiopia 2005
Percentage
with a
DPT Polio1 No vaccina- Number
Background vacci- tion card of
characteristic BCG 1 2 3 0 1 2 3 Measles All2 nations seen children
Sex
Male 63.8 60.7 49.0 34.5 18.3 75.1 66.0 46.1 36.4 22.5 23.1 38.7 959
Female 56.9 55.6 45.0 29.1 16.5 73.5 63.2 43.3 33.2 18.2 25.1 35.0 917

Birth order
1 65.9 66.7 52.2 40.5 21.1 78.1 66.1 46.6 39.5 26.8 21.7 45.3 359
2-3 63.9 61.4 51.8 34.4 21.4 75.9 66.6 48.2 35.2 21.1 20.9 41.7 543
4-5 55.4 54.0 44.0 28.1 15.9 67.8 59.3 39.7 32.8 17.4 30.0 32.1 448
6+ 57.3 52.7 41.2 26.5 12.1 75.7 66.0 44.0 33.1 17.7 23.7 30.3 527

Residence
Urban 84.0 84.9 78.6 65.7 43.1 86.9 80.8 69.3 65.4 49.3 11.3 62.0 147
Rural 58.4 55.9 44.3 29.0 15.2 73.3 63.3 42.6 32.2 17.9 25.1 34.7 1,729

Region
Tigray 77.4 85.9 70.9 51.6 19.6 89.8 77.3 56.6 63.3 32.9 7.2 58.4 135
Affar 27.6 13.5 8.7 2.8 4.6 58.2 36.9 19.9 8.1 0.6 38.8 4.0 18
Amhara 62.3 57.2 46.7 31.5 11.0 78.1 70.7 45.6 34.8 17.1 20.6 33.3 482
Oromiya 57.8 54.2 43.7 28.5 18.5 73.7 61.5 41.1 29.4 20.2 25.5 38.8 691
Somali 17.1 14.9 11.1 5.6 5.2 19.8 17.7 10.2 6.4 2.8 78.0 8.1 78
Benishangul-Gumuz 53.5 49.6 41.4 30.7 9.4 70.0 59.4 36.7 33.4 18.5 28.5 28.7 16
SNNP 64.2 64.8 50.4 33.2 21.0 75.3 66.6 50.2 37.7 20.3 21.7 35.5 408
Gambela 49.3 39.8 29.8 20.3 26.2 68.1 59.5 41.4 30.7 15.9 31.9 22.5 5
Harari 67.4 64.6 56.5 45.8 33.0 74.7 61.9 52.0 39.9 34.9 23.7 41.0 4
Addis Ababa 93.5 93.8 90.5 83.8 71.3 97.7 92.7 85.5 78.8 69.9 2.3 68.3 32
Dire Dawa 75.4 69.6 68.3 61.4 33.6 81.8 79.2 65.1 55.7 43.4 18.2 54.8 7

Education
No education 56.5 54.5 42.5 27.9 14.6 71.2 61.0 39.8 30.0 17.2 27.3 34.4 1,456
Primary 70.7 68.3 59.5 40.7 19.6 83.3 74.5 58.7 48.4 28.6 14.2 42.3 328
Secondary and higher 85.8 80.9 73.6 62.2 54.5 92.5 86.0 71.5 63.4 41.5 7.5 56.8 93

Wealth quintile
Lowest 50.0 47.4 37.2 25.6 16.0 68.6 57.9 38.2 24.9 14.1 30.0 31.3 450
Second 60.9 57.0 44.9 26.8 11.7 71.7 60.6 38.3 29.0 16.7 28.1 31.2 399
Middle 59.6 59.3 45.0 33.0 15.3 75.4 64.2 45.2 37.6 21.8 22.4 39.2 381
Fourth 65.4 60.3 50.6 30.6 17.4 78.5 72.3 48.8 36.1 17.9 17.9 35.2 345
Highest 70.6 72.2 62.9 47.9 29.8 80.2 71.8 57.5 52.5 35.6 18.9 51.7 302

Total 60.4 58.2 47.0 31.9 17.4 74.3 64.6 44.7 34.9 20.4 24.0 36.9 1,877
1
Polio 0 is the polio vaccination given at birth.
2
BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth)

Trends in Vaccination Coverage

One way of measuring trends in vaccination coverage is to compare coverage among children
of different ages in the 2005 EDHS. Table 10.4 shows the percentage of children who have received
vaccinations during the first year of life by current age. This type of data can provide information on
trends in vaccination coverage over the past four years.

Child Health | 131


Table 10.4 Vaccinations in the first year of life

Percentage of children under five years of age at the time of the survey who received specific vaccines by 12 months of age, and
percentage with a vaccination card, by current age of child, Ethiopia 2005
Percentage
with a
DPT Polio1 No vaccina- Number
Current age vacci- tion card of
in months BCG 1 2 3 0 1 2 3 Measles All2 nations seen children
12-23 57.4 54.9 43.9 29.0 16.9 70.0 60.2 41.0 28.5 16.7 28.0 36.9 1,877
24-35 45.3 39.1 30.0 19.7 10.7 60.0 50.7 35.8 18.8 10.4 39.2 22.2 1,892
36-47 42.4 34.5 27.5 17.5 9.6 53.9 47.1 35.4 17.8 8.0 43.7 13.9 2,105
48-59 36.2 30.1 24.9 15.8 7.4 47.7 42.1 30.5 15.3 7.2 51.3 11.6 2,013

Total 46.9 40.6 32.3 20.9 11.2 60.0 52.0 37.4 20.8 10.7 38.4 20.8 7,887

Note: Information was obtained from the vaccination card or if there was no written record, from the mother. For children whose
information was based on the mother's report, the proportion of vaccinations given during the first year of life was assumed to be the same
as for children with a written record of vaccinations.
1
Polio 0 is the polio vaccination given at birth.
2
BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth)

There are notable changes in vaccination coverage over the past five years. The percentage of
children who have received no vaccinations at all by 12 months of age has declined significantly over
the past four years from 51 percent among children age 48-59 months at the time of the survey to 28
percent among children age 12-23 months. The percentage fully immunized by age 12 months has
increased from 7 percent to 17 percent. Not surprisingly, vaccination cards were shown for 37 percent
of children age 12-23 months but for only 12 percent of children age 48-59 months. This may be
because vaccination cards for older children have been discarded.

Trends in vaccination coverage can be seen by comparing similarly collected data in the 2000
EDHS with the data from the 2005 EDHS. The data show that vaccination coverage in Ethiopia has
improved over the past five years. The percentage of children age 12-23 months fully vaccinated at
the time of the survey increased by 43 percent from 14 percent in 2000 to 20 percent in 2005.
However, the percentage who had received none of the six basic vaccinations increased from 17
percent in 2000 to 24 percent in 2005. With the exception of Polio 1, the percentage of children who
received all the other vaccinations has increased in the past five years, with the largest increase seen in
the percentage of children under five who received DPT 3 by 12 months of age.

10.3 ACUTE RESPIRATORY INFECTION

Acute respiratory infection (ARI) is among the leading causes of childhood morbidity and
mortality throughout the world. Early diagnosis and treatment with antibiotics can prevent a large
proportion of deaths caused by ARI. In the 2005 Ethiopia DHS survey, the prevalence of ARI was
estimated by asking mothers whether their children under age five had been ill with a cough
accompanied by short, rapid breathing in the two weeks preceding the survey. These symptoms are
compatible with ARI. It should be noted that the morbidity data collected are subjective in the sense
that they are based on the mother’s perception of illness without validation by medical personnel.

Table 10.5 shows that 13 percent of children under five years of age showed symptoms of
ARI at some time in the two weeks preceding the survey. Prevalence of ARI varies by age of child.
Children age 6-11 months are most likely to show symptoms of ARI (18 percent), compared with
children in the other age groups. There are small differences in the prevalence of ARI by gender of the
child and wealth quintile. Children living in households that use wood/straw or animal dung for
cooking are proportionately more likely to exhibit symptoms of ARI than children living in
households using other sources of cooking fuel.

132 | Child Health


Table 10.5 Prevalence and treatment of symptoms of ARI

Among children under age five, the percentage who had symptoms of acute respiratory
infection (ARI), in the two weeks preceding the survey and the percentage with symptoms of
ARI who took specific treatments according to background characteristics, Ethiopia 2005

Children under age five with


symptoms of ARI
Percentage
for whom
Children under age five treatment
Percentage was sought
with from a Percentage
Background symptoms Number of health facility who took Number of
characteristic of ARI1 children or provider2 antibiotics children
Age in months
<6 13.8 1,152 21.6 5.2 159
6-11 17.7 1,071 19.2 4.3 190
12-23 14.6 1,877 22.4 3.9 274
24-35 13.1 1,892 20.2 6.5 247
36-47 10.8 2,105 17.2 6.1 226
48-59 8.5 2,013 9.7 2.8 172
Sex
Male 12.6 5,129 18.9 4.3 646
Female 12.5 4,980 18.5 5.5 623
Residence
Urban 8.5 752 45.6 11.0 64
Rural 12.9 9,357 17.3 4.6 1,205
Region
Tigray 14.4 653 13.9 7.0 94
Affar 5.3 96 * * 5
Amhara 9.3 2,312 14.7 1.6 215
Oromiya 14.2 4,017 20.3 5.1 572
Somali 7.0 432 (7.6) (3.7) 30
Benishangul-Gumuz 9.6 95 23.0 12.6 9
SNNP 14.4 2,273 19.6 5.6 328
Gambela 10.4 29 (35.4) (7.0) 3
Harari 9.3 21 (34.9) (4.4) 2
Addis Ababa 6.1 146 * * 9
Dire Dawa 2.4 34 * * 1
Cooking fuel
Electricity or gas (0.2) 12 * * 0
Kerosene 4.7 128 * * 6
Charcoal 10.2 167 (51.8) (9.8) 17
Wood/straw3 12.8 9,025 18.1 5.0 1,156
Animal dung 11.6 768 16.7 0.0 89
Other/missing (2.5) 9 * * 0
Mother's education
No education 12.5 7,951 15.4 4.1 997
Primary 13.5 1,709 27.6 7.2 231
Secondary and higher 9.2 450 (50.1) (11.8) 41
Wealth quintile
Lowest 12.3 2,218 18.6 4.2 272
Second 11.4 2,122 12.3 3.9 241
Middle 14.6 2,210 20.7 5.5 323
Fourth 13.1 2,015 13.2 5.2 265
Highest 10.8 1,544 33.1 5.9 167
Total 12.6 10,109 18.7 4.9 1,269

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a
figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Symptoms of ARI (cough accompanied by short rapid breathing which was chest-related) is
considered a proxy for pneumonia.
2
Excludes pharmacy, shop, and traditional practitioner
3
Includes grass, shrubs, crop residues.

Child Health | 133


Cough and rapid breathing were higher among children in rural areas (13 percent) than
children in urban areas (9 percent). Prevalence of ARI ranges from a high of 14 percent among
children under five living in Tigray, Oromiya and SNNP to a low of 2 percent among children in Dire
Dawa. ARI prevalence is lower for children whose mothers have at least some secondary education.

Only 19 percent of all children under five with symptoms of ARI were taken to a health
facility or provider. There are differences in the proportion of children with ARI symptoms taken to a
health facility by child’s age; children under age six months and children age 12-23 months are more
likely to be taken to a health facility than other children. There is no gender difference in children
taken to a health facility or provider. Children of women with primary or secondary education are
more likely to be taken to a health facility or provider when they have ARI than other children.

The proportion of children with cough and rapid breathing who were taken to a health facility
is much higher in urban areas (46 percent) than in rural areas (17 percent).

Five percent of children with symptoms of ARI received antibiotics.

Compared with 2000, far fewer children in 2005 were reported to have ARI in the two weeks
preceding the survey, and a slightly higher proportion were taken for treatment.

10.4 FEVER

Fever is a major manifestation of malaria and other acute infections in children. Malaria and
fever contribute to high levels of malnutrition and mortality. While fever can occur year-round,
malaria is more prevalent after the end of the rainy season. For this reason, temporal factors must be
taken into account when interpreting fever as an indicator of malaria prevalence. Since malaria is a
major contributory cause of death in infancy and childhood in many developing countries, the so-
called presumptive treatment of fever with anti-malarial medication is advocated in many countries
where malaria is endemic. Malaria is discussed in greater detail in Chapter 12.

Table 10.6 shows the percentage of children under five with fever during the two weeks
preceding the survey and the percentage receiving various treatments, by selected background
characteristics. Nineteen percent of children under five were reported to have had fever in the two
weeks preceding the survey. The prevalence of fever varies by age of child. Children age 6-11 months
and 12-23 months are more commonly sick with fever (28 percent and 23 percent, respectively) than
other children.

There are no significant variations in the prevalence of fever by sex of the child, place of
residence, or wealth quintile of the household. The prevalence of fever among children under five
varies from a low of 12 percent in Dire Dawa to a high of 24 percent in SNNP. The prevalence of
fever is also relatively high among children living in Tigray (20 percent) and Oromiya (19 percent).

Less than one in five (18 percent) children with fever were taken to a health facility or
provider for treatment. Younger children, male children, and children of mothers with some
secondary or higher education were more likely to be taken to a health facility or provider for
treatment of fever than other children. Likewise, children of mothers in the highest wealth quintile,
children living in urban areas, and children living in Addis Ababa were more likely to be treated in a
health facility or by a provider. A very small percentage of children with fever received anti-malarial
drugs (3 percent) or antibiotic drugs (6 percent).

134 | Child Health


Table 10.6 Prevalence and treatment of fever

Among children under age five, the percentage who had a fever in the two weeks preceding the survey and the
percentage with fever for whom treatment was sought from a health facility or provider, who took antimalarial
drugs and who took antibiotic drugs, by background characteristics, Ethiopia 2005

Children under age five with fever


Percentage
for whom
Children under age five treatment was Percentage Percentage
sought from a who took who took
Background Percentage Number of health facility or antimalarial antibiotic Number of
characteristic with fever children provider1 drugs drugs children
Age in months
<6 16.8 1,152 19.0 0.6 7.2 194
6-11 27.6 1,071 20.3 4.4 6.8 295
12-23 23.3 1,877 18.3 2.7 6.4 438
24-35 21.6 1,892 16.5 1.9 6.4 408
36-47 15.1 2,105 17.0 3.5 6.2 317
48-59 11.6 2,013 14.0 4.9 5.7 233

Sex
Male 18.2 5,129 19.2 2.7 6.6 935
Female 19.1 4,980 15.9 3.2 6.3 951

Residence
Urban 16.0 752 45.3 4.2 13.3 121
Rural 18.9 9,357 15.6 2.9 6.0 1,765

Region
Tigray 20.3 653 10.1 0.0 6.4 132
Affar 17.0 96 12.1 9.0 7.6 16
Amhara 14.2 2,312 12.6 2.4 2.3 329
Oromiya 19.0 4,017 20.2 1.5 7.2 764
Somali 14.0 432 4.4 0.0 1.9 60
Benishangul-Gumuz 15.3 95 21.0 4.0 7.9 15
SNNP 23.5 2,273 18.5 6.3 7.8 534
Gambela 17.8 29 28.0 11.2 4.1 5
Harari 13.7 21 23.1 1.2 6.1 3
Addis Ababa 16.1 146 50.9 3.3 20.4 23
Dire Dawa 12.3 34 (28.6) (0.0) (6.8) 4

Mother's education
No education 18.3 7,951 13.0 2.5 4.9 1,457
Primary 21.3 1,709 29.4 4.9 11.2 364
Secondary and higher 14.4 450 53.9 4.1 14.1 65

Wealth quintile
Lowest 19.1 2,218 10.8 0.5 4.8 422
Second 19.5 2,122 14.2 2.7 2.8 413
Middle 19.7 2,210 16.6 3.6 9.0 436
Fourth 17.7 2,015 16.4 3.5 6.8 357
Highest 16.7 1,544 37.0 5.7 10.0 258

Total 18.7 10,109 17.5 3.0 6.4 1,886

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


1
Excludes pharmacy, shop, and traditional practitioner

10.5 PREVALENCE OF DIARRHOEA

Dehydration caused by severe diarrhoea is a major cause of morbidity and mortality among
young children although the condition can be easily treated with oral rehydration therapy (ORT).
Exposure to diarrhoea-causing agents is frequently related to the use of contaminated water and to
unhygienic practices in food preparation and disposal of excreta. In interpreting the findings of the
2005 Ethiopia DHS survey, it should be borne in mind that prevalence of diarrhoea varies seasonally.

Child Health | 135


Table 10.7 shows the percentage Table 10.7 Prevalence of diarrhoea
of children under five with diarrhoea in
Percentage of children under age five who had diarrhoea in the two
the two weeks preceding the survey weeks preceding the survey, by background characteristics, Ethiopia 2005
according to selected background
Diarrhoea in the two weeks
characteristics. Overall, 18 percent of all preceding the survey
children under five had diarrhoea while 6 Background All Diarrhoea Number of
percent had diarrhoea with blood. characteristic diarrhoea with blood children
Age in months
The occurrence of diarrhoea <6 13.9 1.9 1,152
6-11 29.3 6.7 1,071
varies by age of the child. Young 12-23 28.3 10.2 1,877
children age 6-23 months are more prone 24-35 18.5 7.6 1,892
to diarrhoea than children in the other age 36-47 12.4 5.2 2,105
groups. There are no variations in the 48-59 10.0 4.4 2,013
prevalence of diarrhoea by child’s sex. Sex
Diarrhoea is more common among rural Male 17.9 6.2 5,129
children (19 percent) than urban children Female 18.0 6.2 4,980
(12 percent). There are also variations in
Residence
the prevalence of diarrhoea by regions. Urban 12.1 3.3 752
Children living in the SNNP Region are Rural 18.5 6.4 9,357
more susceptible to episodes of diarrhoea
Region
(25 percent) than children living in the Tigray 12.8 5.4 653
other region. Children living in Dire Affar 13.7 3.0 96
Dawa and Somali have the lowest Amhara 14.6 6.5 2,312
prevalence of diarrhoea when compared Oromiya 17.7 4.9 4,017
Somali 12.2 2.5 432
with children living in the other regions Benishangul-Gumuz 21.3 7.2 95
(12 percent). The prevalence of diarrhoea SNNP 25.1 9.6 2,273
with blood follows a pattern similar to Gambela 15.1 2.9 29
that observed for diarrhoea in general. Harari 18.8 3.5 21
Addis Ababa 12.9 2.7 146
Dire Dawa 11.6 2.2 34
10.6 DIARRHOEA TREATMENT
Mother's education
In the 2005 EDHS, mothers of No education 18.1 6.3 7,951
Primary 19.4 6.8 1,709
children who had diarrhoea were asked Secondary and higher 9.8 1.9 450
about what was done to treat the illness.
Table 10.8 shows the percentage of Wealth quintile
Lowest 17.8 5.2 2,218
children with diarrhoea who received Second 20.2 7.0 2,122
specific treatments according to back- Middle 19.7 6.7 2,210
ground characteristics. Twenty-two per- Fourth 16.8 7.5 2,015
cent of children with diarrhoea were Highest 14.3 4.0 1,544
taken to a health provider. Nearly one in Source of drinking water1
two children (45 percent) of mothers with Improved 16.6 5.2 5,798
some secondary or higher education and Non-improved 19.9 7.6 4,294
more than one in three children (37 Other/missing (27.3) (7.0) 18

percent) of mothers in the highest wealth Toilet facility2


quintile were taken to a health provider. Improved, not shared 22.0 9.7 605
Notable differences also exist by place of Not improved 17.7 6.0 9,504
residence. The proportion of children in Total 18.0 6.2 10,109
urban areas taken to a health facility is 35
percent whereas only 22 percent of Note: 1
Figures in parentheses are based on 25-49 unweighted cases.
See Table 2.7 for definition of categories.
children in rural areas were taken to a 2 See Table 2.8 for definition of categories.
health provider. There are slight
variations between regions. More than two-fifths of children living in Gambela were taken to a health
provider in contrast to less than one in ten children living in Affar and Somali.

136 | Child Health


Table 10.8 Diarrhoea treatment

Among children under age five who had diarrhoea in the two weeks preceding the survey, the percentage who were taken for treatment to a health
provider, the percentage who received oral rehydration therapy (ORT), and the percentage given other treatments, by background characteristics, Ethiopia
2005

Percentage
of children Oral rehydration therapy (ORT)
with ORS Recom- Number
diarrhoea packets mended Other treatments of
taken to or pre- home Either Anti- Anti- Zinc Home No children
Background a health packaged fluids ORS or Increased Any biotic motility supple- remedy/ treat- with
characteristic provider1 liquid (RHF) RHF fluids ORT drugs drugs ments other Missing ment diarrhoea
Age in months
<6 15.9 5.1 13.5 16.8 2.4 19.2 10.5 0.0 0.0 15.2 0.4 63.9 160
6-11 17.9 17.3 21.4 32.7 8.3 37.7 7.4 1.6 0.0 10.8 0.0 56.7 314
12-23 26.5 27.5 18.9 37.7 5.8 40.1 10.6 0.4 0.3 16.9 0.0 47.4 531
24-35 20.3 18.6 16.4 28.8 8.8 34.9 10.4 1.1 0.7 19.1 0.2 47.8 350
36-47 22.1 20.4 21.9 32.7 12.6 39.1 16.0 0.0 0.0 14.6 0.6 41.1 261
48-59 26.5 17.4 19.7 32.4 17.7 43.5 7.3 1.4 0.0 18.6 0.0 41.7 202

Sex
Male 24.8 21.4 20.2 33.9 7.7 38.5 12.0 1.0 0.4 15.5 0.3 47.5 920
Female 19.6 18.4 17.5 30.0 9.9 35.6 8.8 0.5 0.1 16.5 0.0 50.6 898

Type of diarrhoea
Non bloody 20.1 17.6 17.9 29.9 8.8 34.4 10.2 1.0 0.2 14.8 0.3 51.9 1,192
Bloody 26.3 24.3 20.8 36.0 8.7 42.2 10.7 0.3 0.3 18.2 0.0 43.4 626

Residence
Urban 35.0 45.7 33.1 56.6 8.1 59.2 10.1 0.0 0.0 17.5 0.0 34.8 91
Rural 21.6 18.6 18.1 30.7 8.8 35.9 10.4 0.8 0.2 15.9 0.2 49.7 1,727

Region
Tigray 18.8 21.1 25.6 41.5 23.3 53.5 12.4 0.0 0.0 2.9 0.7 42.5 84
Affar 9.2 8.8 11.8 16.3 23.9 40.2 5.3 0.0 0.0 6.8 1.5 51.6 13
Amhara 27.1 19.9 18.8 32.3 1.0 32.9 9.0 0.6 0.5 15.9 0.0 53.1 337
Oromiya 23.5 22.6 19.6 35.7 10.7 40.4 11.7 1.7 0.2 13.4 0.2 47.1 709
Somali 8.5 15.8 35.1 40.7 2.9 40.7 0.8 0.0 1.4 17.2 1.3 49.8 53
Benishangul-Gumuz 29.6 24.9 28.5 39.6 5.0 40.8 8.6 0.0 0.0 16.8 0.0 48.4 20
SNNP 18.6 15.9 14.3 23.8 9.2 31.0 10.5 0.0 0.0 21.2 0.0 50.8 571
Gambela 40.2 27.6 23.6 41.7 3.4 41.7 11.2 1.5 0.0 14.4 0.0 45.6 4
Harari 31.3 22.6 28.7 40.3 30.9 57.3 7.6 1.0 0.0 16.2 1.3 30.5 4
Addis Ababa (44.6) (45.3) (47.7) (66.0) (9.4) (70.9) (7.0) (0.0) (0.0) (18.7) (0.0) (23.4) 19
Dire Dawa (25.7) (31.3) (10.6) (40.4) (9.6) (45.5) (0.0) (0.0) (0.0) (8.9) (0.0) (51.8) 4
Mother's education
No education 18.9 17.0 17.0 28.9 8.5 33.7 9.4 0.8 0.2 15.9 0.2 51.8 1,443
Primary 33.6 28.4 23.9 41.0 9.2 46.9 13.2 0.8 0.5 16.6 0.0 40.4 332
Secondary and higher 44.6 51.6 41.8 64.9 16.0 73.0 21.7 0.0 0.0 13.7 0.0 21.6 44

Wealth quintile
Lowest 14.3 13.5 15.0 25.4 6.1 28.9 10.4 0.7 0.2 16.1 0.2 56.3 395
Second 17.1 13.5 19.0 27.1 9.3 32.3 7.9 0.7 0.0 15.8 0.4 51.5 428
Middle 27.1 23.1 18.2 32.8 10.9 38.9 13.4 1.1 0.4 14.2 0.0 45.6 436
Fourth 21.8 19.8 16.7 31.4 7.7 36.8 9.5 0.5 0.0 16.4 0.2 50.5 339
Highest 37.2 37.8 30.2 52.5 10.3 57.6 10.6 0.9 0.7 19.2 0.0 35.5 221

Total 22.2 19.9 18.9 32.0 8.8 37.1 10.4 0.8 0.2 16.0 0.2 49.0 1,819

Note: ORT includes solution prepared from oral rehydration salt (ORS) packets or prepackaged liquids, recommended home fluids (RHF), and increased
fluids. Figures in parentheses are based on 25-49 unweighted cases.
1
Excludes pharmacy, shop and traditional practitioner

Thirty-seven percent of children with diarrhoea were treated with some kind of oral re-
hydration therapy (ORT): 20 percent were treated with ORS prepared from an ORS packet, 19 percent
were given recommended home fluids, and 9 percent were given increased fluids.

Child Health | 137


Ten percent of children were given antibiotic drugs and 16 percent were given home remedies
or other treatments. However, about half (49 percent) of children with diarrhoea did not receive any
treatment at all.

Diarrhoea treatment does not vary significantly by age. Male children and children who had
diarrhoea with blood are more likely to receive ORT than others. Large variations exist by mother’s
education and wealth quintile. There are also marked differences between urban and rural areas.
Three-fifths of children in urban areas (59 percent) received ORT compared with just over one-third
of children in rural areas (36 percent). Children living in SNNP are least likely to receive ORT.

Comparable data from the 2000 EDHS show that only 13 percent of children with diarrhoea
were taken to a health provider in 2000 compared with 22 percent in 2005. On the other hand, a
higher percentage of children with diarrhoea in 2005 than in 2000 did not receive any treatment (49
percent versus 39 percent).

10.7 FEEDING PRACTICES

Mothers are encouraged to continue feeding children with diarrhoea normally and to increase
the amount of fluids. These practices help to reduce dehydration and minimize the adverse
consequences of diarrhoea on the child’s nutritional status. Mothers were asked whether they gave the
child less, the same amount, or more fluids and food than usual when their child had diarrhoea. Table
10.9 shows the percent distribution of children under five who had diarrhoea in the past two weeks by
feeding practices, according to background characteristics.

Nineteen percent of children who had diarrhoea were given the same amount of liquid as
usual, 9 percent were given more, 32 percent were given somewhat less than the usual amount, and 26
percent were given much less than the usual amount. Fourteen percent of children who had diarrhoea
were given no liquids.

Regarding the amount of food offered to children who had diarrhoea, 14 percent were given
the same as usual, only 1 percent were given more, 30 percent were given somewhat less than the
usual amount of food, 26 percent were given much less than the usual amount of food, and 18 percent
did not receive food during their illness, presumably because these children had not yet started eating
solid food.

Older children age 36 months and above, children who did not have bloody diarrhoea,
children of the most educated mothers, children in the highest wealth quintile and children residing in
Tigray are more likely to receive more or the same amount of liquid during episodes of diarrhoea than
other children. A similar pattern is seen regarding the amount of food offered during diarrhoea.

138 | Child Health


Table 10.9 Feeding practices during diarrhoea

Percent distribution of children under five years who had diarrhoea in the two weeks preceding the survey by amount of liquids and food offered compared
with normal practice, according to background characteristics, Ethiopia 2005

Amount of liquids offered Amount of food offered Number of


Same Some- Same Some- Never children
Background as what Much Don't as what Much gave Don't with
characteristic More usual less less None know Total More usual less less None food know Total diarrhoea
Age in months
<6 2.4 24.5 17.2 27.1 28.9 0.0 100.0 0.1 7.2 4.9 2.1 0.1 84.7 0.9 100.0 160
6-11 8.3 16.6 30.2 26.9 17.5 0.6 100.0 0.9 12.3 15.8 17.5 14.4 38.9 0.2 100.0 314
12-23 5.8 19.9 32.8 26.2 14.1 1.2 100.0 1.8 11.4 31.4 28.6 15.2 11.0 0.7 100.0 531
24-35 8.8 19.6 32.3 28.5 10.4 0.4 100.0 0.5 15.7 34.6 36.3 11.6 0.6 0.6 100.0 350
36-47 12.6 18.4 37.1 23.4 6.8 1.8 100.0 1.7 16.7 42.6 25.3 11.4 0.5 1.9 100.0 261
48-59 17.7 11.4 39.2 22.5 9.2 0.0 100.0 1.5 18.6 39.1 35.1 5.6 0.0 0.0 100.0 202

Sex
Male 7.7 20.2 32.1 25.3 14.2 0.4 100.0 1.1 13.6 30.1 25.3 11.3 18.0 0.6 100.0 920
Female 9.9 16.8 32.3 26.7 13.1 1.2 100.0 1.3 13.5 28.8 26.9 11.6 17.2 0.8 100.0 898

Type of diarrhoea
Non bloody 8.8 21.8 33.2 22.5 12.4 1.2 100.0 1.1 15.6 29.6 22.4 9.9 20.6 0.8 100.0 1,192
Bloody 8.7 12.2 30.2 32.8 16.1 0.0 100.0 1.3 9.6 29.3 33.2 14.4 11.7 0.5 100.0 626

Residence
Urban 8.1 21.3 40.7 21.3 8.5 0.0 100.0 0.2 14.8 38.1 25.3 2.5 19.1 0.0 100.0 91
Rural 8.8 18.4 31.7 26.3 14.0 0.8 100.0 1.2 13.5 29.0 26.2 11.9 17.5 0.7 100.0 1,727

Region
Tigray 23.3 23.1 28.6 18.5 2.4 4.1 100.0 4.5 14.6 34.7 28.4 8.5 7.6 1.8 100.0 84
Affar 23.9 21.5 29.1 12.3 13.3 0.0 100.0 9.6 26.6 12.8 30.0 2.5 18.6 0.0 100.0 13
Amhara 1.0 21.0 31.5 26.0 20.5 0.0 100.0 0.6 17.1 27.0 25.2 15.6 14.1 0.4 100.0 337
Oromiya 10.7 17.1 29.8 25.2 15.7 1.5 100.0 0.7 13.1 26.2 26.4 13.8 19.3 0.6 100.0 709
Somali 2.9 3.1 37.1 52.4 4.4 0.0 100.0 1.8 2.9 32.6 50.2 0.0 12.5 0.0 100.0 53
Benishangul-Gumuz 5.0 23.0 41.5 19.6 10.9 0.0 100.0 4.2 16.9 35.7 21.8 10.9 10.4 0.0 100.0 20
SNNP 9.2 18.7 35.3 26.6 10.2 0.0 100.0 1.4 12.1 33.8 23.8 7.9 20.1 0.9 100.0 571
Gambela 3.4 34.1 41.0 5.8 15.6 0.0 100.0 0.6 20.9 46.5 8.0 10.2 12.8 1.0 100.0 4
Harari 30.9 10.1 33.3 18.0 3.9 3.9 100.0 11.2 10.1 34.0 27.4 6.5 6.9 3.9 100.0 4
Addis Ababa (9.4) (36.3) (27.3) (23.1) (3.9) (0.0) (100.0) (0.0) (26.4) (26.4) (31.7) (7.2) (8.3) (0.0) (100.0) 19
Dire Dawa (9.6) (22.0) (45.3) (23.1) (0.0) (0.0) (100.0) (1.8) (7.4) (52.7) (8.0) (8.7) (21.3) (0.0) (100.0) 4

Mother's education
No education 8.5 18.1 31.9 27.2 13.5 0.8 100.0 1.3 13.3 29.8 26.7 10.9 17.2 0.9 100.0 1,443
Primary 9.2 19.6 33.9 21.4 15.2 0.7 100.0 0.7 14.4 27.1 23.8 15.3 18.7 0.0 100.0 332
Secondary and higher 16.0 25.1 30.9 21.0 7.0 0.0 100.0 0.3 17.1 35.7 24.3 0.7 21.9 0.0 100.0 44

Wealth quintile
Lowest 6.1 17.2 33.8 25.5 17.1 0.3 100.0 0.9 11.0 28.4 27.0 14.2 17.0 1.4 100.0 395
Second 9.3 19.0 34.8 25.2 11.4 0.5 100.0 1.2 14.9 25.5 29.3 12.2 15.7 1.1 100.0 428
Middle 10.9 15.1 33.8 24.9 14.2 1.2 100.0 0.6 12.0 35.1 22.1 10.9 19.4 0.0 100.0 436
Fourth 7.7 18.6 25.7 31.9 15.2 1.0 100.0 1.8 15.1 24.5 27.1 9.8 21.2 0.6 100.0 339
Highest 10.3 26.8 31.3 21.9 8.7 1.1 100.0 2.0 16.3 35.4 24.8 8.5 13.1 0.0 100.0 221

Total 8.8 18.5 32.2 26.0 13.7 0.8 100.0 1.2 13.6 29.5 26.1 11.4 17.6 0.7 100.0 1,819

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

10.8 KNOWLEDGE OF ORS PACKETS

A simple and effective response to dehydration caused by diarrhoea is a prompt increase in


the child’s fluid intake through some form of oral rehydration therapy, which may include the use of a
solution prepared from packets of oral rehydration salts (ORS). To ascertain how widespread
knowledge of ORS is in Ethiopia, respondents were asked whether they know about ORS packets.

Child Health | 139


Table 10.10 shows that slightly less than half of Table 10.10 Knowledge of ORS packets or pre-
women (46 percent) who gave birth in the five years packaged liquids
preceding the survey know about ORS packets. There Percentage of mothers who gave birth in the five
are significant differences in knowledge of ORS packets years preceding the survey who know about ORS
between women residing in urban and rural areas. packets or pre-packaged liquids for treatment of
Knowledge is twice as high among urban women (85 diarrhoea, by background characteristics, Ethiopia
2005
percent) than among rural women (43 percent). Knowl-
edge of ORS also varies by region. More than nine in ten Percentage of
mothers in Addis Ababa (94 percent) and about four in mothers who
know about
five mothers in Tigray, Harari, and Dire Dawa know ORS packets
about ORS packets, compared with slightly more than or
three in ten mothers in the Amhara and Benishangul- Background prepackaged Number of
characteristic liquids mothers
Gumuz regions.
Age
There are marked differences in knowledge of 15-19 42.2 440
ORS packets by mother’s level of education; 89 percent 20-24 50.5 1,473
25-29 46.4 1,961
of mothers with some secondary or higher education
30-34 43.2 1,428
know about ORS packets compared with 41 percent of 35-49 45.8 2,006
mothers with no education. Similarly, knowledge of
ORS packets is widespread among mothers in the Residence
highest wealth quintile (73 percent), compared with Urban 85.3 634
mothers in the lowest wealth index (41 percent). Rural 42.5 6,674

There has been a steep decline in the proportion Region


of mothers who have heard about ORS, from 66 percent Tigray 80.8 480
Affar 54.0 68
in 2000 to 46 percent in 2005.
Amhara 31.7 1,856
Oromiya 49.9 2,723
10.9 STOOL DISPOSAL Somali 45.5 288
Benishangul-Gumuz 36.1 69
If human faeces are left uncontained, disease SNNP 41.8 1,632
may spread by direct contact or by animal contact with Gambela 50.0 23
the faeces. Hence, the proper disposal of children’s Harari 80.0 15
stools is extremely important in preventing the spread of Addis Ababa 94.1 129
Dire Dawa 79.1 25
disease. Table 10.11 presents information on the disposal
of the stools of children under five, by background Education
characteristics. No education 41.4 5,734
Primary 55.7 1,205
Sixty-seven percent of children’s stools are left Secondary and higher 88.9 368
uncontained: 7 percent are put or rinsed into a drain or
ditch, 11 percent are thrown into the garbage, and 49 Wealth quintile
percent are left in the open. Slightly more than one in Lowest 41.1 1,520
Second 39.2 1,553
five children’s stools are disposed of hygienically. Two
Middle 41.0 1,586
percent of children under five use a toilet or latrine. Fourth 42.4 1,451
Additionally, 17 percent of children’s stool are disposed Highest 73.1 1,196
of in the toilet or latrine, and 2 percent are buried in the
yard. Total 46.2 7,307

There are pronounced differences by mother’s ORS = Oral rehydration salts


level of education and type of toilet facilities in the way
stools are disposed of. For more than half the children (51 percent) of mothers with secondary and
higher education, stools are disposed of hygienically (child uses toilet, child’s stool thrown in toilet,
or buried in yard), compared with 17 percent of children of mothers with no education. Similarly, 51
percent of children in households with improved toilets that are not shared with other households,
have their stools contained compared with 19 percent of children in the households using non-
improved or shared toilet facilities.

140 | Child Health


Children’s stools are more likely to be contained in urban areas (52 percent) than in rural
areas (19 percent). This marked difference could be attributed to the fact that toilet facilities are more
available in urban areas. The table also shows that 69 percent of children’s stools in rural areas are
thrown in the garbage, rinsed in a drain, or left in the open compared with 44 percent in urban areas.
There are large variations in the way the child’s faeces are disposed of. For example, the percentage
of children whose stools are contained ranges from a low of 11 percent in Somali to a high of 68
percent in Addis Ababa. Furthermore, 61 percent of children’s stools are left in the open in the Tigray
and Somali regions, compared with 5 percent in Addis Ababa.

Table 10.11 Disposal of children's stools

Among mothers whose youngest child under age five is living with her, percent distribution by the manner of disposing of the child's last
faecal matter, according to background characteristics, Ethiopia 2005

Children's stools contained Children's stools uncontained


Child used Put/rinsed Put/rinsed Thrown
Background toilet or into toilet into drain into Left in Don't Number of
characteristic latrine or latrine Buried or ditch garbage the open Other know Total mothers
Age of child in months
<6 0.3 11.2 1.3 10.1 7.6 49.9 18.9 0.7 100.0 1,142
6-11 1.0 16.5 1.8 7.0 11.8 48.9 12.2 0.9 100.0 1,057
12-17 0.6 17.7 2.5 7.6 12.2 48.0 10.6 0.8 100.0 1,091
18-23 0.8 21.2 1.6 6.1 12.7 49.5 7.2 0.7 100.0 718
24-35 1.4 17.5 1.6 6.0 12.9 51.5 8.2 1.0 100.0 1,442
36-59 6.6 20.6 1.9 5.4 9.3 46.5 8.5 1.2 100.0 1,529
Toilet facilities
Improved, not shared1 7.9 40.8 2.1 8.1 3.2 28.7 8.5 0.7 100.0 420
Not improved or shared 1.7 15.9 1.8 6.9 11.4 50.3 11.0 0.9 100.0 6,559
Residence
Urban 5.4 44.8 1.6 12.6 13.6 17.7 4.2 0.1 100.0 586
Rural 1.8 14.9 1.8 6.4 10.7 51.9 11.5 1.0 100.0 6,393
Region
Tigray 0.9 10.2 5.3 3.5 16.0 60.9 2.5 0.7 100.0 466
Affar 2.5 14.8 2.1 6.3 19.1 53.8 1.4 0.0 100.0 63
Amhara 1.7 11.7 1.8 6.6 9.8 55.9 11.9 0.6 100.0 1,737
Oromiya 1.5 9.4 1.4 9.3 12.5 52.6 12.1 1.1 100.0 2,630
Somali 1.3 6.8 2.8 1.2 23.3 60.8 2.0 1.8 100.0 273
Benishangul-Gumuz 3.1 20.8 0.7 2.1 7.1 54.0 10.8 1.4 100.0 65
SNNP 3.9 37.3 1.2 5.0 6.1 32.8 12.8 0.9 100.0 1,567
Gambela 1.8 14.5 0.6 5.7 17.8 54.2 4.3 1.0 100.0 22
Harari 2.8 22.5 4.7 3.8 21.2 32.9 10.3 1.8 100.0 14
Addis Ababa 3.7 63.2 0.6 15.3 6.9 5.4 4.4 0.6 100.0 118
Dire Dawa 2.3 39.8 3.2 6.1 6.3 40.5 1.5 0.3 100.0 24
Education
No education 1.6 13.3 1.9 6.7 11.5 52.9 11.2 0.9 100.0 5,485
Primary 3.1 29.1 1.2 6.2 9.4 38.3 11.4 1.3 100.0 1,147
Secondary and higher 6.4 43.1 1.3 13.4 7.7 23.0 4.8 0.2 100.0 348
Wealth quintile
Lowest 0.5 4.5 2.7 7.0 13.0 59.3 11.8 1.2 100.0 1,476
Second 0.7 9.8 1.8 7.2 11.1 55.4 12.9 1.1 100.0 1,477
Middle 1.9 18.2 1.2 6.1 11.4 50.2 10.1 0.9 100.0 1,514
Fourth 3.2 21.4 2.0 6.2 9.5 45.8 11.0 0.9 100.0 1,389
Highest 5.0 38.4 1.0 8.6 9.1 29.5 7.9 0.4 100.0 1,123

Total 2.1 17.4 1.8 6.9 10.9 49.0 10.9 0.9 100.0 6,979
1
Non-shared facilities that are of the types flush or pour flush into a piped sewer system/septic tank/pit latrine, ventilated, improved pit
(VIP) latrine, pit latrine with a slab and composting toilet.

Child Health | 141


 
NUTRITION OF CHILDREN AND WOMEN 11
This chapter covers the nutritional status of children and women. The section on children
covers the following related topics: infant and young child feeding practices, including breastfeeding
and feeding with solid/semi-solid foods; diversity of foods fed; frequency of feeding; micronutrient
intake among children and women; and prevalence of anaemia. The sections on nutritional status
cover anthropometric assessment of the nutritional status of children under five years of age and the
nutritional status of women 15 to 49 years of age.

Adequate nutrition is critical to child development. The period from birth to two years of age
is important for optimal growth, health and development, especially since it is during this period that
children are particularly vulnerable to growth retardation, micronutrient deficiencies, and common
childhood illnesses such as diarrhoea and acute respiratory infections (ARI).

A woman’s nutritional status has important implications for her health as well as the health of
her children. Malnutrition in women results in reduced productivity, an increased susceptibility to
infections, retarded recovery from illness, and heightened risk of adverse pregnancy outcomes. A
woman who has poor nutritional status as indicated by a low body mass index (BMI), short stature,
anaemia, or other micronutrient deficiency, has a greater risk of obstructed labour, having a baby with
a low birth weight, producing lower quality breast milk, death due to postpartum haemorrhage, and
illness for herself and her baby.

11.1 INITIATION OF BREASTFEEDING


Early initiation of breastfeeding is encouraged for a number of reasons. Mothers benefit from
early suckling because it stimulates breast milk production and facilitates the release of oxytocin,
which helps the contraction of the uterus and reduces postpartum blood loss. The first breast milk
contains colostrum, which is highly nutritious and has antibodies that protect the newborn from
diseases. Early initiation of breastfeeding also fosters bonding between mother and child.

Table 11.1 shows the percentage of all children born in the five years before the survey by
breastfeeding status and the timing of initial breastfeeding, by background characteristics.
Breastfeeding is nearly universal in Ethiopia, with 96 percent of children born in the five years
preceding the survey having been breastfed at some time. The proportion of children ever breastfed
ranges from a low of 93 percent in Addis Ababa to a high of 99 percent in Harari. However, the
percentage of children ever breastfed does not vary much by other background characteristics.

More than two in three children are breastfed within one hour of birth (69 percent) and 86
percent within one day of birth. Twenty-nine percent of children were given a prelacteal feed, that is,
something other than breast milk during the first three days of life. Forty-five percent of children were
given the first milk. The percentage of children who are breastfed early has increased in the past five
years, the increase being more pronounced for children breastfed within 1 hour.

There is no difference in the timing of initial breastfeeding by gender of the child. However,
other characteristics of the infant and mother, such as type of assistance at delivery, place of delivery,
have important influences on early breastfeeding practices. Rural children are more likely than urban
children to start breastfeeding within one hour and within one day of birth, as are children born in
Dire Dawa and Somali compared with children in the other regions. Highly educated mothers are less
likely than those with little or no education to put their newborn to the breast within the first hour or
day of birth. Differences in early breastfeeding by wealth are small. Early initiation of breastfeeding is
more common among children whose mothers were assisted at delivery by a trained traditional birth
attendant and among children delivered at home.

Nutrition of Children and Women | 143


Table 11.1 Initial breastfeeding

Percentage of children born in the five years preceding the survey who were ever breastfed and for last-born children ever breastfed
in the five years preceding the survey, the percentage who started breastfeeding within one hour and within one day of birth and
the percentage who received a prelacteal feed, according to background characteristics, Ethiopia 2005
Percentage who
started breastfeeding:
Percentage Percentage Percentage
who started who started who Number of
Percentage breastfeeding breastfeeding received a Percentage children
Background ever Number of within 1 hour within 1 day prelacteal who received ever
characteristic breastfed children of birth of birth1 feed2 the first milk breastfed
Sex
Male 96.0 5,723 68.4 85.2 29.5 44.9 3,668
Female 95.9 5,440 69.8 86.3 28.4 45.7 3,441
Residence
Urban 95.0 815 64.8 81.9 38.8 43.8 608
Rural 96.0 10,348 69.5 86.1 28.0 45.5 6,501
Region
Tigray 98.5 698 52.9 73.7 30.6 55.8 475
Affar 97.2 107 86.4 91.1 36.8 68.3 67
Amhara 97.1 2,621 62.6 77.4 44.6 44.8 1,823
Oromiya 94.8 4,411 72.1 88.5 26.0 45.8 2,624
Somali 95.1 477 91.4 94.0 19.2 53.7 275
Benishangul-Gumuz 96.7 105 72.1 80.3 19.0 45.4 67
SNNP 96.4 2,500 71.4 92.7 15.4 39.3 1,596
Gambela 95.9 31 72.7 80.8 28.3 43.0 22
Harari 99.0 22 73.7 88.2 48.6 75.9 15
Addis Ababa 92.9 153 66.2 86.7 49.4 42.1 120
Dire Dawa 98.1 37 91.4 94.4 34.2 66.5 24
Mother's education
No education 96.2 8,838 70.4 86.2 28.8 46.4 5,594
Primary 95.1 1,855 64.8 84.6 28.2 38.5 1,157
Secondary and higher 95.4 470 63.0 81.5 34.8 51.0 357
Wealth quintile
Lowest 96.4 2,440 72.1 85.4 30.7 49.3 1,486
Second 95.8 2,356 69.7 85.5 27.3 46.5 1,510
Middle 95.8 2,486 69.9 85.6 26.8 45.6 1,541
Fourth 95.3 2,222 67.0 86.4 28.5 43.5 1,415
Highest 96.6 1,660 65.8 85.8 32.3 40.7 1,157
Assistance at delivery
Health professional3 93.2 644 62.2 84.4 30.0 49.5 487
Trained traditional birth
attendant 95.5 734 70.8 88.2 28.6 41.0 445
Untrained traditional birth
attendant 96.3 2,399 68.7 84.1 35.2 50.4 1,480
Other 96.0 6,756 69.2 85.6 28.0 43.3 4,261
No one 97.1 607 75.6 92.8 17.1 47.7 430
Missing 100.0 23 46.2 46.2 0.0 29.9 7
Place of delivery
Health facility 93.4 589 61.4 84.9 29.6 49.2 444
At home 96.1 10,502 69.7 85.9 28.9 45.0 6,631
Other 94.9 45 52.2 82.0 32.0 53.7 28
Missing 100.0 26 34.1 34.8 0.6 34.8 6

Total 96.0 11,163 69.1 85.7 29.0 45.3 7,109

Note: Table is based on births in the five years preceding the survey whether the children are living or dead.
1
Includes children who started breastfeeding within one hour of birth.
2
Received something other than breast milk during the first three days of life, before the mother started breastfeeding regularly.
3
Doctor, nurse/midwife, or auxiliary midwife

11.2 BREASTFEEDING STATUS BY AGE

UNICEF and WHO recommend that children be exclusively breastfed during the first 6
months of life and that children be given solid or semisolid complementary food in addition to
continued breastfeeding from six months on. Exclusive breastfeeding is recommended because breast
milk is uncontaminated and contains all the nutrients necessary for children in the first few months of

144 | Nutrition of Children and Women


life. In addition, the mother's antibodies in breast milk provide immunity to disease. Early supple-
mentation is discouraged for several reasons. First, it exposes infants to pathogens and increases their
risk of infection, especially disease. Second, it decreases infants' intake of breast milk and therefore
suckling, which reduces breast milk production. Third, in a harsh socioeconomic environment,
supplementary food is often nutritionally inferior.

Information on supplementation was obtained by asking mothers about the current breast-
feeding status of all children under five years of age and, for the youngest child born in the three-year
period before the survey and living with the mother, food (liquids or solids) given to the child the day
before the survey..

Table 11.2 shows the percent distribution of youngest children under three years living with
the mother by breastfeeding status and percentage of children under three years using a bottle with a
nipple, according to age in months. The data presented in Table 11.2 and Figure 11.1 shows that not
all children under 6 months are exclusively breastfed. Contrary to WHO's recommendations only one
in three Ethiopian children age 4-5 months is exclusively breastfed. The table also shows that just
over two-thirds of children under 2 months of age are exclusively breastfed, 10 percent consume
breast milk and plain water, 5 percent consume breast milk and other non-milk liquids, and 11 percent
consumed breast milk and other milk. Six percent of children under 2 months are given
complementary foods. The EDHS results also indicate that complementary foods are not introduced in
a timely fashion for many children. At 6-8 months of age, 14 percent of children continue to be
exclusively breastfed, 9 percent receive plain water in addition to breast milk, 6 percent consume
other water-based liquids, 20 percent consume other milk, and 50 percent consume complementary
foods. The proportion of exclusively breastfed children drops to 1 in 20 by age 9-11 months, and
continues to decline thereafter.

Table 11.2 Breastfeeding status by age

Percent distribution of youngest children under three years living with the mother by breastfeeding status, and percentage of all
children under three years using a bottle with a nipple, according to age in months, Ethiopia 2005

Breastfeeding and consuming: Percentage


Not Plain Non-milk Comple- Number using a
Age in breast- Exclusively water liquids/ Other mentary of bottle with Number of
months feeding breastfed only juice milk foods Total children a nipple1 children
<2 1.6 67.3 9.9 5.0 10.6 5.6 100.0 328 7.6 331
2-3 1.2 49.4 14.4 7.0 15.1 12.9 100.0 458 13.2 461
4-5 1.3 31.6 18.7 3.2 23.8 21.5 100.0 355 17.9 360
6-8 1.6 14.1 9.0 5.5 19.8 50.0 100.0 598 18.7 608
9-11 5.2 4.7 6.3 1.5 8.4 74.0 100.0 459 17.0 463
12-17 6.5 2.3 3.3 1.1 2.9 83.9 100.0 1,091 10.7 1,115
18-23 11.9 0.5 1.5 0.8 1.8 83.5 100.0 718 8.4 762
24-35 38.8 0.2 0.6 0.5 0.5 59.4 100.0 1,442 7.6 1,892

<4 1.4 56.8 12.5 6.1 13.2 9.9 100.0 787 10.9 791
<6 1.3 49.0 14.5 5.2 16.5 13.5 100.0 1,142 13.0 1,152
6-9 2.5 12.7 8.4 4.5 17.5 54.4 100.0 791 17.4 804
12-23 8.6 1.6 2.6 1.0 2.5 83.7 100.0 1,809 9.7 1,877

Note: Breastfeeding status refers to a "24-hour" period (yesterday and last night). Children who are classified as breastfeeding and
consuming plain water only consumed no liquid or solid supplements. The categories of not breastfeeding, exclusively breastfed,
breastfeeding and consuming plain water, non-milk liquids/juice, other milk, and complementary foods (solids and semi-solids) are
hierarchical and mutually exclusive, and their percentages add to 100 percent. Thus children who receive breast milk and non-milk
liquids and who do not receive complementary foods are classified in the non-milk liquid category even though they may also get
plain water. Any children who get complementary food are classified in that category as long as they are breastfeeding as well.
1
Based on all children under 3 years.

Nutrition of Children and Women | 145


Figure 11.1 Breastfeeding Practices by Age
100

80

Not breastfeeding
Breast milk and
60 complementary foods
Breast milk and
other milk
Breast milk and
40 non-milk liquids
Breast milk and plain water
Exclusively breastfed
20

0
<2 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23

Age in Months
EDHS 2005

Figure 11.2 shows the breastfeeding status of children 0-5 months and 6-9 months for the
years 2000 and 2005. Exclusive breastfeeding declined slightly among children under six months
while complementary feeding increased between the two surveys.

Figure 11.2 Trends in Infant Feeding Practice for Children


0-5 Months and 6-9 Months, 2000 and 2005
Percent
100

80
Not breastfeeding
Breast milk and
complementary foods
60
Breast milk and
other milk
Breast milk and
40 non-milk liquids
Breast milk and plain water
Exclusively breastfed
20

0
2000 2005 2000 2005
0-5 months 6-9 months

Bottle-feeding is discouraged at any age. It is usually associated with increased risk of illness,
and especially diarrhoeal disease, because of the difficulty in sterilizing the nipples properly. Bottle-
feeding also shortens the period of postpartum amenorrhoea and increases the risk of pregnancy. The
practice of bottle-feeding with a nipple is not widespread in Ethiopia. However, the proportion of
children who are bottle-fed rises from 8 percent among children age less than two months to 19
percent among children age 6-8 months, after which it declines gradually to 8 percent among children
18-35 months of age.

146 | Nutrition of Children and Women


11.3 DURATION AND FREQUENCY OF BREASTFEEDING

Table 11.3 shows the median duration of breastfeeding by selected background


characteristics. The estimates of median and mean durations of breastfeeding are based on current
status data, that is, the proportion of last-born children in the three years preceding the survey who
were being breastfed at the time of the survey.

Table 11.3 Median duration and frequency of breastfeeding

Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children born in the three
years preceding the survey, percentage of breastfeeding children under six months living with the mother who were breastfed six or
more times in the 24 hours preceding the survey, and mean number of feeds (day/night), by background characteristics, Ethiopia
2005

Breastfeeding children under six months2


1
Median duration (months) of breastfeeding Percentage
Any Exclusive Predominant breastfed Mean Mean
Background breast- breast- breast- Number of 6+ times in number of number of Number of
3
characteristic feeding feeding feeding children last 24 hours day feeds night feeds children
Sex
Male 25.5 2.1 4.5 3,428 96.2 6.8 5.5 602
Female 26.2 2.1 4.3 3,120 94.3 6.4 5.7 507
Residence
Urban 24.8 1.8 3.2 491 93.4 6.4 5.3 71
Rural 25.9 2.1 4.5 6,057 95.4 6.7 5.6 1,038
Region
Tigray 25.9 1.6 6.3 397 99.0 6.2 4.8 62
Affar 24.5 0.4 0.7 65 98.0 7.6 6.9 10
Amhara •36.0 4.3 7.1 1,527 96.3 7.1 5.5 280
Oromiya 24.6 1.6 3.4 2,633 93.4 6.1 5.7 399
Somali 21.8 0.5 2.9 279 100.0 8.6 5.8 43
Benishangul-Gumuz 23.1 1.6 4.0 61 91.5 6.6 5.2 12
SNNP 26.1 1.8 3.2 1,447 95.3 6.7 5.6 280
Gambela •36.0 1.6 4.0 17 (100.0) (7.7) (6.3) 3
Harari 20.6 0.8 3.1 14 93.0 6.3 4.7 3
Addis Ababa 25.7 0.6 0.9 87 (97.3) (7.0) (5.0) 13
Dire Dawa 20.3 0.5 5.0 23 (100.0) (7.9) (6.4) 4
Mother's education
No education 26.2 2.3 4.7 5,116 95.4 6.7 5.6 876
Primary 24.9 1.7 3.8 1,142 94.0 6.5 5.6 192
Secondary and higher 23.3 1.6 2.1 290 99.0 6.1 5.0 41
Wealth quintile
Lowest 25.1 0.7 3.4 1,403 97.0 7.1 6.0 221
Second 27.1 2.6 5.2 1,386 96.5 6.4 5.4 220
Middle 25.4 3.0 4.6 1,470 96.3 6.5 5.8 251
Fourth 25.9 2.4 4.5 1,316 91.1 6.6 5.2 263
Highest 25.3 2.2 3.2 974 96.6 6.8 5.8 154

All children 25.8 2.1 4.4 6,548 95.3 6.6 5.6 1,109

Mean for all children 25.5 4.0 6.0 na na na na na

Note: Median and mean durations are based on current status. The median duration of any breastfeeding is shown as •36.0 for
groups in which the exact median cannot be calculated because the proportion of breastfeeding children does not drop below 50
percent in any age group for children under 36 months of age. Includes children living and deceased at the time of the survey.
Figures in parentheses are based on 25-49 unweighted cases.
na = Not applicable
1
It is assumed that non-last-born children or last born child not currently living with the mother are not currently breastfeeding
2
Excludes children who do not have a valid answer on the number of times breastfed
3
Either exclusively breastfed or received breast milk and plain water, non-milk based liquids, and/or juice only

Nutrition of Children and Women | 147


The median duration of breastfeeding is 25.8 months, while the mean duration is 25.5 months.
There is little difference in the duration of breastfeeding by sex of the child. Rural children are
breastfed for a slightly longer duration than urban children, as are children living in SNNP compared
with children in other regions. Highly educated mothers breastfeed their children for a shorter
duration than mothers with little or no education.

Both duration and frequency of breastfeeding can affect the length of postpartum amenor-
rhoea. Table 11.3 shows that the overwhelming majority (95 percent) of children under six months of
age were breastfed 6 or more times in the 24 hours preceding the survey. In line with expectations,
breastfeeding is slightly more frequent in the daytime than at night, with the mean number of feeds in
the daytime being 6.6 compared with 5.6 at night. Breastfeeding in the day is more frequent among
children residing in the Somali Region than in the other regions, while night feeds are most frequent
among children in Affar.

11.4 TYPES OF SUPPLEMENTAL FOOD

Table 11.4 shows information on the types of food given to the youngest child under three
years of age living with the mother on the day and night preceding the survey, according to their
breastfeeding status. The introduction of other liquids such as water, juice, and formula takes place
earlier than the recommended age of about 6 months. Even among the youngest breastfeeding
children (<2 months), 10 percent consume other liquids, and 12 percent drink milk other than breast
milk. Consumption of liquids other than milk increases gradually with age, and by age 24-35 months
more than one in two children receives liquid supplements other than milk. Consumption of milk,
other than breast milk and infant formula, peaks at 6-8 months (48 percent) and then declines
thereafter. Supplementing with infant formula at any age is uncommon in Ethiopia.

WHO recommends the introduction of solid food to infants around the age of 6 months
because by that age breast milk by itself is no longer sufficient to maintain a child's optimal growth.
The percentage receiving solid or semisolid food increases gradually; by age two most children are
fed solid or semisolid foods. Nevertheless, it is disconcerting to note that even at 6-8 months of age,
only one in two children are consuming solid or semisolid food.

At age 6-23 months, the proportion of children consuming foods made from grains (70
percent) is the highest, compared with the consumption of other types of solid or semisolid foods.
Only 14 percent of children less than three years of age consumed vitamin A-rich foods in the day and
night preceding the survey. Meat, fish, poultry and eggs have bodybuilding substances essential to
good health; they are important for balanced physical and mental development. The introduction of
these foods in the diet is late and few children consume them. For instance, at age 6-23 months, only
one in ten children consume meat, fish, shellfish, poultry or eggs.

As expected, the percentage of non-breastfeeding children who consume supplements at an


earlier age is higher than the percentage of breastfeeding children.

148 | Nutrition of Children and Women


Table 11.4 Foods and liquids consumed by children in the day or night preceding the interview

Percentage of youngest children under three years of age living with the mother who consumed specific foods in the day or night preceding the
interview, by breastfeeding status and age, Ethiopia 2005

Solid or semi-solid foods


Food Food Meat/ Cheese, Any Foods
Liquids
Foods Fruits and made made fish/ yogurt, solid or made
Fortified made vegetables Other from from shellfish/ other semi- with oil/ Number
Age in Infant Other Other baby from rich in fruits and roots/ legumes poultry/ milk solid fat/ of
months formula milk liquids foods grains vitamin A vegetables tubers and nuts eggs product food butter children
BREASTFEEDING CHILDREN

<2 0.2 12.2 10.0 0.1 3.4 0.5 0.0 0.0 0.3 0.0 0.1 5.7 0.6 323
2-3 1.2 20.4 12.4 0.7 6.6 1.7 0.0 2.1 0.6 1.7 0.9 13.1 0.9 453
4-5 0.6 31.0 13.3 1.7 16.1 1.4 1.4 1.0 1.7 0.0 1.9 21.7 2.7 351
6-8 1.3 47.5 30.1 2.5 40.2 4.0 2.6 8.1 8.2 5.5 8.6 50.6 13.1 588
9-11 0.2 43.2 33.6 5.3 67.1 11.2 6.0 17.8 18.1 5.4 11.6 77.7 27.6 435
12-17 0.8 35.2 46.1 4.4 78.7 17.5 5.5 24.3 30.6 12.2 15.7 89.5 39.2 1,021
18-23 1.1 31.0 49.8 3.4 87.5 18.0 5.8 23.9 42.0 14.2 15.5 94.4 49.7 632
24-35 1.6 30.2 53.1 2.7 88.1 21.6 5.0 24.2 46.1 9.8 16.4 97.1 47.6 882

6-23 0.9 38.2 41.4 3.9 70.4 13.6 5.0 19.6 26.3 10.1 13.4 80.2 34.0 2,676

Total 1.0 32.7 36.5 2.9 58.9 12.2 3.9 16.0 23.9 7.8 11.0 67.4 28.7 4,685

NONBREASTFEEDING CHILDREN

0-11 11.1 63.3 57.1 5.9 54.0 8.2 8.7 26.2 17.3 22.2 31.2 60.0 37.2 49
12-17 1.5 61.2 81.6 4.3 82.9 36.0 8.3 40.1 22.5 20.3 12.6 95.2 34.0 71
18-23 2.1 62.4 63.6 5.2 82.8 18.8 10.4 30.9 27.7 22.4 27.8 99.1 48.6 85
24-35 1.1 40.3 60.5 2.4 91.4 25.9 9.0 26.9 41.8 15.2 22.7 98.9 48.9 560

6-23 4.0 63.1 70.4 5.5 80.3 24.0 10.0 34.8 25.3 23.4 24.9 93.8 42.7 189

Total 1.9 46.2 62.6 3.1 87.3 24.9 9.1 28.5 36.9 17.0 22.9 96.1 46.7 765

Note: Breastfeeding status and food consumed refer to a "24-hour" period (yesterday and last night).
1
Other milk includes fresh, tinned and powdered cow or other animal milk
2
Does not include plain water
3
Includes fortified baby food
4
Includes pumpkin, carrots, squash, sweet potatoes, dark green leafy vegetables, mangoes, papayas, and other locally grown fruits and vegetables
that are rich in vitamin A

11.5 FOODS CONSUMED BY MOTHERS


The quality and quantity of food that mothers consume influences their health and that of their
children, especially the health of breastfeeding children. The 2005 EDHS included questions on the
type of foods consumed by mothers of children under age three during the day and night preceding the
interview.

Table 11.5 shows that most mothers of young children consume foods made from grains (88
percent), one in two mothers consume foods made from legumes and nuts, one-third consume foods
made from roots or tubers and vitamin A-rich fruits and vegetables. Smaller proportions of mothers
consume cheese, yogurt, milk or other milk products (23 percent) and meat, fish, shellfish, poultry
and eggs (14 percent). Eighty-six percent of mothers drink tea or coffee and 56 percent consume
foods made with oil, fat or butter.

Nutrition of Children and Women | 149


Table 11.5 Foods consumed by mothers in the day and night preceding the interview

Percentage of mothers of children under three years of age who consumed specific types of foods in the day and night preceding the
interview, by background characteristics, Ethiopia 2005

Foods Foods Meat/ Foods


Foods made made fish/ Cheese/ Fruits/ made
made from from shellfish/ yogurt/ vegetables Other with oil/ Number
Background from roots/ legumes/ poultry/ milk/ milk rich in fruits/ fat/ Sugary Tea/ of
characteristic grains tubers nuts eggs products vitamin A vegetables butter foods coffee mothers
Age at birth
<20 89.2 29.5 52.0 12.2 20.2 28.6 5.3 56.8 2.6 84.1 760
20-24 90.4 29.3 49.5 15.5 21.4 29.4 6.3 57.7 3.1 82.4 1,402
25-29 87.8 35.5 48.6 14.9 25.4 32.5 6.5 56.3 3.2 87.0 1,415
30-34 83.9 32.8 44.4 14.9 22.8 36.5 7.5 53.6 2.7 87.5 968
35-49 86.8 32.4 50.6 12.1 25.4 28.1 3.3 55.7 2.8 89.4 905

Residence
Urban 97.1 38.9 63.5 31.5 23.5 39.2 19.8 81.2 8.8 92.3 411
Rural 87.1 31.5 47.7 12.8 23.1 30.5 4.8 54.1 2.5 85.4 5,038

Region
Tigray 96.6 4.0 68.8 24.6 6.9 9.5 8.5 76.9 3.4 78.3 348
Affar 92.2 5.1 25.1 18.6 73.4 11.4 3.9 69.3 3.3 92.5 51
Amhara 94.4 23.1 76.2 19.3 13.8 13.2 3.3 67.5 2.2 86.6 1,296
Oromiya 92.6 23.9 49.1 12.9 29.1 33.2 5.6 57.7 3.1 85.4 2,137
Somali 94.0 11.8 9.2 7.6 41.1 4.6 2.0 48.8 8.5 70.6 214
Benishangul-Gumuz 90.0 12.1 48.0 22.6 14.7 27.8 7.4 53.7 3.8 83.2 50
SNNP 67.8 68.4 21.0 7.9 22.3 57.4 7.0 34.2 1.8 90.9 1,231
Gambela 95.3 26.7 33.6 24.9 25.3 56.5 12.8 55.3 4.1 68.7 15
Harari 100.0 30.6 49.7 16.3 25.3 42.7 17.9 60.6 3.1 79.7 12
Addis Ababa 99.4 41.5 74.5 27.3 21.7 35.9 34.6 90.2 11.5 94.2 77
Dire Dawa 94.8 39.1 31.4 15.1 41.6 28.8 20.5 57.1 6.3 60.0 19

Education
No education 87.4 30.3 47.4 12.5 22.2 29.2 4.2 53.8 2.7 84.6 4,262
Primary 87.5 37.8 52.1 15.8 25.9 38.0 9.5 60.0 1.4 89.3 932
Secondary and higher 96.6 40.8 62.1 37.0 29.1 38.7 21.9 81.5 13.3 95.6 255

Wealth quintile
Lowest 89.0 18.6 44.1 12.6 26.3 19.7 3.8 48.5 2.6 78.2 1,154
Second 86.2 30.9 48.3 9.7 21.6 31.6 4.5 48.9 2.7 84.1 1,192
Middle 86.9 32.0 46.3 12.9 23.1 31.3 4.9 55.5 2.4 87.5 1,196
Fourth 85.6 41.2 49.8 13.9 19.7 36.0 5.9 59.8 2.0 90.2 1,086
Highest 92.9 40.9 59.0 25.2 25.8 39.8 12.6 73.4 5.9 91.4 822

Total 87.8 32.1 48.9 14.2 23.2 31.1 5.9 56.1 2.9 85.9 5,450

Note: Table refers to foods consumed in the preceding "24-hour" period (yesterday and last night)
1
Includes pumpkin, carrots, squash, sweet potatoes, dark green leafy vegetables, mangoes, papayas, and other locally grown fruits and
vegetables that are rich in vitamin A

11.6 MICRONUTRIENT INTAKE

Micronutrient deficiencies are a result of inadequate intake of micronutrient-rich foods and


the inadequate utilization of available micronutrients in the diet as a result of infections, parasitic
infestations, and other factors. Measures of micronutrient fortification through the use of iodized
household salt, micronutrient supplementation with iron and vitamin A, consumption of vitamin A-
rich and iron-rich foods, and micronutrient status in terms of anaemia and night blindness are
discussed in the following section for both women and children.

150 | Nutrition of Children and Women


11.6.1 Iodine Intake

Insufficient iodine in the diet can lead to serious health problems. Disorders arising from
iodine deficiency range from goiter to mental and neurological disorders. Deficiency of iodine also
causes abortion, stillbirth, low birth weight in infants, and premature birth. The principal cause of
iodine deficiency is inadequate iodine in foods. Since iodine cannot be stored for long periods by the
body, tiny amounts are needed regularly (100-150 micrograms per day per person).

In the 2005 EDHS cooking salt in households was tested for the presence of iodine using salt
testing kits supplied by UNICEF. Salt that contains at least 15 parts per million (ppm) of iodine is
considered to be adequately iodized. Of the 99 percent of households in which an iodine test was
carried out, only 20 percent had salt that was adequately iodized. Wealth and place of residence
make little difference in iodine fortification (Table 11.6). Households in Dire Dawa are most likely to
consume salt that is adequately iodized (62 percent) while households in Benishangul-Gumuz least
likely (14 percent).

Table 11.6 Presence of iodized salt in household

Percent distribution of households with salt tested for iodine content by level of iodine in salt (parts per million), percentage
of households tested, and percentage of households with no salt, according to background characteristics, Ethiopia 2005

Among all
Iodine content of salt in households,
households tested: the percentage:
Background None Inadequate Adequate Number of With salt With Number of
characteristic (0 ppm) (<15 ppm) (15+ ppm) Total households tested no salt households
Residence
Urban 46.1 32.9 21.0 100.0 1,939 98.2 0.1 1,974
Rural 45.6 34.7 19.7 100.0 11,606 98.8 0.1 11,747
Region
Tigray 43.7 28.3 28.0 100.0 932 99.2 0.4 940
Affar 39.0 38.0 23.0 100.0 136 98.8 0.0 138
Amhara 53.4 31.7 14.9 100.0 3,658 98.6 0.1 3,709
Oromiya 40.3 37.7 22.0 100.0 4,749 99.1 0.0 4,790
Somali 41.8 33.6 24.7 100.0 535 99.0 0.0 540
Benishangul-Gumuz 58.7 27.7 13.6 100.0 127 99.4 0.0 128
SNNP 45.9 35.6 18.5 100.0 2,746 98.0 0.2 2,802
Gambela 34.9 27.4 37.6 100.0 45 96.7 0.4 47
Harari 41.5 29.7 28.8 100.0 38 98.0 0.0 39
Addis Ababa 50.4 31.7 17.9 100.0 516 98.4 0.0 525
Dire Dawa 8.3 29.4 62.3 100.0 63 98.5 0.0 64
Wealth quintile
Lowest 43.4 34.5 22.1 100.0 2,733 99.1 0.1 2,757
Second 48.0 33.4 18.7 100.0 2,813 99.1 0.0 2,838
Middle 44.0 36.2 19.8 100.0 2,636 98.7 0.0 2,670
Fourth 45.9 35.0 19.1 100.0 2,492 98.5 0.1 2,531
Highest 46.9 33.3 19.9 100.0 2,872 98.2 0.1 2,925

Total 45.7 34.4 19.9 100.0 13,546 98.7 0.1 13,721

11.6.2 Micronutrient Intake Among Children

A serious contributor to childhood morbidity and mortality is micronutrient deficiency.


Children can receive micronutrients from foods, food fortification, and direct supplementation. Table
11.7 looks at measures relating to intake of several key micronutrients among children.

Vitamin A is an essential micronutrient for the immune system and plays an important role in
maintaining the epithelial tissue in the body. Severe vitamin A deficieny (VAD) can cause eye
damage. VAD can also increase severity of infections such as measles and diarrheal diseases in
children and slows recovery from illness. Vitamin A is found in breast milk, other milks, liver, eggs,

Nutrition of Children and Women | 151


fish, butter, red palm oil, mangoes, papayas, carrots, pumpkins, and dark green leafy vegetables. The
liver can store an adequate amount of the vitamin for four to six months. Periodic dosing (usually
every six months) of vitamin A supplements is one method of ensuring that children at risk do not
develop VAD.

The EDHS collected information on the consumption of vitamin A-rich foods and on the
coverage of supplements. Table 11.7 shows that 26 percent of last-born children living with the
mother consumed vitamin A-rich foods in the 24-hour period before the survey. Consumption of
vitamin A-rich foods increases from 8 percent among children age 6-8 months to 33 percent among
children age 24-35 months. There is no gender difference in the consumption of vitamin A-rich foods
and no discernible difference by birth order. Not surprisingly, breastfeeding children are much less
likely to consume vitamin A-rich foods than nonbreastfeeding children. Urban children are nearly
twice as likely to consume vitamin A-rich foods as rural children. Children living in Gambela and
Addis Ababa are more likely than children living in other regions to consume vitamin A-rich foods.
Children born to mothers with at least some secondary education are more likely to have received
foods rich in vitamin A than children born to mothers with little or no education. Children living in
the wealthiest households are much more likely to consume vitamin A-rich foods than children living
in other households.

Eleven percent of young children consume foods rich in iron. Noticeable differences by
background characteristics are also seen in the consumption of iron-rich foods by young children.
Consumption of iron-rich foods rises to peak of 15 percent among children age 18-23 months, is
slightly higher among female than male children, and among lower than higher order births.
Differences by other background variables are similar to those seen for the consumption of vitamin A-
rich foods.

Nearly one in two children age 6-59 months received a vitamin A supplement in the six
months before the survey. Differences in the consumption of vitamin A supplements by gender, birth
order, breastfeeding status and mother’s age at birth are small. The urban-rural difference in vitamin
A intake is marked, with rural children much less likely to receive vitamin A supplements than
children in urban areas. Children residing in Benishangul-Gumuz are least likely to receive vitamin A
supplements compared with children in the other regions. Vitamin A supplementation children rises
as mother’s education and household wealth increases.

As discussed earlier, inadequate amounts of iodine in the diet are related to serious health
risks for young children. The EDHS results show that 19 percent of children 6-59 months live in
households using adequately iodized salt. Children under age one, rural children, and children living
in Dire Dawa are more likely than their counterparts to live in households using adequately iodized
salt. There is no clear pattern by mother’s age at birth or wealth quintile in the percentage of children
living in households using adequately iodized salt.

152 | Nutrition of Children and Women


Table 11.7 Micronutrient intake among children

Percentage of last-born children age 6-35 months living with the mother who consumed foods rich in vitamin A and
iron in the 24 hours preceding the survey, and percentage of children age 6-59 months who received vitamin A
supplements in the six months preceding the survey, and percentage of children under five living in households with
adequately iodized salt, by background characteristics, Ethiopia 2005

Children age 6-59


Children age months in households
Last-born children age 6-35 months 6-59 months with salt tested
Consumed Given
foods rich in Consumed vitamin A Household
vitamin A foods rich in supplements salt
Background in past iron in past Number of in past Number of adequately Number of
1 2
characteristic 24 hours 24 hours children 6 months children iodized3 children
Child’s age in months
6-8 8.4 5.4 598 41.8 608 21.2 603
9-11 18.3 7.5 459 38.9 463 21.9 455
12-17 28.0 12.8 1,091 45.2 1,115 16.3 1,101
18-23 29.4 15.2 718 49.6 762 18.4 753
24-35 32.5 11.9 1,442 46.2 1,892 19.1 1,876
36-47 na na na 47.9 2,105 19.6 2,081
48-59 na na na 44.9 2,013 18.7 1,986
Mother's age at birth
<20 26.4 12.1 599 44.3 1,314 15.6 1,294
20-24 27.4 13.5 1,103 45.5 2,427 18.9 2,400
25-29 25.1 11.7 1,106 44.9 2,206 20.1 2,170
30-34 30.3 10.5 773 48.1 1,607 20.2 1,597
35-49 20.3 7.6 727 46.4 1,404 19.3 1,394
Sex
Male 26.0 10.6 2,206 45.7 4,508 18.5 4,467
Female 26.0 12.0 2,102 45.9 4,450 19.5 4,388
Birth order
2-3 27.7 13.4 703 45.8 1,474 17.5 1,459
4-5 27.5 13.8 1,239 46.3 2,726 19.3 2,692
6+ 26.8 9.8 1,048 48.0 2,122 19.4 2,091
Breastfeeding status
Breastfeeding 23.2 10.1 3,558 44.5 3,976 18.4 3,931
Not breastfeeding 39.2 17.1 739 47.3 4,881 19.4 4,825
Residence
Urban 44.2 28.7 335 62.0 673 14.4 668
Rural 24.5 9.9 3,973 44.5 8,285 19.4 8,186
Region
Tigray 25.1 20.7 286 65.3 591 25.0 588
Affar 9.3 6.8 41 33.3 85 23.5 84
Amhara 19.2 12.1 1,010 43.2 2,026 14.2 1,995
Oromiya 26.4 10.9 1,721 43.0 3,599 21.1 3,576
Somali 7.9 6.6 166 38.8 383 22.6 378
Benishangul-Gumuz 31.1 16.2 38 27.4 83 13.7 83
SNNP 35.4 8.4 948 49.9 1,986 17.4 1,948
Gambela 38.2 16.3 12 39.1 26 32.2 25
Harari 33.9 21.4 9 36.1 18 27.1 18
Addis Ababa 37.9 20.5 64 53.2 130 11.8 130
Dire Dawa 23.9 18.6 15 46.7 31 53.0 31
Mother's education
No education 22.9 9.0 3,371 43.8 7,052 19.1 6,967
Primary 33.1 14.9 727 50.3 1,502 19.6 1,488
Secondary and higher 51.1 35.4 210 63.6 404 14.4 400
Wealth quintile
Lowest 16.9 6.9 926 39.5 1,990 20.4 1,969
Second 26.1 8.7 964 42.1 1,893 17.4 1,872
Middle 24.0 10.6 940 45.6 1,953 18.7 1,934
Fourth 28.9 11.6 818 49.6 1,744 20.7 1,719
Highest 37.9 22.1 659 55.4 1,378 17.5 1,360

Total 26.0 11.3 4,308 45.8 8,958 19.0 8,855

Note: Information on vitamin A supplements is based on mother's recall. Total includes 98 children with missing
information on breastfeeding status who are not shown separately.
na = Not applicable
1
Includes meat (and organ meat), fish, poultry, eggs, pumpkin, red or yellow yams or squash, carrots, red sweet
potatoes, dark green leafy vegetables, mango, papaya, and other locally grown fruits and vegetables that are rich in
vitamin A
2
Includes meat (including organ meat) fish, poultry and eggs.
3
Salt containing 15 ppm of iodine or more.

Nutrition of Children and Women | 153


11.6.3 Micronutrient Intake among Mothers

A mother's nutritional status during pregnancy is important both for the child's intrauterine
development and for protection against maternal morbidity and mortality. Night blindness is an
indicator of severe vitamin A deficiency, and pregnant women are especially prone to suffer from it.

Table 11.8 shows the micronutrient intake among mothers of young children by background
characteristics. Two-fifths of mothers consumed vitamin A-rich foods and 14 percent consumed iron-
rich foods. Twenty-one percent of mothers received vitamin A supplements postpartum. One in five
mothers reported having difficulty seeing at night but when adjusted for those mothers who had no
difficulty seeing in the daytime, only 6 percent of mothers are considered to have suffered from night
blindness during their pregnancy. The majority of mothers did not take iron supplements during their
pregnancy (89 percent). Nineteen percent of mothers live in households using adequately iodized salt.

Consumption of vitamin A-rich foods is higher among mothers whose age at birth was 30-34,
mothers residing in urban areas, mothers living in Gambela, mothers with at least secondary
education, and mothers in the highest wealth quintile. Urban residence, education, and wealth also
exert a positive influence on the consumption of iron-rich foods. Consumption of iron-rich foods is
highest in Addis Ababa, Gambela, and Tigray and lowest in SNNP and Somali.

Night blindness during pregnancy is more prevalent among older mothers (age 30 and above),
mothers of higher order births, rural mothers, mothers residing in Amhara, mothers with no education,
and mothers in the poorest households.

154 | Nutrition of Children and Women


Table 11.8 Micronutrient intake among mothers

Percentage of women with a child under age three years living with her who consumed foods rich in vitamin A and iron in the 24 hours preceding the survey, and
among women with a birth in the five years preceding the survey, percentage who received a vitamin A dose in the first two months after delivery, percentage who
suffered from night blindness during pregnancy, percentage who took iron tablets or syrup for specific number of days, and percentage who live in households with
adequately iodized salt, by background characteristics, Ethiopia 2005

Number
Mothers with a living of women Women in
child under age 3 years Number of days iron tablets taken with a households with
who consumed: during pregnancy birth in salt tested
Night blindness
Foods Received the 5 Percentage
during pregnancy
rich in Iron- Number vitamin A Don't years with salt Number
Background vitamin rich of dose post- know/ preceding adequately of
characteristics A1 foods2 women partum3 Reported Adjusted4 None <60 60-89 90+ missing the survey iodized5 women
Age at birth
<20 36.3 12.2 760 19.9 14.1 4.3 90.2 8.3 0.4 0.0 1.1 994 15.2 974
20-24 40.2 15.5 1,402 19.9 18.6 5.7 90.7 7.9 0.0 0.2 1.2 1,822 17.3 1,808
25-29 42.7 14.9 1,415 21.7 22.3 6.1 88.3 10.4 0.1 0.0 1.2 1,781 20.0 1,754
30-34 46.8 14.9 968 20.6 24.8 7.3 88.2 10.5 0.1 0.2 1.0 1,320 19.8 1,300
35-49 38.0 12.1 905 20.7 29.5 6.9 89.4 9.5 0.0 0.1 1.0 1,391 19.6 1,380

Number of children
ever born
1 40.2 14.8 909 19.7 12.9 4.8 90.2 8.2 0.2 0.0 1.5 1,190 16.1 1,177
2-3 41.1 15.5 1,606 20.7 19.5 6.1 89.1 9.2 0.3 0.2 1.2 2,089 18.4 2,065
4-5 41.7 13.4 1,318 22.2 23.3 6.1 90.2 9.0 0.0 0.0 0.7 1,692 19.5 1,668
6+ 41.2 13.2 1,616 19.8 28.2 6.8 88.6 10.2 0.0 0.1 1.1 2,336 19.3 2,306

Residence
Urban 54.4 31.5 411 36.0 11.5 3.1 79.7 15.9 0.4 0.2 3.8 634 14.8 629
Rural 40.0 12.8 5,038 19.1 23.1 6.4 90.3 8.7 0.1 0.1 0.9 6,674 18.9 6,587

Region
Tigray 32.5 24.6 348 17.5 24.9 8.3 87.8 10.1 0.0 0.2 1.9 480 25.6 478
Affar 22.8 18.6 51 18.4 14.4 4.1 89.7 6.1 0.0 0.0 4.2 68 20.9 67
Amhara 30.1 19.3 1,296 16.2 21.2 11.7 91.5 7.3 0.0 0.1 1.2 1,856 14.1 1,827
Oromiya 40.7 12.9 2,137 23.9 24.4 4.6 89.5 9.5 0.1 0.1 0.7 2,723 20.1 2,702
Somali 10.2 7.6 214 14.5 17.4 4.5 91.0 6.9 0.5 0.0 1.6 288 19.8 285
Benishangul-Gumuz 41.5 22.6 50 13.2 12.7 5.8 90.6 7.1 0.0 0.0 2.3 69 12.2 68
SNNP 61.2 7.9 1,231 22.1 22.1 2.6 87.8 11.1 0.1 0.0 1.0 1,632 18.5 1,598
Gambela 64.1 24.9 15 25.4 6.3 2.0 81.4 15.3 0.3 0.2 2.7 23 31.1 22
Harari 48.9 16.3 12 26.0 10.5 1.2 79.9 18.2 0.5 0.0 1.5 15 27.3 15
Addis Ababa 49.0 27.3 77 21.8 3.1 0.9 79.6 15.4 0.6 0.7 3.7 129 13.8 129
Dire Dawa 35.0 15.1 19 28.9 6.8 1.9 87.5 10.0 0.2 0.4 1.9 25 55.4 25

Education
No education 38.8 12.5 4,262 18.2 23.7 6.8 90.4 8.5 0.1 0.1 1.0 5,734 18.9 5,663
Primary 46.8 15.8 932 25.8 19.0 4.1 88.3 10.7 0.0 0.0 1.0 1,205 18.1 1,189
Secondary and
higher 58.4 37.0 255 41.2 7.9 2.8 77.1 17.6 1.2 0.2 3.9 368 15.4 364

Wealth quintile
Lowest 30.3 12.6 1,154 15.8 27.1 8.6 93.8 5.0 0.0 0.3 1.0 1,520 20.4 1,504
Second 39.0 9.7 1,192 16.7 22.7 6.5 91.1 7.8 0.1 0.0 1.0 1,553 17.6 1,534
Middle 42.0 12.9 1,196 19.9 23.9 7.1 89.4 9.9 0.1 0.2 0.4 1,586 18.2 1,568
Fourth 45.2 13.9 1,086 22.3 20.0 3.6 88.5 10.6 0.0 0.0 0.8 1,451 19.0 1,432
Highest 52.8 25.2 822 30.7 15.0 4.1 82.5 14.4 0.4 0.1 2.7 1,196 17.4 1,177

Total 41.1 14.2 5,450 20.6 22.1 6.1 89.4 9.3 0.1 0.1 1.1 7,307 18.6 7,216
1
Includes meat (and organ meat), fish, poultry, eggs, pumpkin, red or yellow yams or squash, carrots, red sweet potatoes, mango, papaya, and other locally grown
fruits and vegetables that are rich in vitamin A.
2
Includes meat (and organ meat), fish, poultry, eggs.
3
In the first two months after delivery.
4
Women who reported night blindness but did not report difficulty with vision during the day.
5
Salt containing 15 ppm of iodine or more.

Nutrition of Children and Women | 155


11.7 PREVALENCE OF ANAEMIA
The most common causes of anaemia in developing countries are inadequate intake of iron,
folate, vitamin B12 or other nutrients. Anaemia can also result from sickle cell disease, malaria, and
intestinal worm infestation. Anaemia may be the underlying cause of maternal mortality, spontaneous
abortion, premature birth, and low birth weight. Iron and folic acid supplementation and anti-malarial
prophylaxis for pregnant women, promotion of the use of insecticide-treated bednets by pregnant
women and children under five, and six-month de-worming for children are some of the important
measures to reduce anaemia prevalence among vulnerable groups. Anaemia is characterized by a low
level of haemoglobin in the blood. The 2005 EDHS measured haemoglobin levels to identify anaemia
in children and women. The resulting data are the first of its kind in Ethiopia.

11.7.1 Prevalence of Anaemia in Children

Table 11.9 shows the percentage of children age 6-59 months classified as having anaemia, by
background characteristics. More than half (54 percent) of Ethiopian children 6-59 months old are
anaemic, with 21 percent mildly anaemic, 28 percent moderately anaemic, and 4 percent severely
anaemic. Severe anaemia is highest among children age 9-11 months, male children, children of
mothers who were not interviewed and not in the household at the time of the interview, children
living in the Somali Region, children of mothers with little or no education, and children in the
poorest households. Surprisingly, severe anaemia does not vary much by urban-rural residence. This
indicates the widespread nature of the problem and the need to intensify the various components of
the anaemia control strategy.

156 | Nutrition of Children and Women


Table 11.9 Prevalence of anaemia in children

Percentage of children age 6-59 months classified as having anaemia, by background


characteristics, Ethiopia 2005

Anaemia status
Mild Moderate
Background Any (10.0- (7.0- Severe Number of
characteristic anaemia 10.9 g/dl) 9.9 g/dl) (>7.0 g/dl) children
Age in months
6-8 77.2 20.8 53.1 3.4 226
9-11 73.3 23.1 41.9 8.3 199
12-17 73.7 26.2 41.4 6.1 521
18-23 62.2 24.1 33.6 4.5 344
24-35 50.7 20.7 26.5 3.5 882
36-47 48.1 23.4 22.2 2.5 1,002
48-59 38.2 16.1 18.5 3.6 965
Sex
Male 55.0 21.6 28.9 4.6 2,055
Female 52.1 21.1 27.7 3.3 2,083
Mother’s status
Interviewed 53.9 21.4 28.6 3.9 3,846
Not interviewed but in
household 47.6 20.9 26.1 0.5 111
Not interviewed and not in
household2 49.5 20.9 23.2 5.4 182
Residence
Urban 46.8 18.4 24.8 3.5 270
Rural 54.0 21.6 28.5 3.9 3,868
Region
Tigray 56.5 23.9 28.8 3.8 288
Affar 58.5 25.3 28.8 4.4 32
Amhara 52.0 20.0 26.6 5.4 858
Oromiya 56.0 22.3 30.2 3.5 1,717
Somali 85.6 19.7 51.7 14.1 124
Benishangul-Gumuz 54.3 24.6 25.2 4.4 39
SNNP 46.2 20.7 23.5 2.0 1,004
Gambela 61.8 25.3 32.5 4.0 10
Harari 56.1 23.6 29.3 3.1 7
Addis Ababa 37.5 9.6 23.9 4.0 45
Dire Dawa 60.7 20.0 29.1 11.5 14
Mother's education1
No education 54.5 21.8 28.7 4.0 3,122
Primary 51.4 20.9 26.8 3.7 685
Secondary and higher 47.9 15.0 31.5 1.4 149
Wealth quintile
Lowest 59.9 22.2 32.3 5.4 923
Second 55.7 22.3 28.8 4.6 888
Middle 52.8 19.8 29.4 3.6 899
Fourth 49.1 20.8 25.1 3.2 853
Highest 47.8 21.7 24.0 2.0 576
Total 53.5 21.4 28.3 3.9 4,138

Note: Table is based on children who stayed in the household the night before the interview.
Prevalence is adjusted for altitude using formulas recommended by CDC (CDC, 1998).
Haemoglobin is measured as grams per decilitre (g/dl).
1
For women who were not interviewed, information is taken from the Household
Questionnaire. Excludes children whose mothers were not listed in the household schedule.
2
Includes children whose mothers are deceased

11.7.2 Prevalence of Anaemia in Women

Table 11.10 shows the prevalence of anaemia among women age 15-49, which is less
pronounced than among children. Twenty-seven percent of women are anaemic, with 17 percent
mildly anaemic, 8 percent moderately anaemic, and just over 1 percent severely anaemic. Lack of
education, being pregnant, and living in poor households are associated with higher prevalence.
Anaemia is also higher among rural than urban women. Women residing in Affar, Somali and Dire
Dawa are much more likely to be severely anaemic than women living in the other regions.

Nutrition of Children and Women | 157


Table 11.10 Prevalence of anaemia in women

Percentage of women with anaemia, by background characteristics, Ethiopia


2005

Anaemia status
Background Any Mild Moderate Severe Number of
characteristic anaemia anaemia anaemia anaemia women
Age1
15-19 24.8 16.6 7.4 0.9 1,489
20-29 24.5 15.9 7.4 1.2 2,163
30-39 30.6 19.9 8.8 1.9 1,489
40-49 27.7 18.2 8.3 1.3 1,000
Children ever born2
None 21.5 14.9 5.6 1.0 1,909
1 29.0 18.3 9.8 0.9 593
2-3 28.2 17.8 8.6 1.8 1,101
4-5 28.6 16.4 11.2 1.0 1,012
6+ 29.4 20.5 7.2 1.6 1,526
Maternity status2
Pregnant 30.6 14.7 13.0 3.0 520
Breastfeeding 29.8 20.2 8.3 1.3 2,222
Neither 23.9 16.0 6.8 1.0 3,398
Residence
Urban 17.8 13.4 3.7 0.7 948
Rural 28.2 18.1 8.6 1.4 5,193
Region
Tigray 29.3 22.4 6.3 0.6 411
Affar 40.4 26.2 10.9 3.4 55
Amhara 31.0 21.4 8.1 1.5 1,486
Oromiya 24.9 15.7 8.0 1.2 2,177
Somali 39.8 20.1 14.9 4.8 181
Benishangul-Gumuz 31.3 20.7 9.9 0.8 59
SNNP 23.5 14.8 7.7 1.0 1,437
Gambela 42.0 29.4 10.8 1.7 21
Harari 22.4 15.2 6.7 0.5 16
Addis Ababa 14.6 10.7 3.1 0.8 271
Dire Dawa 25.8 17.9 5.4 2.5 26
Education1
No education 29.4 18.4 9.5 1.4 4,045
Primary 23.0 16.2 5.3 1.5 1,447
Secondary and higher 17.0 13.6 3.1 0.3 649
Smoking status2
Yes 35.2 16.4 18.8 0.0 91
No 26.4 17.4 7.7 1.3 6,046
Wealth quintile
Lowest 31.8 18.6 11.7 1.5 1,138
Second 30.3 19.2 9.6 1.4 1,218
Middle 26.7 17.6 7.9 1.3 1,206
Fourth 28.5 18.5 8.4 1.7 1,165
Highest 17.4 13.9 2.8 0.7 1,414

Total 26.6 17.4 7.9 1.3 6,141

Note: Table is based on women who stayed in the household the night before
the interview. Prevalence is adjusted for altitude using formulas recommended
by CDC (CDC, 1998). Women with <7.0 g/dl of haemoglobin have severe
anaemia, women with 7.0-9.9 g/dl have moderate anaemia, and pregnant
women with 10.0-10.9 g/dl and nonpregnant women with 10.0-11.9 g/dl have
mild anaemia. Total includes 5 women missing information on smoking status
who are not shown separately.
1
For women who were not interviewed, information is taken from the
Household Questionnaire.
2
Excludes women who were not interviewed

158 | Nutrition of Children and Women


11.8 NUTRITIONAL STATUS

The nutritional status of young children and women of reproductive age reflects household,
community, and national development. Children and women are most vulnerable to malnutrition in
developing countries because of low dietary intakes, infectious diseases, lack of appropriate care, and
inequitable distribution of food within the household.

11.8.1 Nutritional Status of Children

The 2005 EDHS included information on the nutritional status of children under five years of
age for three indices, namely, weight-for-age, height-for-age and weight-for-height, taking age and
sex into consideration. Weight measurements were taken using a lightweight electronic SECA scale
designed and manufactured under the guidance of UNICEF, and height measurements were carried
out using a measuring board produced by Shorr Productions. Children younger than 24 months were
measured lying down (recumbent length) on the board, while standing height was measured for older
children. The scale allowed for the weighing of very young children through an automatic mother-
child adjustment that eliminated the mother’s weight while she was standing on the scale with her
baby.

As recommended by WHO, the anthropometric measurements of children in the survey were


compared with an international reference population defined by the U.S. National Centre for Health
Statistics (NCHS) and accepted by the U.S. Centres for Disease Control and Prevention (CDC). Each
of the three nutritional status indicators described below are expressed in standard deviation units (Z-
scores) from the median of the reference population. The use of this reference population is based on
the finding that well nourished young children in all population groups (for which data exist) follow
very similar growth patterns. The reference populations are useful for comparison, facilitating the
examination of differences in the anthropometric status of subgroups in a population and changes in
nutritional status over time. In any large population, there is variation in height and weight; this
variation approximates a normal distribution.

Each of these indices—height-for-age, weight-for-height, and weight-for-age—provides dif-


ferent information about growth and body composition, which is used to assess nutritional status. The
height-for-age index is an indicator of linear growth retardation and cumulative growth deficits.
Children whose height-for-age Z-score is below minus two standard deviations (-2 SD) from the
median of the reference population are considered short for their age (stunted) and are chronically
malnourished. Children who are below minus three standard deviations (-3 SD) from the median of
the reference population are considered severely stunted. Stunting reflects failure to receive adequate
nutrition over a long period of time and is also affected by recurrent and chronic illness. Height-for-
age, therefore, represents the long-term effects of malnutrition in a population and does not vary
according to recent dietary intake.

The weight-for-height index measures body mass in relation to body length and describes
current nutritional status. Children whose Z-scores are below minus two standard deviations (-2 SD)
from the median of the reference population are considered thin (wasted) for their height and are
acutely malnourished. Wasting represents the failure to receive adequate nutrition in the period
immediately preceding the survey and may be the result of inadequate food intake or a recent episode
of illness causing loss of weight and the onset of malnutrition. Children whose weight-for-height is
below minus three standard deviations (-3 SD) from the median of the reference population are
considered severely wasted.

Weight-for-age is a composite index of height-for-age and weight-for-height. It takes into


account both acute and chronic malnutrition. Children whose weight-for-age is below minus two
standard deviations from the median of the reference population are classified as underweight.
Children whose weight-for-age is below minus three standard deviations (-3 SD) from the median of
the reference population are considered severely underweight.

Nutrition of Children and Women | 159


Height and weight data were collected in all the households that were included in the male
subsample of households. A total of 5,280 children under five were identified in the households. Five
percent of children had missing information on height or weight, 8 percent had height or weight
measures considered to be out of the range for their ages, and less than 1 percent had incomplete age
information. The final analysis on nutritional status is based on the remaining 4,586 (87 percent)
children. The results are shown in Table 11.11.

Table 11.11 Nutritional status of children

Percentage of children under five years classified as malnourished according to three anthropometric indices of nutritional status: height-for-age,
weight-for-height, and weight-for-age, by background characteristics, Ethiopia 2005

Height-for-age Weight-for-height Weight-for-age


Percentage Percentage Percentage Percentage Percentage Percentage
Background below below Mean Z- below below Mean Z- below below Mean Z- Number of
characteristic -3 SD -2 SD1 score (SD) -3 SD -2 SD1 score (SD) -3 SD -2 SD1 score (SD) children
Age in months
<6 1.3 8.1 (0.1) 1.0 6.4 0.3 0.0 4.4 0.2 389
6-8 3.8 26.6 (1.0) 1.8 10.3 (0.2) 4.8 19.1 (1.0) 243
9-11 12.3 32.7 (1.4) 0.5 14.2 (0.6) 13.8 38.2 (1.6) 211
12-17 18.6 46.3 (1.7) 4.3 18.8 (0.9) 15.0 47.5 (1.8) 510
18-23 31.2 61.7 (2.2) 2.6 16.6 (0.8) 14.9 48.2 (1.9) 326
24-35 27.7 51.3 (1.9) 1.7 9.0 (0.6) 12.7 42.2 (1.7) 901
36-47 30.5 52.5 (2.1) 2.4 8.5 (0.7) 13.2 40.9 (1.7) 1,016
48-59 31.3 54.1 (2.1) 2.4 8.5 (0.6) 9.5 42.6 (1.7) 989
Sex
Male 24.1 47.2 (1.8) 2.8 11.4 (0.6) 11.5 38.9 (1.6) 2,317
Female 24.2 45.8 (1.8) 1.7 9.6 (0.5) 10.7 37.9 (1.5) 2,269
Birth order2
1 18.5 38.2 (1.5) 1.9 9.6 (0.5) 8.4 33.9 (1.3) 661
2-3 21.7 44.7 (1.7) 2.4 9.9 (0.6) 10.5 35.7 (1.5) 1,286
4-5 25.9 48.5 (1.9) 2.2 12.9 (0.7) 13.4 41.6 (1.6) 1,019
6+ 26.8 50.5 (1.9) 1.9 9.8 (0.6) 10.8 41.2 (1.6) 1,330
Birth interval in months2
First birth3 18.5 38.2 (1.5) 1.9 9.6 (0.5) 8.4 33.9 (1.3) 661
<24 28.6 52.8 (2.0) 0.9 11.4 (0.5) 13.2 42.4 (1.6) 711
24-47 25.4 48.2 (1.9) 1.8 9.5 (0.6) 11.1 39.7 (1.6) 2,262
48+ 18.2 41.6 (1.5) 4.9 13.9 (0.7) 10.7 35.1 (1.5) 661
Size at birth2
Very small 27.8 52.7 (2.0) 2.6 15.5 (0.8) 15.6 49.5 (1.8) 841
Small 25.9 48.3 (1.8) 4.4 16.3 (0.9) 16.0 45.6 (1.8) 341
Average or larger 22.5 44.5 (1.7) 1.8 8.6 (0.5) 9.1 34.8 (1.4) 3,106
Mother's age4
15-19 18.6 38.4 (1.2) 0.2 6.7 (0.3) 7.6 30.0 (1.0) 204
20-24 19.9 41.3 (1.6) 2.6 12.2 (0.6) 11.2 37.8 (1.4) 835
25-29 22.6 45.9 (1.8) 1.5 9.7 (0.5) 9.2 36.2 (1.5) 1,233
30-34 26.0 48.5 (1.9) 1.9 10.9 (0.7) 13.5 40.2 (1.6) 919
35-49 27.1 49.9 (1.9) 2.9 10.6 (0.6) 11.5 41.5 (1.6) 1,217
Mother's nutritional status
Underweight (BMI <18.5) 25.5 50.4 (2.0) 2.0 15.0 (0.9) 13.5 49.6 (1.8) 805
Normal (BMI 18.5 - 24.9) 22.3 45.2 (1.7) 2.5 9.9 (0.5) 10.8 36.5 (1.5) 2,664
Overweight (BMI >= 25) 18.7 40.5 (1.5) 2.4 6.0 (0.0) 4.1 19.9 (0.9) 120
Missing 3.0 26.9 (1.4) 0.0 12.1 (0.8) 0.0 37.0 (1.5) 20
Mother’s status
Interviewed 23.8 46.4 (1.8) 2.1 10.5 (0.6) 11.0 38.5 (1.5) 4,296
Not interviewed but in
household 26.3 43.8 (1.8) 1.8 11.1 (0.5) 13.9 38.5 (1.5) 112
Not interviewed and not
in household5 30.6 51.3 (1.8) 5.3 9.7 (0.7) 12.3 35.7 (1.6) 178
Continued...

160 | Nutrition of Children and Women


Table 11.11—Continued

Percentage of children under five years classified as malnourished according to three anthropometric indices of nutritional status: height-for-age,
weight-for-height, and weight-for-age, by background characteristics, Ethiopia 2005

Height-for-age Weight-for-height Weight-for-age


Percentage Percentage Percentage Percentage Percentage Percentage
Background below below Mean Z- below below Mean Z- below below Mean Z- Number of
characteristic -3 SD -2 SD1 score (SD) -3 SD -2 SD1 score (SD) -3 SD -2 SD1 score (SD) children
Residence
Urban 10.2 29.8 (1.1) 2.5 6.3 (0.3) 4.8 22.9 (0.9) 362
Rural 25.3 47.9 (1.8) 2.2 10.9 (0.6) 11.6 39.7 (1.6) 4,224
Region
Tigray 16.7 41.0 (1.7) 1.9 11.6 (1.0) 11.3 41.9 (1.7) 316
Affar 21.6 40.8 (1.5) 2.9 9.9 (0.4) 12.9 34.1 (1.2) 46
Amhara 26.5 56.6 (2.1) 3.0 14.2 (0.8) 15.0 48.9 (1.9) 973
Oromiya 21.8 41.0 (1.6) 2.4 9.6 (0.5) 8.2 34.4 (1.4) 1,867
Somali 30.3 45.2 (1.8) 5.1 23.7 (1.0) 17.8 50.9 (1.8) 177
Benishangul-Gumuz 19.7 39.7 (1.6) 3.9 16.0 (1.0) 15.4 44.6 (1.8) 46
SNNP 29.1 51.6 (2.0) 0.9 6.5 (0.4) 11.9 34.7 (1.5) 1,057
Gambela 12.6 29.3 (1.1) 3.8 6.8 (0.5) 4.1 26.7 (1.1) 11
Harari 17.0 38.7 (1.3) 0.0 9.1 (0.4) 5.8 26.7 (1.1) 10
Addis Ababa 5.4 18.4 (0.7) 0.0 1.7 (0.2) 1.5 11.0 (0.6) 67
Dire Dawa 13.8 30.8 (1.0) 4.4 11.4 (0.9) 8.4 29.6 (1.3) 16
Mother's education
No education 26.3 49.1 (1.9) 2.3 11.2 (0.6) 12.3 41.4 (1.6) 3,450
Primary 17.9 39.8 (1.6) 1.7 10.1 (0.4) 7.6 32.0 (1.3) 754
Secondary and higher 4.7 24.0 (1.0) 0.0 1.3 0.0 2.6 13.6 (0.6) 204
Wealth quintile
Lowest 26.5 47.9 (1.8) 3.3 13.0 (0.8) 12.6 42.9 (1.7) 1,014
Second 27.5 54.0 (2.0) 3.4 13.4 (0.7) 15.2 43.6 (1.7) 994
Middle 27.3 45.8 (1.8) 1.8 10.7 (0.5) 10.7 38.3 (1.5) 942
Fourth 20.1 46.4 (1.8) 0.8 7.6 (0.5) 8.9 34.8 (1.5) 944
Highest 16.8 34.9 (1.4) 1.6 6.2 (0.4) 6.4 29.4 (1.2) 692

Total 24.1 46.5 (1.8) 2.2 10.5 (0.6) 11.1 38.4 (1.5) 4,586

Note: Table is based on children who stayed in the household the night before the interview. Each of the indices is expressed in standard deviation
units (SD) from the median of the NCHS/CDC/WHO International Reference Population. The percentage of children who are more than three or
more than two standard deviations below the median of the International Reference Population (-3 SD and -2 SD) are shown according to
background characteristics. Table is based on children with valid dates of birth (month and year) and valid measurement of both height and weight.
Total includes 6 children missing information on birth size who are not shown separately. Figures in parentheses are based on 25-49 unweighted
cases.
1
Includes children who are below -3 standard deviations (SD) from the International Reference Population median.
2
Excludes children whose mothers were not interviewed
3
First born twins (triplets, etc.) are counted as first births because they do not have a previous birth interval.
4
For women who were not interviewed, information is taken from the Household Questionnaire. Excludes children whose mothers were not listed
in the household schedule.
5
Includes children whose mothers are deceased

Forty-seven percent of children under five are stunted and 24 percent are severely stunted.
Eleven percent of children under five are wasted and 2 percent are severely wasted. The weight for-
age indicator shows that 38 percent of children under five are underweight and 11 percent are severely
underweight.

Table 11.11 and Figure 11.3 indicate that stunting is apparent even among children less than 6
months of age (8 percent). Stunting increases with the age of the child; this is evidenced by the
increase in stunting from 27 percent among children age 6-8 months to 62 percent among children age
18-23 months. The level then declines slowly to between 51 and 54 percent among children age two
years and older. There is very little difference in the level of stunting by gender. Stunting increases
with increasing birth order of the child but decreases with increasing birth interval. Size at birth is an
important indicator of the nutritional status of children. Stunting is higher among children who were
reported to have been very small at birth (53 percent) than among children who were small, average,

Nutrition of Children and Women | 161


or larger in size at birth. The percentage of children stunted decreases with increasing level of
mother’s education and increases with increasing age of mother. Children whose biological mothers
were not in the household are more likely to be stunted (51 percent) than children whose mothers
were interviewed (46 percent). The relationship between stunting and wealth status is not uniform,
though children in the highest wealth quintile are least likely to be stunted compared with those in the
other wealth quintiles than those in the other groups. Rural children are more stunted (48 percent) than
urban children (30 percent). Regional variation in nutritional status of children is substantial. Stunting
levels are above the national average in the Amhara (57 percent) and SNNP (52 percent) regions.

The prevalence of wasting is higher than the national average among children age 9-23
months. The percentage of children classified as wasted is highest among children of birth order 4 and
5 (13 percent). The proportion of children wasted is higher in rural areas (11 percent) than in urban
areas (6 percent). Wasting is higher than the national average in Somali (24 percent), Benishangul-
Gumuz (16 percent), Amhara (14 percent), Tigray (12 percent) and Dire Dawa (11 percent). The level
of wasting decreases with increasing wealth.

Table 11.11 and Figure 11.3 show that the percentage of children underweight increases
sharply from 4 percent among children under age 6 months to 19 percent among children age 6-8
months, doubles among children age 9-11 months, and peaks at 48 percent among children age 12-23
months with very small decreases thereafter. This may be due to inappropriate and/or inadequate
feeding practices because increasing levels of children underweight by age coincides with the age at
which normal complementary feeding starts. The percentages of underweight children in Somali (51
percent), Amhara (49 percent) and Benishangul-Gumuz (45 percent) are above the national average.
Differentials for the other background characteristics are very similar to those discussed under
stunting and wasting.

Figure 11.3 Nutritional Status of Children Under Age Five

Percent
70

60

50 
       
40       
      

30 

20 


10  


 

0
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58

Age in months

Stunted average Wasted average  Underweight average

EDHS 2005

11.8.2 Trends in Children’s Nutritional Status

Data from the 2005 EDHS can be compared with similarly collected data from the 2000
EDHS. A comparison of the data shows that there have been some improvements in the nutritional
status of children in the past five years. The percentage of children stunted fell by 10 percent from 52
percent in 2000 to 47 percent in 2005. Similarly, the percentage of children underweight declined by
19 percent from 47 percent in 2000 to 38 percent in 2005. There was, however, no change over the
five-year period in the percentage of children wasted.

162 | Nutrition of Children and Women


11.8.3 Nutritional Status of Women

The 2005 EDHS collected information on the height and weight of women in the reproductive
age group. The data are used to derive a measure of adult nutritional status known as body mass index
(BMI). In this report, two indicators of nutritional status are presented—height and body mass index
(BMI).

The height of a woman is associated with past socioeconomic status and nutrition during
childhood and adolescence. A woman’s height is used to predict the risk of difficulty in delivery
because small stature is often associated with small pelvis size and the potential for obstructed labour.
The risk of giving birth to a low birth weight baby is influenced by the mother’s nutritional status. The
cutoff point for the height at which mothers can be considered at risk varies between populations but
normally falls between 140 and 150 centimetres. As in other DHS surveys, a cutoff point of 145 cm is
used for the 2005 EDHS.

The index used to measure thinness or obesity is known as the body mass index (BMI), or the
Quetelet index. BMI is defined as weight in kilogrammes divided by height squared in metres
(kg/m2). A cut-off point of 18.5 is used to define thinness or acute undernutrition and a BMI of 25 or
above usually indicates overweight or obesity.

Table 11.12 presents the mean values of the two indicators of nutritional status and the
proportions of women falling into high-risk categories, according to background characteristics.
Women for whom there was no information on height and/or weight and for whom a BMI could not
be estimated are excluded from this analysis. The data analysis on BMI is based on 5,901 women,
while the height analysis is based on 6,636 women age 15-49 years. The mean height of women is
157 centimetres, which is above the critical height of 145 centimetres. Overall, 3 percent of women
are shorter than 145 cm. There are very small differences in the mean height of women by background
characteristics. Women in the Somali and Gambela regions, on the average are taller than women in
the other regions. Women in Amhara have the shortest mean height and, along with Affar, the highest
proportion below 145 cm. Women with at least some secondary education are at least 1 cm taller than
women who have not attended school. There is no clear difference in the pattern of height by other
characteristics.

Table 11.12 shows that there are large differentials across background characteristics in the
percentage of women assessed as malnourished (BMI less than 18.5) or “thin” and overweight (BMI
25 or higher). Twenty-seven percent of women were found to be chronically malnourished (BMI less
than 18.5), while only 4 percent were overweight or obese. Three in ten women age 15-19 and women
age 45-49 are thin or undernourished. Variation between urban and rural women is marked. More
women have a BMI less than 18.5 in rural areas (28 percent) than in urban areas (19 percent).
However, the percentage of overweight or obese women is higher in urban areas (14 percent) than in
rural areas (2 percent). Gambela (39 percent) and Tigray (38 percent) have the highest percentage of
undernourished women and Addis Ababa has the lowest percentage (15 percent). The percentage of
overweight or obese women increases with increasing educational level. It is also elevated for the
highest wealth quintile.

Nutrition of Children and Women | 163


Table 11.12 Nutritional status of women by background characteristics

Among women age 15-49, mean height, percentage under 145 cm, mean body mass index (BMI), and percentage with specific BMI levels, by
background characteristics, Ethiopia 2005

Height BMI (kg/m2)


<17.0 •25.0
Percent- 17.0- (moder- (over- 25.0-
Mean age Number 18.5- 18.4 ately and weight 29.9
Background height in below of Mean 24.9 <18.5 (mildly severely or (over- •30.0 Number
characteristic cm 145 cm women BMI (normal) (thin) thin) thin) obese) weight) (obese) of women
Age
15-19 155.5 4.8 1,608 19.7 64.5 32.5 17.0 15.5 3.0 2.8 0.1 1,517
20-29 156.8 3.1 2,358 20.3 75.8 20.8 15.6 5.2 3.4 3.0 0.4 2,002
30-39 156.9 2.4 1,596 20.4 68.9 24.8 17.6 7.2 6.3 5.4 0.9 1,359
40-49 156.9 2.1 1,074 20.2 63.2 30.9 23.0 7.9 6.0 4.2 1.8 1,024

Residence
Urban 156.9 1.9 1,145 21.5 67.0 18.8 11.6 7.2 14.2 11.9 2.3 1,112
Rural 156.4 3.4 5,492 19.9 69.6 28.3 19.1 9.1 2.2 1.8 0.3 4,789

Region
Tigray 156.8 2.8 443 19.3 60.8 37.5 22.0 15.6 1.6 1.6 0.0 390
Affar 156.4 4.3 69 20.0 62.9 33.0 18.5 14.4 4.1 3.6 0.5 61
Amhara 155.1 4.3 1,609 19.9 70.5 27.0 17.6 9.4 2.4 2.0 0.4 1,471
Oromiya 156.9 2.2 2,331 20.4 71.1 24.3 17.6 6.7 4.6 3.9 0.7 2,036
Somali 162.0 1.9 230 20.1 55.4 34.9 17.5 17.4 9.7 8.6 1.1 202
Benishangul-Gumuz 156.5 1.6 61 19.6 65.3 32.9 22.6 10.3 1.8 1.8 0.0 53
SNNP 156.3 4.1 1,490 20.0 70.2 26.7 18.5 8.2 3.0 2.9 0.2 1,295
Gambela 160.5 1.2 23 19.4 59.5 38.5 23.2 15.3 2.0 1.9 0.2 20
Harari 158.6 1.7 19 21.0 69.4 20.6 13.3 7.3 10.0 6.7 3.4 17
Addis Ababa 156.8 2.1 329 22.0 67.2 15.4 9.8 5.5 17.5 13.0 4.5 325
Dire Dawa 158.7 1.3 32 21.3 61.4 24.2 14.7 9.5 14.3 10.8 3.6 31

Education
No education 156.5 3.3 4,336 20.0 69.7 27.4 19.3 8.1 2.9 2.4 0.4 3,761
Primary 156.1 3.8 1,535 20.0 68.4 28.1 16.3 11.8 3.5 3.1 0.4 1,393
Secondary and higher 157.7 1.5 766 21.4 67.1 18.8 12.3 6.5 14.1 11.4 2.7 747

Wealth quintile
Lowest 157.1 3.3 1,225 19.8 68.5 29.9 19.9 10.0 1.6 0.9 0.7 1,071
Second 155.3 3.9 1,295 19.8 66.6 30.2 20.8 9.4 3.2 2.8 0.4 1,104
Middle 156.3 3.7 1,251 19.8 69.0 29.3 18.8 10.5 1.7 1.5 0.2 1,068
Fourth 156.6 3.7 1,223 19.9 71.6 26.6 17.9 8.7 1.8 1.8 0.1 1,091
Highest 157.2 1.7 1,642 21.1 69.6 19.5 13.2 6.3 10.9 9.2 1.7 1,567

Total 156.5 3.2 6,636 20.2 69.1 26.5 17.7 8.8 4.4 3.7 0.7 5,901

Note: The Body Mass Index (BMI) is expressed as the ratio of weight in kilogrammes to the square of height in metres (kg/m2).
1
Excludes pregnant women and women with a birth in the preceding 2 months

164 | Nutrition of Children and Women


MALARIA 12
12.1 INTRODUCTION

Malaria is a leading public health problem in Ethiopia. In 2004-05, the disease was reported
as the primary cause of health problems, accounting for 17 percent of outpatient visits, 15 percent of
hospital admissions, and 29 percent of in-patient deaths (MOH, 2005a). Almost 75 percent of the land
is malarious and an estimated 50 million people (68 percent) live in areas at risk of malaria. Areas at
altitude below 2000 metres above sea level are generally considered malarious. However, local
transmission has also been detected in areas at altitudes as high as 2,500 metres. The transmission
pattern is unstable and often characterized by focal and cyclic large scale epidemics. The most recent
malaria epidemic, which occurred in 2003, affected 211 districts where more than 2 million clinical
cases were recorded (Negash et al., 2005).

The malaria transmission season runs from September to December, following the major
rainy season from June to August, with a minor transmission season from April to May in areas that
receive rains during the short rainy season from February to March. Localized or widespread malaria
epidemics can occur during the transmission season. The widespread epidemics have a cyclical
pattern of 5 to 8 years that follows major climatic changes. The 2005 EDHS was fielded from the end
of April 2005 to the end of August 2005, before the main malaria transmission season began.

The type and application of malaria prevention and control interventions is determined by the
transmission characteristics of the disease in different parts of the country. Insecticide treated nets
(ITNs) are generally distributed in areas where malaria transmission occurs for more than 3 months of
the year. The ITN distribution system through the public sector gives priority for free distribution to
pregnant mothers and children under five years of age in targeted high priority areas. A private sector
ITN distribution at subsidized or market prices also operates in Ethiopia (MOH, 2004a). Indoor
residual spraying with DDT or Malathion, as per WHO recommendations, is generally limited to
localities in the highland fringe areas that are prone to epidemics.

Implementation of the first five-year strategic plan for malaria prevention and control (2001-
2005) was completed in December 2005. The period is in line with the DHS surveys conducted in
2000 and 2005. Findings from the EDHS 2005 provide population-based estimates on the current
coverage of major malaria prevention and control interventions and can be used as a baseline for the
next plans.

12.1.1 Malaria Vector Control

Ownership of Mosquito Nets

The use of ITNs is one of the major components of the selective vector control strategy in
Ethiopia. The effectiveness of this intervention depends on high coverage and effective utilization.
The ITN distribution in Ethiopia primarily targets households with children less than five years of age
and pregnant women in targeted areas (MOH, 2004a). In Ethiopia there are various types of ITNs
distributed through the public and private sector. This includes the ordinary ITNs that require re-
treatment with insecticide every 6 months and the long-lasting insecticide treated nets (LLINs) that
can retain effective concentration of insecticides for up to 20 washes. During the EDHS 2005 survey,
information was collected on the ownership and use of mosquito nets, both treated and untreated.

In an effort to make mosquito nets more affordable and to ensure equitable distribution, the
government of Ethiopia endorses a segmented market approach whereby the most vulnerable and at-

Malaria | 165
risk groups are given free ITNs. In addition, in selected areas the private sector subsidizes the sale of
ITNs. To boost ITN distribution through both the public and private sectors, the government has since
2002 reduced the tax and tariff on ITNs.

Table 12.1 shows the percentage of households with at least one and with more than one
mosquito net (treated or untreated) and the percentage of households with at least one and with more
than one ITN by background characteristics. The data show that only about 6 percent of households in
Ethiopia own a mosquito net whether treated or untreated. The percentage of households having more
than one net is about 1 percent. Five percent of households own at least one ever-treated net. Urban
households are more likely to own any kind of net (11 percent) compared with rural households (5
percent). Mosquito net ownership is highest in the Gambela Region (31 percent) and lowest in Addis
Ababa (1 percent). Comparable data from the 2000 EDHS show that only 1 percent of households in
Ethiopia had bednets at that time, with urban households slightly more likely than rural households to
possess bednets (3 percent and 1 percent, respectively). In 2000, households in the Affar, Gambela,
and Somali regions were more likely to have bednets (31 percent, 12 percent, and 6 percent,
respectively) primarily because the prevalence of malaria is high in those regions.

Table 12.1 Household possession of mosquito nets

Percentage of households with at least one and more than one mosquito net (treated or untreated), ever-treated mosquito net, and insecticide-
treated net (ITN), and the average number of nets per household, by background characteristics, Ethiopia 2005

Insecticide-treated mosquito net2


Any type mosquito net Ever-treated mosquito net1 (ITNs)
Average
Average number of Average
Percentage Percentage number of Percentage Percentage ever-treated Percentage Percentage number of
Background with at with more nets per with at with more nets per with at with more ITNs per Number of
characteristics least one than one household least one than one household least one than one household households
Residence
Urban 10.8 2.8 0.1 8.4 1.9 0.1 5.4 1.0 0.1 1,974
Rural 4.8 0.6 0.1 3.8 0.3 0.0 3.1 0.2 0.0 11,747
Region
Tigray 16.3 3.0 0.2 13.5 2.4 0.2 8.9 1.2 0.1 940
Affar 21.4 6.2 0.3 9.5 2.0 0.1 6.3 0.9 0.1 138
Amhara 3.8 1.0 0.0 2.3 0.6 0.0 1.3 0.3 0.0 3,709
Oromiya 2.8 0.5 0.0 2.4 0.3 0.0 1.9 0.1 0.0 4,790
Somali 6.6 1.4 0.1 4.8 0.9 0.1 4.2 0.8 0.1 540
Benishangul-Gumuz 15.4 2.3 0.2 8.3 1.2 0.1 4.5 0.7 0.1 128
SNNP 8.2 0.4 0.1 7.5 0.3 0.1 6.6 0.2 0.1 2,802
Gambela 30.6 12.9 0.5 17.9 6.7 0.3 10.8 3.8 0.2 47
Harari 6.0 0.4 0.1 3.5 0.2 0.0 1.9 0.1 0.0 39
Addis Ababa 1.0 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 525
Dire Dawa 22.4 0.3 0.2 18.6 0.3 0.2 17.0 0.1 0.2 64
Wealth quintile
Lowest 4.7 0.6 0.1 3.5 0.4 0.0 2.9 0.2 0.0 2,757
Second 3.4 0.5 0.0 2.5 0.2 0.0 2.1 0.1 0.0 2,838
Middle 4.3 0.6 0.1 3.2 0.3 0.0 2.9 0.2 0.0 2,670
Fourth 5.1 0.4 0.1 4.4 0.2 0.0 3.4 0.1 0.0 2,531
Highest 10.5 2.4 0.1 8.3 1.6 0.1 5.5 0.8 0.1 2,925
Altitude
0 - 999 36.1 13.3 0.5 22.5 6.9 0.3 14.1 3.4 0.2 279
1000 - 1499 12.4 2.5 0.2 10.7 2.1 0.1 7.8 0.9 0.1 853
1500 - 1999 9.0 1.1 0.1 7.1 0.6 0.1 5.8 0.3 0.1 5,085
2000+ 1.5 0.2 0.0 1.2 0.1 0.0 0.8 0.1 0.0 7,376

Total 5.7 0.9 0.1 4.4 0.6 0.1 3.4 0.3 0.0 13,721

Note: Total includes 138 households missing information on altitude and not shown separately.
1
An ever-treated net is a pretreated net or a non-pretreated net which has subsequently been soaked with insecticide at any time.
2
An insecticide-treated net (ITN) is 1) a factory-treated net that does not require any further treatment, or 2) a pretreated net obtained within the
last 12 months, or 3) a net that has been soaked with insecticide within the past 12 months.

166 | Malaria
Consistent with the degree of risk of malaria, ownership of mosquito net varies inversely with
altitude. For example, 36 percent of households in areas below 1,000 metres own some kind of net,
while the corresponding figure for households at and above 2,000 metres is only 2 percent.

Three percent of households reported owning an ITN. Households in Addis Ababa reported
almost no ownership of ITNs, while those in the Dire Dawa Administrative Council have the highest
level of ITN ownership (17 percent), followed by the Gambela Region (11 percent). Subsequent to the
fielding of the 2005 EDHS, the largest ever distribution campaign in Ethiopia was conducted from
September to December 2005, in which more than 3 million ITNs were distributed. Sixty percent of
these nets were LLINs.

Use of Mosquito Nets by Children

Children under five years of age are especially vulnerable to malaria and are targeted as a
high priority group for ITNs. Therefore, households in targeted areas with children under five years of
age have a greater chance of getting free ITNs through the public distribution system.

Table 12.2 presents information on the percentage of children under age five who slept under
a mosquito net (treated or untreated) the night before the survey. Overall, just over 2 percent of
children slept under a net the night prior to the survey, while less than 2 percent slept under ever-
treated nets and ITNs the night prior to the survey.

Little variation was observed in the use of nets by age or sex of children. Children in urban
areas are almost five times as likely to sleep under a mosquito net (9 percent) as children in rural areas
(2 percent). The proportion of children who sleep under any type of mosquito net is highest in Dire
Dawa (20 percent), followed by Affar (14 percent) and Gambela (12 percent). It is lowest is in Addis
Ababa (1 percent).

The proportion sleeping under a net is highest among children in the highest wealth quintile.
This could be indicative of high income as a contributor to better awareness and ability to buy nets.
This emphasizes the need for better communication to improve utilization of nets by the most
vulnerable groups at high risk of malaria. Use of nets varies inversely with altitude, with large
differences in mosquito net use between children living at altitudes less than 1,000 metres (19
percent) and those living at altitudes above 1,000 metres (4 percent and less).

Malaria | 167
Table 12.2 Use of mosquito nets by children

Percentage of children under five years of age who slept under a mosquito net (treated or
untreated), an ever-treated mosquito net, or an insecticide-treated net (ITN) the night
before the interview, by background characteristics, Ethiopia 2005

Percentage of Percentage of Percentage of


children who children who children who
slept under slept under an slept under
any net the ever-treated net an ITN the
Background preceding the preceding preceding Number of
characteristic night night1 night children
Age in months
< 12 2.9 2.0 1.8 2,284
12-23 2.5 2.0 1.7 1,955
24-35 2.1 1.5 0.8 1,969
36-47 1.7 1.5 1.4 2,243
48-59 2.4 2.1 1.6 2,239
Sex
Male 2.3 1.8 1.6 5,426
Female 2.4 1.8 1.4 5,266
Residence
Urban 9.3 6.7 3.6 780
Rural 1.8 1.5 1.3 9,911
Region
Tigray 2.1 2.0 1.6 686
Affar 13.8 5.4 3.1 101
Amhara 2.1 1.2 0.9 2,440
Oromiya 1.0 0.8 0.4 4,220
Somali 5.5 4.0 3.7 453
Benishangul-Gumuz 3.7 2.1 1.4 102
SNNP 3.6 3.4 3.2 2,449
Gambela 12.2 4.7 2.2 30
Harari 2.0 1.2 1.0 22
Addis Ababa 0.6 0.1 0.1 151
Dire Dawa 20.4 19.6 19.0 38
Wealth quintile
Lowest 1.8 1.6 1.4 2,352
Second 1.1 0.8 0.8 2,256
Middle 1.8 1.1 1.1 2,337
Fourth 2.1 1.8 1.7 2,150
Highest 6.0 4.7 2.8 1,596
Altitude
0 - 999 19.3 11.5 8.4 213
1000 - 1499 2.8 2.5 2.1 777
1500 - 1999 3.8 3.1 2.6 4,080
2000+ 0.5 0.4 0.3 5,498

Total 2.3 1.8 1.5 10,691

Note: Total includes 115 children missing information on altitude who are not shown
separately.
1
An ever-treated net is a pretreated net or a non-pretreated net that has been soaked
with insecticide at any time.
2
An insecticide-treated net (ITN) is 1) a factory-treated net that does not require any
further treatment, or 2) a pretreated net obtained within the past 12 months, or 3) a net
that has been soaked with insecticide in the past 12 months.

Use of Mosquito Nets by Women

As in the case of children under five years of age, pregnant women are also one of the target
groups of high priority for ITNs, with households in targeted areas where pregnant women reside
having a greater chance of getting free ITNs through the public distribution system. The 2004-05
health and health-related indicators of the Federal Ministry of Health identify malaria as the primary
cause of health problems among female patients attending health facilities, and accounts for 15

168 | Malaria
percent of out-patient consultations, 19 percent of admissions, and 29 percent of in-patients deaths
(MOH, 2005a). Given that the level of fertility in the population is high, the burden of malaria on
women, especially pregnant women, is high. Despite this, the level of utilization of ITNs by all
women and by pregnant women is not sufficient for what the problem calls for.

Table 12.3 shows the percentage of all women and pregnant women who slept under any
mosquito net and the proportion who slept under an ITN the night prior to the interview, by
background characteristics. Generally, a very small proportion of women slept under a mosquito net
(2 percent), and only 1 percent of pregnant women slept under an ITN. Thus, the data show little
difference in the use of nets between pregnant and non-pregnant women (both 2 percent). Women in
urban areas are more than twice as likely as women in rural areas to sleep under a mosquito net.
Urban pregnant women are more than ten times as likely to sleep under a net as rural pregnant
women.

Table 12.3 Use of mosquito nets by women

Percentage of all women age 15-49 and pregnant women age 15-49 who slept under a mosquito net (treated or untreated), an ever-
treated mosquito net, or an insecticide-treated net (ITN) the night before the interview, by background characteristics, Ethiopia 2005

Percentage of all women age 15-49 who: Percentage of pregnant women age 15-49 who:
Slept under Slept under
an ever- Slept an ever-
Slept under treated Slept under under any treated Slept under
any net the net the an ITN2 the net the net the an ITN2 the Number of
Background preceding preceding preceding Number of preceding preceding preceding pregnant
characteristic night night1 night women night night1 night women
Residence
Urban 4.4 3.4 2.3 2,569 11.0 9.5 6.4 60
Rural 1.9 1.5 1.3 11,915 1.1 0.8 0.8 1,121
Region
Tigray 2.1 2.1 1.6 946 3.1 3.1 2.8 80
Affar 12.3 6.6 3.8 150 13.3 8.0 5.9 12
Amhara 1.7 1.0 0.7 3,582 1.5 0.3 0.3 253
Oromiya 1.2 0.9 0.6 5,154 0.0 0.0 0.0 450
Somali 4.8 3.2 2.9 504 2.2 1.5 1.5 46
Benishangul-Gumuz 5.5 2.8 2.0 129 1.2 0.0 0.0 13
SNNP 4.2 4.0 3.5 3,085 2.9 2.9 2.4 308
Gambela 12.0 6.4 4.1 45 6.7 5.6 2.7 3
Harari 1.1 0.9 0.5 40 0.0 0.0 0.0 2
Addis Ababa 0.1 0.0 0.0 776 (0.0) (0.0) (0.0) 11
Dire Dawa 8.9 8.4 7.9 71 * * * 3
Education
No education 1.9 1.5 1.2 9,416 1.1 0.7 0.7 868
Primary 3.0 2.5 2.1 3,469 2.6 2.6 2.2 257
Secondary and higher 3.4 2.2 1.5 1,599 4.1 3.0 1.5 55
Wealth quintile
Lowest 1.7 1.3 1.2 2,526 1.1 1.0 0.9 246
Second 1.3 0.9 0.8 2,732 1.1 0.3 0.3 292
Middle 1.6 1.1 1.1 2,789 0.2 0.0 0.0 287
Fourth 2.0 1.8 1.6 2,721 1.4 1.2 1.2 221
Highest 4.3 3.4 2.2 3,716 7.0 6.1 4.7 135
Altitude
0 - 999 17.5 10.8 7.7 280 13.2 9.5 7.8 19
1000 - 1499 3.3 2.7 2.1 861 5.1 4.4 4.0 73
1500 - 1999 4.2 3.4 2.8 5,391 1.7 1.2 1.0 473
2000+ 0.4 0.3 0.2 7,821 0.8 0.7 0.5 599

Total 2.3 1.8 1.4 14,484 1.6 1.2 1.1 1,181

Note: Total includes 137 women and 17 pregnant women for whom information on altitude is not known. Figures in parentheses are
based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.
1
An ever-treated net is a pretreated net or a non-pretreated net that has been soaked with insecticide at any time.
2
An insecticide-treated net (ITN) is 1) a factory-treated net that does not require any further treatment, or 2) a pretreated net obtained
within the past 12 months, or 3) a net that has been soaked with insecticide in the past 12 months.

Malaria | 169
The use of mosquito nets among all women is highest in the Affar and Gambela regions (12
percent each) and lowest in Addis Ababa (negligible use). The highest percentage of women sleeping
under an ever-treated net or ITN the night before the survey was reported in Dire Dawa (8 percent).
Among pregnant women, use of mosquito nets is highest in Affar (13 percent slept under any net, 8
percent slept under an ever-treated net, and 6 percent slept under an ITN). In general, the use of
mosquito nets (treated and untreated) increases among women and pregnant women as the level of
wealth increases. A higher proportion of women in low altitude areas use mosquito nets than those in
higher altitudes, and the highest coverage (18 percent) is reported in areas of less than 1,000 metres.
Eight percent of pregnant women living in areas less than 1,000 metres slept under an ITN the night
before the interview.

Use of Mosquito Nets by Population age Five and Older

The malaria transmission pattern in Ethiopia is highly seasonal and unstable. Because of this
unstable transmission and infrequent exposure to infection, immunity is generally underdeveloped and
all age groups are at risk of malarial disease. Although pregnant mothers and children under five years
of age are the most vulnerable, the population age five and older is also at high risk, and adult deaths
from malaria during epidemics are relatively high.

Table 12.4 shows the percentage of the population age five and older who slept under a
mosquito net whether treated or untreated, and the proportion who slept under an ITN the night prior
to the interview, by background characteristics. Generally, a very low percentage of this population
slept under any net (2 percent), an ever-treated-net (1 percent), or an ITN (1 percent).

The pattern of use of mosquito nets in this population is similar to that for pregnant women
and children under age five. Persons age five and older in urban areas are more likely to sleep under a
mosquito net than those in the rural areas. Use of mosquito nets among this group is highest in
Gambela (9 percent use any net, 5 percent use an ever-treated net, and 3 percent use an ITN),
followed by Affar (8 percent use any net, 4 percent use an ever-treated net, and 2 percent use an ITN).
The population age five and older sleeping under an ITN the night before the interview was highest in
Dire Dawa (6 percent), followed by Gambela (3 percent) and SNNP (3 percent).

In general, the use of mosquito nets (treated and untreated) among this group increases
slightly as the level of wealth increases. Use of mosquito nets is higher in areas at altitudes below
1,000 metres, with 12 percent using any net, 7 using an ever-treated net, and 5 percent using an ITN.

170 | Malaria
Table 12.4 Use of mosquito nets by population age five and older

Percentage of population age five and older who slept under a mosquito net (treated
and untreated), under an ever-treated mosquito net, or an insecticide-treated net
(ITN) the night before the interview, by background characteristics, Ethiopia 2005

Percentage
Percentage who slept Percentage
who slept under an ever- who slept Number of
under any net treated net under an ITN2 persons
Background the preceding the preceding the preceding age 5 and
characteristic night night1 night older
Sex
Male 1.5 1.2 1.0 28,219
Female 1.7 1.4 1.0 28,626
Residence
Urban 3.4 2.7 1.8 7,395
Rural 1.3 1.1 0.9 49,450
Region
Tigray 1.6 1.5 1.2 3,587
Affar 7.8 3.7 2.3 606
Amhara 0.9 0.5 0.3 14,356
Oromiya 0.8 0.6 0.5 20,546
Somali 3.2 2.3 2.0 2,292
Benishangul-Gumuz 3.1 1.6 1.1 485
SNNP 3.1 2.9 2.5 12,299
Gambela 9.1 5.1 3.4 169
Harari 0.6 0.4 0.2 135
Addis Ababa 0.1 0.0 0.0 2,127
Dire Dawa 6.2 6.0 5.6 241
Wealth quintile
Lowest 1.2 1.0 0.9 11,064
Second 0.9 0.7 0.6 11,175
Middle 1.2 0.9 0.9 11,243
Fourth 1.3 1.2 1.1 11,347
Highest 3.1 2.5 1.7 12,016
Altitude
0 - 999 11.6 7.1 5.2 1,124
1000 - 1499 2.7 2.4 1.8 3,443
1500 - 1999 2.8 2.4 2.0 21,122
2000+ 0.2 0.2 0.1 30,554

Total 1.6 1.3 1.0 56,845

Note: Total includes 611 persons missing information on altitude who are not shown
separately.
1
An ever-treated net is 1) a pretreated net or a non-pretreated net that has been
soaked with insecticide at any time.
2
An insecticide-treated net (ITN) is 1) a factory-treated net that does not require any
further treatment, or 2) a pretreated net obtained within the past 12 months, or 3) a
net that has been soaked with insecticide in the past 12 months.

Indoor Residual Spraying of Insecticide

The malaria vector control programme in Ethiopia employs an integrated application of vector
control interventions that augment each other for maximum reduction in vector longevity and hence
transmission. The selection and application of vector control interventions is based on the principles
of integrated vector management whereby the judicious use of insecticides is ensured in an economi-
cally and environmentally agreeable manner. The service is fully funded by the government and the
public receives services at no cost.

Indoor residual spraying with DDT or Malathion, as per WHO recommendations, is one of
the major malaria vector control interventions applied to preempt malaria epidemics in selected
epidemic-prone localities. The intervention annually is estimated to cover 20-30 percent of the malaria

Malaria | 171
epidemic-prone localities (MOH, unpublished sources). The operation demands substantial financial
input and coordinated logistics. The amount of insecticide utilized each year costs an estimated
US$2.5 million and the operational cost is much higher.

This intervention has been applied in the country since the 1950s. The level of coverage is
usually reported in activity reports. However, efforts to collect data on the percentage of unit
structures that received spraying and where the sprayed walls remained intact without being re-
plastered (mud, white wash, reconstructed) have not been implemented. For the first time, population-
based data on the coverage and status of sprayed unit structures have been collected through the
household questionnaire of the 2005 EDHS. Table 12.5 shows the percentage of houses sprayed
within the past six months and the percentage of houses with white insecticide powder visible on the
sprayed walls.

Table 12.5 Coverage of spraying programs

Percentage of households occupying a dwelling in which the inner walls were ever sprayed
with insecticide to prevent malaria, percentage of households occupying a dwelling whose
inner walls were sprayed with insecticide 0-6 months preceding the survey, and percentage
of households occupying a dwelling with white insecticide powder visible on the inner
walls, by background characteristics, Ethiopia 2005

Percentage of
households Percentage of
Percentage of occupying a households
households dwelling sprayed occupying a
occupying a with insecticide dwelling
dwelling ever to prevent with white
sprayed with malaria insecticide
insecticide 0-6 months powder visible
Background to prevent preceding on the inner Number of
characteristic malaria the survey walls households
Residence
Urban 7.0 3.2 2.5 1,974
Rural 11.1 2.1 2.8 11,747
Region
Tigray 22.4 2.5 4.1 940
Affar 11.0 3.5 1.4 138
Amhara 13.1 2.8 3.7 3,709
Oromiya 8.5 2.1 2.3 4,790
Somali 0.6 0.4 0.1 540
Benishangul-Gumuz 25.6 0.4 0.6 128
SNNP 9.1 2.1 2.8 2,802
Gambela 25.7 1.9 2.5 47
Harari 5.5 2.3 0.3 39
Addis Ababa 0.5 0.2 0.0 525
Dire Dawa 23.3 17.0 12.7 64
Wealth quintile
Lowest 10.4 2.2 3.1 2,757
Second 10.4 2.6 3.0 2,838
Middle 11.9 1.5 2.6 2,670
Fourth 11.2 2.1 2.6 2,531
Highest 8.8 2.8 2.5 2,925
Altitude
0 - 999 18.6 2.6 4.2 279
1000 - 1499 18.4 4.1 4.8 853
1500 - 1999 17.0 3.9 4.7 5,085
2000+ 4.9 0.9 1.1 7,376

Total 10.5 2.3 2.8 13,721

Note: Total includes 138 households missing information on altitude that are not shown
separately.

172 | Malaria
Eleven percent of households were reported as ever having been sprayed with insecticide to
prevent malaria, with 2 percent having been sprayed in the past six months. Only 3 percent were
reported to have white powder visible on the inner walls.

The coverage of houses ever sprayed is highest in Gambela and Benshangul-Gumuz regions
(26 percent each) followed by Dire Dawa (23 percent) and Tigray (22 percent). The percentage of
houses sprayed in the six months preceding the survey is highest in Dire Dawa (17 percent), while it is
below 4 percent in all other regions. The highest percentage of houses with visible insecticide powder
on sprayed walls is in Dire Dawa (13 percent) followed by Tigray and Amhara (4 percent each) and
SNNP (3 percent).

Houses located at altitudes less than 2,000 metres are more likely to have ever been sprayed
and more likely to have been sprayed within the past 6 months than houses located at or above 2,000
metres. For example, more than 17 percent of households located below 2,000 meters were sprayed at
some time, compared with less than 5 percent of households at or above 2,000 metres.

Malaria Prophylaxis in Pregnancy

The malaria prevention and control guidelines in the country recommend the use of
chemoprophylaxis as a preventive measure. The drug recommended for chemoprophylaxis starting
July 2004 is mefloquine (MOH, 2004b). Chemoprophylaxis is recommended for visitors to malarious
areas and pregnant mothers residing in malaria endemic areas. Intermittent preventive treatment (IPT)
using sulfadoxine-pyrimethamine for the prevention of malaria during pregnancy has never been
officially adopted and introduced by the Ministry of Health. This intervention is recommended for
areas with stable transmission. Therefore, its application in Ethiopia where transmission is generally
seasonal and unstable is not recommended. Even in some parts of the country like Gambela, where
the malaria transmission season is relatively long (more than 6 months), the intervention has not been
implemented because of the co-existence of P. vivax infections (approximately 40 percent), for which
sulfadoxine-pyrimethamine is not effective. The high level of resistance to sulfadoxine-
pyrimethamine (36 percent, range 20-54) that led to the change of the first-line, anti-malarial drug for
the treatment of falciparum malaria to the ACT drug Artemether-Lumefantrine was the other reason
for not applying the intervention (Jima et al., 2005) .

Table 12.6 indicates summary findings on the preventive use of anti-malarial drugs and use of
IPT. Four percent of pregnant women took an anti-malarial drug, 2 percent took SP/Fansidar, 1
percent received two or more doses of SP/Fansidar, less than 1 percent received any SP/Fansidar
during an antenatal visit, and a negligible percent received two or more doses of SP/Fansidar at least
once during an ANC visit (IPT). Since SP/Fansidar is not recommended as a prophylactic drug and
has never been introduced for IPT, it is not surprising that the percentage who received it during an
ANC visit is low and probably reflects individual practice by service providers and users.

Malaria | 173
Table 12.6 Prophylactic use of antimalarial drugs and use of intermittent preventive treatment (IPT) by women during
pregnancy
Percentage of women who took any antimalarial drugs for prevention, who took SP/Fansidar, and who received
intermittent preventive treatment (IPT), during the pregnancy for their last live birth in the two years preceding the
survey, by background characteristics, Ethiopia 2005

Intermittent preventive treatment (IPT)1


SP/Fansidar
Percentage Percentage who
Percentage Percentage who received received 2+
who took any who took Percentage any SP/Fansidar doses, at least
Background antimalarial any who took during an once during an Number of
characteristic drug SP/Fansidar 2+ doses ANC visit ANC visit women
Residence
Urban 5.4 2.9 1.0 1.0 0.3 322
Rural 4.3 2.0 1.2 0.5 0.3 3,999
Region
Tigray 4.5 2.5 1.8 0.5 0.3 256
Affar 11.6 5.1 2.3 0.9 0.7 41
Amhara 7.0 3.9 1.6 0.8 0.2 1,046
Oromiya 1.5 0.6 0.4 0.4 0.4 1,668
Somali 0.7 0.7 0.7 0.0 0.0 168
Benishangul-Gumuz 13.3 5.8 2.2 1.1 0.3 40
SNNP 6.6 2.8 2.0 0.5 0.5 1,005
Gambela 9.8 4.3 2.3 0.8 0.3 11
Harari 2.9 1.4 0.0 0.0 0.0 10
Addis Ababa 0.0 0.0 0.0 0.0 0.0 61
Dire Dawa 1.4 1.4 0.8 1.4 0.8 15
Education
No education 4.1 2.1 1.2 0.5 0.3 3,363
Primary 5.5 2.2 1.7 0.8 0.7 768
Secondary and higher 3.6 1.6 0.2 0.2 0.2 190
Wealth quintile
Lowest 2.4 1.6 1.2 0.3 0.2 918
Second 2.7 1.7 1.1 0.4 0.3 926
Middle 6.3 2.3 1.4 0.6 0.4 957
Fourth 4.7 2.9 1.6 0.6 0.4 859
Highest 6.2 2.0 0.6 0.8 0.4 660
Altitude
0 - 999 14.3 6.0 4.3 0.6 0.4 80
1000 - 1499 11.4 3.8 2.4 0.7 0.5 285
1500 - 1999 5.5 2.8 1.6 0.9 0.6 1,659
2000+ 2.2 1.2 0.6 0.2 0.1 2,262

Total 4.4 2.1 1.2 0.5 0.3 4,321

Note: Total includes 30 women missing information on altitude who are not shown separately.
1
IPT = Intermittent preventive treatment (received SP/Fansidar during an antenatal (ANC) visit).

12.1.2 Malaria Diagnosis and Treatment

Treatment of Malaria in Children

Child illness and death in Ethiopia are due primarily to five common childhood illnesses,
namely, pneumonia (ARI), diarrhoea, malaria, measles and malnutrition, and often to a combination
of these conditions (MOH 2005b).

The level of childhood mortality in Ethiopia is one of the highest in the world. The 2004-05
health and health-related indicators of the Ministry of Health identified malaria as the primary cause
of health problems in infants, accounting for 19 percent of out-patient visits, 18 percent of admissions,
and 28 percent of in-patients deaths (MOH, 2005a). Thus, children under five are recognized as the
most vulnerable group for whom diagnosis and treatment should be given priority.

174 | Malaria
Table 12.7 presents data on the percentage of children under age five with fever who received
treatment for malaria. Overall, of the 19 percent of children with fever in the two weeks preceding the
survey, 3 percent took anti-malarial drugs but less than 1 percent took the anti-malarial drug the same
day or the next day following the onset of fever.

Table 12.7 Prevalence and prompt treatment of children with fever

Percentage of children under age five with fever in the two weeks preceding the survey, and among
children with fever, the percentage who received antimalarial drugs and the percentage who
received the drugs the same or next day following the onset of fever, by background characteristics,
Ethiopia 2005

Children under age five Children under age five with fever
Percentage Percentage
with fever in Percentage who received
the two weeks who received antimalarial
Background preceding Number of antimalarial drugs same or Number of
characteristic the survey children drugs next day children
Age in months
<6 16.8 1,152 0.6 0.0 194
6-11 27.6 1,071 4.4 0.0 295
12-23 23.3 1,877 2.7 0.8 438
24-35 21.6 1,892 1.9 1.2 408
36-47 15.1 2,105 3.5 0.1 317
48-59 11.6 2,013 4.9 1.9 233
Sex
Male 18.2 5,129 2.7 0.8 935
Female 19.1 4,980 3.2 0.5 951
Residence
Urban 16.0 752 4.2 1.6 121
Rural 18.9 9,357 2.9 0.6 1,765
Region
Tigray 20.3 653 0.0 0.0 132
Affar 17.0 96 9.0 6.6 16
Amhara 14.2 2,312 2.4 0.6 329
Oromiya 19.0 4,017 1.5 0.6 764
Somali 14.0 432 0.0 0.0 60
Benishangul-Gumuz 15.3 95 4.0 1.6 15
SNNP 23.5 2,273 6.3 0.8 534
Gambela 17.8 29 11.2 6.6 5
Harari 13.7 21 1.2 0.0 3
Addis Ababa 16.1 146 3.3 1.5 23
Dire Dawa 12.3 34 (0.0) (0.0) 4
Mother's education
No education 18.3 7,951 2.5 0.7 1,457
Primary 21.3 1,709 4.9 0.4 364
Secondary and higher 14.4 450 4.1 1.5 65
Wealth quintile
Lowest 19.1 2,218 0.5 0.0 422
Second 19.5 2,122 2.7 1.1 413
Middle 19.7 2,210 3.6 0.4 436
Fourth 17.7 2,015 3.5 0.5 357
Highest 16.7 1,544 5.7 1.8 258
Altitude
0 - 999 14.8 205 12.8 4.0 30
1000 - 1499 23.6 732 3.4 0.9 173
1500 - 1999 19.8 3,857 3.9 0.4 763
2000+ 17.0 5,205 1.9 0.7 886

Total 18.7 10,109 3.0 0.7 1,886

Note: Total includes 102 children under age five and 27 children under age five with fever missing
information on altitude and not shown separately. Figures in parentheses are based on 25-49
unweighted cases.

Malaria | 175
Types of Anti-Malarial Drugs Used

In Ethiopia, the first-line, anti-malarial drug for the treatment of malaria has been changing
over the past decade. The main reason for change was the level of efficacy of the drugs. Chloroquine
was the first-line, anti-malarial drug for the treatment of uncomplicated malaria until 1998. However,
because of the high level of failure (65 percent) of chloroquine for the treatment of uncomplicated
falciparum malaria that was detected through a nationwide study conducted at 18 sentinel sites in
1997-1998, the drug was replaced by SP/Fansidar (WHO 2001).

At the time of the introduction of SP/Fansidar as the first-line drug, the level of treatment
failure observed was about 7 percent (WHO, 2001). In subsequent years, however, unpublished
reports from isolated studies indicated higher treatment failure rates. As a result, a nationwide study
on the therapeutic efficacy of SP/Fansidar for the treatment of uncomplicated falciparum malaria was
conducted at 10 sentinel sites from October to December 2003. A mean treatment failure rate of 36
percent (ranging from 20-54 percent) was reported.

Cognizant of the high treatment failure rates of SP/Fansidar and the need to shift to more
effective anti-malarial drugs, the Ministry of Health—after a series of consultative meetings with
experts in the field and based on WHO recommendations—decided to introduce the Artemisinin-
based combination therapy (ACT) drug Artemether-Lumefantrine in July 2004 (MOH, 2004b). The
introduction of the new ACT drug and the phasing out of the old drug was estimated to take up to two
years given the limited supply of the new drug and the size of the country. Since the introduction of
the new ACT drug over 5.5 million treatment courses have been distributed with much of the ACT
drug distributed from September to December 2005 (MOH, 2006). The new ACT drug is used in all
health facilities. However, its distribution for home and community use has not yet been implemented,
pending local evidence regarding the ease and economic feasibility of using the ACT drug at home
and at the community level.

Table 12.8 presents data on the percentage of children treated with specific anti-malarial
drugs. The most common anti-malarial drugs used are SP/Fansidar and chloroquine (about 1 percent
each) and quinine (less than 1 percent). Artemether-Lumefantrine use was reported in only one region,
Harari, and the number of febrile cases treated with the drug in the region was about 1 percent.

176 | Malaria
Table 12.8 Type and timing of antimalarial drugs received by children with fever

Among children under five years of age with fever in the two weeks preceding the survey, the percentage who received specific
antimalarial drugs and the percentage who received the drugs the same or next day following the onset of fever, by background
characteristics, Ethiopia 2005

Percentage of children with fever


who received drug the same
Percentage of children with fever who received drug or next day Number
Other of
Background SP/ Artemether/ anti- SP/ children
characteristic Fansidar Chloroquine lumefantrine Quinine malarial Fansidar Chloroquine Quinine with fever
Age in months
<6 0.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 194
6-11 1.4 2.0 0.0 1.6 0.0 0.0 0.0 0.0 295
12-23 1.3 1.1 0.0 0.4 0.0 0.4 0.3 0.0 438
24-35 0.7 1.0 0.0 0.0 0.3 0.6 0.5 0.0 408
36-47 2.6 1.9 0.0 0.0 0.0 0.0 0.1 0.0 317
48-59 1.8 2.6 0.0 1.2 0.0 0.1 0.6 1.2 233
Sex
Male 1.1 1.8 0.0 0.3 0.0 0.1 0.4 0.3 935
Female 1.7 1.0 0.0 0.7 0.1 0.4 0.1 0.0 951
Residence
Urban 0.8 3.4 0.0 0.0 0.1 0.4 1.2 0.0 121
Rural 1.4 1.3 0.0 0.5 0.1 0.2 0.2 0.2 1,765
Region
Tigray 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 132
Affar 4.9 4.1 0.0 0.0 0.0 4.9 1.7 0.0 16
Amhara 0.9 1.1 0.0 0.0 0.3 0.0 0.6 0.0 329
Oromiya 0.5 0.0 0.0 1.0 0.0 0.2 0.0 0.4 764
Somali 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 60
Benishangul-Gumuz 2.4 2.8 0.0 0.0 0.0 0.0 1.6 0.0 15
SNNP 3.1 4.0 0.0 0.3 0.0 0.3 0.5 0.0 534
Gambela 6.8 6.2 0.0 0.5 2.2 5.0 2.7 0.0 5
Harari 0.0 0.0 1.2 0.0 0.0 0.0 0.0 0.0 3
Addis Ababa 3.3 0.0 0.0 0.0 0.0 1.5 0.0 0.0 23
Dire Dawa (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) 4
Mother's education
No education 1.3 1.0 0.0 0.4 0.0 0.3 0.3 0.2 1,457
Primary 1.7 2.8 0.0 1.1 0.3 0.0 0.4 0.0 364
Secondary and higher 1.9 2.3 0.0 0.0 0.0 1.2 0.3 0.0 65
Wealth quintile
Lowest 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 422
Second 0.8 1.2 0.0 0.7 0.0 0.4 0.0 0.7 413
Middle 2.3 1.1 0.0 0.5 0.0 0.4 0.0 0.0 436
Fourth 1.4 2.1 0.0 0.7 0.3 0.1 0.4 0.0 357
Highest 2.0 3.7 0.0 0.6 0.0 0.3 1.4 0.0 258
Altitude
0 - 999 7.1 2.6 0.0 0.1 3.7 3.5 0.8 0.0 30
1000 - 1499 2.5 1.8 0.0 0.0 0.0 0.0 0.9 0.0 173
1500 - 1999 2.1 2.2 0.0 0.2 0.0 0.4 0.0 0.0 763
2000+ 0.4 0.7 0.0 0.9 0.0 0.0 0.4 0.3 886

Total 1.4 1.4 0.0 0.5 0.1 0.2 0.3 0.1 1,886

Note: Total includes 27 children for whom information on altitude is not known. Figures in parentheses are based on 25-49
unweighted cases.

Malaria | 177
 
HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES,
AND BEHAVIOUR 13
The chapter presents current levels of Table 13.1 Knowledge of AIDS
HIV/AIDS knowledge, attitudes, and related
Percentage of women and men age 15-49 who have heard of AIDS,
behaviours for the general adult population. by background characteristics, Ethiopia 2005
The chapter then focuses on HIV/AIDS
Women Men
knowledge and patterns of sexual activity Number Number
among young people, as youth are the main Background Has heard of Has heard of
target of many HIV prevention efforts. The characteristic of AIDS women of AIDS men
findings in this chapter will assist the AIDS Age
control program in Ethiopia to identify 15-24 90.2 5,813 95.3 2,399
15-19 89.2 3,266 94.0 1,335
particular groups of people most in need of 20-24 91.5 2,547 97.1 1,064
information and services and most vulnerable 25-29 89.1 2,517 96.9 741
to the risk of HIV infection. 30-39 89.4 3,410 98.2 1,405
40-49 90.4 2,330 96.6 919

13.1 KNOWLEDGE OF HIV/AIDS AND Marital status


Never married 91.1 3,516 95.0 2,417
OF TRANSMISSION AND Ever had sex 96.3 223 99.8 412
PREVENTION METHODS Never had sex 90.8 3,293 94.0 2,005
Married/living together 89.1 9,066 97.6 2,890
Divorced/separated/
13.1.1 Awareness of AIDS widowed 91.4 1,488 99.4 157
Residence
In Ethiopia, knowledge of AIDS is Urban 98.6 2,499 99.7 854
Rural 88.0 11,571 95.9 4,610
widespread but not universal; 90 percent of
women 15-49 and 97 percent of men 15-49 Region
Tigray 97.0 919 99.7 315
have heard of AIDS (Table 13.1).1 The level Affar 85.4 146 96.4 59
of awareness of AIDS is lowest in the Somali Amhara 87.9 3,482 96.2 1,347
and Gambela regions. In the Somali Region, Oromiya 94.7 5,010 98.4 2,041
only half of women and 64 percent of men Somali 50.0 486 64.3 180
Benishangul-Gumuz 67.7 124 94.6 50
know about AIDS while, in Gambela, 63 SNNP 87.3 2,995 97.2 1,143
percent of women and 88 percent of men Gambela 62.9 44 87.7 19
have heard about AIDS. Knowledge of AIDS Harari 98.2 39 99.8 15
Addis Ababa 99.2 756 99.4 266
exceeds 90 percent among men in all other Dire Dawa 96.9 69 97.8 27
groups while among women, knowledge
Education
levels are more variable but exceed 80 No education 86.1 9,271 92.5 2,164
percent among all other groups. Primary 95.6 3,123 98.8 2,140
Secondary and higher 99.8 1,675 99.9 1,160
13.1.2 Knowledge of Ways to Reduce Wealth quintile
Lowest 80.4 2,428 91.2 980
HIV/AIDS Transmission
Second 87.8 2,643 96.0 1,052
Middle 89.2 2,732 97.5 980
HIV/AIDS prevention programmes Fourth 91.5 2,647 97.6 1,088
focus their messages and efforts on three Highest 97.0 3,621 99.1 1,364
important aspects of behaviour: delaying Total 15-49 89.9 14,070 96.5 5,464
sexual debut in young persons (abstinence), Total men 15-59 na na 96.6 6,033
limiting the number of sexual partners/ na = Not applicable
staying faithful to one partner, and use of
condoms (the ABC message). To ascertain whether programmes have effectively communicated these
messages, EDHS respondents were prompted with specific questions about whether it is possible to
1
For tables in this chapter that relate to the general adult population, the base population includes women and
men age 15-49. For the male tables, an additional row has been added to provide information for all men ages
15-59.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 179


reduce the chances of getting the AIDS virus by having just one faithful sexual partner, using a
condom at every sexual encounter, and abstaining from sex.

Table 13.2 presents levels of knowledge for the various HIV/AIDS prevention methods by
background characteristics. Women and men are most aware that the chances of getting the AIDS
virus can be reduced by limiting sex to one uninfected partner who has no other partners (63 percent
and 79 percent, respectively) or by abstaining from sexual intercourse (62 percent and 80 percent,
respectively). Knowledge of condoms and the role that they can play in preventing transmission of the
AIDS virus is much less common, particularly among women. Around four in ten women and six in
ten men are aware that using a condom during sexual encounters can reduce HIV/AIDS transmission.
Even fewer women and men are aware that using condoms and limiting sex to one uninfected partner
can reduce the risk of getting the AIDS virus (35 percent and 57 percent, respectively).

As Table 13.2 shows, young women age 15-24 are generally somewhat more knowledgeable
of the various modes of prevention than older women, while the opposite pattern is observed among
men. Considering the relationship with marital status, among women, knowledge of HIV/AIDS
prevention methods is highest among the never-married group and lowest among those who are
currently in union. Never-married women who ever had sex are the most likely to report knowledge of
the various modes of prevention. Among men, the differences in knowledge of various prevention
modes by marital status are not as great as those among women. As is the case with women, however,
never-married men who ever had sex are the most knowledgeable about ways to reduce the risk of
getting the AIDS virus.

Among both women and men, levels of knowledge of preventive methods are higher in urban
than in rural areas. There is considerable variability across regions in knowledge of prevention
methods. Among women, knowledge levels for the various methods are highest in Addis Ababa and
lowest in the Somali Region. Among men, knowledge levels tend to be higher in Tigray, Harari,
Addis Ababa, and Dire Dawa than in other regions and lowest in the Somali Region.

Women and men with higher levels of schooling are more likely than those with less
schooling to be aware of various preventive methods. Similarly, women and men in higher wealth
quintiles are more likely than those in lower quintiles to be aware of ways to prevent the transmission
of the HIV virus.

180 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.2 Knowledge of methods of HIV prevention

Percentage of women and men age 15-49 who, in response to a prompted question, say that people can reduce the risk of getting the AIDS
virus by using condoms every time they have sexual intercourse, by having one sex partner who is not infected and has no other partners,
and by abstaining from sexual intercourse, by background characteristics, Ethiopia 2005

Women Men
Use Use
condoms1 condoms1
Limit sex and limit Abstain Limit sex and limit Abstain
to one sex to one from Number to one sex to one from Number
Background Use uninfected uninfected sexual of Use uninfected uninfected sexual of
characteristic condoms1 partner2 partner2 intercourse women condoms1 partner2 partner2 intercourse men
Age
15-24 47.4 66.1 41.1 64.2 5,813 65.7 76.5 58.2 77.8 2,399
15-19 47.4 65.0 40.8 63.7 3,266 66.4 73.2 57.4 77.5 1,335
20-24 47.4 67.5 41.4 64.9 2,547 64.9 80.6 59.1 78.2 1,064
25-29 38.6 60.8 33.8 61.2 2,517 62.4 82.6 54.7 83.8 741
30-39 34.2 58.9 29.1 61.0 3,410 64.3 81.3 56.2 82.8 1,405
40-49 32.7 60.2 27.7 60.3 2,330 61.8 79.5 56.0 80.4 919
Marital status
Never married 54.2 70.5 48.0 68.5 3,516 65.3 76.4 57.6 77.5 2,417
Ever had sex 70.2 78.8 64.7 71.9 223 74.2 85.1 65.9 83.1 412
Never had sex 53.1 69.9 46.9 68.3 3,293 63.5 74.6 55.9 76.3 2,005
Married/living
together 34.5 59.5 29.2 59.8 9,066 63.2 81.1 55.9 82.6 2,890
Divorced/separated/
widowed 42.1 61.4 36.0 62.4 1,488 68.1 80.9 63.5 81.6 157
Residence
Urban 72.2 81.8 65.5 75.9 2,499 82.5 89.0 75.5 89.5 854
Rural 33.3 58.3 28.0 59.3 11,571 60.9 77.2 53.4 78.6 4,610
Region
Tigray 52.3 72.1 47.4 76.8 919 77.9 92.3 73.8 96.0 315
Affar 27.2 36.9 22.2 41.5 146 60.6 73.5 52.3 73.5 59
Amhara 35.9 56.8 29.5 54.5 3,482 74.9 79.7 65.7 86.3 1,347
Oromiya 41.0 68.3 35.6 69.4 5,010 61.8 81.5 54.1 78.1 2,041
Somali 10.6 26.2 9.3 22.8 486 15.8 32.0 14.6 36.3 180
Benishangul-Gumuz 29.0 43.3 23.2 41.9 124 58.2 72.1 51.7 80.6 50
SNNP 35.9 57.9 30.4 58.1 2,995 57.2 77.1 50.9 78.1 1,143
Gambela 25.3 34.0 18.2 39.1 44 54.2 60.9 46.7 60.3 19
Harari 60.7 77.5 54.8 73.9 39 74.0 95.9 72.9 96.2 15
Addis Ababa 78.5 87.4 72.6 82.3 756 77.8 83.1 68.2 89.9 266
Dire Dawa 56.7 69.3 49.8 70.1 69 70.9 85.6 67.1 83.1 27
Education
No education 28.3 54.4 23.5 56.4 9,271 51.6 72.2 44.9 73.6 2,164
Primary 54.1 72.7 46.5 68.8 3,123 66.7 80.9 59.1 82.6 2,140
Secondary and higher 80.1 88.0 74.3 82.7 1,675 83.2 88.4 75.1 88.8 1,160
Wealth quintile
Lowest 21.9 46.0 18.2 47.7 2,428 52.3 69.8 47.1 68.5 980
Second 29.7 55.5 25.1 57.2 2,643 59.8 75.9 51.2 79.1 1,052
Middle 33.6 61.1 28.8 61.4 2,732 62.3 77.6 54.1 79.0 980
Fourth 39.5 63.8 32.9 65.4 2,647 63.0 79.9 54.5 82.7 1,088
Highest 65.7 78.6 58.3 74.1 3,621 78.7 88.4 72.2 88.8 1,364

Total 15-49 40.2 62.5 34.6 62.3 14,070 64.3 79.0 56.9 80.3 5,464

Total men 15-59 na na na na na 62.9 78.6 55.7 80.0 6,033

na=Not applicable
1
Every time they have sexual intercourse
2
Who has no other partners

13.1.3 Knowledge about Transmission

The 2005 EDHS included questions to assess the prevalence of common misconceptions
about AIDS and HIV transmission. Respondents were asked whether they think it is possible for a
healthy-looking person to have the AIDS virus. They were asked whether a person can get AIDS from
mosquito bites, by supernatural means, or by eating from the same plate as a person who has AIDS.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 181


The results in Tables 13.3.1 and 13.3.2 indicate that many Ethiopian adults lack accurate
knowledge about the ways in which the AIDS virus can and cannot be transmitted. Particularly
critical is the fact that only 51 percent of women and 69 percent of men know that a healthy-looking
person can have (and thus transmit) the virus that causes AIDS. Many women and men also
erroneously believe that AIDS can be transmitted by mosquito bites; only 47 percent of women and
57 percent of men reject this common misconception. Larger proportions of women and men are
aware that the AIDS virus cannot be transmitted by supernatural means (70 percent and 84 percent,
respectively) and by sharing food with a person who has AIDS (63 percent and 80 percent,
respectively). Overall, only a minority of women (27 percent) and men (42 percent) both reject two of
the more common misconceptions in Ethiopia—that AIDS can be transmitted by mosquito bites and
that a person can become infected with the AIDS virus by sharing food or utensils with someone who
is infected—and believe that a healthy-looking person can have the AIDS virus.

Tables 13.3.1 and 13.3.2 provide an assessment of the level of comprehensive knowledge of
HIV/AIDS prevention and transmission. Comprehensive knowledge is defined as: 1) knowing that
both condom use and limiting sex partners to one uninfected person are HIV/AIDS prevention
methods, 2) being aware that a healthy-looking person can have HIV, and 3) rejecting the two most
common local misconceptions—that HIV/AIDS can be transmitted through mosquito bites and by
sharing food. According to the EDHS results, 16 percent of women and 30 percent of men in Ethiopia
have comprehensive knowledge of HIV/AIDS prevention and transmission.

Finally, Tables 13.3.1 and 13.3.2 document considerable variation in HIV/AIDS knowledge.
Although the patterns are not completely consistent, particularly among men, the proportions of
women and men who reject the most common misconceptions, who know that a healthy-looking
person can have the AIDS virus, or who have comprehensive knowledge about AIDS generally
decrease with age. Sexually active, never-married women and men tend to be more knowledgeable
than men and women in other marital status categories.

For all indicators, the proportion of women and men with correct knowledge about
HIV/AIDS prevention and transmission is higher in urban than rural areas. Variations in knowledge
levels by region are marked among both women and men, with the highest levels observed among
residents of Addis Ababa and the lowest levels found in the Somali Region (Figure 13.1).

Education and wealth are directly related to both correct knowledge concerning common
misconceptions and comprehensive knowledge of HIV/AIDS prevention and transmission. Among
women, for example, 53 percent of women with a secondary or higher education have comprehensive
knowledge about prevention and transmission modes compared with 7 percent of women with no
education. Among men, the level of comprehensive knowledge varies from 18 percent among those
with no education to 57 percent of those with a secondary or higher education.

182 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.3.1 Misconceptions and comprehensive knowledge about AIDS: women

Percentage of women age 15-49 who say that a healthy-looking person can have the AIDS virus and who, in response to prompted questions,
correctly reject local misconceptions about AIDS transmission, and the percentage with a comprehensive knowledge about AIDS, by
background characteristics, Ethiopia 2005

Percentage who
say that a
Percentage of women who say that:
healthy-looking
A person cannot person can have
become the AIDS virus Percentage
A healthy- AIDS cannot AIDS cannot infected by and who reject with a
looking person be transmitted be transmitted sharing food the two most comprehensive
Background can have the by mosquito by super- with a person common local knowledge Number of
characteristic AIDS virus bites natural means who has AIDS misconceptions1 about AIDS2 women
Age
15-24 55.5 53.1 72.6 68.9 32.7 20.5 5,813
15-19 55.8 54.8 72.7 68.8 34.1 21.1 3,266
20-24 55.1 51.0 72.5 69.0 30.9 19.7 2,547
25-29 49.0 44.6 72.0 64.0 24.8 14.4 2,517
30-39 44.4 43.6 66.9 57.0 21.4 11.5 3,410
40-49 48.9 39.6 66.5 58.5 21.9 11.8 2,330

Marital status
Never married 60.2 60.4 76.5 74.4 39.7 26.5 3,516
Ever had sex 72.1 66.8 87.5 85.3 51.0 40.8 223
Never had sex 59.4 60.0 75.7 73.7 39.0 25.6 3,293
Married/living together 46.4 42.1 67.6 58.8 21.5 11.5 9,066
Divorced/separated/
widowed 53.4 46.0 70.8 65.9 28.1 16.2 1,488

Residence
Urban 78.8 71.2 91.0 90.4 56.8 42.4 2,499
Rural 44.5 41.9 65.6 57.6 20.3 10.0 11,571

Region
Tigray 36.7 35.6 65.6 60.4 16.6 13.1 919
Affar 40.9 41.2 48.3 46.5 21.6 12.8 146
Amhara 53.5 48.2 75.0 67.4 31.0 15.2 3,482
Oromiya 58.6 44.2 67.9 60.5 25.4 15.3 5,010
Somali 10.6 17.4 22.3 22.4 6.2 3.9 486
Benishangul-Gumuz 33.9 38.9 52.2 51.3 20.8 11.1 124
SNNP 36.2 52.8 72.5 64.2 21.4 11.5 2,995
Gambela 32.2 37.5 50.4 48.3 21.1 8.9 44
Harari 50.1 64.3 76.8 81.9 35.1 28.3 39
Addis Ababa 88.8 71.7 96.0 95.1 64.5 50.1 756
Dire Dawa 50.3 65.7 83.9 79.9 36.8 27.2 69

Education
No education 41.2 36.8 62.2 53.3 16.6 7.3 9,271
Primary 60.3 58.5 79.9 76.0 34.8 20.9 3,123
Secondary and higher 84.4 82.6 95.6 96.3 68.3 53.0 1,675

Wealth quintile
Lowest 31.3 30.4 53.0 43.0 12.6 6.2 2,428
Second 42.7 39.4 61.7 52.4 18.0 8.1 2,643
Middle 46.5 43.9 67.9 58.5 20.6 9.7 2,732
Fourth 51.3 46.2 73.2 67.3 24.4 11.8 2,647
Highest 71.7 66.8 87.3 86.0 49.2 35.3 3,621

Total 15-49 50.6 47.1 70.1 63.4 26.8 15.8 14,070


1
AIDS can be transmitted through mosquito bites and by sharing food.
2
Respondent knows that using a condom at every sexual intercourse and having just one uninfected and faithful partner can reduce the risk of
getting the AIDS virus, knows that a healthy-looking person can have the AIDS virus, and rejects the two most common local misconceptions
about AIDS transmission.

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Table 13.3.2 Misconceptions and comprehensive knowledge about AIDS: men

Percentage of men age 15-49 who say that a healthy-looking person can have the AIDS virus and who, in response to prompted questions,
correctly reject local misconceptions about AIDS transmission or prevention, and the percentage with a comprehensive knowledge about AIDS, by
background characteristics, Ethiopia 2005

Percentage who
say that a
healthy-looking
Percentage of men who say that: person can have
A person cannot the AIDS virus Percentage
A healthy- AIDS cannot AIDS cannot become infected and who reject with a
looking person be transmitted be transmitted by sharing food the two most comprehensive
Background can have the by mosquito by super-natural with a person common local knowledge Number of
characteristic AIDS virus bites means who has AIDS misconceptions1 about AIDS2 men
Age
15-24 70.1 60.4 82.6 81.0 45.7 33.3 2,399
15-19 68.0 59.0 82.2 78.0 44.1 32.1 1,335
20-24 72.9 62.0 83.2 84.7 47.7 34.8 1,064
25-29 69.5 55.1 84.3 82.9 39.7 25.9 741
30-39 69.3 53.1 85.2 80.0 37.3 26.7 1,405
40-49 65.7 56.4 82.8 74.5 39.6 29.6 919
Marital status
Never married 70.4 61.1 82.6 80.8 46.1 33.4 2,417
Ever had sex 80.9 67.4 88.4 91.5 54.7 42.4 412
Never had sex 68.2 59.8 81.5 78.6 44.3 31.5 2,005
Married/living together 67.9 54.1 84.1 79.2 38.3 27.0 2,890
Divorced/separated/
widowed 72.1 51.9 86.9 78.0 37.5 31.1 157
Residence
Urban 90.2 79.6 93.3 93.6 71.5 56.7 854
Rural 65.2 53.0 81.7 77.4 36.2 25.0 4,610
Region
Tigray 77.3 55.1 87.0 81.3 44.6 36.5 315
Affar 66.3 45.9 63.9 71.3 30.9 20.2 59
Amhara 76.1 64.1 91.1 82.0 51.8 41.6 1,347
Oromiya 69.6 46.8 76.3 77.7 33.4 22.2 2,041
Somali 31.7 34.8 37.9 36.1 16.2 8.5 180
Benishangul-Gumuz 57.0 59.7 85.5 80.4 40.0 31.7 50
SNNP 58.8 66.2 91.4 84.1 40.4 26.1 1,143
Gambela 50.2 56.1 76.9 73.1 34.2 22.0 19
Harari 78.4 76.4 91.1 92.1 62.1 53.0 15
Addis Ababa 92.3 80.2 97.5 96.4 74.6 53.8 266
Dire Dawa 76.1 64.5 89.4 89.8 51.0 40.6 27
Education
No education 55.7 42.6 76.5 67.1 26.1 17.5 2,164
Primary 71.6 58.8 85.5 84.6 40.8 28.2 2,140
Secondary and higher 89.5 81.3 93.1 95.2 72.4 56.5 1,160
Wealth quintile
Lowest 53.7 40.8 69.8 63.8 24.6 17.7 980
Second 63.6 52.4 81.1 76.7 34.0 23.7 1,052
Middle 70.1 53.0 82.7 79.8 37.9 24.3 980
Fourth 66.8 59.5 88.4 82.7 40.5 26.7 1,088
Highest 85.4 73.7 92.0 91.8 63.7 50.4 1,364

Total 15-49 69.1 57.1 83.5 79.9 41.7 30.0 5,464

Total men 15-59 68.4 55.9 83.5 78.7 40.2 28.7 6,033
1
AIDS can be transmitted through mosquito bites and by sharing food.
2
Respondent knows that using a condom at every sexual intercourse and having just one uninfected and faithful partner can reduce the risk of
getting the AIDS virus, knows that a healthy-looking person can have the AIDS virus, and rejects the two most common local misconceptions about
AIDS transmission.

184 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Figure 13.1 Percentage of Women and Men Age 15-49 with
Comprehensive Knowledge about AIDS
Tigray 13
37
Affar 13
20
Amhara 15
42
Oromiya 15
22
Somali 4
9
Benishangul-Gumuz 11
32
SNNP 12
26
Gambela 9
22
Harari 28
53
Addis Ababa 50
54
Dire Dawa 27
41
0 10 20 30 40 50 60
Percent
Women Men
Note: Comprehensive knowledge is defined as: 1) knowing that both condom use
and limiting sex partners to one uninfected partner are HIV-prevention methods;
2) being aware that a healthy-looking person can have HIV; and 3) rejecting
the two most common local misconceptions--that HIV/AIDS can be transmitted
through mosquito bites and by sharing food. EDHS 2005

13.1.4 Knowledge about Mother-to-Child Transmission

Increasing knowledge of ways in which HIV can be transmitted from mother to child and the
fact that the risk of transmission can be reduced by using antiretroviral drugs is critical to reducing
mother-to-child transmission (MTCT). To obtain information on these issues, respondents in the 2005
EDHS were asked if the virus that causes AIDS can be transmitted from a mother to a child during
breastfeeding and whether a mother with HIV can reduce the risk of transmission to the baby by
taking certain drugs (antiretrovirals) during pregnancy (see Table 13.4).

Although 69 percent of women and 75 percent of men know that HIV can be transmitted by
breastfeeding, only slightly more than around one-fifth of women and one-fourth of men know that
the risk of MTCT can be reduced through the use of certain drugs during pregnancy. Twenty percent
of women and 26 percent of men are aware of both aspects of MTCT transmission.

There are marked differences in MTCT knowledge among women and men by age, marital
status, residence, education, and wealth. Knowledge about mother-to-child transmission is highest
among men and women living in urban areas, especially among those in Addis Ababa. Knowledge
levels are lowest among women and men who have no education, who are in the lowest wealth
quintile, and who live in the Somali Region. Particularly notable is the comparatively low level of
knowledge among pregnant women; just 10 percent of pregnant women are aware that HIV can be
transmitted from mother to child during breastfeeding and that mother-to-child transmission can be
reduced by taking certain drugs during pregnancy.

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Table 13.4 Knowledge of prevention of mother to child transmission of HIV

Percentage of women and men age 15-49 who know that HIV can be transmitted from mother to child by breastfeeding and that the risk of
mother-to-child transmission (MTCT) of HIV can be reduced by the mother taking special drugs during pregnancy, by background characteristics,
Ethiopia 2005

Women1 Men
HIV can be HIV can be
Risk of MTCT transmitted by Risk of MTCT transmitted by
can be breastfeeding and can be breastfeeding and
reduced by risk of MTCT can reduced by risk of MTCT
HIV can be mother be reduced by HIV can be mother taking can be reduced
transmitted taking special mother taking Number transmitted special drugs by mother taking Number
Background by drugs during special drugs of by during special drugs of
characteristic breastfeeding pregnancy during pregnancy women breastfeeding pregnancy during pregnancy men
Age
15-24 70.8 26.0 23.7 2,872 73.4 31.4 27.9 2,399
15-19 70.2 27.2 25.3 1,645 71.8 28.7 25.6 1,335
20-24 71.6 24.3 21.6 1,228 75.4 34.8 30.9 1,064
25-29 70.4 20.0 18.5 1,167 74.4 30.8 26.6 741
30-39 69.1 17.3 16.5 1,622 76.1 28.2 25.0 1,405
40-49 64.6 15.5 14.3 1,090 75.2 21.7 20.3 919

Marital status
Never married 74.0 33.9 31.2 1,703 72.6 33.7 29.9 2,417
Ever had sex 78.8 49.7 44.9 104 77.8 47.4 40.6 412
Never had sex 73.7 32.8 30.3 1,599 71.6 30.9 27.7 2,005
Married/living together 67.8 16.2 14.9 4,317 76.0 24.6 22.0 2,890
Divorced/separated/
widowed 67.1 20.7 19.7 731 77.5 33.1 29.7 157

Pregnancy status
Pregnant 62.2 11.7 10.0 566 na na na na
Not pregnant 70.0 22.0 20.4 6,185 na na na na

Residence
Urban 85.4 55.6 51.5 1,173 79.9 62.0 53.1 854
Rural 65.9 13.9 12.8 5,579 73.6 22.7 20.7 4,610

Region
Tigray 77.0 20.5 18.8 448 83.7 36.2 33.2 315
Affar 36.0 13.3 12.1 72 62.2 32.9 28.0 59
Amhara 62.5 20.7 18.7 1,640 75.2 29.4 26.2 1,347
Oromiya 78.4 18.4 17.5 2,368 76.8 28.8 26.1 2,041
Somali 12.9 6.2 6.1 243 36.2 6.2 5.5 180
Benishangul-Gumuz 43.2 15.5 15.1 62 72.9 27.7 25.4 50
SNNP 68.9 15.7 14.6 1,504 74.3 19.2 17.4 1,143
Gambela 44.8 12.0 11.4 23 65.7 34.7 30.9 19
Harari 78.5 52.4 47.7 20 75.2 60.7 49.9 15
Addis Ababa 83.9 77.6 69.4 339 73.0 69.6 56.9 266
Dire Dawa 72.4 41.8 40.5 33 78.5 54.1 46.3 27

Education
No education 61.4 12.4 11.5 4,419 65.4 14.8 13.9 2,164
Primary 81.5 25.0 22.9 1,552 78.5 27.5 24.5 2,140
Secondary and higher 90.0 62.8 58.0 781 84.3 57.7 50.2 1,160

Wealth quintile
Lowest 52.1 8.6 8.0 1,251 65.5 16.3 15.3 980
Second 64.7 13.1 12.3 1,321 73.0 19.0 17.2 1,052
Middle 68.3 14.0 12.5 1,273 75.0 25.9 23.2 980
Fourth 71.7 15.0 13.9 1,234 77.5 24.5 21.4 1,088
Highest 84.9 46.9 43.4 1,672 79.5 51.2 45.0 1,364

Total 15-49 69.3 21.2 19.5 6,751 74.5 28.9 25.7 5,464

Total men 15-59 na na na na 74.4 27.9 24.9 6,033

Note: Only women in households selected for the male subsample were administered questions on MTCT.
na = Not applicable

186 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


13.2 STIGMA ASSOCIATED WITH AIDS AND ATTITUDES RELATED TO HIV/AIDS

Knowledge and beliefs about AIDS affect how people treat those they know to be living with
HIV. In the 2005 EDHS, a number of questions were posed to respondents to measure their attitudes
towards HIV-infected people including questions about their willingness to buy vegetables from an
infected vegetable seller, to let others know the HIV status of family members, and to take care of
relatives who have the AIDS virus in their own household. They were also asked whether an HIV-
positive female who is not sick should be allowed to continue teaching. Tables 13.5.1 and 13.5.2 show
the percentages who express positive attitudes towards people with HIV among women and men who
have heard about HIV/AIDS by background characteristics.

Both women and men tend to express more positive attitudes in response to the questions
concerning behaviour towards HIV-infected relatives than to the questions about shopkeepers or
teachers. Sixty-five percent of women and 77 percent of men say that they would not want to keep
secret that a family member was infected with the AIDS virus and 59 percent of women and 72
percent of men say they would be willing to care for a family member with the AIDS virus in their
home. In contrast, only 42 percent of women and 52 percent of men say that an HIV-positive teacher
should be allowed to continue teaching and only 20 percent of women and 26 percent of men would
buy fresh food from a shopkeeper with AIDS. The percentage expressing accepting attitudes on all
four measures is low, 11 percent among women and 17 percent among men.

Higher education, wealth, and urban residence are related to more accepting attitudes towards
those who are HIV positive. Among men, for example, the percentage expressing accepting attitudes
towards those living with AIDS on all four measures exceeds 40 percent among urban residents, those
with a secondary or higher education, and those living in Addis Ababa, Dire Dawa or Harari. Among
women, the percentage expressing accepting attitudes on all four measures exceeds 40 percent among
those with a secondary or higher education and those living in Addis Ababa and Harari.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 187


Table 13.5.1 Accepting attitudes toward those living with HIV: women

Among women who have heard of HIV/AIDS, percentage expressing specific accepting attitudes toward people with HIV,
by background characteristics, Ethiopia 2005

Percentage of women who:


Are willing to Would buy Say that a female Would not
care for family fresh teacher with the want to keep Percentage
member with vegetables AIDS virus and is secret that a expressing
the AIDS from not sick should family accepting Number of
virus in the shopkeeper be allowed to member got attitudes on women who
Background respondent’s who has the continue infected with all four have heard of
characteristic home AIDS virus teaching the AIDS virus indicators HIV/AIDS
Age
15-24 64.0 25.7 48.6 64.8 14.5 5,244
15-19 64.7 27.1 51.4 65.9 15.2 2,913
20-24 63.2 23.9 45.1 63.4 13.5 2,331
25-29 55.5 18.1 39.3 66.1 10.1 2,243
30-39 55.5 14.8 34.8 64.3 7.2 3,049
40-49 55.4 15.0 35.9 66.3 7.1 2,107
Marital status
Never married 69.2 35.3 58.5 64.9 20.4 3,204
Ever had sex 81.1 59.3 76.6 66.6 38.4 214
Never had sex 68.4 33.6 57.2 64.8 19.2 2,990
Married/living together 54.3 13.8 34.5 65.1 6.8 8,078
Divorced/separated/
widowed 63.1 20.3 42.8 66.4 11.2 1,361
Residence
Urban 86.0 58.4 78.9 71.1 37.3 2,463
Rural 52.5 10.6 32.4 63.7 4.3 10,180
Region
Tigray 84.9 29.5 39.0 60.3 14.2 892
Affar 60.9 14.4 36.8 53.9 5.1 125
Amhara 71.0 16.5 43.9 68.5 8.6 3,061
Oromiya 44.9 15.3 34.8 68.6 8.0 4,742
Somali 68.5 22.4 24.4 47.0 8.6 243
Benishangul-Gumuz 73.8 17.2 45.8 55.0 10.7 84
SNNP 49.4 12.3 37.8 57.7 5.7 2,613
Gambela 69.5 27.9 55.2 52.2 15.1 28
Harari 69.4 50.6 66.8 85.5 42.4 38
Addis Ababa 94.3 73.9 91.9 68.5 46.9 750
Dire Dawa 76.9 49.8 64.8 78.7 37.1 67
Education
No education 51.6 9.0 29.3 63.2 3.4 7,986
Primary 62.0 22.9 49.0 67.6 11.7 2,985
Secondary and higher 88.8 66.7 86.4 70.2 44.1 1,672
Wealth quintile
Lowest 51.8 7.6 22.6 59.6 2.5 1,952
Second 50.2 9.0 27.8 61.5 3.4 2,321
Middle 48.8 9.8 31.8 65.6 3.0 2,437
Fourth 55.4 11.7 38.4 65.6 5.3 2,421
Highest 78.3 46.7 70.0 70.0 29.2 3,513

Total 15-49 59.0 19.9 41.5 65.2 10.7 12,643

188 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.5.2 Accepting attitudes toward those living with HIV: men

Among men who have heard of HIV/AIDS, percentage expressing specific accepting attitudes toward people with HIV, by
background characteristics, Ethiopia 2005

Percentage of men who:


Would buy Say that a female Would not
Are willing to fresh teacher with the want to keep Percentage
care for family vegetables AIDS virus and is secret that a expressing
member with the from not sick should family accepting Number of
AIDS virus in the shopkeeper be allowed to member got attitudes on men who
Background respondent's who has the continue infected with all four have heard
characteristic home AIDS virus teaching the AIDS virus indicators of HIV/AIDS
Age
15-24 72.4 30.7 54.6 76.2 18.9 2,287
15-19 70.0 30.5 53.4 75.6 19.1 1,255
20-24 75.3 30.9 56.2 76.9 18.8 1,033
25-29 70.5 27.0 54.2 76.0 17.6 718
30-39 71.8 21.1 49.0 79.2 13.9 1,380
40-49 70.4 21.7 47.1 77.1 14.4 888
Marital status
Never married 73.2 33.1 56.0 76.7 20.9 2,297
Ever had sex 82.3 48.5 68.3 80.9 33.3 411
Never had sex 71.2 29.7 53.3 75.8 18.2 1,885
Married/living together 69.8 20.3 47.7 77.2 13.0 2,820
Divorced/separated/
widowed 80.7 30.5 65.4 81.2 21.2 157
Residence
Urban 90.8 64.5 82.8 79.2 45.3 851
Rural 67.9 18.8 45.9 76.7 11.2 4,422
Region
Tigray 86.6 38.0 59.2 86.1 27.5 314
Affar 84.6 32.6 48.6 68.3 15.0 57
Amhara 82.7 25.9 62.9 75.3 19.7 1,295
Oromiya 58.8 22.5 42.6 82.0 13.6 2,009
Somali 79.9 24.2 68.5 51.7 13.0 116
Benishangul-Gumuz 72.4 23.4 59.8 71.0 14.6 47
SNNP 70.2 17.5 43.3 71.4 8.3 1,111
Gambela 77.3 51.0 67.6 80.8 32.5 17
Harari 85.1 54.7 76.4 83.5 43.0 15
Addis Ababa 94.2 71.4 82.8 74.9 44.0 265
Dire Dawa 78.1 52.0 66.6 84.8 43.3 27
Education
No education 63.3 12.2 39.4 75.8 7.2 2,002
Primary 69.0 22.9 48.4 76.0 12.5 2,114
Secondary and higher 90.7 56.2 79.5 81.3 40.6 1,158
Wealth quintile
Lowest 59.7 13.3 35.9 76.5 6.7 893
Second 64.6 15.6 41.1 75.7 8.2 1,011
Middle 69.3 17.0 46.9 77.0 10.5 955
Fourth 71.8 22.1 50.8 76.3 13.4 1,062
Highest 86.2 52.1 74.6 79.3 36.5 1,353
Total 15-49 71.6 26.1 51.8 77.1 16.7 5,273
Total men 15-59 71.2 25.4 50.8 77.4 15.9 5,826

13.3 ATTITUDES TOWARDS NEGOTIATING SAFER SEX

Knowledge about HIV transmission and ways to prevent it are of little use if people feel
powerless to negotiate safer sex practices with their partner. In an effort to assess the ability of women
to negotiate safer sex with a spouse who has an STI, EDHS respondents were asked two attitudinal
questions: is a wife justified in refusing to have sex with her husband when she knows he has a
disease that can be transmitted through sexual contact, and is a woman in the same circumstances
justified in asking her husband to use a condom?

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 189


Table 13.6 shows that 85 percent of women and 89 percent of men believe that, if she knows
her husband has an STI, a woman is justified in either refusing to have sex with him or asking him to
wear a condom. Considering the two actions separately, the majority of both women (81 percent) and
men (85 percent) say that a woman can refuse to have sex. Far fewer women (42 percent) and
somewhat fewer men (65 percent) agree that a woman would be justified in asking the man to use a
condom.

Table 13.6 Attitudes toward negotiating safer sex with husband

Percentage of women and men age 15-49 who believe that if a husband has a sexually transmitted disease his wife is justified in
either refusing to have sexual relations with him or asking that he use a condom, by background characteristics, Ethiopia 2005

Women who believe that wife is justified in: Men who believe that wife is justified in:
Either
Either refusing refusing
Asking sexual sexual
Refusing to that they relations or Refusing to Asking that relations or
Background have sexual use a asking to use Number have sexual they use a asking to use Number
characteristic relations condom a condom of women relations condom a condom of men
Age
15-24 82.1 48.3 85.4 5,813 83.5 63.8 87.5 2,399
15-19 80.3 48.3 83.5 3,266 81.3 60.7 85.3 1,335
20-24 84.4 48.2 87.8 2,547 86.4 67.8 90.2 1,064
25-29 82.3 40.8 85.9 2,517 87.1 68.2 91.0 741
30-39 79.5 36.2 82.6 3,410 86.3 67.6 91.1 1,405
40-49 80.9 34.0 83.7 2,330 86.1 59.2 88.4 919
Marital status
Never married 82.0 54.7 85.5 3,516 82.5 63.6 86.9 2,417
Ever had sex 90.9 76.8 94.9 223 90.0 82.0 94.2 412
Never had sex 81.4 53.2 84.8 3,293 80.9 59.9 85.4 2,005
Married/living together 80.5 36.2 83.8 9,066 87.2 64.9 90.7 2,890
Divorced/separated/
widowed 84.2 44.0 86.5 1,488 89.2 73.9 91.8 157
Residence
Urban 90.4 74.7 95.0 2,499 92.7 84.0 97.0 854
Rural 79.3 34.5 82.3 11,571 83.8 61.0 87.6 4,610
Region
Tigray 81.9 41.8 84.3 919 95.1 68.3 98.3 315
Affar 60.1 21.7 64.4 146 79.5 67.2 84.4 59
Amhara 86.7 42.6 89.3 3,482 93.4 74.8 95.4 1,347
Oromiya 82.6 43.1 85.9 5,010 79.1 67.8 84.8 2,041
Somali 59.4 7.9 59.9 486 85.7 22.9 86.5 180
Benishangul-Gumuz 67.1 33.1 70.6 124 78.4 53.2 81.8 50
SNNP 74.6 33.0 79.1 2,995 81.9 47.0 85.7 1,143
Gambela 54.7 21.8 58.7 44 65.0 63.0 78.2 19
Harari 85.1 62.0 90.2 39 94.3 81.5 98.2 15
Addis Ababa 94.3 87.4 98.0 756 94.5 88.3 97.3 266
Dire Dawa 85.5 56.4 87.7 69 94.1 70.2 95.4 27
Education
No education 77.9 29.7 80.5 9,271 83.4 54.4 86.1 2,164
Primary 84.6 54.7 89.2 3,123 83.6 64.2 88.2 2,140
Secondary and higher 94.0 83.2 98.2 1,675 91.3 84.4 96.0 1,160
Wealth quintile
Lowest 74.2 24.8 76.2 2,428 79.1 49.0 82.0 980
Second 79.3 29.9 81.6 2,643 83.5 58.6 87.0 1,052
Middle 79.3 35.4 82.6 2,732 85.5 64.7 89.9 980
Fourth 82.4 40.1 85.7 2,647 85.1 64.8 89.1 1,088
Highest 88.1 67.3 92.9 3,621 90.6 80.3 95.0 1,364

Total 15-49 81.3 41.6 84.5 14,070 85.2 64.6 89.1 5,464

Total men 15-59 na na na na 85.3 63.9 89.0 6,033

na = Not applicable

190 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


The majority of respondents in all groups support a woman’s right to negotiate safer sex.
However, there are differences by background characteristics in the percentages of respondents
holding this opinion. For example, the higher a respondent’s educational attainment, the more likely
he or she is to say that a woman can refuse sex or propose using a condom. Support for women’s
negotiating rights also increases across wealth quintiles among both women and men. The proportions
supporting a woman’s right to negotiate safer sex vary considerably across regions. Among women,
the percentage saying that a woman is justified in refusing sex and asking that a condom be used
ranges from a low of 59 percent in Gambela to 98 percent in Addis Ababa. Among men, support for
women’s negotiating rights is also lowest in Gambela (78 percent) and highest in Tigray, Harari (98
percent each) and Addis Ababa (97 percent).

13.4 HIGHER-RISK SEX

Given that most HIV infections in Ethiopia are contracted through heterosexual contact,
information on sexual behaviour is important in designing and monitoring intervention programmes to
control the spread of the epidemic. In the context of HIV/AIDS prevention, limiting the number of
sexual partners and having protected sex are crucial to combating the epidemic.

The 2005 EDHS included questions on respondents’ sexual partners during the 12 months
preceding the survey. For male respondents, an additional question was asked on whether they paid
for sex during the 12 months preceding the interview. Information on the use of condoms at the last
sexual encounter with each type of partner was collected from both women and men. Finally, sexually
active women and men were asked about the total number of partners they had during their lifetime.
These questions are of course sensitive, and in interpreting the results in this section it is important to
remember that respondents’ answers are likely subject to at least some reporting bias.

13.4.1 Multiple Sexual Partners and Higher-Risk Sex

Tables 13.7.1 and 13.7.2 present several indicators based on information collected from
women and men who had ever had intercourse about their sexual partners during the 12-month period
before the survey and over their lifetime. The first two indicators in the tables assess the prevalence of
multiple partners and of higher-risk sexual intercourse among women and men who reported having
intercourse during the 12 months prior to the survey. Higher-risk sex involves sexual intercourse with
a partner who is neither a spouse nor a cohabiting partner. The third indicator relates to condom use
during the last higher-risk sexual encounter. The fourth indicator, the mean number of sexual partners
that a woman or man has had during their lifetime, provides an assessment of lifetime exposure to one
of the elements of higher-risk sex, multiple partners.

The tables show that, among those who had sex in the previous 12 months, less than 1 percent
of women age 15-49 and only 4 percent of men age 15-49 report having had two or more sexual
partners during the period. Somewhat larger proportions—3 percent of women and 9 percent of
men—report having had higher-risk sexual intercourse in the past 12 months (i.e., sexual intercourse
with someone other than their spouse or cohabiting partner).

The differentials presented in the tables suggest that higher-risk sex, particularly among
women, is concentrated in a limited number of population subgroups. First the prevalence of higher-
risk sex is virtually universal among never-married women and men who reported having sexual
intercourse during the 12-month period prior to the EDHS.2 Looking at the other marital status
categories, very few women and men who were currently in union (less than 1 percent) reported
higher-risk sexual encounters during the 12 months prior to the survey,, while 25 percent of women
and 33 percent of men who were widowed, divorced or separated said they had engaged in higher-risk
sex during the period.

2
To determine marital status, the EDHS asked respondents whether or not they were currently or had ever been
married or lived together with a partner. Thus, by definition, most sexual intercourse among respondents
classified as never-married is high risk, i.e., it involves a nonmarital, noncohabiting partner.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 191


Table 13.7.1 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: women

Among women age 15-49 who had sexual intercourse in the past 12 months, the percentage who had intercourse with more
than one partner and the percentage who had higher-risk sexual intercourse, and among those having higher-risk intercourse
in the past 12 months, the percentage reporting that a condom was used at last higher-risk intercourse, and among women
who ever had sexual intercourse, the mean number of sexual partners during lifetime, by background characteristics, Ethiopia
2005

Women who had higher-


Women who had sexual intercourse risk intercourse1 Women who ever had
in past 12 months in past 12 months sexual intercourse
Percentage Percentage
Percentage who had who reported Mean
who had 2+ higher-risk using a number of
partners intercourse1 condom at last sexual
Background in past in past Number of higher-risk Number of partners in Number of
characteristic 12 months 12 months women intercourse1 women lifetime women
Age
15-24 0.5 5.8 1,212 28.4 71 1.2 1,360
15-19 0.4 7.2 411 27.1 29 1.2 469
20-24 0.6 5.1 800 29.3 41 1.3 891
25-29 0.1 1.7 977 (32.7) 17 1.3 1,075
30-39 0.2 1.6 1,360 * 21 1.6 1,585
40-49 0.0 1.3 805 * 10 1.6 1,086
Marital status
Never married and ever
had sex 1.0 99.7 63 28.7 63 2.4 104
Married/living together 0.2 0.5 4,142 (7.8) 20 1.4 4,291
Divorced/separated/
widowed 1.0 24.5 148 (23.2) 36 1.8 711
Residence
Urban 0.4 13.5 492 39.9 66 1.7 709
Rural 0.2 1.4 3,862 3.0 53 1.4 4,396
Region
Tigray 0.0 5.2 290 * 15 1.5 347
Affar 0.7 2.0 55 * 1 1.3 63
Amhara 0.1 2.9 1,140 * 33 1.8 1,374
Oromiya 0.2 2.8 1,558 * 43 1.2 1,764
Somali 0.0 0.0 161 * 0 1.1 196
Benishangul-Gumuz 0.7 2.0 47 * 1 1.6 52
SNNP 0.4 0.5 942 * 5 1.2 1,070
Gambela 0.6 5.0 14 * 1 1.5 19
Harari 0.4 3.7 12 * 0 1.3 14
Addis Ababa 0.3 15.7 117 (34.9) 18 2.3 182
Dire Dawa 1.5 9.2 18 * 2 1.5 24
Education
No education 0.3 1.4 3,318 (9.0) 47 1.5 3,876
Primary 0.0 4.0 740 (30.2) 30 1.3 853
Secondary and higher 0.1 14.4 296 34.9 43 1.5 376
Wealth quintile
Lowest 0.2 1.3 888 * 12 1.4 1,047
Second 0.3 1.8 936 * 16 1.4 1,064
Middle 0.3 1.1 877 * 10 1.4 988
Fourth 0.2 1.5 827 * 13 1.4 939
Highest 0.3 8.3 826 40.8 68 1.6 1,067

Total 0.2 2.7 4,354 23.6 119 1.4 5,106

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than
25 unweighted cases and has been suppressed.
1
Sexual intercourse with a nonmarital, noncohabiting partner

192 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.7.2 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: men

Among men age 15-49 who had sexual intercourse in the past 12 months, the percentage who had intercourse with more
than one partner and the percentage who had higher-risk sexual intercourse, and among those having higher-risk
intercourse in the past 12 months, the percentage reporting that a condom was used at last higher-risk intercourse, and
among men who ever had sexual intercourse, the mean number of sexual partners during lifetime, by background
characteristics, Ethiopia 2005

Men who had higher-risk


Men who had sexual intercourse intercourse1 Men who ever had
in past 12 months in past 12 months sexual intercourse
Percentage Percentage
Percentage who had who reported Mean
who had 2+ higher-risk using a number of
partners intercourse1 condom at last sexual
Background in past in past Number higher-risk Number partners in Number
characteristic 12 months 12 months of men intercourse1 of men lifetime of men
Age
15-24 4.8 37.4 446 50.2 167 2.0 561
15-19 3.9 68.0 78 44.0 53 2.0 96
20-24 5.0 31.0 368 53.1 114 2.0 465
25-29 3.2 9.1 531 47.1 48 2.2 600
30-39 4.0 3.1 1,291 57.2 39 2.6 1,355
40-49 4.6 1.1 853 * 9 4.0 902

Marital status
Never married and ever
had sex 9.7 98.0 227 53.0 222 3.0 407
Married/living together 3.7 0.8 2,840 (28.3) 24 2.7 2,861
Divorced/separated/
widowed 3.3 33.2 53 (70.0) 18 3.7 150

Residence
Urban 3.2 29.9 393 79.9 118 4.4 490
Rural 4.3 5.4 2,728 29.4 146 2.5 2,928

Region
Tigray 4.5 15.9 187 (53.7) 30 2.7 194
Affar 7.1 15.9 45 (38.7) 7 3.5 47
Amhara 2.0 3.5 775 * 27 3.3 845
Oromiya 3.5 8.8 1,147 (46.0) 101 2.5 1,255
Somali 3.2 2.6 116 * 3 1.8 124
Benishangul-Gumuz 12.7 5.0 34 * 2 2.8 35
SNNP 6.5 4.6 657 * 31 2.2 705
Gambela 12.4 28.2 12 45.3 4 5.7 15
Harari 2.2 20.8 10 (76.9) 2 3.5 11
Addis Ababa 6.1 44.4 123 70.9 55 4.8 170
Dire Dawa 7.6 22.3 15 (70.9) 3 3.1 17

Education
No education 4.0 2.7 1,532 9.8 41 2.5 1,642
Primary 4.6 7.8 1,077 46.1 84 2.5 1,156
Secondary and higher 3.5 27.1 512 67.9 139 4.1 620

Wealth quintile
Lowest 3.4 4.8 566 15.2 27 2.1 615
Second 4.6 5.3 645 (32.7) 34 2.6 686
Middle 4.9 4.8 648 (34.8) 31 2.2 676
Fourth 4.7 6.9 604 (29.0) 42 2.8 648
Highest 3.0 19.7 658 76.2 129 3.9 794

Total 15-49 4.1 8.5 3,121 51.9 264 2.8 3,418

Total men 15-59 4.1 7.3 3,630 51.7 266 3.0 3,974

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer
than 25 unweighted cases and has been suppressed.
1
Sexual intercourse with a nonmarital, noncohabiting partner

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 193


Because many respondents in the 15-24 age group are likely to be never-married, it is
expected that higher-risk sex would be more prevalent in these cohorts than among older women and
men. What is somewhat surprising is the size of the gender differential in the reporting of these sexual
behaviours among respondents in this age range. For example, 37 percent of men age 15-24 who had
sexual intercourse during the 12-month period prior to the survey reported that they had engaged in
higher-risk sex compared with 6 percent of women in the same cohort. The size of the differential
suggests that there may be significant underreporting of recent sexual activity among never-married
women in this age cohort. As noted in Chapter 6, only 6 percent of never-married women reported
that they had ever had sex.

Considering the other variables in Tables 13.7.1 and 13.7.2, higher-risk sex among both
women and men is most prevalent among those living in urban areas, in Addis Ababa, those with a
secondary or higher education, and those in the highest wealth quintile. Among men, the prevalence
of higher-risk sex is also notably high among men living in Gambela, Dire Dawa, Harari, Tigray and
Affar (Figure 13.2).

Figure 13.2 Multiple Sexual Partners and Higher-Risk Sexual


Intercourse in the Past 12 Months among Men Age 15-49
50
44

40

30 28

21 22
20 16 16
13 12
9 8
10 7 7 6
5 5 5
2 4 4 3 3 2
0
ay r ra a al
i l- la i s
gr fa iy gu
P
be
ar di ire
Ti Af ha m m an uz SN
N ar Ad aba D wa
A m ro So sh m am H a
O ni Gu G Ab D
Be Region

2+ partners in Higher-risk intercourse


past 12 months in past 12 months

Note: Higher-risk sexual intercourse refers to intercourse


EDHS 2005
with a nonmarital, noncohabiting partner.

As mentioned above, condom use is an important tool in the fight to curtail the spread of
HIV/AIDS. Although truly effective protection would require condom use at every sexual encounter,
the most important sexual encounters to cover are those considered to be “higher risk.”, i.e., sex with
a nonmarital, noncohabitating partner in the 12 months preceding the survey. Tables 13.7.1 and 13.7.2
show that, among women reporting they engaged in higher-risk sex during the 12-month period prior
to the survey, 24 percent reported a condom was used the last time they had higher-risk intercourse.
Men who engaged in higher-risk sex during the year before the survey were much more likely to
report condom use; around half said that a condom was used during their last higher-risk sexual
encounter. The numbers of respondents, particularly women, reporting higher-risk sex are frequently
quite small, making it difficult to assess differences in the prevalence of condom use across
subgroups. However, the results sugge st that, among men who engaged in higher-risk sex, condom
use is highest among urban residents, those with a secondary or higher education, and those in the
highest wealth quintile.

194 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Finally, Tables 13.7.1 and 13.7.2 show that men who have ever been sexually active report
having an average (mean number) of 2.8 lifetime sexual partners, more than twice the average
reported by women who have ever been sexually active (1.4 partners). The mean number of sexual
partners for both women and men increases with age and is higher among urban than rural residents.
Regions in which the mean number of lifetime partners among women is comparatively higher
include Addis Ababa (2.3) and Amhara (1.8). Among men, the highest mean numbers of lifetime
sexual partners were reported in Gambela (5.7 partners) and Addis Ababa (4.8 partners).

13.4.2 Paid Sex Table 13.8 Payment by men for sexual intercourse

Percentage of men age 15-49 reporting payment for sexual


Paid sex is considered a special category of intercourse in the past 12 months, by background
higher-risk sex. Male respondents in the 2005 characteristics, Ethiopia 2005
EDHS were asked whether they had paid money in
Percentage
exchange for sex in the past 12 months or if any of reporting sex
their last three partners in the past 12 months was a with commercial
commercial sex worker. sex worker
Background in past Number of
characteristic 12 months1 men
Less than 1 percent of men had engaged in
paid sex in the year before the survey (Table 13.8). Age
15-24 0.8 2,399
The highest percentages of men reporting that they 15-19 0.5 1,335
had engaged in paid sex are observed among men 20-24 1.2 1,064
in Gambela (5 percent), Affar (2 percent), and 25-29 0.8 741
30-39 1.2 1,405
Tigray (2 percent) and men who were divorced,
40-49 0.5 919
separated or widowed (3 percent).
Marital status
Never married 0.9 2,417
Finally, about one-third of the small num- Married or living together 0.7 2,890
ber of men reporting they engaged in higher-risk Divorced/separated/
sex used a condom at last sex with a prostitute (data widowed 2.9 157
not shown). Residence
Urban 1.1 854
Rural 0.8 4,610
13.5 TESTING FOR HIV
Region
Tigray 2.0 315
Knowledge of HIV status helps HIV- Affar 2.4 59
negative individuals make specific decisions to Amhara 0.6 1,347
reduce risk and increase safer sex practices so they Oromiya 1.1 2,041
Somali 0.0 180
can remain disease free. For those who are HIV Benishangul-Gumuz 1.9 50
infected, knowledge of their status allows them to SNNP 0.2 1,143
take action to protect their sexual partners, to access Gambela 4.8 19
treatment, and to plan for the future. Testing of Harari 1.3 15
Addis Ababa 1.6 266
pregnant women is especially important so action Dire Dawa 1.5 27
can be taken to prevent mother-to-child trans- Education
mission. No education 0.9 2,164
Primary 0.8 2,140
To obtain information on the prevalence of Secondary and higher 0.9 1,160
HIV testing, all respondents were asked whether Wealth quintile
they had ever been tested for HIV. If they said that Lowest 0.3 980
Second 1.3 1,052
they had, respondents were asked whether they had Middle 1.1 980
received the results of their last test. Women giving Fourth 0.6 1,088
birth in the two-year period before the survey were Highest 1.0 1,364
asked additional questions regarding testing that
Total 15-49 0.9 5,464
may have occurred as part of any antenatal care
they received prior to the birth. Total men 15-59 0.8 6,033
1
Includes men who reported that at least one of their last
three sexual partners in the past 12 months was a
commercial sex worker.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 195


Tables 13.9.1 and 13.9.2 show that, among the adult population age 15-49, 4 percent of
women and 6 percent of men have been tested for HIV at some time. The majority of women and men
who were tested indicated that that they had received the results of their test. Around half of the
women who had ever been tested and received the test results said that they had received results from
an HIV test taken during the 12 months prior to the survey. Among both women and men, the
proportions ever tested are higher among those under age 30 than among those age 30 and older.
Considering marital status, testing rates are highest among never-married women and men who have
ever had sex and widowed, divorced and separated men. Considering the other characteristics for
which results are presented in the tables, the highest testing rates are observed among urban residents,
residents of Addis Ababa, Harari, and Dire Dawa, those with a secondary or higher education, and
those in the highest wealth quintile.

Table 13.9.1 Coverage of prior HIV testing: women

Percent distribution of women by whether tested for HIV and by whether received the results of the test, and
the percentage of women who received their test results the last time they were tested for HIV in the past 12
months, according to background characteristics, Ethiopia 2005

Ever tested
Don’t Percentage
know/ Never who received
missing tested/ results from
Did not whether don’t HIV test taken
Background Received receive received know/ in past Number of
characteristic results results results missing Total 12 months women
Age
15-24 4.9 0.2 0.3 94.6 100.0 2.9 2,872
15-19 3.6 0.4 0.3 95.7 100.0 2.4 1,645
20-24 6.7 0.0 0.2 93.1 100.0 3.6 1,228
25-29 4.5 0.1 0.0 95.4 100.0 1.7 1,167
30-39 2.5 0.1 0.0 97.3 100.0 1.0 1,622
40-49 1.8 0.0 0.0 98.2 100.0 0.6 1,090
Marital status
Never married 6.6 0.3 0.3 92.8 100.0 3.8 1,703
Ever had sex 29.0 0.0 0.0 70.9 100.0 12.2 104
Never had sex 5.1 0.3 0.3 94.2 100.0 3.2 1,599
Married/living together 2.3 0.1 0.1 97.5 100.0 0.9 4,317
Divorced/separated/
widowed 5.7 0.0 0.0 94.3 100.0 3.1 731
Residence
Urban 16.6 0.5 0.5 82.4 100.0 7.8 1,173
Rural 1.0 0.1 0.0 98.8 100.0 0.6 5,579
Region
Tigray 3.0 0.2 0.0 96.8 100.0 1.9 448
Affar 2.7 0.0 0.0 97.3 100.0 1.8 72
Amhara 1.8 0.0 0.1 98.1 100.0 1.0 1,640
Oromiya 2.9 0.1 0.2 96.7 100.0 1.4 2,368
Somali 1.9 0.1 0.0 98.0 100.0 1.3 243
Benishangul-Gumuz 3.0 0.1 0.0 96.9 100.0 0.8 62
SNNP 2.4 0.3 0.0 97.3 100.0 1.4 1,504
Gambela 0.8 0.2 0.0 99.0 100.0 0.6 23
Harari 13.9 0.8 2.2 83.1 100.0 7.8 20
Addis Ababa 26.5 0.6 0.1 72.9 100.0 10.9 339
Dire Dawa 12.5 0.4 0.0 87.1 100.0 5.2 33
Education
No education 0.6 0.0 0.0 99.3 100.0 0.3 4,419
Primary 4.0 0.3 0.2 95.5 100.0 2.2 1,552
Secondary and higher 20.8 0.6 0.7 77.9 100.0 10.0 781
Wealth quintile
Lowest 0.0 0.1 0.0 99.9 100.0 0.1 1,251
Second 0.7 0.0 0.0 99.3 100.0 0.2 1,321
Middle 0.9 0.1 0.2 98.9 100.0 0.8 1,273
Fourth 2.0 0.3 0.0 97.7 100.0 1.2 1,234
Highest 12.5 0.2 0.3 86.9 100.0 5.7 1,672

Total 3.8 0.2 0.1 96.0 100.0 1.9 6,751

Note: Only women in households selected for the male subsample were administered questions on prior
testing.

196 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.9.2 Coverage of prior HIV testing: men

Percent distribution of men by whether tested for HIV and by whether received the results of the test, and the
percentage of women who received their test results the last time they were tested for HIV in the past 12 months,
according to background characteristics, Ethiopia 2005

Ever tested
Don’t Percentage
know/ who received
missing Never results from
Did not whether tested/ HIV test taken
Background Received receive received don’t know/ in past Number
characteristic results results results missing Total 12 months of men
Age
15-24 4.7 0.3 0.1 94.8 100.0 2.6 2,399
15-19 2.0 0.0 0.2 97.7 100.0 1.5 1,335
20-24 8.1 0.7 0.0 91.2 100.0 4.0 1,064
25-29 8.7 0.5 0.0 90.8 100.0 4.1 741
30-39 4.5 0.8 0.1 94.6 100.0 1.6 1,405
40-49 3.1 0.6 0.0 96.4 100.0 1.0 919
Marital status
Never married 5.4 0.3 0.1 94.2 100.0 3.0 2,417
Ever had sex 17.6 0.0 0.0 82.3 100.0 8.5 412
Never had sex 2.9 0.3 0.2 96.6 100.0 1.8 2,005
Married/living together 4.2 0.7 0.0 95.0 100.0 1.6 2,890
Divorced/separated/
widowed 10.6 0.3 0.0 89.0 100.0 3.4 157
Residence
Urban 17.4 1.7 0.5 80.4 100.0 7.8 854
Rural 2.6 0.3 0.0 97.1 100.0 1.2 4,610
Region
Tigray 4.8 0.6 0.9 93.7 100.0 2.5 315
Affar 3.0 0.6 0.0 96.4 100.0 1.2 59
Amhara 4.0 0.6 0.0 95.4 100.0 2.5 1,347
Oromiya 3.9 0.5 0.0 95.5 100.0 1.7 2,041
Somali 0.0 0.0 0.0 100.0 100.0 0.0 180
Benishangul-Gumuz 2.7 0.2 0.0 97.1 100.0 1.5 50
SNNP 3.5 0.4 0.0 96.1 100.0 1.3 1,143
Gambela 2.4 0.8 0.0 96.8 100.0 0.6 19
Harari 17.1 0.7 1.4 80.8 100.0 7.4 15
Addis Ababa 26.4 0.8 0.5 72.4 100.0 11.0 266
Dire Dawa 13.9 1.2 0.0 84.9 100.0 7.3 27
Education
No education 1.6 0.1 0.0 98.3 100.0 0.9 2,164
Primary 3.7 0.6 0.0 95.8 100.0 1.3 2,140
Secondary and higher 13.6 1.1 0.3 85.0 100.0 6.7 1,160
Wealth quintile
Lowest 1.1 0.3 0.0 98.6 100.0 0.3 980
Second 1.0 0.2 0.0 98.8 100.0 0.6 1,052
Middle 2.5 0.4 0.0 97.1 100.0 1.4 980
Fourth 4.2 0.3 0.0 95.5 100.0 1.6 1,088
Highest 13.1 1.1 0.3 85.5 100.0 6.1 1,364

Total 15-49 4.9 0.5 0.1 94.5 100.0 2.3 5,464

Total men 15-59 4.6 0.5 0.1 94.9 100.0 2.1 6,033

Table 13.10 presents data on HIV/AIDS information and counselling during antenatal care.
Among women who gave birth in the past two years, 3 percent received information and counselling
about HIV/AIDS during antenatal care for their most recent birth. Less than 1 percent of the women
reported that they were offered and accepted an HIV test during antenatal care. Taking both these
elements into account, the EDHS results indicate that less than 1 percent of women giving birth
during the two-year period prior to the survey were counselled about HIV, voluntarily accepted an
offer of an HIV test, and received the test results. Women who gave birth during the two-year period
before the survey were most likely to have received HIV/AIDS counselling and/or testing services
during antenatal care if they lived in an urban area, especially in Addis Ababa, had a secondary or
higher education, or were in the highest wealth quintile.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 197


In interpreting the findings in Table 13.10, it is important to recognize that the very low
coverage of HIV counselling and testing among women giving birth during the two-year period
before the survey is in part due to the fact that only a minority of pregnant women obtain antenatal
care.

Table 13.10 Pregnant women counselled and tested for HIV

Among women who gave birth in the two years preceding the survey, the percentage who received
HIV counselling during antenatal care for their most recent birth, and among those who accepted an
offer of HIV testing, percentage who received and did not receive their test results, by background
characteristics, Ethiopia

Among those who


accepted an offer of
an HIV test during Percentage who
Percentage antenatal care, were counselled, Number of
who received percentage who:2 were offered and women who
HIV counselling Did not accepted an HIV gave birth in
Background during Received receive test, and received the past
characteristic antenatal care1
results results results2 2 years3
Age
15-24 3.3 0.9 0.0 0.5 672
15-19 1.8 0.3 0.2 0.0 176
20-24 3.8 1.1 0.0 0.6 496
25-29 2.3 1.0 0.1 0.5 592
30-39 3.3 0.7 0.3 0.7 679
40-49 3.9 0.7 0.0 0.5 176
Marital status
Never married and ever
had sex 0.9 0.9 0.0 * 9
Married/living together 3.0 0.8 0.1 0.6 2,015
Divorced/separated/
widowed 4.0 2.2 0.3 0.0 95
Residence
Urban 20.0 6.7 1.8 5.5 156
Rural 1.7 0.4 0.0 0.2 1,963
Region
Tigray 4.7 0.0 0.0 0.0 134
Affar 2.6 0.0 1.3 0.0 25
Amhara 2.0 0.4 0.0 0.0 491
Oromiya 0.9 0.3 0.0 0.0 799
Somali 0.0 0.0 0.0 0.0 90
Benishangul-Gumuz 0.9 0.4 0.0 0.0 21
SNNP 4.8 0.6 0.2 0.6 512
Gambela 6.9 0.7 0.0 0.7 6
Harari 8.6 7.1 0.0 6.0 5
Addis Ababa 50.0 33.1 4.2 26.8 29
Dire Dawa 9.8 6.2 0.0 6.2 7
Education
No education 1.5 0.4 0.0 0.1 1,630
Primary 4.5 1.1 0.4 1.0 395
Secondary and higher 24.1 8.0 0.7 7.4 93
Wealth quintile
Lowest 0.3 0.0 0.0 0.0 460
Second 1.8 0.3 0.0 0.3 466
Middle 0.8 0.9 0.0 0.0 470
Fourth 3.4 0.4 0.3 0.4 426
Highest 12.3 3.6 0.5 2.9 297
Total 3.1 0.8 0.1 0.6 2,119

Note: Only women in households selected for the male subsample were administered questions on
MTCT. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.
1
In this context, "counselled" means that someone talked with the respondent about all three of the
following topics: 1) babies getting the AIDS virus from their mother, 2) preventing the virus, and 3)
getting tested for the virus.
2
Only women who were offered the test are included here; women who were either required or asked
for the test are excluded from the numerator of this measure.
3
Denominator for percentages includes women who did not receive antenatal care for their last birth in
the past two years.

198 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


13.6 REPORTS OF RECENT SEXUALLY TRANSMITTED INFECTIONS

Information about the incidence of sexually transmitted infections (STIs) is not only useful as
a marker of unprotected sexual intercourse but also as a cofactor for HIV transmission. The 2005
EDHS asked respondents who had ever had sex whether they had had an STI in the past 12 months.
They were also asked whether, in the past year, they had experienced a genital sore or ulcer, and
whether they had any genital discharge. These symptoms have been shown useful in identifying STIs
in men. They are less easily interpreted in women because women are likely to experience more non-
STI conditions of the reproductive tract that produce a discharge.

Table 13.11 shows that about 2 percent each of women and men who have ever been sexually
active had an STI and/or STI symptoms in the 12 months prior to the survey. Those reporting STI
symptoms were somewhat more likely to say they had had an abnormal genital discharge than to
report a genital ulcer. It is likely that these figures, which are quite low, underestimate the actual
prevalence of STIs among the sexually active population in Ethiopia.

Table 13.11 Self-reported prevalence of sexually-transmitted infections (STI) and STI symptoms

Among women and men age 15-49 who ever had sexual intercourse, the percentage reporting having had an STI and/or symptoms of an
STI in the past 12 months, by background characteristics, Ethiopia 2005

Women Men
STI, Number of STI, Number of
genital women genital men who
Abnormal Genital discharge, who ever Abnormal Genital discharge, ever had
Background genital sore or sore or had sexual genital sore or sore or sexual
characteristic STI discharge ulcer ulcer intercourse STI discharge ulcer ulcer intercourse
Age
15-19 0.3 1.0 0.2 1.4 904 0.4 0.1 0.1 0.5 97
20-24 0.4 1.1 0.4 1.5 1,850 0.4 0.7 0.5 1.2 469
25-29 0.6 1.6 0.5 2.4 2,314 0.9 0.8 0.2 1.4 601
30-39 0.4 1.3 1.1 1.9 3,357 0.4 0.8 0.3 1.2 1,367
40-49 0.6 1.5 1.2 2.3 2,323 1.0 1.8 0.7 2.3 916
Marital status
Never married 0.5 2.6 0.2 3.1 223 0.6 0.6 0.3 1.2 412
Married or living together 0.5 1.2 0.8 1.9 9,058 0.4 0.9 0.3 1.3 2,886
Divorced/separated/
widowed 0.2 1.8 1.0 2.5 1,467 5.1 3.7 3.3 6.1 152
Residence
Urban 0.7 1.6 1.1 2.5 1,518 1.0 1.4 0.8 1.6 506
Rural 0.5 1.3 0.7 1.9 9,230 0.6 0.9 0.4 1.5 2,943
Region
Tigray 0.1 1.1 0.4 1.3 721 0.5 0.4 0.5 1.3 198
Affar 0.0 1.0 1.0 1.5 126 0.5 0.4 0.4 0.5 49
Amhara 0.4 1.1 0.4 1.6 2,917 0.0 0.5 0.4 0.7 848
Oromiya 0.8 1.4 1.0 2.2 3,770 1.1 0.5 0.6 1.5 1,270
Somali 0.2 0.8 1.2 1.7 399 2.5 8.3 0.6 8.8 126
Benishangul-Gumuz 0.1 0.6 1.0 1.6 105 0.0 0.0 0.0 0.0 35
SNNP 0.3 1.6 0.9 2.2 2,179 0.2 1.3 0.2 1.3 706
Gambela 0.6 1.6 1.7 2.7 38 0.7 2.1 1.3 2.8 15
Harari 0.4 0.3 0.4 0.6 27 0.4 0.4 0.4 0.4 12
Addis Ababa 1.1 2.3 1.4 3.5 415 1.1 0.9 0.4 1.6 173
Dire Dawa 0.3 0.2 0.1 0.4 50 0.8 0.0 0.8 0.8 18
Education
No education 0.5 1.4 0.8 2.0 8,242 0.7 1.3 0.3 1.9 1,653
Primary 0.3 1.3 0.8 1.9 1,695 0.5 0.8 0.8 1.2 1,163
Secondary and higher 0.5 1.4 0.8 1.9 810 0.7 0.5 0.2 1.1 635
Wealth quintile
Lowest 0.5 1.5 1.0 2.2 2,055 1.0 1.8 0.5 2.4 617
Second 0.4 1.4 0.9 2.1 2,189 0.3 1.2 0.5 1.7 689
Middle 0.3 1.0 0.5 1.4 2,137 0.0 0.2 0.2 0.2 683
Fourth 0.8 1.3 0.7 2.0 2,052 1.0 0.6 0.3 1.5 651
Highest 0.5 1.5 0.8 2.2 2,315 1.1 1.2 0.6 1.8 810
Total 15-49 0.5 1.4 0.8 2.0 10,748 0.7 1.0 0.4 1.5 3,450
Total men 15-59 na na na na na 0.8 1.0 0.4 1.5 4,019

na = Not applicable

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 199


13.7 MALE CIRCUMCISION Table 13.12 Prevalence of male circumcision

Percentage of men circumcised, according to selected


Circumcision of men is widely practiced in background characteristics, Ethiopia 2005
Ethiopia and often serves as a rite of passage to
Percentage
adulthood. Some studies have shown that absence of of men
circumcision may be a contributory factor to the risk Background who are Number of
characteristic circumcised men
of contracting STIs, including HIV. To investigate
this relationship the EDHS asked all men if they had Age
15-19 86.7 1,335
been circumcised. Table 13.12 shows that 93 percent 20-24 93.3 1,064
of Ethiopian men age 15-59 are circumcised. Cir- 25-29 93.2 741
cumcision is highest among men age 40-44 and low- 30-34 94.5 754
est among those age 15-19. 35-39 92.5 651
40-44 97.8 497
45-49 93.8 422
Currently married men are slightly more 50-54 96.7 335
likely to be circumcised than formerly married men. 55-59 94.4 235
Men who have never married are least likely to be Marital status
circumcised. Circumcision is highest among Ortho- Never married 90.3 2,419
Married or living together 94.1 3,424
dox Christians and lowest among men of other un- Divorced/separated/widowed 92.7 190
specified religions.
Residence
Urban 97.9 916
With the exception of men in Gambela and Rural 91.6 5,117
SNNP, circumcision is nearly universal among men Region
in the other regions. Less than one in two men living Tigray 98.0 366
in Gambela is circumcised, while three in four men Affar 98.5 65
living in SNNP are circumcised. Amhara 97.3 1,521
Oromiya 94.2 2,222
Somali 99.2 202
There is no clear relationship between edu- Benishangul-Gumuz 97.6 54
cation and male circumcision. However, men with at SNNP 79.6 1,244
least secondary education are most likely to be cir- Gambela 46.8 21
Harari 99.5 16
cumcised. Addis Ababa 98.5 292
Dire Dawa 99.7 30
13.8 INJECTIONS Education
No education 93.0 2,589
Injection overuse in a health care setting can Primary 90.1 2,252
Secondary and higher 96.1 1,192
contribute to the transmission of blood-borne patho-
gens because it amplifies the effect of unsafe Wealth quintile
Lowest 88.9 1,100
practices such as reuse of injection equipment. As a Second 90.8 1,184
consequence, the proportion of injections given with Middle 91.8 1,081
reused injection equipment is an important pre- Fourth 93.2 1,200
Highest 96.6 1,469
vention indicator in an initiative to control the
spread of HIV/AIDS. Religion
Orthodox 97.3 2,974
Catholic 78.4 61
Table 13.13 presents data on the prevalence Protestant 80.1 1,038
of injections among respondents. Respondents were Moslem 94.3 1,788
asked if they had had any injections given by a Other 74.5 55
health worker in the 12 months preceding the sur- Total 92.5 6,033
vey, and if so, the number of injections they had
received and whether their last injection was given with a syringe from a new, unopened package. It
should be noted that medical injections can be self-administered (e.g., insulin for diabetes). These
injections were not included in the calculation.

Women are more likely than men to report receiving at least one injection (26 percent and 19
percent, respectively). These may in part reflect the fact that a substantial proportion of women are
currently using injectable contraceptives. The average number of injections received from a health
provider was 1.1 among women and 1.0 among men.

200 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.13 shows that the largest variations in the injection prevalence indicator are across
regions. Among women, for example, the percentage reporting they had received at least one injection
from a health worker during the 12 months prior to the survey varies from 6 percent in the Somali
Region to 32 percent among women in SNNP and Addis Ababa. Among men, the likelihood of
having received an injection is lowest in the Somali Region (4 percent) and highest in Benishangul-
Gumuz (29 percent). Urban residents are more likely than rural residents to have received at least one
injection from a health provider, although the differential is greater for women than for men. The
percentage receiving at least one injection from a health provider varies directly with education
among both women and men. Among women, there is also a direct association between wealth
quintile and the likelihood of receiving at least one injection. Among men, however, the association
between wealth and receipt of an injection is not consistent.

Table 13.13 Prevalence of injections

Percent of women and men age 15-49 who received at least one injection from a health worker1 in the past 12 months, the average number of medical
injections1 per person, and among those who received an injection, the percentage for whom the health worker took the syringe and needle from a
new and unopened package for the last injection, by background characteristics, Ethiopia 2005

Women Men
Percentage Percentage
who Last Number who Last Number
received an injection, receiving received an injection, receiving
injection syringe injections injection syringe and injections
from a Average and needle from a from a Average needle from a
health number of taken from health health number of taken from health
worker in medical Number newly worker in worker in medical Number newly worker in
Background the past injections of opened the past the past injections of opened the past
characteristic 12 months per year women package 12 months 12 months per year men package 12 months
Age
15-19 22.7 0.8 3,266 92.8 741 18.1 0.7 1,335 96.6 242
20-24 26.1 1.1 2,547 93.1 665 21.2 1.1 1,064 94.6 226
25-29 28.7 1.2 2,517 89.9 722 18.2 1.1 741 97.3 135
30-39 25.9 1.3 3,410 89.1 882 19.5 1.0 1,405 93.1 274
40-49 25.6 1.2 2,330 88.9 596 17.1 1.1 919 94.5 157
Residence
Urban 30.4 1.8 2,499 98.6 759 20.3 1.1 854 98.4 173
Rural 24.6 1.0 11,571 88.6 2,847 18.7 0.9 4,610 94.4 860
Region
Tigray 16.5 0.7 919 93.4 152 16.2 0.8 315 95.9 51
Affar 15.3 1.2 146 88.9 22 14.7 0.9 59 (99.2) 9
Amhara 23.4 1.0 3,482 82.0 815 15.5 0.6 1,347 91.2 208
Oromiya 26.6 1.1 5,010 91.9 1,333 22.4 1.4 2,041 96.2 458
Somali 5.7 0.4 486 80.9 28 3.8 0.2 180 * 7
Benishangul-Gumuz 25.3 1.2 124 94.4 31 28.5 1.5 50 97.6 14
SNNP 31.6 1.2 2,995 94.6 945 17.7 0.7 1,143 94.7 203
Gambela 25.2 1.9 44 96.8 11 25.0 1.5 19 96.4 5
Harari 26.2 1.2 39 98.8 10 19.5 0.8 15 100.0 3
Addis Ababa 31.9 2.2 756 96.5 241 26.5 1.4 266 97.6 71
Dire Dawa 24.9 1.9 69 96.7 17 17.6 1.4 27 94.5 5
Education
No education 23.1 1.0 9,271 86.7 2,139 13.9 0.7 2,164 93.4 300
Primary 29.6 1.2 3,123 95.5 924 21.8 1.1 2,140 95.0 466
Secondary and higher 32.4 1.7 1,675 98.4 542 23.0 1.2 1,160 97.0 267
Wealth quintile
Lowest 17.0 0.7 2,428 81.8 412 16.6 1.1 980 97.1 162
Second 21.3 0.8 2,643 90.6 563 20.6 1.1 1,052 90.3 217
Middle 25.1 1.0 2,732 85.1 687 16.6 0.8 980 96.5 163
Fourth 29.3 1.1 2,647 91.0 776 20.3 0.9 1,088 94.3 221
Highest 32.2 1.7 3,621 97.1 1,167 19.8 1.0 1,364 97.3 270
Total 15-49 25.6 1.1 14,070 90.7 3,606 18.9 1.0 5,464 95.0 1,033
Total men 15-59 na na na na na 19.1 1.0 6,033 94.3 1,155

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and
has been suppressed.
na = Not applicable
1
Includes injections given by a doctor, nurse, pharmacist, dentist or other health worker

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 201


The majority of recent injections (91 percent among women and 95 percent among men) were
given with a needle and syringe taken from a newly opened package. Women living in Somali (81
percent) and Amhara (82 percent) and women in the lowest wealth quintile (82 percent) are the least
likely to report that the injection was given using a needle and syringe from a previously unopened
package.

13.9 HIV/AIDS-RELATED KNOWLEDGE AND BEHAVIOUR AMONG YOUTH

Knowledge of HIV/AIDS issues and related sexual behaviour among youth age 15-24 is of
particular interest because the period between sexual initiation and marriage is for many young people
a time of sexual experimentation that may involve high-risk behaviours. This section considers a
number of issues that relate to both transmission and prevention of HIV/AIDS among youth,
including the extent to which youth have comprehensive knowledge of HIV/AIDS transmission and
prevention modes and knowledge of a source where they can obtain condoms. Issues such as
abstinence, age at sexual debut, age differences between partners, and condom use are also covered in
this section.

13.9.1 Knowledge about HIV/AIDS and Source for Condoms

Knowledge of how HIV is transmitted is crucial to enabling young people to avoid AIDS.
Young people are often at greater risk because they may have shorter relationships with more partners
or engage in other risky behaviours. As discussed earlier, comprehensive knowledge is defined as
knowing that: 1) people can reduce their chances of getting the AIDS virus by having sex with only
one uninfected, faithful partner and by using condoms consistently; 2) a healthy-looking person can
have the AIDS virus; and 3) HIV cannot be transmitted by mosquito bites or by sharing food with a
person who has AIDS.

Table 13.14 shows that only around one-fifth of women and one-third of men age 15-24 know
all of these facts about HIV/AIDS. The level of comprehensive knowledge about HIV/AIDS does not
vary greatly by age within the youth population. Among young women, comprehensive knowledge is
highest among the never-married, especially those who have ever had sex. Among young men,
comprehensive knowledge is most common among the small numbers who were divorced, separated
or widowed.

As expected, comprehensive HIV/AIDS knowledge is much more common among urban than
rural youth. Among young women, the level of comprehensive knowledge ranges from a low of 1
percent in the Somali Region to a high of 50 percent in Addis Ababa. Among young men,
comprehensive knowledge is lowest in the Somali Region (7 percent) and highest in Harari (54
percent) and Addis Ababa (53 percent). Young women with a secondary education or higher are more
than six times as likely as those with no schooling to have comprehensive knowledge of HIV/AIDS
while highly educated young men are more than three times as likely as those with no education to
have comprehensive knowledge. Youth in the highest wealth quintile are much more likely to have
comprehensive knowledge than other youth.

Because of the important role that condoms play in combating the transmission of HIV,
respondents were asked whether they knew where condoms could be obtained. Only responses about
“formal” sources were counted, so that friends and family and other similar sources were not in-
cluded.

As shown in Table 13.14, young men are more likely than young women to know where to
obtain a condom (56 and 34 percent, respectively). Among either sex, knowledge of a condom source
does not vary consistently with age. Never-married young women, particularly those who have had
sex, are much more likely to know about a source for condoms than those who have ever married.
Among young men, the variations in knowledge by marital status are comparatively minor. Among
both young women and men, those in urban areas are more likely than those in rural areas to know of

202 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


a condom source. Knowledge of a condom source is lowest in the Somali Region (7 percent of
women and 20 percent of men) and highest in Addis Ababa (87 percent of women and 82 percent of
men). Consistent with the patterns observed for other indicators, youth who are better educated and
live in wealthier households are more likely than other youth to know a source of condoms.

Finally, to gauge the extent of support for programmes to increase condom knowledge among
youth, all EDHS respondents (youth and adults) were asked whether they thought that children age
12-14 should be taught about using condoms to avoid AIDS.

Table 13.14 Comprehensive knowledge about AIDS and a source for condoms among youth

Percentage of young women and men age 15-24 with comprehensive knowledge about AIDS and percentage with knowledge
of a source of condoms, by background characteristics, Ethiopia 2005

Women Men
Percentage with Percentage with
comprehensive Percentage who comprehensive Percentage who
Background knowledge know a condom Number of knowledge know a condom Number of
characteristic of AIDS1 source2 women of AIDS1 source2 men
Age
15-19 21.1 34.4 3,266 32.1 51.8 1,335
15-17 21.3 34.2 1,952 31.5 50.6 822
18-19 20.7 34.7 1,313 33.0 53.7 513
20-24 19.7 34.4 2,547 34.8 60.3 1,064
20-22 19.6 32.5 1,797 34.4 61.3 740
23-24 19.9 38.9 751 35.8 58.1 324
Marital status
Never married 26.1 42.2 3,165 32.9 55.5 2,081
Ever had sex 40.3 66.6 136 38.0 53.2 257
Never had sex 25.5 41.1 3,030 32.2 55.8 1,824
Married/living together 13.4 23.8 2,284 34.2 56.8 284
Divorced/separated/
widowed 15.7 32.9 363 (47.3) (51.3) 35
Residence
Urban 44.4 81.4 1,242 54.4 81.5 431
Rural 14.0 21.6 4,571 28.6 49.9 1,968
Region
Tigray 17.5 45.8 387 46.8 60.4 145
Affar 17.4 34.7 54 20.3 39.9 18
Amhara 19.9 35.6 1,392 44.8 58.7 614
Oromiya 20.2 27.3 2,131 25.2 53.5 907
Somali 1.4 6.7 155 7.4 19.6 60
Benishangul-Gumuz 15.1 28.9 51 42.8 52.0 18
SNNP 15.9 27.6 1,197 28.2 52.2 491
Gambela 10.6 29.7 17 21.4 53.4 8
Harari 30.1 66.7 17 53.7 63.5 6
Addis Ababa 49.8 87.3 382 52.6 82.2 120
Dire Dawa 29.7 63.2 29 43.8 68.4 12
Education
No education 8.0 12.8 2,841 14.1 30.7 630
Primary 22.9 39.0 1,996 31.3 53.8 1,135
Secondary and higher 51.7 87.8 975 55.8 83.4 634
Wealth quintile
Lowest 8.2 10.6 836 20.4 37.0 425
Second 11.5 17.0 1,045 29.0 46.2 421
Middle 13.5 20.0 1,135 29.4 49.8 391
Fourth 16.5 26.5 1,043 28.3 58.3 493
Highest 38.5 70.0 1,753 50.1 74.6 669

Total 15-24 20.5 34.4 5,813 33.3 55.6 2,399

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


1
Respondent knows that using a condom at every sexual intercourse and having just one uninfected and faithful partner can
reduce the risk of getting the AIDS virus, knows that a healthy-looking person can have the AIDS virus, and rejects the two most
common local misconceptions about AIDS transmission.
2
Friends, family members, and home are not considered sources for condoms.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 203


Table 13.15 shows that 54 percent of women and 77 percent of men age 18-49 agree that
children age 12-14 should be taught about using a condom to avoid AIDS. Women and men age 18-
29 appear to be slightly more supportive of condom education for children age 12-14 than older
adults. Among adult women, support for condom education is higher among urban than rural residents
and increases as expected with education and wealth. There is also considerable regional variability in
the level of support for condom education among women, from a low of 4 percent in the Somali
Region to a high of 73 percent in Addis Ababa. Among adult men, support for condom education does
not vary consistently with education and wealth, and rural residents are almost as likely as urban
residents to express support. The Somali Region again stands out as having the lowest level of support
from men (19 percent). In the other regions, support for condom education varies from 71 percent in
Harari to 90 percent in Tigray.

Table 13.15 Adult support for education about condom use to prevent AIDS

Percentage of women and men 18-49 who agree that children 12-14 years
should be taught about using a condom to avoid AIDS, by background
characteristics, Ethiopia 2005

Background Women Men


characteristic Percentage Number Percentage Number
Age
18-19 57.4 689 73.9 513
20-24 59.6 1,228 79.9 1,064
25-29 56.4 1,167 78.6 741
30-39 51.8 1,622 77.6 1,405
40-49 47.2 1,090 71.9 919
Marital status
Never married 63.8 914 76.1 1,600
Ever had sex 73.7 95 81.9 390
Never had sex 62.6 819 74.2 1,210
Married/living together 52.2 4,186 76.7 2,886
Divorced/separated/
widowed 53.3 696 83.9 156
Residence
Urban 71.0 984 78.5 721
Rural 50.7 4,811 76.4 3,920
Region
Tigray 67.9 371 90.3 270
Affar 30.2 64 77.1 54
Amhara 54.1 1,409 82.6 1,127
Oromiya 56.0 2,060 75.0 1,733
Somali 4.4 215 18.9 156
Benishangul-Gumuz 36.8 55 71.8 43
SNNP 53.8 1,272 78.8 972
Gambela 39.2 21 75.5 17
Harari 49.4 17 70.5 13
Addis Ababa 72.7 283 76.9 235
Dire Dawa 55.2 29 77.3 23
Education
No education 46.9 4,090 70.4 2,008
Primary 70.3 1,074 83.1 1,655
Secondary and higher 73.7 631 78.9 979
Wealth quintile
Lowest 38.8 1,098 66.7 825
Second 49.2 1,156 79.3 918
Middle 52.6 1,099 77.2 845
Fourth 57.3 1,045 80.2 906
Highest 69.2 1,398 78.9 1,148

Total 18-49 54.2 5,795 76.7 4,641

Total 18-59 na na 76.1 5,211

Note: Only women in households selected for the male subsample were
administered questions on MTCT.
na = Not applicable

204 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


13.9.2 Age at First Sex and Condom Use at First Sexual Intercourse

Information from the EDHS can be used to look at several important issues relating to the
initiation of sexual activity among youth including age at first sex and condom use at first sexual
intercourse.

Table 13.16 shows the proportions of women and men in the 15-24 age cohort who had sex
before age 15 and before age 18. Sixteen percent of young women and 2 percent of young men had
sex by age 15 while 35 percent of young women and 9 percent of young men had sex by age 18.

Table 13.16 Age at first sex among youth

Percentage of young women and men age 15-24 who have had sexual intercourse before exact ages 15 and 18, by
background characteristics, Ethiopia 2005

Women Men
Percentage who Percentage who Percentage who Percentage who
have had sexual have had sexual have had sexual have had sexual
intercourse intercourse Number of intercourse intercourse Number of
Background before exact before exact women before exact before exact men
characteristic age 15 age 18 15-24 age 15 age 18 15-24
Age
15-19 11.1 na 3,266 1.7 na 1,335
15-17 9.0 na 1,952 1.4 na 822
18-19 14.2 36.6 1,313 2.1 10.0 513
20-24 21.9 48.6 2,547 1.7 14.1 1,064
20-22 22.0 48.9 1,797 1.5 14.8 740
23-24 21.5 47.9 751 2.2 12.4 324

Marital status
Never married 0.2 1.8 3,165 1.6 6.5 2,081
Married or living together 33.2 74.6 2,284 2.0 30.2 284
Divorced/separated/
widowed 42.5 78.1 363 4.4 (11.9) 35

Knows a condom source1


Yes 9.8 25.3 1,998 2.2 11.6 1,411
No 19.0 40.3 3,815 0.9 6.3 988

Residence
Urban 7.4 20.1 1,242 1.5 9.6 431
Rural 18.1 39.3 4,571 1.7 9.3 1,968

Region
Tigray 20.0 39.7 387 0.0 8.5 145
Affar 13.5 47.4 54 5.5 26.6 18
Amhara 32.0 54.5 1,392 1.4 6.3 614
Oromiya 11.5 31.6 2,131 1.4 9.8 907
Somali 10.6 34.7 155 3.8 10.9 60
Benishangul-Gumuz 22.0 51.2 51 0.9 14.8 18
SNNP 7.1 22.4 1,197 2.2 9.8 491
Gambela 23.5 55.5 17 19.0 51.7 8
Harari 6.2 29.9 17 1.5 15.4 6
Addis Ababa 6.1 16.3 382 2.3 14.0 120
Dire Dawa 7.4 28.2 29 1.6 16.1 12

Education
No education 25.4 52.6 2,841 1.0 9.2 630
Primary 8.3 22.0 1,996 1.9 8.8 1,135
Secondary and higher 3.5 11.5 975 2.0 10.6 634

Wealth quintile
Lowest 20.0 45.2 836 1.3 8.9 425
Second 20.4 44.3 1,045 1.3 8.6 421
Middle 21.2 40.5 1,135 1.8 9.9 391
Fourth 16.3 35.4 1,043 2.9 10.3 493
Highest 7.4 21.4 1,753 1.2 9.2 669

Total 15-24 15.8 35.2 5,813 1.7 9.4 2,399

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


1
Friends, family members, and home are not considered sources for condoms.
na = Not applicable

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 205


Looking at the age patterns for young women, the proportions of young women reporting that
they had sex before age 15 are markedly lower among those under age 18 than among older girls.
Young women age 18-19 were less likely than those age 20-24 to say they had initiated sex before age
18. This likely reflects the effect of rising age at marriage because only very small proportions of
never-married young women report that they had sex by age 15 (0.2 percent) or by age 18 (2 percent).
Other differentials in the indicators for young women reflect the influence of factors that predict
delayed marriage, e.g., young women in urban areas are much less likely to have had sex by age 15 or
by age 18 than young women in rural areas.

Differentials in these indicators for young men tend to be minor. This is at least in part
because the proportions initiating sexual activity at an early age are not large in most subgroups with
the exception of Gambela and to a lesser extent Affar. More than half of young men in Gambela and
more than one-quarter of young men in Affar report that they had sex for the first time before age 18.

To assess the extent of condom use from the beginning of sexual exposure, respondents age
15-24 were asked whether they had used condoms the first time they had sex. Table 13.17 shows that
only 1 percent of young women and 17 percent of young men used condoms during their first sexual
encounter. Never-married women and men were much more likely than ever-married youth to have
used a condom. Higher educational attainment, greater wealth, and urban residence are related to a
greater likelihood that condoms were used the first time a young woman and, particularly, a young
man had sex.

206 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.17 Condom use at first sexual intercourse among youth

Percentage of young women and young men age 15-24 who used a condom the first time they
had sexual intercourse, by background characteristics, Ethiopia 2005

Women Men
Percentage who Number who Percentage who Number who
used a condom have ever had used a condom have ever had
Background at first sexual sexual at first sexual sexual
characteristic intercourse intercourse intercourse intercourse
Age
15-19 0.8 904 23.3 97
15-17 0.0 332 (26.0) 25
18-19 1.2 572 22.4 72
20-24 1.1 1,850 15.6 469
20-22 0.5 1,285 17.8 269
23-24 2.4 565 12.8 201

Marital status
Never married 10.0 136 31.9 257
Married or living together 0.6 2,276 4.9 280
Divorced/separated/
widowed 0.1 342 (0.5) 29

Knows a condom source1


Yes 3.2 744 22.0 385
No 0.2 2,009 6.2 182

Residence
Urban 5.7 393 48.0 117
Rural 0.2 2,361 8.8 449

Region
Tigray 0.6 196 (30.0) 34
Affar 3.7 34 (10.3) 9
Amhara 0.2 864 12.0 142
Oromiya 1.2 967 17.5 215
Somali 0.0 77 * 11
Benishangul-Gumuz 0.6 34 (14.0) 5
SNNP 1.0 441 9.8 98
Gambela 0.5 12 13.8 5
Harari 8.5 8 20.2 2
Addis Ababa 6.0 108 41.3 41
Dire Dawa 4.0 12 (49.5) 3

Education
No education 0.2 1,916 4.6 193
Primary 1.4 602 16.1 218
Secondary and higher 7.0 235 33.4 156

Wealth quintile
Lowest 0.2 484 8.8 93
Second 0.3 604 5.1 87
Middle 0.0 587 8.9 117
Fourth 0.3 483 6.8 98
Highest 4.0 595 38.7 171

Total 15-24 1.0 2,754 16.9 566

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a
figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Friends, family members, and home are not considered sources for condoms.

13.9.3 Recent Sexual Activity

The period between age at first sex and age at marriage is often a time of sexual
experimentation. Unfortunately, in the era of HIV/AIDS, it can also be a risky time. Table 13.18
presents data on the percentage of never-married young women and men age 15-24 who have not yet
engaged in sex, the percentage who had sex in the 12 months preceding the survey, and the percentage
who used condoms during most recent sex.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 207


Table 13.18 Premarital sexual intercourse and condom use among youth

Among never-married women and men age 15-24, the percentage who have never had sexual intercourse, the percentage
who have had sexual intercourse in the past 12 months, and, among those who have had sexual intercourse in the past 12
months, the percentage who used a condom at last sexual intercourse, by background characteristics, Ethiopia 2005

Women Men
Percentage Percentage Percentage
who have Number who have Number who used
Percentage had sexual of never- Percentage had sexual of never- a condom
who never intercourse married who never intercourse married at last Number
had sexual in the past women had sexual in the past men sexual of
Background characteristic intercourse 12 months 15-24 intercourse 12 months 15-24 intercourse men
Age
15-19 97.5 1.0 2,394 94.6 3.9 1,304 44.8 51
15-17 98.7 0.5 1,622 97.2 2.0 817 (28.7) 16
18-19 94.8 2.2 773 90.2 7.2 487 52.2 35
20-24 90.3 3.1 771 75.9 13.4 777 51.8 104
20-22 91.9 2.6 555 80.3 11.5 584 54.2 67
23-24 86.1 4.3 216 62.9 19.0 194 47.5 37
Knows a condom source1
Yes 93.2 2.6 1,335 82.6 10.8 1,231 57.8 133
No 97.5 0.8 1,831 94.9 2.6 850 (0.0) 22
Residence
Urban 90.5 3.3 938 76.5 15.2 410 84.5 62
Rural 97.9 0.8 2,228 90.4 5.6 1,672 26.1 93
Region
Tigray 95.5 1.3 200 84.3 11.8 132 * 16
Affar 94.4 2.6 21 65.3 30.1 15 * 5
Amhara 95.9 0.9 523 93.2 3.4 497 * 17
Oromiya 96.0 2.1 1,210 85.7 9.0 807 (38.9) 73
Somali 100.0 0.0 77 92.8 5.4 52 * 3
Benishangul-Gumuz 95.6 1.1 19 91.3 7.3 14 * 1
SNNP 98.7 0.5 765 92.4 3.6 425 36.1 15
Gambela 84.5 7.3 7 49.9 37.1 6 (43.8) 2
Harari 91.8 3.2 10 76.2 17.1 4 * 1
Addis Ababa 87.0 3.0 314 67.3 18.3 116 75.9 21
Dire Dawa 89.1 2.9 19 75.8 16.6 11 * 2
Education
No education 96.9 1.0 939 91.8 4.2 472 (17.1) 20
Primary 96.3 1.2 1,434 90.7 5.4 1,007 42.1 54
Secondary and higher 93.2 2.8 792 79.3 13.5 602 62.4 81
Wealth quintile
Lowest 98.3 1.3 354 93.3 3.5 354 (22.6) 12
Second 98.5 1.2 443 91.4 5.3 363 * 19
Middle 98.2 0.6 552 88.5 7.2 310 * 22
Fourth 97.6 0.4 562 89.9 6.3 437 * 28
Highest 92.1 2.6 1,254 80.1 11.9 617 77.2 74

Total 15-24 95.7 1.5 3,165 87.6 7.5 2,081 49.5 155

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer
than 25 unweighted cases and has been suppressed.
1
Friends, family members, and home are not considered sources for condoms.

The great majority of never-married young women (96 percent) and men (88 percent)
reported that they had never had sex, and, as a result, the proportions reporting recent sexual activity
(i.e., within the 12-month period before the survey) are low (2 percent among young women and 8
percent among young men). Half of never-married young men reporting recent sexual activity used a
condom the last time they had sex compared with around one-third of young women (data not shown).

Given the comparatively small proportion of never-married young women reporting


premarital sexual intercourse, differentials in this indicator are generally minimal. Among never-
married young men, the proportion reporting premarital sexual activity tends to increase with age,
education, and wealth, and is higher among urban than rural residents. Looking at regional variations,
Gambela and Affar have the highest proportions of never-married young men reporting premarital
sex.

208 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


13.9.4 Higher-Risk Sex

The most common mode of transmission of HIV in Ethiopia is through unprotected sex with
an infected person. To prevent HIV/AIDS transmission, it is important that young people practice safe
sex through the much-advocated ABC method (abstinence, being faithful to one uninfected partner,
and condom use). Table 13.19 presents data on the percentage of young people engaging in higher-
risk sex (sex with a nonmarital, noncohabiting partner) in the 12-month period preceding the survey,
and the rate of condom use in these higher-risk sexual encounters. Among sexually active youth age
15-24, 6 percent of women and 37 percent of men engaged in higher-risk sexual activity in the past 12
months. One-quarter of these women and just under half of these men reported condom use in their
last higher-risk encounter (data not shown).

Table 13.19 Higher-risk sexual intercourse among youth


Among young women and men age 15-24 who had sexual intercourse in the past 12 months,
the percentage who had higher-risk sexual intercourse, and among those who had higher-risk
sexual intercourse in the past 12 months, the percentage who used a condom at last higher-
risk sexual intercourse, by background characteristics, Ethiopia 2005

Women Men
Number of
Percentage women Percentage Number of
who had sexually who had women
higher-risk active higher-risk sex sexually
Background sex in past in past in past active in past
characteristic 12 months 12 months 12 months 12 months
Age
15-19 7.2 411 68.0 78
15-17 5.6 145 96.6 18
18-19 8.0 267 59.2 59
20-24 5.1 800 31.0 368
20-22 5.1 518 33.4 214
23-24 5.2 282 27.7 155
Marital status
Never married 99.6 48 98.7 155
Married or living together 1.1 1,099 3.8 278
Divorced/separated/
widowed 16.5 65 24.8 13
Knows a condom source1
Yes 12.8 378 47.7 295
No 2.7 834 17.3 151
Residence
Urban 26.4 154 76.8 83
Rural 2.9 1,058 28.5 363
Region
Tigray 7.7 94 61.3 28
Affar 4.5 14 60.3 8
Amhara 4.0 375 15.3 113
Oromiya 6.9 430 42.6 170
Somali 0.0 32 29.1 10
Benishangul-Gumuz 3.4 16 21.5 5
SNNP 2.4 209 29.3 80
Gambela 8.0 4 68.0 4
Harari 7.5 4 39.1 2
Addis Ababa 39.8 28 92.0 24
Dire Dawa 15.1 4 76.2 2
Education
No education 2.7 823 14.9 160
Primary 7.2 280 34.6 175
Secondary and higher 25.7 109 73.9 112
Wealth quintile
Lowest 2.2 234 22.3 77
Second 4.1 269 28.1 73
Middle 2.3 265 24.1 102
Fourth 3.9 200 38.3 78
Highest 16.7 243 64.5 116
Total 15-24 5.8 1,212 37.4 446
1
Friends, family members, and home are not considered sources for condoms.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 209


Among young women and men, there are significant differences in the prevalence of higher-
risk sex by background characteristics. Youth with a secondary or higher education are much more
likely than those with less schooling to have engaged in higher-risk sex, and higher-risk sexual
activity, particularly among young women, is concentrated among those in the highest wealth quintile.
Urban youth are considerably more likely than rural youth to have engaged in risky sexual behaviour.
Addis Ababa and Dire Dawa stand out as regions with the highest proportions of youth reporting that
they have engaged in higher-risk sex.

13.9.5 Age-Mixing in Sexual Relationships

In many societies, young women have sexual relationships with men who are considerably
older than they are. This practice can contribute to the wider spread of HIV and other STIs because if
a younger, uninfected partner has sex with an older, infected partner, the younger, uninfected partner
can contract the virus. To investigate this practice, in the 2005 EDHS women age 15-24 who had sex
with a nonmarital, noncohabiting partner in the 12 months preceding the survey were asked whether
the man was younger, about the same age, or older than they were. If older, they were asked if they
thought he was less than ten years older or ten or more years older. Less than 1 percent of the small
number of young women who had engaged in higher-risk sex in the 12-month period prior to the
survey reported that they had had intercourse with a man who was ten or more years older (not shown
in table).

13.9.6 Drunkenness during Sexual Intercourse

Sexual intercourse when one or both partners are under the influence of alcohol is more likely
to be unplanned than otherwise, and the partners are less likely to use condoms. Respondents who had
had sex during the preceding 12 months were asked if they or their partner drank alcohol the last time
they had sex, and if so, whether they or their partner were drunk. Table 13.20 shows the prevalence of
sexual intercourse while drunk. The overall prevalence of sex when the respondent or partner is drunk
is low, especially for young women (3 percent for women and 2 percent for men). Given the rarity of
the phenomenon, differences across groups are minimal.

210 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


Table 13.20 Drunkenness during sexual intercourse among youth

Percentage of young women and men age 15-24 who had sexual intercourse in the past
12 months while being drunk, by background characteristics, Ethiopia 2005

Women Men
Number who Number who
had sexual had sexual
Respondent intercourse Respondent intercourse
Background and/or in past and/or in past
characteristic partner drunk 12 months partner drunk 12 months
Age
15-19 2.9 411 1.9 78
15-17 0.1 145 0.6 18
18-19 4.5 267 2.3 59
20-24 3.3 800 2.3 368
20-22 4.5 518 3.1 214
23-24 1.1 282 1.3 155

Marital status
Never married 7.6 48 4.8 155
Married or living together 2.9 1,099 0.9 278
Divorced/separated/
widowed 5.6 65 0.0 13

Knows a condom source1


Yes 4.3 378 2.6 295
No 2.7 834 1.6 151

Residence
Urban 6.3 154 2.5 83
Rural 2.7 1,058 2.2 363

Region
Tigray 0.0 94 2.8 28
Affar 2.3 14 4.6 8
Amhara 1.6 375 1.1 113
Oromiya 5.1 430 2.0 170
Somali 0.0 32 0.0 10
Benishangul-Gumuz 0.9 16 0.0 5
SNNP 3.9 209 3.0 80
Gambela 6.4 4 1.5 4
Harari 0.0 4 0.0 2
Addis Ababa 6.2 28 6.6 24
Dire Dawa 4.1 4 7.1 2

Education
No education 2.7 823 1.6 160
Primary 4.5 280 2.2 175
Secondary and higher 3.4 109 3.3 112

Wealth quintile
Lowest 1.6 234 1.8 77
Second 4.5 269 0.0 73
Middle 1.3 265 3.5 102
Fourth 3.0 200 2.4 78
Highest 5.5 243 2.8 116

Total 15-24 3.2 1,212 2.3 446


1
Friends, family members, and home are not considered sources for condoms.

HIV/AIDS-Related Knowledge, Attitudes, and Behavior | 211


13.9.7 HIV Testing

Young people may believe there are barriers to accessing and using many health services and
facilities, particularly for sensitive concerns relating to sexual health, such as sexually transmitted
infections like HIV/AIDS. Table 13.21 presents data on the percentage of sexually active youth being
tested and receiving the results within the past year. Young men are about three times as likely as
young women to have been tested for HIV (6 percent and 2 percent, respectively). Given the generally
low level of testing, differences across groups should be interpreted cautiously. However, there is a
clear tendency for testing rates to be higher among urban youth, youth with a secondary or higher
education, youth in the highest wealth quintile, and youth living in Addis Ababa.

Table 13.21 Recent HIV tests among youth

Among young women and men age 15-24 who have had sexual intercourse in the past 12
months, the percentage who have had an HIV test in the past 12 months and received the
results of the test, by background characteristics, Ethiopia 2005

Women Men
Percentage who Percentage who
have been tested have been tested
for HIV and for HIV and
received results received results
Background in past Number of in past Number of
characteristic 12 months women 12 months men
Age
15-19 1.8 411 8.3 78
15-17 1.1 145 (0.3) 18
18-19 2.2 267 10.8 59
20-24 1.9 800 5.6 368
20-22 2.3 518 5.7 214
23-24 1.1 282 5.5 155

Knows a condom source1


Yes 4.2 378 6.6 295
No 0.8 834 5.2 151

Residence
Urban 8.1 154 15.2 83
Rural 1.0 1,058 4.0 363

Region
Tigray 1.2 94 (6.6) 28
Affar 0.0 14 (3.7) 8
Amhara 1.6 375 7.6 113
Oromiya 0.6 430 3.2 170
Somali 0.0 32 * 10
Benishangul-Gumuz 1.0 16 (2.9) 5
SNNP 3.2 209 (5.1) 80
Gambela 1.4 4 3.2 4
Harari 7.0 4 5.3 2
Addis Ababa 18.9 28 25.4 24
Dire Dawa 7.4 4 (13.9) 2

Education
No education 0.4 823 6.6 160
Primary 3.0 280 1.2 175
Secondary and higher 9.8 109 13.0 112

Wealth quintile
Lowest 0.0 234 0.1 77
Second 0.6 269 2.0 73
Middle 0.9 265 3.6 102
Fourth 1.7 200 4.7 78
Highest 6.3 243 15.8 116

Total 1.9 1,212 6.1 446

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that
a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Friends, family members, and home are not considered sources for condoms.

212 | HIV/AIDS-Related Knowledge, Attitudes, and Behavior


HIV PREVALENCE AND ASSOCIATED FACTORS 14
The 2005 EDHS is the first national survey in Ethiopia to include HIV testing. In Ethiopia, as
in most of sub-Saharan Africa, national HIV prevalence estimates have been derived primarily from
sentinel surveillance regarding pregnant women attending antenatal care facilities. Although the
information from the ANC surveillance system has been very useful for assessing HIV levels, and
especially for monitoring trends in HIV prevalence, the inclusion of HIV testing in the 2005 EDHS
offers the opportunity to obtain information on the magnitude and patterns of HIV infection in the
general reproductive age population in Ethiopia. Thus, the HIV prevalence data from the EDHS are
expected to provide important information to plan the national response to the AIDS epidemic in
Ethiopia.

This chapter first presents information on the coverage of HIV testing among eligible survey
respondents and then discusses levels and differentials in HIV prevalence among those tested. The
chapter also considers the similarities and differences between the 2005 EDHS HIV findings and HIV
estimates from other data sources, specifically the HIV results from the 2005 round of antenatal
sentinel surveillance. Lastly, it discusses the effect of nonresponse on HIV rates.

14.1 COVERAGE OF HIV TESTING IN THE EDHS

All women age 15-49 and all men age 15-59 living in the households that were chosen for the
male survey (i.e., half of all households sampled for the 2005 EDHS) were eligible for the HIV testing
component of the EDHS.1 Table 14.1 shows the coverage rates for HIV testing among eligible
respondents by reason for not being tested, according to gender and residence. HIV tests were
conducted for 83 percent of the 7,142 eligible women and 76 percent of the 6,778 eligible men. For
both sexes combined, coverage was 80 percent. Refusals were the most important reason for non-
response on the HIV testing component of the survey for both women (13 percent) and men (17
percent).

Rural residents were more likely to be tested than their urban counterparts (85 percent and 67
percent, respectively). Differences in HIV testing coverage rates are also evident by region. Among
both sexes, SNNP had the highest rate of testing (90 percent), followed by Tigray and Oromiya (87
percent), while the rates were lowest in Dire Dawa (60 percent) and the Somali Region (65 percent).

Table 14.2 shows coverage rates for HIV testing by age group, education, and wealth. If HIV
status influenced participation in the testing, coverage would be expected to decline with age since
HIV levels typically increase sharply with age before levelling off or declining at the older ages. In
fact, coverage rates for testing in the EDHS tend to rise with age, although not consistently, among
women and men. Considering the relationship with education, those with little or no education are
more likely to have been tested, while men and women with at least some secondary education were
least likely to be tested. Similarly, those in the highest quintile of the wealth index were the least
likely to be tested.

In order to further explore whether nonresponse might have an impact on the HIV
seroprevalence results, tables describing the relationship between participation in the HIV testing and
a number of other characteristics related to HIV risk were also examined (see Tables A.3-A.6 in
Appendix A). These tables show that nonresponse levels tend to increase, although often not

1
For additional information on the HIV testing component of the 2005 EDHS, see Chapter 1.

HIV Prevalence and Associated Factors | 213


markedly, with a number of characteristics associated with a higher risk for HIV. For example,
coverage rates among women and, especially, men are lower among those who have ever been
sexually active than among those who have never had sex, and lower among those reporting that they
had higher-risk sexual intercourse in the 12-month period before the survey than those who did not
engage in higher-risk sex.

Table 14.1 HIV testing coverage by residence and region

Percent distribution of women age 15-49 and men age 15-59 eligible for HIV testing by testing status, according to residence and region
u
( nweighted), Ethiopia 2005

Tested Refused Absent/other/missing


Background Not Not Not Unweighted
characteristic Interviewed interviewed Interviewed interviewed Interviewed interviewed Total number
WOMEN 15-49

Residence
Urban 72.7 0.1 18.8 3.7 1.3 3.3 100.0 2,239
Rural 88.0 0.2 7.8 1.6 0.8 1.8 100.0 4,903
Region
Tigray 90.2 0.0 6.1 0.2 1.3 2.2 100.0 625
Affar 72.8 0.7 20.5 3.0 1.5 1.5 100.0 405
Amhara 87.7 0.1 9.4 0.7 0.7 1.3 100.0 937
Oromiya 87.6 0.3 7.4 1.8 0.5 2.4 100.0 1,101
Somali 71.3 0.3 20.2 5.2 0.6 2.5 100.0 362
Benishangul-Gumuz 89.2 0.0 6.4 1.6 1.4 1.4 100.0 436
SNNP 93.2 0.1 3.9 0.8 0.9 1.0 100.0 1,070
Gambela 82.8 0.2 8.0 4.6 1.5 2.9 100.0 413
Harari 73.6 0.0 17.9 4.5 1.3 2.8 100.0 469
Addis Ababa 73.8 0.1 17.4 3.6 0.9 4.2 100.0 912
Dire Dawa 70.9 0.0 22.6 2.4 0.7 3.4 100.0 412

Total 83.2 0.2 11.2 2.2 1.0 2.3 100.0 7,142

MEN 15-59

Residence
Urban 59.5 0.1 22.6 6.7 1.4 9.7 100.0 1,948
Rural 81.8 0.2 8.6 3.6 0.8 5.0 100.0 4,830
Region
Tigray 84.2 0.0 5.5 2.7 1.2 6.4 100.0 563
Affar 60.2 0.3 20.2 8.0 0.8 10.6 100.0 387
Amhara 84.9 0.2 7.8 2.8 0.8 3.4 100.0 959
Oromiya 85.2 0.1 6.7 3.2 0.6 4.3 100.0 1,126
Somali 57.4 0.6 26.2 8.3 0.0 7.4 100.0 336
Benishangul-Gumuz 82.4 0.0 11.7 2.5 0.7 2.7 100.0 403
SNNP 86.0 0.2 5.1 3.5 0.9 4.3 100.0 956
Gambela 74.4 0.3 9.5 6.3 1.3 8.3 100.0 398
Harari 66.2 0.2 17.0 5.9 1.7 9.0 100.0 423
Addis Ababa 62.2 0.0 20.0 6.2 1.4 10.1 100.0 834
Dire Dawa 47.3 0.3 34.6 6.1 2.0 9.7 100.0 393

Total 75.4 0.2 12.6 4.5 1.0 6.3 100.0 6,778

TOTAL 15-49

Residence
Urban 66.9 0.1 20.4 5.0 1.4 6.2 100.0 4,054
Rural 84.9 0.2 8.2 2.6 0.8 3.4 100.0 9,263
Region
Tigray 87.4 0.0 5.8 1.4 1.3 4.2 100.0 1,107
Affar 66.9 0.5 19.8 5.7 1.1 6.1 100.0 758
Amhara 86.1 0.2 8.7 1.8 0.8 2.5 100.0 1,791
Oromiya 86.3 0.2 7.0 2.4 0.6 3.5 100.0 2,134
Somali 64.4 0.5 23.3 6.8 0.3 4.8 100.0 665
Benishangul-Gumuz 86.3 0.0 8.8 2.0 0.9 2.0 100.0 804
SNNP 89.8 0.2 4.5 2.1 0.9 2.6 100.0 1,952
Gambela 79.2 0.3 8.7 5.4 1.4 5.1 100.0 783
Harari 70.3 0.1 17.8 5.1 1.3 5.4 100.0 864
Addis Ababa 68.3 0.1 18.4 4.9 1.2 7.1 100.0 1,681
Dire Dawa 59.8 0.1 28.1 4.1 1.3 6.6 100.0 778

Total 79.4 0.2 11.9 3.3 1.0 4.3 100.0 13,317

214 | HIV Prevalence and Associated Factors


Table 14.2 HIV testing coverage by background characteristics

Percent distribution of women age 15-49 and men age 15-59 eligible for HIV testing by testing status, according to background
characteristics (unweighted), Ethiopia 2005
Tested Refused Absent/other/missing
Background Not Not Not Unweighted
characteristic Interviewed interviewed Interviewed interviewed Interviewed interviewed Total number
WOMEN 15-49

Age
15-19 81.8 0.5 10.4 2.8 1.2 3.3 100.0 1,718
20-24 81.5 0.1 12.6 2.8 1.0 2.1 100.0 1,329
25-29 84.1 0.1 10.8 1.8 0.7 2.5 100.0 1,311
30-34 85.2 0.0 10.8 1.4 1.1 1.5 100.0 853
35-39 82.7 0.0 12.2 2.2 0.7 2.2 100.0 821
40-44 85.7 0.0 10.3 2.2 0.5 1.3 100.0 602
45-49 84.4 0.2 12.0 1.2 1.4 0.8 100.0 508
Education
No education 85.4 0.2 9.6 2.0 0.9 1.9 100.0 4,251
Primary 84.6 0.2 9.7 2.0 1.0 2.6 100.0 1,563
Secondary and higher 74.5 0.0 18.1 3.2 1.1 3.0 100.0 1,328
Wealth quintile
Lowest 83.1 0.2 10.7 2.9 1.0 2.2 100.0 1,473
Second 88.0 0.2 8.2 1.1 0.5 2.0 100.0 1,070
Middle 92.1 0.1 4.6 0.6 1.2 1.4 100.0 1,006
Fourth 90.8 0.3 5.5 1.3 0.8 1.2 100.0 968
Highest 75.0 0.1 17.4 3.2 1.1 3.1 100.0 2,625

Total 83.2 0.2 11.2 2.2 1.0 2.3 100.0 7,142

MEN 15-59

Age
15-19 74.1 0.1 12.5 4.9 1.1 7.2 100.0 1,457
20-24 75.1 0.0 11.6 5.2 0.9 7.1 100.0 1,185
25-29 73.7 0.4 12.4 4.7 1.0 7.8 100.0 953
30-34 75.6 0.1 13.7 3.7 1.0 5.9 100.0 841
35-39 74.9 0.3 14.1 4.4 0.7 5.7 100.0 725
40-44 75.3 0.0 13.8 4.9 0.9 5.1 100.0 551
45-49 78.8 0.4 11.0 3.9 0.9 5.0 100.0 463
50-54 78.6 0.0 12.3 3.3 1.9 3.8 100.0 365
55-59 79.8 0.0 12.2 2.9 1.3 3.8 100.0 238
Education
No education 77.0 0.3 10.6 5.2 1.1 5.9 100.0 2,745
Primary 81.6 0.1 9.9 2.8 0.7 4.9 100.0 2,111
Secondary and higher 66.3 0.1 18.6 5.4 1.3 8.4 100.0 1,919
Wealth quintile
Lowest 75.1 0.2 12.1 4.9 0.9 6.7 100.0 1,377
Second 84.5 0.1 6.8 3.3 1.1 4.1 100.0 1,016
Middle 85.5 0.3 5.4 3.6 0.9 4.3 100.0 957
Fourth 82.7 0.2 8.7 3.1 0.7 4.6 100.0 994
Highest 64.7 0.1 19.8 5.7 1.2 8.5 100.0 2,434

Total 75.4 0.2 12.6 4.5 1.0 6.3 100.0 6,778

Note:Total for men includes 3 cases with missing information on education, who are not shown separately

HIV Prevalence and Associated Factors | 215


14.2 HIV PREVALENCE

Results from the 2005 EDHS indicate that 1.4 percent of Ethiopian adults age 15-49 are
infected with HIV (Figure 14.1). HIV prevalence in women is nearly 2 percent, while for men 15-49,
it is just under 1 percent. The female-to-male infection ratio of 2.1 is higher than what has been
previously assumed in the Ethiopian situation. However, it is consistent with female-to-male HIV
infection ratios observed in a number of other countries in sub-Saharan Africa: Senegal – ratio of 2.3
(Ministry of Health, 2005), Guinea – ratio of 2.1 (National Directorate of Statistics, 2005), and
Kenya - ratio of 1.9 (Central Bureau of Statistics, 2004).

Gender differences in infection levels reflect the fact that biological factors make women
more susceptible to the risk of infection. They also relate to the fact that women both initiate sexual
activity and marry at a much younger age than men (see Chapter 6). Also, their husbands (partners)
tend to be older than them.

Figure 14.1 HIV Prevalence among Women and Men


Age 15-49
Percentage HIV positive
2.5

2 1.9

1.5 1.4

1 0.9

0.5

0
Women Men Total

EDHS 2005

14.2.1 HIV Prevalence by Age

Table 14.3 shows for both men and women that HIV prevalence levels rise with age, peaking
among women in their late 30s and among men in their early 40s. The age patterns suggest that young
women are particularly vulnerable to HIV infection compared with young men. Among women age
15-19, for example, 0.7 percent are HIV infected, compared with 0.1 percent of men age 15-19. HIV
prevalence among women 20-24 is over three times that of men in the same age group (1.7 percent
and 0.4 percent, respectively).

216 | HIV Prevalence and Associated Factors


Table 14.3 HIV prevalence by age

Percentage HIV positive among women age 15-49 and men age 15-59 who were tested, by age,
Ethiopia 2005

Women 15-49 Men 15-59 Total 15-49


Percentage Percentage Percentage
Age HIV positive Number HIV positive Number HIV positive Number
15-19 0.7 1,397 0.1 1,175 0.4 2,572
20-24 1.7 1,025 0.4 929 1.1 1,954
25-29 2.1 1,004 0.7 640 1.6 1,645
30-34 1.5 734 1.9 664 1.7 1,398
35-39 4.4 650 1.8 581 3.2 1,231
40-44 3.1 487 2.8 438 3.0 925
45-49 0.8 439 0.0 376 0.5 815
50-54 na na 0.9 293 na na
55-59 na na 0.3 208 na na

Total age 15-49 1.9 5,736 0.9 4,804 1.4 10,540

Total age 15-59 na na 0.9 5,306 na na

na =
Not applicable

14.2.2 HIV Prevalence by Socioeconomic Characteristics

As Table 14.4 shows, urban residents have a significantly higher risk of HIV infection (6
percent) than rural residents (0.7 percent). The risk of HIV infection among rural women and men is
almost identical, while urban women are more than three times as likely as urban men to be infected.

Regional variations in HIV prevalence are also presented in Table 14.4. Prevalence levels are
highest in Gambela (6 percent) and Addis Ababa (5 percent). Other regions in which HIV prevalence
exceeds the national average include Harari, Dire Dawa, Afar, Tigray, and Amhara. Somewhat
surprisingly, SNNP Region has the lowest overall prevalence (0.2 percent). The regional variations
are discussed further below when the 2005 EDHS results are compared with the results of the ANC
surveillance system. In addition, the regional patterns, particularly the unexpectedly low prevalence
rate in the SNNP Region, merit further investigation, including additional future surveys taking into
account both information on regional differences in patterns of risk behaviour available in the 2005
EDHS and data from other sources.

HIV infection levels increase directly with education among both women and men and are
markedly higher among those who have a secondary or higher education compared with those with
less education. Employment (in the past 12 months) is also related to HIV levels among both women
and men, with those who are employed being more likely than the unemployed to be infected.
Particularly among men, those who were unemployed during the 12-month period prior to the survey
are heavily concentrated in the younger age groups where HIV levels are quite low. This helps to
explain why none of the men in this category were HIV positive.

Both women and men in the highest quintile of the wealth index have substantially higher
rates of HIV infection than those in other wealth quintiles.

HIV Prevalence and Associated Factors | 217


Table 14.4 HIV prevalence by socioeconomic characteristics

Percentage HIV positive among women and men age 15-49 who were tested, by socioeconomic
characteristics, Ethiopia 2005

Women Men
Background Percentage Percentage
characteristic HIV positive Number HIV positive Number Total Number
Residence
Urban 7.7 980 2.4 684 5.5 1,664
Rural 0.6 4,756 0.7 4,120 0.7 8,875
Region
Tigray 2.6 387 1.6 274 2.1 661
Affar 3.3 61 2.4 46 2.9 107
Amhara 1.8 1,411 1.6 1,212 1.7 2,623
Oromiya 2.2 2,000 0.4 1,812 1.4 3,812
Somali 1.3 189 0.0 140 0.7 328
Benishangul-Gumuz 0.9 55 0.0 45 0.5 100
SNNP 0.1 1,290 0.4 1,010 0.2 2,300
Gambela 5.5 19 6.7 16 6.0 35
Harari 4.6 16 2.2 13 3.5 29
Addis Ababa 6.1 280 3.0 214 4.7 495
Dire Dawa 4.4 28 1.9 22 3.2 50
Education
No education 1.0 3,745 0.8 1,920 0.9 5,665
Primary 2.5 1,349 0.5 1,912 1.3 3,260
Secondary and higher 5.5 642 2.0 972 3.4 1,614
Employment1
Not currently working 1.5 3,423 0.0 609 1.3 4,032
Currently working 2.3 1,981 1.1 4,187 1.5 6,168
Wealth quintile
Lowest 0.3 1,053 0.7 863 0.5 1,916
Second 1.0 1,108 0.3 949 0.7 2,057
Middle 0.4 1,107 0.9 898 0.6 2,006
Fourth 0.2 1,073 0.4 951 0.3 2,023
Highest 6.1 1,395 2.2 1,143 4.3 2,538

Total 1.9 5,736 0.9 4,804 1.4 10,540

Note:Total excludes numbers missing information on employment status and not shown separately.
1
Employed at any time in the 12 months preceding the survey

14.2.3 HIV Prevalence by Other Sociodemographic Characteristics

Table 14.5 presents the relationships between HIV prevalence and a number of other socio-
demographic variables. As expected, marital status is closely related to HIV prevalence. Women and
men who are widowed, divorced, or separated have significantly higher rates than those who are
married or living together. HIV rates are lowest for respondents who have never been in union.
However, within the latter group, the small number of women who are sexually active but have never
been in a marital union, have an HIV prevalence rate of 9 percent, higher than the levels found among
widowed or divorced and separated women. Among never-married men who have ever had sex, the
HIV rate approaches but is lower than the level among men who are currently married or living with a
partner. Finally, a small proportion of individuals who say they have never had sex are HIV positive.
This suggests either reporting errors in sexual behaviour or non-sexual transmission of HIV.

Considering the type of current union, HIV rates do not differ between those in a polygynous
union and those who are not.

218 | HIV Prevalence and Associated Factors


Table 14.5 looks at how HIV rates relate to two measures of male mobility. The results
indicate that the number of times a man slept away from home is more closely associated with HIV
prevalence than is the total amount of time that a man spent away. The HIV rate is 3 percent among
men who slept away six or more times in the 12-month period prior to the survey compared with less
than 1 percent among men who never slept away and men who slept away fewer than six times.

Table 14.5 HIV prevalence by demographic characteristics

Percentage HIV positive among women and men age 15-49 who were tested, by demographic characteristics,
Ethiopia 2005

Women Men Total


Demographic Percentage Percentage Percentage
characteristic HIV positive Number HIV positive Number HIV positive Number
Marital status
Never married 0.7 1,449 0.3 2,084 0.5 3,532
Ever had sexual intercourse 9.3 92 1.0 330 2.8 422
Never had sexual intercourse 0.1 1,356 0.2 1,754 0.1 3,110
Married/living together 1.6 3,685 1.3 2,583 1.5 6,268
Divorced or separated 8.1 206 * 16 8.4 222
Widowed 5.6 396 1.9 121 4.7 517
Type of union
In polygynous union 1
( .5) 455 1.3 152 1.4 607
Not in polygynous union 1.5 3,194 1.3 2,431 1.4 5,624
Missing polygyny, don’t know 7
( .6) 36 na 0 7
( .6) 36
Not currently in union 2.4 2,051 0.5 2,221 1.4 4,272
Times slept away from home
in past 12 months
0 na na 0.8 3,389 na na
1-2 na na 0.9 821 na na
3-5 na na 0.4 332 na na
6+ na na 3.1 259 na na
Time away in past 12 months
More than 1 month na na 0.8 289 na na
Less than 1 month na na 1.3 1,110 na na
Never away na na 0.8 3,389 na na
Missing na na * 16 na na
Currently pregnant
Yes 1.1 480 na na na na
Not pregnant/not sure 1.9 5,256 na na na na
Antenatal care for births in
past 3 years
No birth 2.0 3,308 na na na na
Birth and ANC by health
professional 3.5 702 na na na na
Birth and no ANC by health
professional 1.0 1,726 na na na na
Delivery care for births in
past 3 years
No birth 2.0 3,308 na na na na
Birth and delivery care by
health professional 9.9 143 na na na na
Birth and no delivery care by
health professional 1.2 2,285 na na na na

Total 1.9 5,736 0.9 4,804 1.4 10,540

Note:Figures in parentheses are based on 25-49 unwei ghted cases. An asterisk indicates that a figure is based on
fewer than 25 unweighted cases and has been suppressed.
na =
Not applicable

HIV Prevalence and Associated Factors | 219


HIV prevalence among women who are currently pregnant is 1 percent, roughly half the level
found among nonpregnant women. This is a somewhat unexpected pattern since, as discussed in the
introduction to this chapter, pregnant women are generally assumed to have a higher risk of HIV
infection than nonpregnant women. It may be related to the fact that fertility is much lower among
urban women than rural women and, thus, the currently pregnant population is likely to be
disproportionately rural and, thus, less exposed to the risk of infection.

Finally, HIV rates are markedly higher among women who received antenatal care at a health
facility and especially among the comparatively few women who received delivery care from a health
professional for births that occurred in the three-year period prior to the survey (4 percent and 10
percent, respectively). Again these relationships are likely related to the fact that women who receive
antenatal and delivery care are much more likely than other women to live in urban areas, be highly
educated, and fall into the highest wealth quintile. All of these latter factors are associated with much
higher than average risk of HIV infection.

14.2.4 HIV Prevalence by Sexual Risk Behaviour

Table 14.6 presents HIV prevalence rates by sexual behaviour indicators among respondents
who have ever had sexual intercourse. In reviewing these results, it is important to remember that
responses about sexual risk behaviours may be subject to reporting bias. Also, sexual behaviour in the
12 months preceding the survey may not adequately reflect lifetime sexual risk.

For women, there is a clear pattern of higher HIV prevalence with sexual debut at ages 16-19
while the age at which men initiated sex appears to be unrelated to their HIV status. The pattern
among women is somewhat unexpected in view of the assumption that early sexual debut would be
associated with a longer average period of sexual activity and thus, greater exposure to the
transmission of the HIV virus. It may reflect the fact that individuals initiating sex at very young ages
are concentrated in groups with lower HIV prevalence (e.g., they live in rural areas or are less
educated).

EDHS respondents are considered to have had a higher-risk sexual encounter if they had
intercourse with a nonmarital, noncohabiting partner. Table 14.6 shows that both women and men
who had a higher-risk sexual partner in the 12-month period before the survey are more likely to be
HIV-infected than those who were sexually active but did not have sex with a higher-risk partner. The
differential is especially large for women, with the small number of women who report having a
higher-risk sexual encounter being seven times as likely to be HIV positive as women who had sex
but not with a higher-risk partner, and more than two times as likely to be HIV positive as women
who did not have sex during the 12-month period. In turn, the comparatively high prevalence among
the latter group of women is probably because many are widowed or divorced or separated women
who, as was shown earlier, have much higher than average risk of HIV infection.

HIV risk is also assumed to increase with the number of lifetime sexual partners that an
individual has. The results in Table 14.6 suggest that HIV risk does not rise directly with the number
of sexual partners but that having a large number of partners (five or more for women and ten or more
for men) is associated with significantly higher rates of HIV infection.

220 | HIV Prevalence and Associated Factors


Table 14.6 HIV prevalence by sexual behaviour

Percentage HIV positive among women and men age 15-49 who ever had sexual intercourse and were tested, by
sexual behaviour characteristics, Ethiopia 2005

Women Men Total


Sexual behaviour Percentage Percentage Percentage
characteristic HIV positive Number HIV positive Number HIV positive Number
Age at first sexual intercourse
15 or less 2.2 2,146 0.5 234 2.0 2,379
16-17 3.5 840 2.2 399 3.1 1,238
18-19 2.7 609 1.3 704 2.0 1,313
20+ 2.2 542 1.3 1,661 1.5 2,202
Non-numeric 0.0 228 4.3 46 0.7 274
Higher-risk intercourse in past
12 months1
Had higher risk sexual intercourse 12.3 106 1.8 218 5.2 324
Had sexual intercourse, not higher
risk 1.6 3,618 1.3 2,557 1.5 6,175
No sexual intercourse in past 12
months 5.4 640 2.0 268 4.4 908
Number of sexual partners in
past 12 months
0 5.4 636 2.1 259 4.5 895
1 1.9 3,719 1.2 2,665 1.6 6,385
2 * 5 4.2 106 4.6 111
3+ * 1 * 7 * 8
Number of higher-risk partners2
in past 12 months
0 2.2 4,228 1.4 2,811 1.8 7,039
1 9.4 132 1.9 206 4.8 338
2+ * 2 0
( .3) 19 5.7 21
Don’t know/missing * 2 * 6 * 9
Condom use
Ever used condom 20.0 88 2.1 322 5.9 410
Never used condom 2.0 4,276 1.3 2,721 1.8 6,998
Condom use at last sexual
intercourse in past 12 months
Used condom 22.4 40 1.6 117 7.0 157
Did not use condom 1.7 3,681 1.3 2,659 1.5 6,340
Condom use at last higher-risk
intercourse1 in past 12 months
Used condom 3
( 0.8) 28 1.8 97 8.2 125
Did not use condom 5.8 79 1.7 121 3.3 199
Number of lifetime partners
1 1.4 3,148 0.6 1,419 1.2 4,567
2 4.7 863 1.8 679 3.4 1,542
3-4 4.1 280 1.3 576 2.3 857
5-9 1
( 0.5) 54 1.4 210 3.3 265
10+ * 4 6.1 134 7.1 137
Paid for sexual intercourse in
past 12 months3
Used condom na na 1
( .6) 15 na 0
Did not use condom na na 2
( .7) 28 na 0
No paid sexual intercourse na na 1.3 2,722 na 0

Total 2.4 4,364 1.4 3,043 2.0 7,407

Note:Total includes men women and men missin g information on whether paid for sexual intercourse in the past 12
months, not shown separately. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates
that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Sexual intercourse with a nonmarital, noncohabiting partner
2
Nonmarital, noncohabiting partners among the last two partners for women and the last three partners for men in
the past 12 months
3
Includes men who report having a prostitute as at least one of their last three partners in the past 12 months
na =Not applicable

HIV Prevalence and Associated Factors | 221


Table 14.6 examines the relationship between condom use (ever use and recent use). When
used properly, condoms are an effective way of preventing the transmission of HIV and other STIs.
Although this would suggest that HIV rates should be lower among condom users, there are a number
of factors that may influence the direction of the relationship. For example, condom use rates may be
higher among individuals who are infected because they are seeking to protect an uninfected partner.
Also, reported condom use cannot be assumed to be “correct condom use.” Thus, it is not surprising
that the association between condom use and infection levels is not uniform in Table14.6. Among
women, condom use is associated with markedly higher levels of HIV infection, while among men, it
is associated with only slightly elevated risk of infection.

Finally, among men, the small number who said that they paid for sex in the 12 months
preceding the survey have higher HIV prevalence than those who reported no paid sex.

In summary, the results presented in Table 14.6 do not demonstrate a consistent relationship
between sexual risk behaviour and HIV prevalence. More detailed analysis is clearly necessary to
understand these relationships because they are often confounded by factors such as age, residence,
and educational status that are associated with both the behavioural measures and HIV prevalence.

14.2.5 HIV Prevalence by Other Characteristics Related to HIV Risk

Table 14.7 presents HIV prevalence by other characteristics related to HIV risk among
women and men who have ever had sex. The table shows that women and men with a history of a
sexually transmitted infection (STI) or STI symptoms have slightly higher rates of HIV infection than
those with no history or symptoms.

Table 14.7 HIV prevalence by STI status and prior HIV testing status

Percentage HIV positive among women and men age 15-49 who have ever had sexual intercourse and were tested for
HIV, by whether they had an STI in the past 12 months and by prior HIV testing status, Ethiopia 2005

Women Men Total


STI in past 12 months/ Percentage Percentage Percentage
Prior HIV testing HIV positive Number HIV positive Number HIV positive Number
STI in past 12 months
Had STI or STI symptoms 3.4 96 2.2 41 3.0 137
No STI, no symptoms 2.4 4,196 1.4 2,984 2.0 7,181
Prior HIV testing
Previously tested 7.1 196 2.2 97 5.5 293
Previously tested, received results of
last test 7.5 179 2.2 95 5.7 273
Previously tested, did not receive
results of last test * 17 * 2 2
( .4) 19
Not tested previously 2.2 3,870 1.5 2,668 1.9 6,538

Total 2.4 4,364 1.4 3,043 2.0 7,407

Note:Total includes numbers missing information on sexually transmitted infections in past 12 months and HIV testing
status not shown separately. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a
figure is based on fewer than 25 unweighted cases and has been suppressed.

The table also shows that the small number of women and men who have been tested for HIV
have higher rates of HIV infection than those who have never been tested. The differential is
especially large among women; 7 percent of women who had been tested for HIV prior to the survey
were HIV positive compared with 2 percent who had not been tested previously.

222 | HIV Prevalence and Associated Factors


14.3 HIV PREVALENCE AND MALE CIRCUMCISION

Although studies have not Table 14.8 HIV prevalence by male circumcision
always found a uniform relationship,
lack of circumcision is considered a Among men age 15-59 who were tested for HIV, percentage HIV positive by
whether circumcised and background characteristics, Ethiopia 2005
risk factor for HIV infection, in part
because of physiological differences Circumcised Uncircumcised
that increase the susceptibility to HIV Background Percentage Percentage
infection among uncircumcised men. characteristic HIV positive Number HIV positive Number

The 2005 EDHS obtained information Age


15-19 0.0 1,015 0.9 159
on male circumcision status, and these 20-24 0.4 862 0.1 67
results can be used to examine the 25-29 0.7 599 1.3 41
relationship between HIV prevalence 30-34 2.0 625 0
( .5) 39
and male circumcision status. Table 35-39 1.6 537 4
( .6) 45
40-44 2.9 429 * 9
14.8 shows that the relationship be- 45-49 0.0 353 0
( .0) 23
tween male circumcision and HIV 50-54 0.9 284 * 9
levels in Ethiopia conforms to the 55-59 0.4 196 * 12
expected pattern of higher rates among Residence
uncircumcised men than circumcised Urban 2.4 713 1
( 0.7) 20
Rural 0.6 4,187 0.6 386
men (0.9 percent and 1.1 percent, re-
Region
spectively). However, the difference in
Tigray 2.0 312 * 6
HIV prevalence is very small and not Affar 2.2 50 * 0
significant. Amhara 1.5 1,332 * 38
Oromiya 0.3 1,845 1.7 125
Somali 0.0 158 * 2
14.4 HIV PREVALENCE AMONG Benishangul-Gumuz 0.0 47 * 1
COUPLES SNNP 0.3 879 0.7 219
Gambela 2.3 8 9.8 9
Harari 2.1 13 * 0
Over 2,674 cohabiting couples Addis Ababa 3.4 231 * 4
were tested for HIV in the 2005 Dire Dawa 1.7 24 * 0
EDHS. Results shown in Table 14.9 Education
indicate that, for 98 percent of cohabit- No education 0.8 2,129 0.9 165
Primary 0.6 1,816 0.2 197
ing couples, both partners tested nega- Secondary and higher 1.9 955 6.0 43
tive for HIV. The majority of the re-
Wealth quintile
maining couples (1.8 percent out of a Lowest 0.7 858 0.2 110
total of 2.1 percent) are discordant, Second 0.3 965 0.2 97
that is, one partner is infected and the Middle 0.7 911 2.2 80
Fourth 0.4 981 0.2 72
other is not. There is clearly an unmet Highest 2.1 1,184 4
( .5) 47
need for VCT services oriented
towards couples, because most of these Total 0.9 4,900 1.1 406
couples do not mutually know their Note:Figures in parentheses are ba sed on 25-49 unweighted cases. An
HIV status. asterisk indicates that a figure is based on fewer than 25 unweighted cases
and has been suppressed.

HIV Prevalence and Associated Factors | 223


Table 14.9 HIV prevalence among couples

Among cohabiting couples both of whom were tested, percent distribution by HIV test results, according
to background characteristics, Ethiopia 2005

Female
Male partner
Both partner positive, Both
partners positive, male partners
Background HIV female partner HIV
characteristic positive negative negative negative Total Number
Woman's age
15-19 0.0 0.4 1.1 98.5 100.0 235
20-29 0.1 1.2 0.9 97.9 100.0 1,151
30-39 0.6 0.3 1.2 97.9 100.0 838
40-49 0.5 1.0 0.9 97.6 100.0 450
Man's age
15-19 * * * * * 18
20-29 0.1 0.3 1.5 98.1 100.0 555
30-39 0.5 1.2 0.9 97.3 100.0 1,029
40-49 0.3 0.5 0.9 98.2 100.0 699
50-59 0.0 0.8 0.8 98.4 100.0 373
Age difference between partners
Man older by 15+ years 0.3 0.8 1.0 97.9 100.0 2,674
Marital status
Married 0.3 0.8 0.9 98.0 100.0 2,640
Living together (0.1) 1
( .0) 8
( .0) 9
( 0.9) 1
( 00.0) 34
Type of union
Monogamous 0.3 0.9 0.9 97.9 100.0 2,463
Polygynous 0.0 0.0 1.2 98.8 100.0 195
Residence
Urban 3.1 2.2 5.6 89.1 100.0 202
Rural 0.1 0.7 0.6 98.6 100.0 2,472
Region
Tigray 0.0 3.3 1.6 95.1 100.0 155
Affar 3.8 0.0 0.0 96.2 100.0 26
Amhara 0.2 1.4 0.7 97.6 100.0 730
Oromiya 0.4 0.2 1.5 97.9 100.0 995
Somali 0.0 0.0 1.3 98.7 100.0 76
Benishangul-Gumuz 0.0 0.0 0.0 100.0 100.0 27
SNNP 0.0 0.2 0.1 99.6 100.0 595
Gambela 2.6 3.1 5.6 88.7 100.0 8
Harari 0.8 1.8 1.6 95.8 100.0 5
Addis Ababa 2.7 3.7 3.7 89.9 100.0 51
Dire Dawa 0.0 0.0 1.6 98.4 100.0 6
Woman’s education
No education 0.1 0.8 0.5 98.6 100.0 2,068
Primary 0.6 0.8 1.8 96.9 100.0 487
Secondary and higher 3.5 0.4 6.8 89.3 100.0 119
Man's education
No education 0.0 0.8 0.4 98.8 100.0 1,487
Primary 0.0 0.5 1.0 98.5 100.0 898
Secondary and higher 2.6 1.8 4.3 91.2 100.0 289
Wealth quintile
Lowest 0.0 1.1 0.0 98.9 100.0 502
Second 0.0 0.0 1.2 98.8 100.0 594
Middle 0.1 0.7 0.6 98.6 100.0 608
Fourth 0.0 0.3 0.0 99.6 100.0 530
Highest 1.7 2.2 3.6 92.6 100.0 440

Total 0.3 0.8 1.0 97.9 100.0 2,674

Note:Total includes number missing information on type of union not shown separately. Figures in
parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer
than 25 unweighted cases and has been suppressed.

224 | HIV Prevalence and Associated Factors


14.5 EDHS AND ANC SURVEILLANCE RESULTS

As noted above, prior to the 2005 EDHS, national prevalence estimates for the general adult
population in Ethiopia were derived from information obtained through the national ANC surveillance
system. The most recent round of ANC surveillance conducted in 2005 included 79 sites in
government health facilities from all 11 regions of the country.

While the rate of HIV infection in pregnant women has been shown to be a reasonable proxy
for the level in the combined male and female adult population in a number of settings (WHO and
UNAIDS, 2000), there are several limitations in estimating the HIV rate in the general adult
population from data derived exclusively from pregnant women attending antenatal clinics. First, it is
recognized that ANC data may overstate the risk of HIV infection in the general population for
several reasons. Most obviously is the fact that the rates among pregnant women are not a good proxy
for male HIV rates, which are typically lower than the rates for women. In addition, ANC data do not
reflect HIV prevalence levels in non-pregnant women, many of whom are at lower risk of HIV
infection either because they are not sexually active or because they use condoms to prevent
pregnancy or to avoid sexually transmitted infections including HIV. The ANC results also do not
represent women who either do not attend a clinic for pregnancy care or receive antenatal care at
facilities not represented in the surveillance system. These women tend to be concentrated in more
rural localities and, thus, are likely to be at lower risk of HIV infection. Although most of the potential
biases in ANC surveillance are related to lower risks of infection, ANC data also potentially exclude
some women who have contracted HIV because HIV infection reduces fertility and because
knowledge of HIV status may influence fertility choices among infected women.

Table 14.10 compares HIV prevalence results from the 2005 EDHS with estimates derived
from the 2005 round of ANC surveillance. The national estimate based on the ANC surveillance
results is 3.5 percent. This compares to the level of 1.4 percent found in the EDHS. Additional
analysis will be needed to understand both the differences and similarities between the ANC and DHS
results. However, initial comparisons of the EDHS and ANC findings suggest that the differences are
owed principally to: (1) the relatively limited coverage of antenatal care services in Ethiopia and (2)
differences in geographic coverage of the EDHS and the ANC surveillance systems.

With respect to the first point, the EDHS results suggest that only around one in four pregnant
women in Ethiopia goes for antenatal care, with coverage levels much higher among urban than rural
women (see Chapter 9). Thus, at least part of the difference between the ANC-based HIV rate and the
EDHS figure may rest in the selective nature of the population attending antenatal care. Some
confirmation for this hypothesis is seen in Figure 14.2. The first two bars in the figure show the HIV
rates for two groups of EDHS respondents: (1) respondents who gave birth during the three-year
period before the survey and received antenatal care and (2) EDHS respondents who either gave birth
but did not receive antenatal care during pregnancy or did not give birth (see also Table 14.5). The
HIV rate for the EDHS respondents is identical to that found in the 2005 ANC surveillance round (3.5
percent) and higher than the rate observed among EDHS respondents who were not ANC clients or
did not give birth (1.6 percent).

HIV Prevalence and Associated Factors | 225


Table 14.10 HIV prevalence results from the EDHS and the National Antenatal Care
Surveillance System

Percentage HIV positive among the adult population age 15-49 reported in the 2005 EDHS and
estimated in the 2005 round of the national antenatal care

2005 EDHS 2005 ANC Round


Number of
Number of Unweighted pregnant
HIV sample number of HIV Number women
Region prevalence points adults tested prevalence of sites tested
Tigray 2.1 50 1,038 4.2 9 3,111
Affar 2.9 35 528 3.1 2 763
Amhara 1.7 80 1,636 4.5 17 6,961
Oromiya 1.4 83 1,924 2.4 20 7,185
Somali 0.7 34 451 1.2 2 607
Benishangul-Gumuz 0.5 30 721 2.8 5 1,615
SNNP 0.2 84 1,819 2.3 12 4,119
Gambela 6.0 29 638 4.0 2 506
Harari 3.5 30 625 5.2 2 569
Addis Ababa 4.7 50 1,192 11.7 3 1,939
Dire Dawa 3.2 30 478 6.8 5 872

Total 1.4 534 11,050 3.5 79 28.247

Note:ANC estimates are from the national HIV/AIDS Prevention and Control Office (HAPCO),
HIV/AIDS/STIs Monitoring and Evaluation Unit.

Figure 14.2 HIV Prevalence among EDHS Respondents


by Antenatal Care Status and HIV Rate from
ANC Surveillance Data
4
3.5 3.5
3.5

2.5

2
1.6
1.5

0.5

0
Had ANC No ANC/no birth HIV rate from ANC
at heatlh facility1 Surveillance Data
HIV rates among women age 15-49
from 2005 EDHS survey
1
Women giving birth in the three-year period before the survey EDHS 2005

226 | HIV Prevalence and Associated Factors


Differences in geographic coverage between the 2005 EDHS survey and the ANC surveil-
lance system are another important factor in explaining the differences in HIV estimates derived from
the two data sources. Figure 14.3 shows the location of both the health facilities included in the ANC
surveillance system and the census enumeration areas from which the 2005 EDHS sample was
drawn.2 The map shows that the facilities included in the ANC surveillance system are mainly
clustered in or near urban areas and along the main transport corridors in Ethiopia (well-known routes
along which the HIV virus is transmitted) while the EDHS clusters are more geographically dispersed.
Confirmation that the geographic concentration of ANC surveillance sites in high transmission areas
is responsible for a large part of the difference between the EDHS HIV rate and the HIV rate derived
from ANC surveillance results is seen in Figure 14.4. EDHS respondents living within 15 kilometres
of the ANC surveillance sites have markedly higher HIV levels than populations living 15 kilometres
or more from the sites. The HIV rate for the adult population living within 15 kilometres is also
similar to that observed in the ANC results. This confirms that the ANC results are a reasonable proxy
for adult prevalence, once they are adjusted for geographic coverage issues, and lends confidence to
the use of the ANC results in assessing trends in the course of the AIDS epidemic. Population-based
surveys like the EDHS are not conducted at frequent enough intervals to effectively monitor trends.

This initial review indicates that the EDHS seroprevalence results are comparable at the
national level with the ANC-based HIV data once differences in the geographic and population
coverage between the two surveys are addressed. However, there are a number of questions that the
comparisons of the EDHS and ANC data raise that will require additional analysis. In particular, there
are questions regarding differences in regional patterns. For example, in Gambela the EDHS found
higher prevalence than would be expected in view of the ANC findings. The very low prevalence rate
in SNNP also deserves additional consideration.

2
The map was created using GIS coordinates for the ANC surveillance sites and for the EDHS clusters.

HIV Prevalence and Associated Factors | 227


228 | HIV Prevalence and Associated Factors
Figure 14.4 HIV Prevalence by Distance from
2005 ANC Sentinel Sites, EDHS Respondents Age 15-49

3.5
3.2

3.0

2.5

2.0

1.5

1.0
1.0

0.5

0.0
15 km
< 15 km
>

EDHS 2005

14.6 EFFECT OF NONRESPONSE ON THE EDHS HIV PREVALENCE RESULTS

As was seen earlier in this chapter, not all eligible EDHS respondents participated in the HIV
testing component. The potential for bias associated with this nonparticipation is a concern since
respondents who refused to be tested or were absent at the time of testing may bias the results in ways
that are different in their characteristics or behaviour from those who consented to provide a blood
sample To address these concerns, it has become standard procedure in DHS surveys with an HIV
testing component to conduct an analysis of those who are not tested in order to look for potential
biases.

Table 14.11 summarizes the results of the nonresponse analysis that was conducted for the
2005 EDHS. The table shows the observed HIV rates for women, men, and the total sample and the
rates for these groups following an adjustment for nonresponse. Overall, the adjustment for
nonresponse raises the HIV prevalence by about 0.2 percentage points above the observed level (from
1.4 percent to 1.6 percent). For women, the adjusted prevalence is 2.1 percent compared with the
observed level of 1.9 percent. For men, the effect of the adjustment is slightly smaller, adding about
0.1 percentage points to the observed rate of 0.9 percent. The differences between the observed and
adjusted rates were not found to be statistically significant. Additional details regarding the non-
response analysis are found in Appendix A.

Table 14.11 Observed and adjusted HIV prevalence among women and men

Percentage HIV positive among women and men age 15-49 who were tested for HIV, by observed
and adjusted prevalence and 95%co nfidence intervals, Ethiopia 2005
Observed HIV prevalence Adjusted HIV prevalence
Prevalence 95%confidence interval Prevalence 95%confidence interval
Sex R
() R-2SE R+2SE R
() R-2SE R+2SE
Women 1.86 1.52 2.21 2.06 1.77 2.37
Men 0.94 0.66 1.22 1.01 0.79 1.24

Total 1.44 1.214 1.67 1.57 1.38 1.76

HIV Prevalence and Associated Factors | 229


Table 14.12 compares observed and adjusted HIV prevalence for women and men according
to various respondent and household characteristics. For the most part, the differences between the
observed and adjusted figures are relatively small.

Table 14.12 Observed and adjusted HIV prevalence among women and men by background characteristics

Percentage HIV positive among women and mean age 15-49 who were tested for HIV, by observed and adjusted
prevalence and background characteristics, Ethiopia 2005

Women Men Total


Background
characteristic Observed Adjusted Observed Adjusted Observed Adjusted
Age
15-19 0.7 0.7 0.1 0.1 0.4 0.4
20-24 1.7 1.9 0.4 0.4 1.1 1.2
25-29 2.1 2.4 0.7 0.8 1.6 1.7
30-34 1.5 1.6 1.9 2.2 1.7 1.8
35-39 4.4 5.1 1.8 2.2 3.2 3.7
40-44 3.1 3.1 2.8 2.9 3.0 3.0
45-49 0.8 1.1 0.0 0.0 0.5 0.6

Residence
Urban 7.7 7.9 2.4 2.6 5.5 5.6
Rural 0.7 0.7 0.7 0.7 0.7 0.7

Region
Tigray 2.6 2.9 1.6 1.6 2.1 2.4
Afar/Somali 1.8 2.0 0.6 0.6 1.3 1.3
Amhara 1.8 2.0 1.6 1.7 1.7 1.8
Oromiya 2.2 2.4 0.4 0.4 1.4 1.5
SNNP 0.1 0.1 0.4 0.4 0.2 0.2
Gambela/ Benishangul-Gumuz 2.1 2.4 1.8 1.9 1.9 2.1
Harari 4.6 4.5 2.2 2.3 3.5 3.6
Addis Ababa 6.1 6.2 3.0 3.6 4.7 5.0
Dire Dawa 4.4 4.5 1.9 1.9 3.2 3.4

Education
No education 1.0 1.1 0.8 0.7 0.9 1.0
Primary 2.5 2.7 0.5 0.5 1.3 1.4
Secondary and higher 5.5 5.9 2.0 2.3 3.4 3.8

Wealth quintile
Lowest 0.3 0.3 0.7 0.6 0.5 0.5
Second 1.0 1.0 0.3 0.3 0.7 0.7
Middle 0.4 0.4 0.9 0.8 0.6 0.6
Fourth 0.2 0.2 0.4 0.4 0.3 0.3
Highest 6.1 6.4 2.2 2.3 4.3 4.5

Total 1.9 2.1 0.9 1.0 1.4 1.6

Minimizing nonresponse is a major challenge to all population-based surveys. The main


reasons are refusal and absence. The analysis of nonresponse in Ethiopia is consistent with results
from other DHS countries with linked HIV data (Kenya, Ghana, Burkina Faso, Tanzania, Cameroon,
Malawi, and Lesotho) and indicates that nonresponse does not bias the national HIV estimates from
population-based surveys significantly (Mishra et al., 2006a, draft manuscript). The overall effect of
nonresponse on the observed national HIV prevalence estimates tends to be small.

It is important to recognize that the adjustments only partially address the nonresponse bias.
The estimates can only be adjusted to the extent that the sociodemographic and behavioural
characteristics included in the analysis are correlated with the risk of HIV infection in each country.
Another limitation is that the adjustments for the “not-interviewed, not-tested” respondents (mostly
absentees) are based on somewhat limited information although variables strongly associated with
HIV infection such as age, residence, education, and wealth are included.

230 | HIV Prevalence and Associated Factors


ADULT AND MATERNAL MORTALITY 15
Since the launch of the Safe Motherhood Initiative in 1987, attention to reproductive health
has increased worldwide, as has the need for reliable countrywide estimates of maternal deaths. In
response to this increased interest, DHS surveys began collecting maternal mortality data through a
series of questions designed to obtain a direct measure of maternal mortality. These questions were
included in the 2005 EDHS, the second time such information was collected in Ethiopia, the first time
was in the 2000 EDHS. In addition to information on maternal mortality, data gathered from the
maternal mortality module also allow for the estimation of adult mortality.

Maternal mortality estimates need a comprehensive and accurate reporting of maternal deaths.
Such estimates can be obtained through vital registration, longitudinal studies of pregnant women, and
household surveys. However, there is no vital registration system in Ethiopia, nor has there been any
national household survey carried out for the sole purpose of estimating maternal mortality. For these
reasons questions on maternal mortality were added to the 2000 EDHS and later to the 2005 EDHS.
The estimates presented in this chapter will play a vital role in filling the need for a reliable national
estimate of maternal mortality. Nevertheless, it is important for users of this information to understand
the inherent problems associated with measuring maternal mortality to avoid misinterpretation of the
survey results.

Direct estimates of maternal mortality use data on the age of surviving sisters of survey
respondents, the age at death of sisters who have died, and the number of years since the death of
sisters. Interviewers in the 2005 EDHS were asked to list all the brothers and sisters born to the natural
mother of female respondents in chronological order starting with the first. Information was then
obtained on the survivorship of each of the siblings, the ages of surviving siblings, the year of death or
years since death of deceased siblings, and the age at death of deceased siblings. For each sister who
died at age 12 or over, the respondent was asked additional questions to determine whether the death
was maternity related; that is, whether the sister was pregnant when she died, and if not, whether the
sister died during childbirth, and if not, whether the sister died within two months of the termination
of a pregnancy or childbirth. Listing all siblings in chronological order of their birth is believed to
result in better reporting of events than would be the case if only information on sisters were sought.
Moreover, the information collected also allows direct estimates of adult male and female mortality.

15.1 DATA QUALITY ISSUES

A brief discussion of data quality is warranted here. This discussion refers to tables in
Appendix C. One measure of the quality of the data collected is the completeness of information on
siblings. Overall, the data on siblings are nearly complete, with only 2 percent of siblings missing
information on age at death and years since death, with little difference between brothers and sisters
(Table C.7). Rather than exclude siblings with missing information from the analysis, the information
on the birth order of siblings in conjunction with other information is used to impute the missing data.1

The distribution of year of birth of respondents in relation to their siblings is another crude
measure of the quality of data. If there is no bias in reporting, the year of birth of siblings should be

1
The imputation procedure is based on the assumption that the reported birth order of the siblings in the birth
history is correct. The first step is to calculate birth dates. For each living sibling with a reported age and for
each dead sibling with complete information on both age at death and year of death, the birth date is calculated.
For a sibling missing these data, a birth date is imputed within the range defined by the birth dates of the
bracketing siblings. In the case of living siblings, an age is calculated from the imputed birth date. In the case
of dead siblings, if either age at death or year of death is reported, that information is combined with the birth
date to produce missing information. If both pieces of information are missing, the age at death is imputed.
This imputation is based on the distribution of the ages at death for those whose year of death is unreported, but
age at death is reported.

Adult and Maternal Mortality | 231


roughly equivalent to the year of birth of respondents overall. The distribution of respondents and their
siblings by year of birth is close, with the median year of birth of respondents identical to that of
siblings (1971 for both), indicating that there is no serious underreporting of siblings (Table C.8).

Yet another crude measure of data quality is the mean number of siblings, or the mean sibship
size (Table C.9). Sibship size is expected to decline as fertility declines over time. The absence of a
monotonic decline in sibship size, even though fertility has declined in Ethiopia, is an indication that
there may be some omission in the reporting of older siblings. However, since adult mortality rates
are reported here for the seven years preceding the survey, this omission is unlikely to affect the
calculation of mortality rates. Moreover, if the omission occurred mostly among sisters who did not
survive to adulthood (which is most likely the case), it may not even bias the estimation of maternal
mortality. This is also confirmed by the sex ratios that are larger than the internationally accepted sex
ratio of 103-105, indicating that either sisters are underreported or brothers are overreported.
Nevertheless, it should be borne in mind that any information that relies on recall of events will suffer
from some degree of misreporting, especially if it pertains to deceased persons and occurred a long
time before the survey.

15.2 ADULT MORTALITY

It is advisable to begin by estimating overall adult Table 15.1 Adult mortality rates
mortality. If the overall mortality estimates display a
Direct estimates of female and male mortality for the
general, stable, and plausible pattern, it lends credence to period 0-6 years prior to the survey, Ethiopia 2005
the maternal mortality estimates derived thereafter. This
is simply because maternal mortality is a subset of adult Exposure Mortality
Age Deaths years rates1
mortality.
FEMALE
Direct estimates of male and female adult 15-19 125 32,168 3.89
mortality are obtained from information collected in the 20-24 172 32,171 5.33
sibling history. Age-specific death rates are computed by 25-29 183 28,305 6.46
dividing the number of deaths in each age group by the 30-34 184 22,881 8.03
total person-months of exposure in that age group during 35-39 132 16,170 8.15
a specified reference period. In total, female respondents 40-44 73 9,742 7.54
45-49 57 5,997 9.52
to the Ethiopia DHS survey reported 80,530 siblings, of
whom 38,392 were sisters and 42,138 were brothers 6.39
a
15-49 925 147,433
(Table C.7). Direct estimates of age-specific mortality
rates for females and males are shown in Table 15.1. To MALE
minimize the impact of possible heaping on years since
15-19 135 33,999 3.96
death ending in zero and five, direct estimates are 20-24 164 35,574 4.61
presented for the period 0-6 years before the survey, 25-29 170 30,503 5.58
which roughly corresponds to 1998-2004. Although the 30-34 167 23,459 7.10
number of sibling deaths is relatively high, because of the 35-39 116 16,852 6.90
large sampling variability, it is preferable to aggregate the 40-44 84 10,527 8.01
data over the age range 15-49. There are more female 45-49 67 6,699 10.07
than male deaths in the seven years preceding the survey a
5.94
(925 compared with 903). The female mortality rate is 6.4 15-49 903 157,613

deaths per 1,000 population and is 8 percent higher than 1 Expressed per 1,000 population
the male mortality rate of 5.9 deaths per 1,000 population. a Age-adjusted rate
The trend in adult mortality can be gauged by comparing
similarly collected data from the 2000 EDHS with data from the 2005 EDHS. The data show that adult
mortality has declined over the past five years with the decline in male mortality much more
significant than the decline in female mortality. Male mortality declined by 26 percent while female
mortality declined by just 4 percent over the past five years.

15.3 MATERNAL MORTALITY

Information on maternal mortality for the period 0-6 years before the survey is shown in Table
15.2. As previously mentioned, this period was chosen to reduce any possible heaping of reported

232 | Adult and Maternal Mortality


years since death on five-year intervals. Age-specific mortality rates are calculated by dividing the
number of maternal deaths by years of exposure. To remove the effect of truncation bias (the upper
boundary for eligibility in the Ethiopia DHS survey is 49 years), the overall rate for women age 15-49
is standardized by the age distribution of the survey respondents. Maternal deaths are defined as any
death that occurred during pregnancy, childbirth, or within two months after the birth or termination of
a pregnancy.2 Maternal mortality in Ethiopia is high relative to developed countries. However, for
each age group, maternal deaths are a relatively rare occurrence. As such, the age-specific pattern
should be interpreted with caution. There were 197 maternal deaths in the seven years preceding the
survey. The maternal mortality rate, which is the annual number of maternal deaths per 1,000 women
age 15-49, for the period 1994-2000 is 1.34. Maternal deaths accounted for 21 percent of all deaths to
women age 15-49; in other words, more than one in five Ethiopian women who died in the seven
years preceding the survey died from pregnancy or pregnancy-related causes.

The maternal mortality ratio, which is obtained by dividing the age-standardized maternal
mortality rate by the age-standardized general fertility rate, is often considered a more useful measure
of maternal mortality since it measures the obstetric risk associated with each live birth. Table 15.2
shows that the maternal mortality ratio for Ethiopia for the period 1998-2004 is 673 deaths per
100,000 live births (or alternatively 7 deaths per 1,000 live births). Similarly collected data from the
2000 EDHS show the maternal mortality ratio for Ethiopia for the period 1994-2000 to be 871 deaths
per 100,000 live births or 9 deaths per 1,000 live births. Although it appears that maternal mortality
may be declining in Ethiopia, the rates are both subject to a high degree of sampling error. Because 95
percent confidence intervals around the two estimates overlap, it is not possible to conclude that there
has been a decline.3

Table 15.2 Direct estimates of maternal mortality

Direct estimates of maternal mortality for the period 0-6 years prior
to the survey, Ethiopia 2000

Proportion
of maternal
deaths to
Maternal Exposure Mortality female
Age deaths years rates1 deaths
15-19 15 32,168 0.470 12.1
20-24 44 32,171 1.353 25.4
25-29 53 28,305 1.870 29.0
30-34 45 22,881 1.960 24.4
35-39 35 16,170 2.170 26.6
40-44 4 9,742 0.433 5.7
45-49 1 5,997 0.202 2.1
a
Total 197 147,433 1.336 21.3
a
General fertility rate (GFR) 0.193
Maternal mortality ratio (MMR)2 673
1
Expressed per 1,000 woman-years of exposure
2
Expressed per 100,000 live births; calculated as the maternal
mortality rate divided by the general fertility rate
a
Age-adjusted rate

2
This time-specific definition includes all deaths that occurred during the specified period even if the death is
due to nonpregnancy-related causes. However, this definition is unlikely to result in overreporting of maternal
deaths because most deaths to women in the specified period are due to maternal causes, and maternal deaths in
general are more likely to be underreported than overreported.
3
The maternal mortality ratio obtained from the 2000 EDHS is 871 deaths per 100,000 live births. The true ratio
of the 95 percent confidence intervals ranges between 703 and 1,039. The true MMR for 2005 ranges from 548
and 799.

Adult and Maternal Mortality | 233


 
WOMEN’S EMPOWERMENT AND DEMOGRAPHIC
AND HEALTH OUTCOME 16
Earlier discussions in this report have shown that Ethiopian women are less educated than
men and have a lower level of literacy and exposure to mass media than their male counterparts. In
addition, the EDHS data have shown that women are predominantly engaged in agricultural
occupations, have little manual skills, and are less likely than men to be engaged in the professional,
technical and managerial fields. Educational attainment, literacy, exposure to mass media, and
employment are critical contributors to women’s empowerment and exert considerable influence on
the development of their personality and on solidifying their position in the household and in society
in general.

In this chapter we explore women’s empowerment in terms of type of earnings, women’s


control over cash earnings, and the magnitude of their earnings relative to their partner’s. In addition,
specific questions were posed to determine women’s role in household decisionmaking, on acceptance
of wife beating, and on opinions about when a wife should be able to refuse sex with her husband.
These questions are used to define three different indicators of women’s empowerment, namely
women’s participation in decisionmaking, the degree of acceptance of wife beating, and the degree of
acceptance of a wife’s right to refuse sex with her husband. The extent to which women’s
empowerment influences maternal and child health and contraceptive decisionmaking is also
examined. Finally, this chapter discusses the proportion of women who have ever been widowed and
dispossessed of property belonging to their late husband.

Additional insight into women’s empowerment in Ethiopia comes from information collected
with a series of questions on harmful traditional practices, namely female genital cutting, the practice
of uvulectomy or tonsillectomy, and marriage by abduction. The survey also collected information on
the prevalence of obstetric fistula, a condition that may develop following childbirth, and which
causes women to be socially ostracized.

16.1 EMPLOYMENT AND FORM OF EARNINGS

Table 16.1 shows the percent distribution of currently married women who were employed in
the 12 months preceding the survey by type of earnings they received (cash, in-kind, or both). Em-
ployment is assumed to go hand in hand with payment for work. Not all women receive earnings for
the work they do, and among women those who do receive earnings not all receive earnings in cash.

Table 16.1 Employment and cash earnings of currently married women

Percentage of currently married women who were employed at any time in the last 12 months and the percent
distribution of currently married women employed in the past 12 months by type of earnings, according to age,
Ethiopia 2005

Currently married Percent distribution of currently married women


women employed in past 12 months by type of earnings
Cash Missing/
Percentage Number of Cash and in- In-kind Not don't Number of
Age employed women only kind only paid know Total women
15-19 24.0 711 12.9 5.0 16.6 65.5 0.0 100.0 171
20-24 29.8 1,574 24.6 4.0 9.6 61.3 0.6 100.0 468
25-29 31.9 2,066 30.5 2.6 7.4 59.4 0.1 100.0 659
30-34 31.8 1,551 32.2 2.4 8.9 56.1 0.4 100.0 493
35-39 31.9 1,343 25.2 3.0 11.9 59.8 0.0 100.0 428
40-44 36.3 960 25.3 3.6 12.6 57.8 0.7 100.0 348
45-49 33.2 862 22.4 4.7 11.6 61.2 0.0 100.0 286

Total 31.5 9,066 26.5 3.4 10.3 59.5 0.3 100.0 2,854

Women’s Empowerment and Demographic and Health Outcome | 235


Thirty-two percent of currently married women reported being employed. Slightly more than
one-fourth (27 percent) of employed women receive payment in cash only and 3 percent receive both
cash and payment in-kind. Ten percent receive payment in-kind alone. Three in five employed women
do not receive any form of payment for their work. The percentage of currently married women who
were employed increases with age up to age 44 and then declines slightly for the oldest age group.

16.2 CONTROL OVER AND RELATIVE MAGNITUDE OF WOMEN’S EARNINGS

As a means of assessing women’s autonomy, currently married women who earned cash for
their work in the 12 months preceding the survey were asked who the main decisionmaker is with
regard to the use of their earnings. This information allows the assessment of women’s control over
their own earnings. It is expected that employment and earnings are more likely to empower women if
women themselves control their own earnings and perceive them as significant relative to those of
their husband or partner. Women who earned cash for their work were asked the relative magnitude of
their earnings compared with those of their husband or partner.

Table 16.2 shows the degree of control women have over the use of their earnings, and their
perception of the magnitude of their earnings relative to those of their husband or partner by
background characteristics. Almost two-fifths of currently married women who receive cash earnings
report that they alone decide how their earnings are used, while more than half of currently married
women say that they decide jointly with their husband or partner. Only 5 percent of women report that
their husband or partner alone decides how their earnings will be used. The proportion of currently
married women who say that they decide by themselves how their earnings are used declined from 62
percent in 2000 to 39 percent in 2005. On the other hand, the percentage of currently married women
who say that they jointly decide with their husband or partner, increased from 32 percent to 51 percent
over the same period.

Younger women age 15-19 and older women age 45-49 are somewhat more likely to make
independent decisions on their earnings than women in the middle age groups. Women with five or
more children are more likely to decide on their own how to use their earnings than women with
fewer children or no children at all. Sixty percent of currently married women with one or two
children make joint decisions with their husbands or partners.

Rural women are more independent in making their own decisions than urban women (41 and
35 percent, respectively). On the other hand, urban women are more likely than rural women to report
that they make decisions about how the money they earn will be used jointly with their husband or
partner.

There are regional variations in the way decisions are made on how women’s earnings are
used. The percentage of women who make independent decisions on their earnings ranges from 64
percent in the Somali Region to about 19 percent in Affar and Benishangul-Gumuz. Among the
regions, women in Amhara (69 percent) are most likely to decide jointly with their husband or partner
on how to spend the money they earn.

More than two-thirds of women with a secondary or higher education say that they decide
jointly with their husband or partner. Surprisingly, women with no education are more likely than
those who have at least secondary education to decide on their own how to use the money they earn.

236 | Women’s Empowerment and Demographic and Health Outcome


Table 16.2 Control over women's earnings and relative magnitude of women's earnings

Percent distribution of currently married women who received cash earnings for employment in the 12 months preceding the survey by person who
decides how earnings are to be used and by whether she earned more or less than her husband/partner, according to background characteristics,
Ethiopia 2005

Person who decides how woman's Woman's earnings compared with


earnings are used husband/partner's earnings
Respond-
ent and Husband/
husband/ Husband/ partner Don't Number
Background Respond- partner partner has no know/ of
characteristic ent only jointly only Other Missing Total More Less Same earnings missing Total women
Age
15-19 46.9 32.5 11.9 0.2 8.5 100.0 9.5 58.4 19.5 1.4 11.2 100.0 31
20-24 40.3 51.3 5.4 0.0 3.1 100.0 7.8 69.5 14.7 4.3 3.7 100.0 134
25-29 27.7 60.3 6.2 0.0 5.8 100.0 14.5 68.0 9.8 0.9 6.8 100.0 218
30-34 37.7 52.3 4.2 0.0 5.9 100.0 11.4 69.3 10.7 2.4 6.2 100.0 171
35-39 37.2 53.0 4.7 0.0 5.1 100.0 15.2 51.4 20.2 7.3 5.8 100.0 121
40-44 50.8 41.4 2.4 0.0 5.5 100.0 17.4 57.4 13.1 6.0 6.1 100.0 101
45-49 55.7 39.4 4.9 0.0 0.0 100.0 12.9 63.5 16.0 7.1 0.5 100.0 78
Number of living children
0 43.1 46.1 7.0 0.0 3.8 100.0 6.2 66.3 20.7 0.4 6.4 100.0 88
1-2 30.7 60.2 3.7 0.0 5.4 100.0 12.6 62.6 15.3 3.3 6.1 100.0 282
3-4 35.7 50.7 7.3 0.0 6.3 100.0 12.8 68.2 8.0 4.3 6.7 100.0 265
5+ 52.0 41.9 3.4 0.0 2.7 100.0 16.3 60.4 15.0 5.3 3.1 100.0 217
Residence
Urban 35.1 57.8 1.6 0.0 5.4 100.0 15.8 64.4 8.8 4.8 6.2 100.0 326
Rural 41.3 47.0 7.2 0.0 4.4 100.0 11.2 64.0 16.5 3.2 5.1 100.0 528
Region
Tigray 26.5 47.6 5.0 0.0 20.9 100.0 2.4 38.8 33.9 1.8 23.0 100.0 94
Affar (19.2) (31.8) (42.0) (0.0) (7.0) 100.0 (8.6) (50.9) (33.5) (0.0) (7.0) 100.0 5
Amhara 23.6 68.5 2.8 0.0 5.0 100.0 11.4 61.3 19.0 1.9 6.4 100.0 141
Oromiya 43.6 50.8 3.9 0.0 1.7 100.0 13.7 69.0 7.9 7.8 1.7 100.0 237
Somali 63.5 30.7 3.0 0.0 2.9 100.0 19.4 62.7 6.3 8.7 2.9 100.0 24
Benishangul-Gumuz 19.5 47.0 27.1 0.0 6.4 100.0 3.9 75.5 19.1 1.6 0.0 100.0 9
SNNP 47.9 42.2 6.8 0.0 3.2 100.0 14.3 70.0 9.0 2.6 4.1 100.0 229
Gambela 31.2 47.3 19.1 0.0 2.3 100.0 10.3 61.7 22.3 2.5 3.2 100.0 5
Harari 54.1 39.3 5.3 0.7 0.5 100.0 27.6 62.2 5.4 1.7 3.1 100.0 8
Addis Ababa 35.7 60.6 2.5 0.0 1.2 100.0 17.9 68.4 10.5 1.6 1.6 100.0 90
Dire Dawa 47.9 40.4 9.8 0.0 1.9 100.0 23.4 59.0 15.0 0.8 1.9 100.0 10
Education
No education 45.9 44.3 5.0 0.0 4.9 100.0 11.2 63.3 15.3 4.5 5.7 100.0 461
Primary 37.0 46.5 11.4 0.0 5.1 100.0 18.0 64.9 8.6 2.5 6.1 100.0 165
Secondary and higher 26.5 68.3 0.7 0.0 4.5 100.0 12.8 65.4 13.5 3.5 4.8 100.0 228
Wealth quintile
Lowest 46.5 37.9 8.4 0.0 7.2 100.0 11.0 62.0 14.0 3.7 9.4 100.0 96
Second 35.3 51.7 10.1 0.0 2.9 100.0 10.6 68.1 15.8 2.5 2.9 100.0 124
Middle 52.0 38.7 6.6 0.0 2.7 100.0 13.1 60.7 14.2 7.5 4.4 100.0 118
Fourth 39.4 47.5 4.8 0.0 8.3 100.0 5.5 67.9 16.9 1.8 7.8 100.0 122
Highest 34.3 59.0 2.3 0.0 4.4 100.0 16.4 63.3 11.4 3.8 5.1 100.0 393

Total 39.0 51.1 5.1 0.0 4.8 100.0 12.9 64.1 13.5 3.8 5.6 100.0 853

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

Regarding relative magnitude of their earnings compared with those of their husband or
partner, 64 percent of women believe that they earn less than their husband or partner, 14 percent
believe that they earn as much as their husband or partner and 13 percent believe that they earn more.
Women age 40-44, women with primary education, women with five or more children, women in the
highest wealth quintile, urban women, and women who live in Harari are more likely than their
counterparts to believe that they earn more than their husband or partner. Three-fourths of women in
Benishangul-Gumuz believe that they earn less than their husband or partner. Table 16.2 shows that 4
percent of women reported that their husband or partner did not bring in any money, and almost 6
percent of women did not know if their husband or partner earned more or less than they did.

Women’s Empowerment and Demographic and Health Outcome | 237


A cross tabulation by the person in the household who decides how women’s cash earnings
are used and how their husband or partner’s cash earnings are used, by the women’s earnings relative
to her husband or partner, may provide some insight into women’s empowerment in the family and
the extent of their control over decisionmaking in the household.

Table 16.3 shows that currently married women who believe they earn more than their
husband are much more likely to decide how their husband or partner’s earnings are used (21
percent). Women who believe that they earn the same amount as their husband are most likely to
make joint decisions with their husband or partner on how their earnings and their partner’s earnings
are used (about 84 percent). Husbands or partners are much more likely to make sole decisions on the
use of their earnings in the case of women who believe that they earn less than their partner (26
percent), women who have no cash earnings of their own (27 percent), and women who did not work
in the past 12 months (41 percent).

Table 16.3 Women's control over her own earnings and over those of her husband/partner

Percent distribution of currently married women by person who decides how a woman's cash earnings are used and the percent distribution by who decides
how a woman's husband/partner's earnings are used, according to the relation between women's and husband's earnings in last 12 months, if any Ethiopia
2005

Person who decides how women's Person who decides how husband/partner's
earnings are used earnings are used
Respond- Respond-
ent and ent and
Women's earnings Respond husband/ Husband/ Respond- husband/ Husband/ Number
relative to husband/ -dent partner partner ent partner partner of
partner's earnings only jointly only Other Missing Total only jointly only Other Missing Total women
More than husband/partner 48.1 46.0 5.8 0.0 0.0 100.0 20.5 61.1 13.1 0.1 5.2 100.0 110
Less than husband/partner 43.3 50.8 5.8 0.0 0.1 100.0 9.6 64.4 25.8 0.0 0.2 100.0 547
Same as husband/partner 11.1 84.6 4.3 0.0 0.0 100.0 6.8 84.0 9.1 0.0 0.0 100.0 115
Husband/partner has no
cash earnings/did not work (76.4) (23.5) (0.0) (0.1) (0.0) 100.0 na na na na na na 33
Woman has no cash
earnings na na na na na na 5.7 66.7 26.5 0.4 0.6 100.0 1,993
Woman did not work in past
na na na na na na 6.9 51.1 41.2 0.3 0.5 100.0 6,212
12 months
Note: Figures in parentheses are based on 25-49 unweighted cases. Excludes cases where women or her husband/partner have no earnings and includes
cases where women do not know whether they earned more or less than their husband/partner.
na = Not applicable

16.3 WOMAN’S PARTICIPATION IN DECISIONMAKING

Decisionmaking can be a complex process and the ability of women to make decisions that
affect the circumstances of their own lives is essential for their empowerment.

In order to assess women’s decisionmaking autonomy, the 2005 EDHS sought information on
women’s participation in four types of household decisions: respondent’s own health care, making
large household purchases; making household purchases for daily needs; and visits to family or
relatives. Table 16.4 shows the percent distribution of currently married women according to the
person in the household who usually makes decisions concerning these matters. Women are
considered to participate in decisionmaking if they make decisions alone or jointly with their husband
or someone else.

238 | Women’s Empowerment and Demographic and Health Outcome


The strength of the role of women in decisionmaking varies with the type of decision. Almost
53 percent of currently married women reported that they alone made the final decision about daily
household purchases. Although 15 percent of currently married woman make sole decisions on their
own health care, one-third say that their husband makes such decisions without consulting them.
Decisions on large household purchases are most likely to be made by the husband or partner alone
(42 percent) or jointly with the wife or partner (45 percent). More than two-thirds of women say that
decisions to visit family or relatives are made jointly with their husband or partner.

Table 16.4 Women's participation in decisionmaking

Percent distribution of currently married women by person who usually makes decisions on four specific issues in the
household, Ethiopia 2005

Respondent
Respondent and husband/ Husband/ Someone
Decision only partner jointly partner only else Other Missing Total
Own health care 14.6 51.2 33.3 0.6 0.1 0.2 100.0
Large household purchases 12.4 44.7 41.9 0.6 0.2 0.2 100.0
Daily household purchases 52.8 30.1 16.0 0.7 0.2 0.2 100.0
Visits to family or relatives 10.4 68.0 20.8 0.4 0.2 0.2 100.0

Table 16.5 shows the percentage of women who report that they alone or jointly have the final
say in specific household decisions, according to background characteristics. The results indicate that
44 percent of currently married women participate in all of the four specified decisions. Only 8
percent of women report that they do not participate in any of the decisions. The majority of currently
married women participate in making decisions on daily purchases (83 percent) and visits to family or
relatives (78 percent), but less so in making decisions about large purchases (57 percent) and on their
own health (66 percent).

Older women are more likely than younger women to have a say in all the specified decisions
as are women who have at least a secondary education compared with women with lower levels of
education. Participation in decisionmaking is also higher among women who are in the highest wealth
quintile, urban women, and women who reside in Addis Ababa, compared with their counterparts.
Participation in decisionmaking is lower among women who reside in the Somali and Gambela
regions. Employed women, especially those employed for cash, are much more likely to have a say in
all the specified decisions than women who are not employed.

Women may have a say in some but not other decisions. To assess a woman’s overall
decisionmaking autonomy, the decisions in which she participates—that is, in which she alone has the
final say or does so jointly with her husband or partner—are added together. The total number of
decisions in which a woman participates is one simple measure of her empowerment. The number of
decisions in which a woman jointly with her husband or partner has the final say is positively related
to women’s empowerment and reflects the degree of decisionmaking control women are able to
exercise in areas that affect their lives and environments. Figure 16.1 shows the distribution of cur-
rently married women according to the number of decisions in which they participate. Forty-four
percent of currently married women participate in all four household decisions, 22 percent participate
in three decisions and 18 percent participate in two decisions. Less than 10 percent of women
participate in one decision or no decision at all.

Women’s Empowerment and Demographic and Health Outcome | 239


Table 16.5 Women's participation in decisionmaking by background characteristics

Percentage of currently married women who usually make decisions on four specific issues in the household either
by themselves or jointly with their husband/partner, by background characteristics, Ethiopia 2005

Own Making Making Visits to All None of the


Background health large daily family or specified specified Number of
characteristic care purchases purchases relatives decisions decisions women
Age
15-19 63.6 52.7 78.1 72.8 40.3 12.5 711
20-24 62.5 54.1 80.7 75.8 40.0 9.4 1,574
25-29 65.0 57.0 83.5 77.8 42.7 8.0 2,066
30-34 64.1 55.6 83.0 78.7 42.4 8.4 1,551
35-39 67.9 57.0 82.3 79.0 43.9 8.6 1,343
40-44 67.0 62.8 85.3 80.5 47.6 6.3 960
45-49 74.1 63.2 88.0 85.3 51.6 4.8 862

Number of living children


0 66.0 56.4 76.2 70.0 40.5 12.9 801
1-2 66.3 57.0 83.0 79.0 44.2 7.9 2,628
3-4 65.7 57.0 83.5 79.0 44.4 8.7 2,631
5+ 65.4 57.5 84.1 79.6 43.0 7.0 3,007

Residence
Urban 83.5 74.0 91.6 91.6 64.8 3.5 959
Rural 63.7 55.1 81.9 76.8 41.0 8.8 8,107

Region
Tigray 65.4 65.1 80.7 89.4 53.8 7.6 570
Affar 67.2 57.0 67.3 74.9 41.0 13.7 109
Amhara 77.4 65.9 84.9 85.4 55.8 7.7 2,330
Oromiya 62.3 56.5 82.8 77.5 41.7 8.4 3,300
Somali 54.0 41.7 72.6 52.5 25.1 20.2 363
Benishangul-Gumuz 57.1 49.9 67.6 68.2 37.8 19.1 92
SNNP 57.9 45.0 83.4 72.1 28.6 6.7 1,988
Gambela 56.1 42.1 71.2 71.8 27.5 11.6 31
Harari 75.0 71.1 95.3 82.9 56.8 1.9 22
Addis Ababa 90.5 86.8 95.4 94.9 81.3 2.2 224
Dire Dawa 72.1 79.0 93.3 79.5 59.1 5.0 37

Education
No education 63.9 54.9 82.0 77.5 41.1 8.7 7,094
Primary 65.8 58.4 83.5 77.0 43.7 8.3 1,402
Secondary and higher 89.3 82.1 92.8 93.0 73.7 2.8 570

Employment
Not employed 62.6 54.0 80.4 75.9 39.4 9.7 6,821
Employed for cash 83.9 71.3 92.0 88.6 60.9 2.7 680
Employed not for cash 71.8 64.3 89.9 84.9 53.8 4.5 1,562
Missing 96.3 100.0 100.0 96.3 96.3 0.0 3

Wealth quintile
Lowest 59.6 47.5 76.9 72.8 35.2 13.1 1,759
Second 61.3 53.9 82.2 76.1 38.9 8.6 1,892
Middle 62.5 56.9 82.5 77.8 41.1 8.4 1,903
Fourth 68.5 60.5 85.6 79.7 45.6 6.0 1,823
Highest 78.2 67.3 87.6 86.1 58.0 5.2 1,689

Total 65.8 57.1 82.9 78.4 43.5 8.3 9,066

240 | Women’s Empowerment and Demographic and Health Outcome


Figure 16.1 Number of Household Decisions in Which
Currently Married Women Participate
Percent
50
44

40

30

22
20 18

10 8 8

0
0 1 2 3 4
Number of household decisions
EDHS 2005

16.4 ATTITUDE TOWARDS REFUSING SEX WITH HUSBAND

The extent of control women have over when and with whom they have sex has important
implications for demographic and health outcomes such as transmission of HIV and other sexually
transmitted infections. It is also an indicator of women’s empowerment because it measures women’s
level of acceptance of norms in certain societies that socialize them to believe that women do not have
the right to refuse sexual intercourse with their husband for any reason. The number of reasons a wife
can refuse to have sexual intercourse with her husband reflects perceptions of sexual roles and
women’s rights over their bodies, and relates positively to women’s sense of self-empowerment.

To measure beliefs about sexual empowerment of women, the 2005 EDHS included questions
on whether the respondent thinks that a wife is justified in refusing to have sexual intercourse with her
husband under three circumstances: she knows her husband has a sexually transmitted disease (STD);
she knows her husband has sexual intercourse with other women; and when she is tired or not in the
mood. These three circumstances for which women’s opinions are sought have been chosen because
they are effective in combining issues of women’s rights and consequences for women’s health.
Tables 16.6.1 and 16.6.2 show the responses of all women and all men, respectively.

Overall, the majority of women agree with each specified reason for refusing to have sex.
Slightly more than three-fifths (62 percent) of women and 72 percent of men agree that all of the
above reasons are justification for a woman to refuse to have sexual relations with her husband. Only
one in ten women and men agree with none of the reasons. The most accepted reasons for refusing to
have sex, among women and men, are if the wife knows her husband has a sexually transmitted
disease and if the wife knows her husband has sex with other women. For both women and men, the
least acceptable reason for a wife to refuse sex is being tired or not in the mood.

Women in the middle age groups, those with no education, unemployed women, women who
have married, those who have five children or more, and poorer women are the least likely to agree
with all of the reasons for refusing sex. Among men, those age 15-19, those who have primary
education, those who are employed but not for cash, those who have never married, and those who
have no children are the least likely to agree with all of the reasons for refusing sex.

Women’s Empowerment and Demographic and Health Outcome | 241


Table 16.6.1 Attitude toward refusing sexual intercourse with husband: women

Percentage of women 15-49 who believe that a wife is justified in refusing to have sexual intercourse with her
husband in specific circumstances, by background characteristics, Ethiopia 2005

Wife is justified in refusing sexual intercourse


with husband if she:
Knows husband Agrees with Agrees with
has a sexually Knows husband all of the none of the
Background transmitted has sex with Is tired or not specified specified Number of
characteristic disease other women in the mood reasons reasons women
Age
15-19 80.3 82.8 71.1 64.5 11.8 3,266
20-24 84.4 84.9 72.6 66.0 8.5 2,547
25-29 82.3 82.3 68.6 61.1 10.0 2,517
30-34 78.6 80.3 67.1 59.0 11.6 1,808
35-39 80.4 81.0 68.5 60.1 10.7 1,602
40-44 80.1 81.0 67.1 59.8 10.9 1,187
45-49 81.7 79.4 67.8 59.2 9.6 1,143

Marital status
Never married 82.0 83.6 72.5 66.9 11.3 3,516
Married or living together 80.5 81.3 68.3 60.2 10.4 9,066
Divorced/separated/
widowed 84.2 83.9 69.8 62.8 8.5 1,488

Number of living children


0 82.4 84.0 72.8 66.8 10.6 4,554
1-2 81.6 82.5 68.6 60.6 9.7 3,226
3-4 80.8 80.7 67.4 60.2 11.5 2,981
5+ 79.8 80.5 67.7 58.9 10.1 3,309

Residence
Urban 90.4 92.4 80.4 75.9 4.3 2,499
Rural 79.3 79.9 67.2 59.2 11.8 11,571

Region
Tigray 81.9 81.3 71.0 63.4 9.7 919
Affar 60.1 58.0 48.3 37.2 29.1 146
Amhara 86.7 87.9 68.2 62.2 6.9 3,482
Oromiya 82.6 84.1 74.8 67.0 8.9 5,010
Somali 59.4 48.3 48.8 33.9 27.5 486
Benishangul-Gumuz 67.1 65.9 51.1 43.4 22.9 124
SNNP 74.6 76.4 63.6 55.8 15.1 2,995
Gambela 54.7 48.6 35.3 27.5 34.3 44
Harari 85.1 89.9 81.5 76.0 6.8 39
Addis Ababa 94.3 96.4 83.1 79.8 1.9 756
Dire Dawa 85.5 86.9 76.9 73.1 10.0 69

Education
No education 77.9 78.2 65.2 56.9 12.8 9,271
Primary 84.6 86.6 75.9 69.3 8.2 3,123
Secondary and higher 94.0 95.4 81.6 77.9 1.9 1,675

Employment
Not employed 79.8 80.7 67.8 60.2 11.6 10,085
Employed for cash 87.0 87.9 74.5 68.6 6.4 1,632
Employed not for cash 83.5 84.3 73.6 66.1 8.5 2,339
Missing 88.9 75.7 50.7 50.7 10.7 14

Wealth quintile
Lowest 74.2 72.6 60.5 51.8 15.5 2,428
Second 79.3 79.0 65.0 57.9 12.4 2,643
Middle 79.3 81.1 68.9 60.1 11.1 2,732
Fourth 82.4 83.3 69.6 62.0 9.7 2,647
Highest 88.1 90.7 79.3 73.8 5.7 3,621

Total 81.3 82.1 69.5 62.1 10.5 14,070

242 | Women’s Empowerment and Demographic and Health Outcome


Table 16.6.2 Attitude toward refusing sexual intercourse with husband: men

Percentage of men age 15-59 believe that a wife is justified in refusing to have sexual intercourse with her husband in
specific circumstances by background characteristics, Ethiopia 2005

Wife is justified in refusing sexual intercourse


with husband if she:
Knows husband Agrees with Agrees with
has a sexually Knows husband Is tired or all of the none of the
Background transmitted has sex with not in the specified specified Number of
characteristic disease other women mood reasons reasons men
Age
15-19 81.3 79.5 72.3 67.3 14.6 1,335
20-24 86.4 83.7 77.8 73.3 10.1 1,064
25-29 87.1 81.7 78.3 72.3 10.4 741
30-34 86.7 85.0 80.0 72.9 8.3 754
35-39 85.9 81.9 77.9 71.4 10.5 651
40-44 87.1 87.0 78.1 74.2 7.2 497
45-49 84.8 85.1 83.1 77.2 10.4 422
50-54 85.3 83.3 79.4 73.3 9.7 335
55-59 89.7 85.8 81.3 75.8 7.1 235
Marital status
Never married 82.5 80.3 74.0 68.7 13.2 2,419
Married or living together 87.2 84.8 79.5 74.1 9.0 3,424
Divorced/separated/
widowed 87.5 83.3 86.8 76.5 6.3 190
Number of living children
0 83.4 81.3 74.6 69.5 12.5 2,766
1-2 88.5 84.5 81.2 75.0 8.6 993
3-4 86.8 82.7 77.4 72.7 10.4 967
5+ 86.0 85.3 81.1 74.7 8.2 1,307
Residence
Urban 92.4 91.2 90.8 85.2 4.0 918
Rural 84.1 81.5 75.2 69.7 11.8 5,115
Region
Tigray 94.5 90.3 85.5 81.7 4.1 366
Affar 78.9 77.4 76.0 69.1 15.2 65
Amhara 93.7 92.6 83.8 81.3 4.3 1,521
Oromiya 79.3 75.5 70.7 63.5 15.8 2,222
Somali 85.3 82.5 88.9 77.3 6.9 202
Benishangul-Gumuz 78.8 79.0 76.7 63.8 10.6 54
SNNP 81.8 80.0 74.4 68.7 13.0 1,244
Gambela 64.0 63.2 64.6 52.3 26.4 21
Harari 94.4 96.1 94.2 91.4 2.7 16
Addis Ababa 94.4 93.5 92.9 88.7 2.9 292
Dire Dawa 94.5 92.4 81.7 77.1 2.0 30
Education
No education 83.8 81.2 75.1 70.1 11.7 2,589
Primary 83.8 81.9 74.9 69.2 12.0 2,252
Secondary and higher 91.4 88.6 87.9 81.7 5.4 1,192
Employment
Not employed 89.2 85.1 81.9 75.5 7.8 867
Employed for cash 82.1 81.5 78.9 73.4 13.0 1,440
Employed not for cash 85.7 83.0 76.0 70.7 10.3 3,723
Missing 98.3 98.3 98.3 98.3 1.7 3
Wealth quintile
Lowest 79.3 76.8 71.8 66.0 16.1 1,100
Second 83.6 81.1 73.9 68.4 12.1 1,184
Middle 85.7 82.2 76.0 69.4 9.8 1,081
Fourth 85.5 83.7 77.0 72.2 10.4 1,200
Highest 90.9 88.9 86.5 81.3 6.0 1,469

Total 85.3 82.9 77.5 72.0 10.6 6,033

Women’s Empowerment and Demographic and Health Outcome | 243


Differences are also notable by urban-rural residence. More than three-fourths of women and
men in urban areas agree with all of the specified reasons for refusing sex and 4 percent agree with
none of the specified reasons. There are substantial variations by region. Women and men residing in
Gambela are the least likely to agree with all of the reasons for refusing sex (28 percent and 52
percent, respectively). Men in Harari and woman in Addis Ababa are the most likely to believe that a
wife is justified in refusing to have sex with her husband for any of the specified reasons.

16.5 ATTITUDES TOWARDS WIFE BEATING

The critical problems that women face are many and diverse. One of these, and essentially the
most serious, is the issue of violence against women. It can be described as the most serious because it
concerns the personal security of women, and right of personal security is fundamental to all other
rights. Domestic violence is a common phenomenon in Ethiopia, in both urban and rural families. If
violence against women is tolerated and accepted in a society, its eradication is made more difficult.

Women who believe that a husband is justified in hitting or beating his wife for any of the
five specified reasons may believe themselves to be low in status both absolutely and relative to men.
Such a perception could act as a barrier to accessing health care for themselves and their children,
affect their attitude towards contraceptive use, and impact their general well being.

To assess women’s and men attitudes towards wife beating, women and men were asked
whether a husband is justified in hitting or beating his wife in each of the following five situations: if
she burns the food; if she argues with him; if she goes out without telling him; if she neglects the
children; and if she refuses to have sexual relations with him. A lower score on the “number of
reasons wife beating is justified” indicates a woman’s greater sense of entitlement, self-esteem and
status, and therefore, has a negative association with women’s empowerment. The results are
summarized on Tables 16.7.1 and 16.7.2.

A sizeable majority of women (81 percent) believe that a husband is justified in beating his
wife for at least one of the specified reasons. This is not unexpected because many traditional customs
in Ethiopia as in many other countries teach and expect women to accept, tolerate and even rationalize
wife beating. This impedes women’s empowerment and has serious health consequences.

A high proportion of respondents agree that wife beating is acceptable, which indicates that
respondents generally accept violence as part of the male-family relationship. The most widely
accepted reasons for wife-beating are going out without telling the partner and neglecting the children
(about 64 percent). Three-fifths of women believe that a husband is justified in beating his wife if she
burns the food or argues with him. Forty-four percent of women feel that denying sex is a justifiable
reason for a man to beat his wife. Compared with women, men are less likely to report that they find
violence against women justifiable (Table 16.7.2) Overall, slightly more than half of Ethiopian men
agree with at least one of the reasons for why a man is justified in beating his wife. Men are most
likely to justify beating a wife if she goes out without telling him (36 percent) or neglects the children
(31 percent). Like women, men are least likely to say that burning food (24 percent) or arguing with
him (31 percent) are grounds for wife beating. Only about one-quarter of men feel that denying sex is
a justifiable reason for wife beating.

The tables also show attitudes towards wife beating by background characteristics. The
percentage of women who agree with at least one of the reasons justifying wife beating is higher
among older women, married women, and those with five or more children. Women who are
employed for cash are less likely to agree with at least one of the reasons for wife beating than those
who are either not employed or are employed but not for cash. Differences are also notable by level of
education; slightly more than half of women with secondary or higher education agree with at least
one specified reason for wife beating, compared with 87 percent of women with no education.

244 | Women’s Empowerment and Demographic and Health Outcome


Table 16.7.1 Attitude toward wife beating: women

Percentage of women 15-49 who agree that a husband is justified in hitting or beating his wife for specific reasons, by
background characteristics, Ethiopia 2005

Husband is justified in hitting or beating his wife if she: Agrees with


Goes out Neglects Refuses to at least one
Background Burns the Argues without the have sex specified Number of
characteristic food with him telling him children with him reason women
Age
15-19 57.4 55.6 59.9 59.9 36.3 77.3 3,266
20-24 59.3 56.4 61.9 63.5 42.0 78.4 2,547
25-29 61.2 58.8 66.3 66.5 45.4 81.8 2,517
30-34 64.4 61.7 66.0 66.8 49.2 83.9 1,808
35-39 62.7 62.3 68.1 67.3 49.1 83.5 1,602
40-44 62.9 59.8 66.4 66.9 47.0 83.5 1,187
45-49 65.3 61.5 66.0 66.2 52.7 84.9 1,143

Marital status
Never married 49.7 48.2 52.0 54.0 31.4 70.0 3,516
Married or living together 65.6 63.0 68.6 68.2 49.4 84.9 9,066
Divorced/separated/
widowed 59.7 57.3 65.7 67.5 43.3 83.4 1,488

Number of living children


0 53.5 51.9 56.6 58.1 34.2 74.0 4,554
1-2 61.9 58.9 65.3 65.8 46.1 82.3 3,226
3-4 65.3 62.6 67.9 68.7 49.2 84.0 2,981
5+ 66.6 64.3 70.2 68.5 51.9 86.6 3,309

Residence
Urban 30.8 34.6 41.5 44.2 19.8 59.0 2,499
Rural 67.5 63.9 69.1 69.0 49.6 85.8 11,571

Region
Tigray 52.0 52.6 61.0 60.0 28.2 73.7 919
Affar 37.0 53.5 62.2 61.7 42.2 80.4 146
Amhara 68.1 66.5 74.9 75.8 45.1 91.3 3,482
Oromiya 65.1 60.6 65.0 63.0 48.2 80.9 5,010
Somali 53.0 55.9 70.5 70.0 54.8 87.7 486
Benishangul-Gumuz 57.3 56.1 61.4 60.8 47.9 83.9 124
SNNP 64.8 60.2 61.5 64.5 49.8 81.1 2,995
Gambela 53.8 51.6 52.3 55.8 45.3 78.4 44
Harari 31.5 37.9 48.2 57.0 24.0 67.0 39
Addis Ababa 13.4 19.2 24.3 30.4 8.4 41.7 756
Dire Dawa 23.5 32.1 36.1 37.1 22.4 47.5 69

Education
No education 67.9 64.3 70.4 69.5 51.0 86.7 9,271
Primary 60.5 59.0 62.2 64.0 40.4 80.1 3,123
Secondary and higher 24.0 27.1 33.5 38.2 14.5 51.0 1,675

Employment
Not employed 62.3 59.8 66.0 65.9 46.2 82.7 10,085
Employed for cash 45.1 45.9 52.2 53.4 32.7 68.3 1,632
Employed not for cash 66.7 63.1 64.6 66.4 44.2 82.8 2,339
Missing 52.0 46.0 43.6 57.9 41.4 58.4 14

Wealth quintile
Lowest 64.4 60.3 71.0 68.9 51.3 87.0 2,428
Second 70.1 66.2 71.5 69.6 53.0 87.1 2,643
Middle 69.5 67.1 69.0 70.0 50.5 86.1 2,732
Fourth 69.6 64.5 69.5 69.1 46.9 85.2 2,647
Highest 39.5 41.6 46.7 50.5 26.7 65.6 3,621

Total 61.0 58.7 64.2 64.6 44.3 81.0 14,070

Eighty-six percent of rural women agree with at least one of the reasons justifying wife beating,
compared with 59 percent among urban woman. There is large variation by region. Nine in ten
women in Amhara agree with at least one specified reason for wife beating compared with slightly
more than two-fifths of women in Addis Ababa (42 percent).

Women’s Empowerment and Demographic and Health Outcome | 245


Men who are married, those who have no education, and those who are employed but do not
earn cash are more likely to agree with at least one specified reason for wife beating. Acceptance of
wife beating declines as the level of education increases. For all reasons, poorer women and men are
more likely than their wealthier counterparts to believe that wife beating is justified.

Acceptance of wife beating for at least one of the specified reasons is generally lower among
urban men than rural men (28 percent and 56 percent, respectively). Similar to women, men’s beliefs
vary greatly by region. Men in Benishangul-Gumuz and Affar are the most likely to agree that wife
beating is justified for at least one specified reason.

Table 16.7.2 Attitude toward wife beating: men

Percentage of men age 15-59 who agree that a husband is justified in hitting or beating his wife for specific
reasons, by background characteristics, Ethiopia 2005

Husband is justified in hitting or beating his wife if she: Agrees with


Goes out Neglects Refuses to at least one
Background Burns the Argues without the have sex specified Number of
characteristic food with him telling him children with him reason men
Age
15-19 27.5 32.4 36.6 32.6 26.6 53.3 1,335
20-24 24.3 29.9 36.5 29.9 23.2 50.6 1,064
25-29 23.0 29.3 36.3 29.4 21.6 50.0 741
30-34 22.6 31.2 35.2 30.8 20.9 50.9 754
35-39 21.2 26.4 32.7 26.6 21.5 48.9 651
40-44 24.6 32.0 37.9 35.6 26.3 53.2 497
45-49 22.6 27.8 36.2 27.4 20.7 50.2 422
50-54 21.7 32.0 37.1 36.0 19.7 53.0 335
55-59 24.7 34.9 39.7 34.4 27.5 55.6 235
Marital status
Never married 24.0 28.9 34.4 28.2 23.7 49.5 2,419
Married or living together 24.1 31.4 37.4 32.5 23.2 53.1 3,424
Divorced/separated/
widowed 25.2 33.2 37.6 39.6 20.9 48.7 190
Number of living children
0 24.1 30.0 35.5 29.5 24.3 50.7 2,766
1-2 23.3 29.5 32.5 30.4 20.2 47.5 993
3-4 24.6 30.7 37.6 33.1 23.3 52.2 967
5+ 24.2 32.2 39.5 33.1 23.9 55.5 1,307
Residence
Urban 7.8 11.8 17.5 13.0 8.8 27.8 918
Rural 27.0 33.8 39.5 34.2 26.0 55.7 5,115
Region
Tigray 15.1 23.9 20.9 23.0 14.2 35.4 366
Affar 36.1 45.4 51.5 47.0 44.9 61.4 65
Amhara 22.9 27.8 36.4 32.4 19.0 52.9 1,521
Oromiya 27.9 36.3 42.0 29.0 27.1 56.0 2,222
Somali 7.9 18.0 22.0 36.1 18.0 38.0 202
Benishangul-Gumuz 32.1 37.9 40.5 43.3 22.6 62.0 54
SNNP 28.5 32.7 38.1 38.6 29.1 56.5 1,244
Gambela 22.0 27.1 37.1 26.0 23.2 54.4 21
Harari 11.3 24.5 25.3 16.0 24.0 38.8 16
Addis Ababa 2.5 4.7 8.6 8.9 3.7 15.2 292
Dire Dawa 9.8 19.1 28.3 28.1 14.9 41.0 30
Education
No education 28.3 36.2 41.3 37.4 27.5 58.3 2,589
Primary 26.8 32.9 39.9 32.5 25.9 55.0 2,252
Secondary and higher 9.6 13.5 18.1 14.3 9.6 29.9 1,192
Employment
Not employed 19.1 23.0 29.4 22.5 19.0 41.4 867
Employed for cash 19.4 24.0 30.3 27.6 17.4 43.6 1,440
Employed not for cash 26.9 34.7 40.1 34.3 26.7 56.8 3,723
Missing 93.8 89.9 55.0 91.9 4.8 95.8 3
Wealth quintile
Lowest 27.1 37.4 39.9 38.6 27.7 56.0 1,100
Second 31.9 37.6 44.3 39.6 31.8 61.4 1,184
Middle 27.6 33.3 38.7 33.5 25.2 56.0 1,081
Fourth 23.7 31.1 39.7 29.6 22.9 53.4 1,200
Highest 13.2 16.9 22.2 17.8 12.2 35.3 1,469

Total 24.1 30.5 36.2 31.0 23.3 51.5 6,033

246 | Women’s Empowerment and Demographic and Health Outcome


16.6 CURRENT USE OF CONTRACEPTION BY WOMEN’S STATUS

A woman’s desire and ability to control her fertility and her choice of contraceptive method
are in part affected by her status in the household and her own sense of empowerment. A woman who
feels that she is unable to control her life may be less likely to feel she can make and carry out
decisions about her fertility. She may also feel the need to choose methods that are less obvious or
which do not depend on her husband’s cooperation. Table16.8 shows the distribution of currently
married women by contraceptive method use, according to the three empowerment indicators.

The data indicate that there is a positive relationship between women’s status and use of
contraception. Contraceptive use is highest among women who participate in most (3-4) household
decisions, who agree that a woman can refuse sexual intercourse with her partner for all three
specified reasons, and who believe that wife beating is not justified for all of the five specified
reasons. This pattern is consistent for both any method and modern methods. For example, current use
of modern contraceptive methods rises from 7 percent among women who believe there is no
justifiable reason for a woman to refuse sexual intercourse with a husband to 16 percent among
women with three reasons for refusing to have sexual intercourse with a husband.

Table 16.8 Current use of contraception by women's status

Percent distribution of currently married women by contraceptive method currently used, according to women's status indicators,
Ethiopia 2005

Modern method
Temporary
methods,1
female
Any sterilization Any tradi- Not
Women's status Any modern and male tional currently Number of
indicators method method Injectables condom method using Total women
Number of decisions in which
woman participates
0 8.0 7.5 4.8 2.7 0.5 92.0 100.0 736
1-2 10.0 9.5 6.8 2.6 0.6 90.0 100.0 2,376
3-4 17.4 16.5 11.8 4.7 0.9 82.6 100.0 5,954

Number of reasons given for


refusing to have sexual inter-
course with husband/partner
0 7.4 7.1 5.2 2.0 0.2 92.6 100.0 946
1-2 13.4 12.6 9.2 3.4 0.8 86.6 100.0 2,663
3 16.6 15.7 11.1 4.7 0.9 83.4 100.0 5,457

Number of reasons given that


justify wife beating
0 24.1 22.0 14.9 7.1 2.2 75.9 100.0 1,371
1-2 16.3 15.2 10.2 5.0 1.2 83.7 100.0 1,585
3-4 13.2 12.7 9.3 3.4 0.4 86.8 100.0 3,130
5 11.1 10.8 8.1 2.7 0.4 88.9 100.0 2,980

Total 14.7 13.9 9.9 4.0 0.8 85.3 100.0 9,066

Note: If more than one method is used, only the most effective method is considered in this tabulation.
1
Pill, IUD, injectables, implants, female condom, diaphragm, foam/jelly and lactational amenorrhoea method.

16.7 IDEAL FAMILY SIZE AND UNMET NEED BY WOMEN’S STATUS

The ability of women to effectively make decisions has important implications for their
fertility preferences and the practice of family planning. An increase in women’s status and
empowerment is recognized as important for efforts to reduce fertility through at least two main
pathways: its negative association with desired family size and its positive association with women’s
ability to meet their own family-size goals through the effective use of contraception.

Women’s Empowerment and Demographic and Health Outcome | 247


Table 16.9 shows how women’s ideal family size and their unmet need for family planning
vary by women’s status indicators. The data indicate that mean ideal family size decreases with
increasing number of decisions in which a woman has a final say and number of reasons to refuse sex
with her husband or partner, and increases with the number of reasons women believe wife beating is
justified. Thus, the data suggests that the more empowered the woman, the fewer children she desires.

Although there is no clear relationship between women’s decisionmaking power and belief
that refusing sexual intercourse is acceptable for any reason, unmet need increases with the number of
reasons women belief that wife beating is justified, indicating that less empowered women as
measured by this indicator are also less able to meet their contraceptive needs.

Table 16.9 Ideal number of children and unmet need for family planning by women’s status

Mean ideal number of children and the percentage of women with an unmet need for family planning, by
women’s status indicators, Ethiopia 2005

Mean ideal Unmet need for family planning2


Women's status number of Number of For For Number of
indicator children1 women spacing limiting Total women
Number of decisions in which
woman participates3
0 5.3 632 23.3 10.9 34.2 736
1-2 5.2 2,045 23.7 13.9 37.6 2,376
3-4 5.0 5,251 18.2 14.1 32.3 5,954

Number of reasons given for


refusing to have sexual intercourse
with husband/partner
0 5.0 1,263 12.1 7.2 19.2 1,471
1-2 5.0 3,496 14.9 9.0 24.0 3,856
3 4.2 7,843 12.3 9.1 21.4 8,743

Number of reasons given that


justify wife beating
0 3.9 2,449 9.3 6.0 15.3 2,673
1-2 4.4 2,368 11.4 8.3 19.7 2,638
3-4 4.7 4,188 13.6 9.4 23.0 4,667
5 4.8 3,597 15.7 10.6 26.3 4,092

Total 4.5 12,602 13.0 8.9 21.9 14,070


1
Excludes respondents who gave non-numeric responses.
2
See Table 7.3 for definition of unmet need for family planning
3
Currently married women

16.8 REPRODUCTIVE HEALTH CARE BY WOMEN’S STATUS

Table 16.10 shows women’s use of antenatal, delivery and postnatal care services by the three
indicators of women’s empowerment. In societies where health care is widespread, women’s
empowerment may not affect their access to reproductive health services; in other societies, however,
increased empowerment of women is likely to increase their ability to seek out and use health services
to better meet their own reproductive health goals, including the goal of safe motherhood.

The data indicate that there is a correlation between women’s status and utilization of health
services. The more empowered a woman, the more likely she is to receive antenatal care, postnatal
care, and delivery assistance from a health professional. For example, nearly one-third of women who
participate in making three or four decisions received antenatal care from health professionals,
compared with 18 percent of women who are not involved in any decisionmaking. Almost one in ten
women who participate in three or four decisions utilized postnatal and delivery care, compared with
2 percent of women who had no say in any decisionmaking.

248 | Women’s Empowerment and Demographic and Health Outcome


Table 16.10 Reproductive health care by women's status

Percentage of women with a live birth in the five years preceding the survey who received antenatal
care, delivery assistance, and postnatal care from a health worker for the most recent birth, by
women’s status indicators, Ethiopia 2005

Received
Received postnatal care
Received delivery from a health
antenatal care assistance professional
from a health from a health within two days Number of
Women's status indicator professional professional of delivery1 births
Number of decisions in which
woman participates2
0 18.1 2.2 2.1 552
1-2 22.4 3.6 4.1 1,878
3-4 30.7 8.5 8.9 4,342

Number of reasons given for


refusing to have sexual intercourse
with husband/partner
0 17.2 3.7 4.1 752
1-2 25.2 4.6 5.8 2,156
3 30.6 8.6 8.8 4,399

Number of reasons given that


justify wife beating
0 38.1 17.2 17.9 1,069
1-2 28.8 9.4 9.3 1,263
3-4 25.4 4.3 4.6 2,498
5 24.9 4.0 4.8 2,477

Total 27.6 7.0 7.4 7,307


1
Includes mothers who delivered in a health facility
2
Currently married women

The number of reasons for which women feel that a wife is justified in refusing to have
sexual intercourse with her husband has a stronger positive relationship with all three variables. For
example, the proportion of women who receive antenatal care increases from 17 percent among
women who think a wife is not justified in refusing to have sex with her husband for any of the
specified reasons to 31 percent among those who said that all three reasons cited were justifiable. A
similar relationship is observed between the number of reasons given for refusing sexual intercourse
with husband/partner and receiving postnatal and delivery care.

The data also show a steady increase in utilization of health services as the number of reasons
wife beating is believed to be justified decreases. For example, 17 percent of women who say wife
beating is not justified in any of the situations described were attended by medical professionals
compared with only 4 percent of women who say that wife beating is justified in all five of the
specified circumstances.

16.9 EARLY CHILDHOOD MORTALITY RATES BY WOMEN’S STATUS

An outcome of empowerment is women’s ability to access information, make decisions, and


act effectively in their own interest or in the interest of those who depend on them. It follows that if
women, who are the primary caretakers of children, are empowered, the health and survival of their
children will be enhanced.

Table 16.11 shows information on the impact of women’s empowerment on infant and child
mortality. Surprisingly, the data show that women who have no final say in any decision in the
household have lower childhood mortality rates than those who have a say in three or four decisions.

Women’s Empowerment and Demographic and Health Outcome | 249


For example, the infant mortality rate for children whose mothers have no final say in any decision is
69 deaths per 1,000 live births, compared with about 79 deaths per 1,000 live births for children of
mothers who participate in three or four decisions in the household.

With the exception of infant mortality, there is no clear association between a woman’s belief
that it is acceptable to refuse sexual intercourse with her husband and childhood mortality. The infant
mortality rate of children whose mothers think a wife is justified in refusing to have sexual intercourse
with her husband for any of the specified reasons is 75 deaths per 1,000 live births, compared with 84
deaths per 1,000 live births for children of those who say that a woman is justified for all three
reasons cited.

Table 16.11 Early childhood mortality rates by women's status

Infant, child, and under-five mortality rates for the 10-year period preceding the survey, by women's status
indicators, Ethiopia 2005

Neonatal Postneonatal Infant Child Under-five


Women's status mortality mortality mortality mortality mortality
indicators (NN) (PNN) (1q0) (4q1) (5q0)
Number of decisions in which
woman participates1
0 34 35 69 61 126
1-2 39 43 82 53 131
3-4 41 38 79 54 128

Number of reasons given for


refusing to have sexual intercourse
with husband/partner
0 36 40 75 61 132
1-2 35 39 74 59 129
3 44 40 84 54 133

Number of reasons given that


justify wife beating
0 38 37 75 45 116
1-2 41 43 85 58 137
3-4 37 43 80 63 138
5 45 36 81 53 130
1
Currently married women

Attitudes towards wife beating are reflections of women’s status. Women who do not approve
of any form of wife beating are assumed to enjoy a higher status in the household and in society. In
turn, this translates into a more favourable mortality profile for their children. The rates of childhood
mortality are generally lower among children whose mothers believe that wife beating is not justified
for any reason. For example, the infant mortality rate for children of mothers who consider wife
beating unjustified for any reason is 75 deaths per 1,000 live births compared with 81 deaths per 1,000
live births for children whose mothers agree with all of the specified reasons for wife beating. A
similar relationship is observed between women’s status and levels of child mortality and under-five
mortality.

16.10 PROPERTY DISPOSSESSION

Property dispossession can make widowed women and their children especially vulnerable. In
many countries, widows are often denied an inheritance either because of common law or religious
laws. Also, in many cases, even where such laws provide for the transfer of property to widows and
their children, enforcement of inheritance laws may be weak, leaving them at the mercy of relatives.

250 | Women’s Empowerment and Demographic and Health Outcome


Table 16.12 shows that 6 percent of women age 15-49 interviewed in the EDHS have been
widowed at some time and of these, one in five has been dispossessed of property belonging to their
late husband.

Dispossession of property is most common among younger women (less than 30 years) who
have been widowed than older women. Previously widowed women who are currently married are
somewhat more likely to be dispossessed of property as are the small numbers of women who have no
children. Women with children under 18 years of age are also somewhat more likely to have property
taken away from them than women with children 18 years and older.

Table 16.12 Widows dispossessed of property

Percentage of de facto women age 15-49 who have been widowed, and the
percentage of widowed women who have been dispossessed of property, by
selected background characteristics, Ethiopia 2005

Ever-widowed women
Percentage Percentage
of ever- who were
Background widowed Number of dispossessed Number of
characteristics women women of property women
Age
15-19 0.3 3,266 * 10
20-29 2.6 5,064 34.6 132
30-39 8.8 3,410 20.4 301
40-49 19.5 2,330 14.3 454
Marital status
Married 3.4 8,914 34.4 302
Living together 12.0 152 * 18
Divorced/separated 2.2 932 (28.5) 21
Widowed 100.0 556 12.0 556
Age of youngest child
No children 0.6 4,357 (42.7) 24
<18 years 8.6 9,535 19.5 820
18 + years 30.0 178 14.2 53
Residence
Urban 6.8 2,499 22.6 171
Rural 6.3 11,571 19.1 726
Region
Tigray 7.5 919 24.9 69
Affar 6.2 146 (16.2) 9
Amhara 6.6 3,482 13.8 231
Oromiya 6.7 5,010 21.0 336
Somali 5.2 486 (9.0) 25
Benishangul-Gumuz 6.7 124 7.1 8
SNNP 5.5 2,995 25.9 164
Gambela 12.6 44 44.3 6
Harari 4.7 39 (22.4) 2
Addis Ababa 5.3 756 17.3 40
Dire Dawa 8.6 69 15.3 6
Education
No education 8.0 9,271 19.0 741
Primary 3.0 3,123 27.7 92
Secondary and higher 3.7 1,481 18.6 54
Wealth quintile
Lowest 8.7 2,428 15.7 210
Second 7.5 2,643 19.8 199
Middle 5.0 2,732 17.3 137
Fourth 5.8 2,647 27.2 155
Highest 5.4 3,621 20.1 196

Total 6.4 14,070 19.8 897

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


indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.

Women’s Empowerment and Demographic and Health Outcome | 251


Urban women are slightly more likely to be dispossessed of property than rural women.
Women living in Gambela are most likely to be dispossessed compared with women living in the
other regions. Surprisingly, women with primary education are more vulnerable to having property
dispossessed than women with no education or women with at least some secondary education. Also,
women in the lowest wealth quintile are least likely to be denied their late husband’s property
compared with women in the other wealth quintiles.

16.11 HARMFUL TRADITIONAL PRACTICES

The 2005 EDHS included a series of questions in the Women’s Questionnaire to gather
information on women’s knowledge and attitude about three specific harmful traditional practices and
their experience with each of them. All women were first asked if they had ever heard of female
circumcision or uvulectomy/tonsillectomy. In addition, ever-married women were asked about the
practice of marriage by abduction. If women had heard of any of these practices, they were further
asked if they themselves had been subject to any of them. Circumcised women were also asked for the
type of circumcision they had had. Women who had children were asked if any of their daughters had
been circumcised or married by abduction, and if any of their children had had a uvulectomy. Finally,
women were also asked for their opinion about whether the specific harmful traditional practice that
they had knowledge of should be continued.

16.11.1 Female Circumcision

Female circumcision, also known as female genital cutting (FGC) or female genital
mutilation, is a common practice in many societies in sub-Saharan Africa. In Ethiopia, the age at
which FGC is performed varies among the different ethnic groups. In Northern Amhara and Tigray,
for example, FGC is performed at infancy and usually on the eighth day after birth (NCTPE, 1998).

Data collected in the 2005 EDHS show that most women age 15-49 have heard of female
circumcision (Table 16.13). With the exception of differences by region, differences by other
background characteristics in the percentage of women who have heard of female circumcision are
small. Less than one in two women in Gambela have heard of female circumcision (45 percent),
compared with nearly all women in Harari, Dire Dawa, Addis Ababa, Affar, Somali and Oromiya and
at least 80 percent of women in Amhara, SNNP, Tigray and Benishangul-Gumuz.

Table 16.13 shows that three in four Ethiopian women have been circumcised. Six percent of
circumcised women reported that their vagina was sewn closed (infibulation) during circumcision,
which is the most severe form of FGC. Infibulation is most common among women age 25-39,
women with no education, and women in the lowest wealth quintile. Rural women are also more
likely than urban women to have experienced infibulation. More than four in five circumcised women
residing in the Somali Region and three in five in Affar have experienced the most severe form of
FGC.

Less than one in three women who have heard of FGC believes that the practice should
continue (Table 16.13). Support for female circumcision varies with background characteristics and is
similar to that discussed under knowledge of female circumcision.

252 | Women’s Empowerment and Demographic and Health Outcome


Table 16.13 Knowledge, prevalence, and support of female circumcision

Percentage of women who have heard of female circumcision and who are circumcised, and among circumcised women the
percentage who have their vagina sewn closed and among women who have heard of female circumcision the percentage who
support the practice, by selected background characteristics, Ethiopia 2005
Among women who have
Percentage Among circumcised heard of female circumcision
of women women
who have Percentage
heard of Percentage Percentage who believe
Background female of women Number of with vagina Number of practice should Number of
characteristic circumcision circumcised women sewn closed women be continued women
Age
15-19 90.0 62.1 3,266 4.7 2,029 22.9 2,939
20-24 92.5 73.0 2,547 5.8 1,860 27.2 2,356
25-29 91.9 77.6 2,517 6.8 1,954 34.5 2,314
30-34 91.1 78.0 1,808 7.7 1,410 36.5 1,647
35-39 93.1 81.2 1,602 7.1 1,302 37.7 1,491
40-44 94.3 81.6 1,187 6.1 969 33.7 1,120
45-49 92.1 80.8 1,143 4.7 924 38.0 1,052
Residence
Urban 97.8 68.5 2,499 5.1 1,713 10.4 2,445
Rural 90.5 75.5 11,571 6.3 8,735 36.3 10,475
Region
Tigray 82.9 29.3 919 1.1 269 21.5 762
Affar 98.4 91.6 146 63.2 134 65.6 144
Amhara 88.9 68.5 3,482 0.6 2,386 39.0 3,095
Oromiya 97.1 87.2 5,010 2.5 4,369 29.8 4,866
Somali 98.1 97.3 486 83.8 473 74.3 477
Benishangul-Gumuz 79.5 67.6 124 3.2 84 40.1 99
SNNP 86.7 71.0 2,995 0.6 2,127 26.0 2,597
Gambela 44.6 27.1 44 1.0 12 21.0 20
Harari 99.8 85.1 39 12.5 33 21.6 39
Addis Ababa 99.5 65.7 756 0.8 497 5.6 753
Dire Dawa 99.8 92.3 69 13.2 64 13.8 69
Education
No education 89.8 77.3 9,271 7.9 7,165 40.6 8,328
Primary 93.8 70.8 3,123 1.9 2,211 20.2 2,928
Secondary and higher 99.3 64.0 1,675 3.0 1,072 4.7 1,663
Wealth quintile
Lowest 87.9 73.0 2,428 21.1 1,773 48.3 2,135
Second 89.7 75.9 2,643 4.1 2,006 39.2 2,370
Middle 90.4 75.4 2,732 3.1 2,059 34.3 2,469
Fourth 92.2 77.6 2,647 1.8 2,055 30.7 2,441
Highest 96.8 70.6 3,621 3.2 2,556 14.1 3,505

Total 91.8 74.3 14,070 6.1 10,448 31.4 12,920

Women who had at least one daughter were asked if any of their daughters had been
circumcised. Thirty-eight percent of women with a daughter reported having at least one of their
daughters circumcised (Table 16.14). The probability that a respondent’s daughter is circumcised
varies directly with her age, rising from 15 percent among women age 15-19 to 67 percent among
women age 45-49, indicating that there may have been a decline in the practice of circumcision in
recent years. Rural women are more likely than urban women to have a daughter circumcised.
Circumcision of daughters is highest in Affar, where 85 percent of women have a circumcised
daughter, and lowest in Gambela where 11 percent of women have a daughter circumcised. Women
with no education are more than twice as likely as women with secondary education or higher to have
a daughter circumcised. There is no uniform relationship between wealth and having a daughter
circumcised. Nevertheless, women in the highest wealth quintile are least likely to have a daughter
circumcised.

Table 16.14 shows that 4 percent of circumcised daughters have experienced the most severe
form of FGC. Infibulation is most prevalent among daughters of women age 30-34, rural women,
women residing in Affar and Somali, women with no education, and women in the poorest wealth
quintile.

Women’s Empowerment and Demographic and Health Outcome | 253


Table 16.14 Daughter's circumcision experience and type of circumcision

Among women with at least one living daughter, percentage with at least one
circumcised daughter, and percent distribution by type of circumcision among
most recently circumcised daughters, according to selected background
characteristics, Ethiopia 2005
Percentage of Number of
women with at Number of most
Mother's least one women with Daughters recently
background daughter at least one with vagina circumcised
characteristic circumcised daughter sewn closed daughters
Age
15-19 14.6 222 (3.5) 32
20-24 14.3 918 4.0 131
25-29 21.2 1,735 3.3 367
30-34 32.0 1,516 6.1 484
35-39 45.4 1,422 4.6 645
40-44 58.9 1,069 4.7 630
45-49 66.6 1,039 2.2 692
Residence
Urban 30.0 914 2.9 274
Rural 38.7 7,007 4.2 2,708
Region
Tigray 30.2 524 0.5 158
Affar 85.1 82 74.1 69
Amhara 56.8 2,014 0.0 1,144
Oromiya 34.9 2,873 0.9 1,003
Somali 28.1 323 62.3 91
Benishangul-Gumuz 49.3 74 1.1 37
SNNP 23.5 1,733 0.7 406
Gambela 11.0 25 0.0 3
Harari 27.1 17 7.8 5
Addis Ababa 25.1 223 0.0 56
Dire Dawa 34.3 32 6.2 11
Education
No education 41.3 6,343 4.5 2,620
Primary 24.7 1,131 0.5 279
Secondary and higher 18.7 446 3.2 83
Wealth quintile
Lowest 38.2 1,613 14.7 617
Second 37.2 1,607 2.6 598
Middle 37.7 1,578 0.8 594
Fourth 41.2 1,603 0.7 661
Highest 33.7 1,518 1.4 512

Total 37.7 7,920 4.1 2,982

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

Female circumcision has declined over the past five years from 80 percent in 2000 to 74
percent in 2005. Support for the practice has also declined from 60 percent to 31 percent over the
same period. In addition, circumcising daughters has declined. Fifty-two percent of mothers with at
least one daughter had a daughter circumcised in 2000 compared with 38 percent in 2005.

16.11.2 Uvulectomy or Tonsillectomy

Uvulectomy is commonly practiced in Ethiopia and involves the removal of the uvula with
horse tail hair or thread looped through a bamboo stick. Often, a special knife-like, sharpened iron is
used to cut the uvula before it is taken out. Tonsillectomy refers to the removal of the tonsils, often
using just the index finger, to treat sore throats and swallowing difficulties (Jeppsson et al., 2003).
These harmful traditional practices may pose a health hazard particularly if carried out with

254 | Women’s Empowerment and Demographic and Health Outcome


unsterilised instruments or in an unhygienic setting. Questions in the EDHS did not distinguish
between the two practices and hence the data discussed in this section refers to knowledge of
uvulectomy and/or tonsillectomy, the prevalence of both, and attitude towards the continuation of
both practices.

Table 16.15 shows that a large majority of women (84 percent) have heard of uvulectomy or
tonsillectomy. Knowledge of the practice is much higher among women in urban than in rural areas
and ranges from a low of 52 percent among women in Gambela to universal knowledge among
women in Tigray. Highly educated women and women from the highest wealth quintile are much
more likely to have heard of the practice than less educated women and women in the other wealth
quintiles. Differences by age are small.

Table 16.15 Knowledge, prevalence, and support of uvulectomy or tonsillectomy

Percentage of women who have heard of uvulectomy/tonsillectomy, percentage of women who


have ever had an uvulectomy/tonsillectomy, and among those who have heard of
uvulectomy/tonsillectomy, the percentage who support the practice, by selected background
characteristics, Ethiopia 2005

Among women who


have heard of
uvulectomy/
tonsillectomy
Percentage of Percentage of Percentage
women who women who who believe
heard of ever had an Number practice
Background uvulectomy/ uvulectomy/ of should be Number of
characteristic tonsillectomy tonsillectomy women continued women
Age
15-19 83.5 37.3 3,266 23.0 2,727
20-24 84.5 37.9 2,547 27.1 2,153
25-29 82.4 42.2 2,517 30.6 2,074
30-34 84.2 46.0 1,808 33.6 1,523
35-39 85.4 44.1 1,602 32.2 1,369
40-44 83.6 45.5 1,187 30.9 993
45-49 85.9 48.5 1,143 33.6 981

Residence
Urban 95.4 46.2 2,499 13.0 2,385
Rural 81.5 40.8 11,571 33.1 9,434

Region
Tigray 99.5 89.2 919 68.3 915
Afar 93.3 76.9 146 69.5 136
Amhara 77.4 42.5 3,482 44.1 2,694
Oromiya 81.6 28.9 5,010 19.8 4,089
Somali 60.9 36.4 486 47.8 296
Benishangul-Gumuz 68.1 29.1 124 34.5 85
SNNP 91.2 46.8 2,995 17.3 2,732
Gambela 51.9 25.2 44 32.7 23
Harari 97.7 58.4 39 19.9 38
Addis Ababa 98.1 42.7 756 7.0 742
Dire Dawa 98.9 69.0 69 13.1 68

Education
No education 81.4 43.5 9,271 37.6 7,548
Primary 84.7 36.8 3,123 18.0 2,647
Secondary and higher 96.9 41.4 1,675 7.4 1,624

Wealth quintile
Lowest 80.6 47.3 2,428 45.9 1,958
Second 82.2 40.3 2,643 37.2 2,174
Middle 82.1 41.7 2,732 30.4 2,243
Fourth 80.5 37.4 2,647 26.6 2,130
Highest 91.5 42.5 3,621 14.4 3,314

Total 84.0 41.8 14,070 29.1 11,819

Women’s Empowerment and Demographic and Health Outcome | 255


More than two in five Ethiopian women have Table 16.16 Daughter's uvulectomy/tonsillectomy
had an uvulectomy or tonsillectomy. The prevalence of Among women with at least one living daughter,
uvulectomy or tonsillectomy increases with woman’s percentage with at least one daughter who ever had
age rising from 37 percent among women age 15-19 to an uvulectomy/tonsillectomy, according to selected
background characteristics, Ethiopia 2005
49 percent among women age 45-49, indicating a
declining trend in the practice. The practice is most Percentage of
women with
prevalent among urban women, women residing in at least one
Tigray, women with no education, and women in the daughter Number of
Mother's who had an women with
lowest wealth quintile. background uvulectomy/ at least one
characteristic tonsillectomy daughter
Table 16.15 shows that 29 percent of women Age
support the continuation of this harmful traditional prac- 15-19 30.6 222
20-24 32.1 918
tice. There is no uniform pattern of support for the 25-29 38.5 1,735
practice by age. One in three rural women supports the 30-34 45.0 1,516
35-39 45.0 1,422
practice compared with just over one in ten urban 40-44 43.4 1,069
women. More than two-thirds of women residing in 45-49 49.6 1,039
Affar and Tigray support the continuation of this prac- Residence
tice compared with less than one in ten women residing Urban 44.5 914
in Addis Ababa. Support for uvulectomy or tonsil- Rural 41.8 7,007
lectomy is highest among women with no education and Region
women in the lowest wealth quintile. Tigray 93.2 524
Affar 79.7 82
Amhara 43.3 2,014
Forty-two percent of women with at least one Oromiya 29.3 2,873
daughter have a daughter who has had an uvulectomy or Somali 22.7 323
Benishangul-Gumuz 32.2 74
tonsillectomy (Table 16.16). The percentage of daugh- SNNP 49.1 1,733
ters who have had a uvulectomy or tonsillectomy in- Gambela 26.2 25
Harari 53.6 17
creases monotonically with age. The percentage of Addis Ababa 38.9 223
daughters exposed to this harmful traditional practice Dire Dawa 46.8 32
varies widely by region, ranging from a low of 23 Education
percent in Somali to a high of 93 percent in Tigray. No education 43.4 6,343
Primary 37.9 1,131
Women with no education are much more likely to have Secondary and higher 34.4 446
a daughter exposed to this practice than women with
some education. Differences by urban-rural residence Wealth quintile
Lowest 45.3 1,613
and wealth quintile are relatively small. Second 41.2 1,607
Middle 42.6 1,578
Fourth 38.9 1,603
16.11.3 Marriage by Abduction Highest 42.4 1,518

Total 42.1 7,920


Marriage by abduction is another harmful tradi-
tional practice that is known to exist in Ethiopia. In
general, the would-be abductor forms a group of intimate friends and relatives to carry out the
abduction (NCTPE, 1998). An unmarried young girl is forcefully dragged or carried over the shoulder
of the abductor who may beat her to subdue her. The girl is then taken to a hideaway. This tactic is
often used as a short cut to marriage. Abduction may be followed by rape.

Eighty-three percent of women have heard of marriage by abduction (Table 16.17). Urban
women are much more likely than rural women to have heard of the practice. Regional variations in
knowledge of the practice is marked, with all or nearly all women in Dire Dawa, Addis Ababa, Harari,
Oromiya and SNNP having heard of the practice, compared with about half of women residing in
Somali, Gambela and Amhara. Educated women are much more likely to be aware of this practice
than women with no education, as are women in the highest wealth quintile compared with women in
the lowest.

256 | Women’s Empowerment and Demographic and Health Outcome


Table 16.17 Knowledge, prevalence, and support of marriage by abduction

Percentage of women who have heard of marriage by abduction percentage of women who ever
had a marriage by abduction and among those who have heard of marriage by abduction, the
percentage who support the practice, by selected background characteristics, Ethiopia 2005

Among women who


have heard of marriage
by abduction
Percentage of Percentage
women who Percentage of who believe
have heard of women practice
Background marriage by married by Number of should be Number of
characteristic abduction abduction women continued women
Age
15-19 83.2 2.5 3,266 2.0 2,717
20-24 84.7 7.3 2,547 2.8 2,158
25-29 83.1 9.5 2,517 3.7 2,092
30-34 82.6 11.4 1,808 3.5 1,493
35-39 81.8 9.6 1,602 3.0 1,310
40-44 83.9 9.9 1,187 2.2 997
45-49 82.1 10.4 1,143 3.3 938

Residence
Urban 93.7 4.7 2,499 1.1 2,342
Rural 80.9 8.5 11,571 3.3 9,363

Region
Tigray 80.6 1.4 919 1.1 741
Affar 79.1 6.1 146 17.9 116
Amhara 53.8 2.4 3,482 3.2 1,872
Oromiya 98.0 10.8 5,010 2.8 4,909
Somali 48.0 4.6 486 17.4 233
Benishangul-Gumuz 58.9 3.5 124 5.1 73
SNNP 96.2 12.9 2,995 2.0 2,882
Gambela 53.6 9.2 44 4.2 24
Harari 99.0 6.9 39 1.8 38
Addis Ababa 99.0 4.3 756 0.6 749
Dire Dawa 99.8 6.6 69 0.7 69

Education
No education 78.0 9.0 9,271 3.7 7,227
Primary 91.2 7.1 3,123 2.1 2,847
Secondary and higher 97.4 2.5 1,675 0.5 1,631

Wealth quintile
Lowest 75.3 7.7 2,428 6.0 1,827
Second 80.1 10.1 2,643 3.2 2,118
Middle 81.6 8.6 2,732 3.1 2,229
Fourth 82.1 7.7 2,647 2.5 2,172
Highest 92.8 5.7 3,621 1.1 3,359

Total 83.2 7.8 14,070 2.9 11,705

Eight percent of women reported that they had been married by abduction. This is most
commonly reported by women age 30-34, rural women, women residing in SNNP and Oromiya and
women with no education. This practice is least common among the wealthiest group of women.

As seen in Table 16.17, there is very little support among Ethiopian women for the
continuation of this harmful traditional practice. Women age 25-29, women residing in rural areas,
women from Affar and Somali, women with no education and women in the lowest wealth quintile
are more likely than their counterparts to support the continuation of this practice.

About 1 percent of daughters of women with at least one daughter was reported to have been
married by abduction, with the practice more common among daughters of older women age 45-49
and daughters of women with no education (Table 16.18). Differences by other background
characteristics are small.

Women’s Empowerment and Demographic and Health Outcome | 257


Table 16.18 Daughter's marriage by abduction

Among women with at least one living daughter,


percentage with at least one daughter who ever had a
marriage by abduction, according to selected
background characteristics, Ethiopia 2005

Percentage of
women with at
least one Number of
Mother's daughter who women with
background was married by at least one
characteristic abduction daughter
Age
15-19 0.0 222
20-24 0.0 918
25-29 0.0 1,735
30-34 0.6 1,516
35-39 0.8 1,422
40-44 4.0 1,069
45-49 4.9 1,039

Residence
Urban 1.5 914
Rural 1.4 7,007

Region
Tigray 0.2 524
Affar 1.8 82
Amhara 0.3 2,014
Oromiya 2.0 2,873
Somali 0.5 323
Benishangul-Gumuz 0.7 74
SNNP 2.3 1,733
Gambela 1.5 25
Harari 2.2 17
Addis Ababa 1.9 223
Dire Dawa 1.2 32

Wealth quintile
Lowest 1.2 1,613
Second 2.3 1,607
Middle 0.9 1,578
Fourth 1.1 1,603
Highest 1.7 1,518

Education
No education 1.7 6,343
Primary 0.2 1,131
Secondary and higher 0.5 446

Total 1.4 7,920

16.11.4 Obstetric Fistula

The 2005 EDHS included a series of questions on obstetric fistula, a condition that develops
when the blood supply to the tissues of the vagina, bladder, and/or rectum is cut off during prolonged
obstructed labour, resulting in the formation of an opening through which urine and/or faeces pass
uncontrollably. Women who develop fistulas are often socially rejected.

All women were asked if they had heard of obstetric fistula, and if they had, whether they
themselves had experienced the condition. Those who reported suffering from obstetric fistula were
asked if they had ever been treated for it. These women were also asked if there were any other
women in the household who suffered from it and if so how many.

258 | Women’s Empowerment and Demographic and Health Outcome


One in four women interviewed in the survey had heard of obstetric fistula. Knowledge of
obstetric fistula is higher among urban women, women residing in Addis Ababa, highly educated
women, and women in the highest wealth quintile (Table 16.19). There is no uniform pattern of
knowledge by age.

Table 16.19 shows that 1 percent of women who have ever had a birth reported experiencing
obstetric fistula. Older women (age 40 and above) and very young women (age 15-19) are slightly
more likely to report the condition, as are women residing in urban areas. Women in the Tigray and
SNNP regions are relatively more likely to have experienced obstetric fistula.

A very small number of women (less than 1 percent) reported ever being treated for obstetric
fistula.

According to information gathered from women who had heard of the condition, 4 percent of
other women resident in the households also suffered from obstetric fistula.

Table 16.19 Prevalence of obstetric fistula

Percentage of women who have heard of obstetric fistula, among women who have ever given birth the percentage who experienced
obstetric fistula and percentage who have been treated for obstetric fistula, and among women who have heard of obstetric fistula the
percentage who live in a household where someone else experienced obstetric fistula, according to selected background characteristics,
Ethiopia 2005

Among women who have Among women who have


ever given birth heard of obstetric fistula
Percentage of
women who Percentage Percentage of
have heard who have Percentage other women in
Background of obstetric experienced ever treated for household with
characteristic fistula Number obstetric fistula obstetric fistula Number obstetric fistula Number
Age
15-19 19.7 3,266 2.0 0.6 443 4.1 642
20-24 24.5 2,547 0.9 0.2 1,535 3.2 625
25-29 24.0 2,517 0.6 0.1 2,194 3.5 604
30-34 21.8 1,808 0.6 0.1 1,701 4.2 395
35-39 24.8 1,602 1.1 0.3 1,559 4.2 398
40-44 26.1 1,187 1.6 0.9 1,155 4.0 310
45-49 25.8 1,143 1.9 0.8 1,125 4.0 295
Education
No education 16.3 9,271 1.0 0.3 7,644 4.5 1,508
Primary 24.3 3,123 1.3 0.4 1,454 4.4 758
Secondary and higher 59.8 1,675 1.0 0.3 615 2.3 1,003
Residence
Urban 50.1 2,499 1.4 0.7 1,232 2.2 1,251
Rural 17.4 11,571 1.0 0.3 8,480 4.8 2,018
Region
Tigray 37.8 919 1.6 0.4 635 13.4 347
Afar 11.7 146 1.0 0.6 106 3.8 17
Amhara 16.0 3,482 0.5 0.5 2,566 1.6 557
Oromiya 23.0 5,010 1.2 0.2 3,467 2.1 1,153
Somali 7.2 486 0.0 0.0 382 5.9 35
Benishangul-Gumuz 14.3 124 0.6 0.0 94 2.3 18
SNNP 19.9 2,995 1.5 0.4 2,056 5.0 597
Gambela 10.9 44 1.1 1.0 34 3.9 5
Harari 46.4 39 0.1 0.0 23 2.1 18
Addis Ababa 66.1 756 1.0 0.5 308 2.3 500
Dire Dawa 31.8 69 1.0 0.2 42 1.5 22
Wealth quintile
Lowest 15.1 2,428 1.3 0.3 1,920 5.0 367
Second 16.9 2,643 0.9 0.2 1,997 3.1 446
Middle 16.2 2,732 0.6 0.1 1,946 6.8 442
Fourth 19.5 2,647 1.6 0.4 1,902 5.6 515
Highest 41.4 3,621 1.0 0.6 1,948 2.3 1,498

Total 23.2 14,070 1.0 0.3 9,713 3.8 3,269

Women’s Empowerment and Demographic and Health Outcome | 259


 
REFERENCES

Central Bureau of Statistics (CBS) [Kenya], Ministry of Health (MOH) [Kenya], and ORC Macro.
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SAMPLE IMPLEMENTATION Appendix A
Table A.1 Sample implementation: women

Percent distribution of households and eligible women by results of the household and individual interviews, and household, eligible women and
overall response rates, according to urban-rural residence and region, Ethiopia 2005

Residence Region
Beni-
shangul- Addis Dire
Result Urban Rural Tigray Affar Amhara Oromiya Somali Gumuz SNNP Gambela Harari Ababa Dawa Total

Selected households
Completed (C) 91.9 94.4 95.0 86.2 95.7 96.2 88.3 91.1 96.1 88.6 94.2 95.2 93.5 93.7
Household present but no
competent respondent at
home (HP) 1.4 0.6 1.0 0.7 0.8 0.2 1.6 1.4 0.4 1.0 2.0 0.6 1.4 0.9
Postponed (P) 0.1 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.0 0.0
Refused (R) 0.5 0.2 0.2 1.2 0.1 0.1 0.3 0.2 0.3 0.2 0.4 0.4 0.4 0.3
Dwelling not found (DNF) 0.4 0.2 0.0 0.4 0.1 0.0 0.9 0.1 0.1 0.2 0.1 0.1 1.1 0.2
Household absent (HA) 1.5 1.5 1.0 1.6 1.2 1.0 4.1 1.5 1.2 3.6 0.8 0.9 1.1 1.5
Dwelling vacant/address not a
dwelling (DV) 3.2 1.4 1.9 4.3 1.0 1.6 1.1 2.8 1.2 5.0 1.6 1.1 2.0 1.9
Dwelling destroy (DD) 0.5 1.3 0.3 4.2 0.7 0.8 2.0 2.9 0.3 1.2 0.4 0.8 0.1 1.1
Other (O) 0.5 0.4 0.4 1.4 0.3 0.1 1.7 0.0 0.2 0.2 0.4 0.7 0.5 0.5

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of sampled
households 3,989 10,656 1,349 935 2,158 2,241 901 954 2,012 925 960 1,400 810 14,645
Household response rate
(HRR) 97.4 98.9 98.7 97.3 98.9 99.6 97.0 98.2 99.1 98.4 97.3 98.7 97.1 98.5

Eligible women
Completed (EWC) 94.4 96.2 97.6 91.9 97.3 96.5 91.4 97.5 97.8 92.4 92.5 94.5 95.2 95.6
Not at home (EWNH) 3.2 1.9 1.2 4.7 1.5 1.8 4.5 0.5 1.4 3.5 3.5 3.3 2.8 2.3
Postponed (EWP) 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.0
Refused (EWR) 1.4 0.8 0.1 2.2 0.3 0.6 2.3 0.9 0.2 2.7 2.2 1.2 1.3 1.0
Partly completed (EWPC) 0.2 0.3 0.2 0.3 0.1 0.2 1.1 0.5 0.2 0.6 0.2 0.2 0.1 0.3
Incapacitated (EWI) 0.5 0.7 0.9 0.7 0.7 0.7 0.3 0.7 0.4 0.4 0.9 0.6 0.2 0.6
Other (EWO) 0.3 0.2 0.1 0.1 0.2 0.2 0.4 0.0 0.0 0.4 0.7 0.2 0.2 0.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of women 4,686 10,031 1,288 859 1,996 2,312 732 868 2,135 789 912 1,978 848 14,717
Eligible women response rate
(EWRR) 94.4 96.2 97.6 91.9 97.3 96.5 91.4 97.5 97.8 92.4 92.5 94.5 95.2 95.6

Overall response rate (ORR) 92.0 95.1 96.3 89.4 96.3 96.1 88.6 95.7 96.8 91.0 90.1 93.3 92.4 94.2
1
Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as:

100 * C
_______________________________
C + HP + P + R + DNF

2
Using the number of eligible women falling into specific response categories, the eligible woman response rate (EWRR) is calculated as:

100 * EWC
___________________________________________________________________________
EWC + EWNH + EWP + EWR + EWPC + EWI + EWO

3
The overall response rate (ORR) is calculated as:

ORR = HRR * EWRR/100

Appendix A | 265
Table A.2 Sample implementation: men

Percent distribution of households and eligible men by results of the household and individual interviews, and household, eligible men and overall
response rates, according to urban-rural residence and region, Ethiopia 2005

Residence Region
Beni-
shangul- Addis Dire
Result Urban Rural Tigray Affar Amhara Oromiya Somali Gumuz SNNP Gambela Harari Ababa Dawa Total

Selected households
Completed (C) 91.7 94.1 94.9 87.6 95.0 95.4 89.0 90.3 95.4 89.2 93.5 94.8 94.1 93.4
Household present but no
competent respondent at
home (HP) 1.2 0.6 1.4 0.9 0.7 0.2 1.1 1.3 0.3 1.3 1.5 0.4 1.3 0.8
Postponed (P) 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Refused (R) 0.6 0.3 0.3 1.5 0.2 0.2 0.2 0.4 0.2 0.2 0.4 0.6 0.0 0.3
Dwelling not found (DNF) 0.4 0.1 0.0 0.2 0.2 0.0 0.9 0.0 0.2 0.2 0.0 0.3 0.8 0.2
Household absent (HA) 2.1 1.6 0.9 1.7 1.3 1.1 5.3 1.7 1.7 4.1 1.0 0.9 1.8 1.7
Dwelling vacant/address not a
dwelling (DV) 3.1 1.5 1.8 2.8 1.3 2.0 0.7 2.9 1.5 4.3 2.5 1.5 1.3 1.9
Dwelling destroy (DD) 0.5 1.3 0.3 3.7 0.9 1.0 1.6 3.4 0.4 0.6 0.4 0.9 0.3 1.1
Other (O) 0.5 0.4 0.3 1.5 0.5 0.0 1.1 0.0 0.3 0.0 0.6 0.6 0.5 0.4

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of sampled households 1,947 5,213 651 458 1,040 1,081 436 476 1,010 462 480 675 391 7,160
Household response rate (HRR) 97.6 98.9 98.3 97.1 98.9 99.5 97.5 98.2 99.3 98.1 98.0 98.6 97.9 98.6

Eligible men
Completed (EMC) 83.6 91.2 90.9 81.1 93.5 92.5 83.6 94.8 92.1 85.2 84.9 83.7 84.0 89.0
Not at home (EMNH) 11.2 6.4 6.6 16.3 4.8 5.4 10.7 2.7 6.0 9.8 10.9 9.7 13.2 7.8
Postponed (EMP) 0.2 0.1 0.0 0.0 0.0 0.2 0.3 0.0 0.1 0.8 0.2 0.1 0.0 0.1
Refused (EMR) 2.6 1.2 0.9 1.6 0.8 0.5 3.6 1.2 0.8 3.0 2.1 3.8 1.5 1.6
Partly completed (EMPC) 0.4 0.1 0.0 0.8 0.0 0.1 0.3 0.2 0.1 0.5 0.2 0.1 0.3 0.2
Incapacitated (EMI) 1.3 0.7 0.7 0.3 0.7 0.9 1.2 1.0 0.6 0.3 1.2 1.7 1.0 0.9
Other (EMO) 0.8 0.2 0.9 0.0 0.1 0.4 0.3 0.0 0.3 0.5 0.5 0.8 0.0 0.4

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of men 1,948 4,830 563 387 959 1,126 336 403 956 398 423 834 393 6,778
Eligible men response rate
(EMRR) 83.6 91.2 90.9 81.1 93.5 92.5 83.6 94.8 92.1 85.2 84.9 83.7 84.0 89.0

Overall response rate (ORR) 81.6 90.2 89.4 78.8 92.5 92.0 81.5 93.1 91.4 83.6 83.2 82.5 82.2 87.7

1
Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as:

100 * C
_______________________________
C + HP + P + R + DNF

2
Using the number of eligible men falling into specific response categories, the eligible man response rate (EWRR) is calculated as:

100 * EMC
___________________________________________________________________________
EMC + EMNH + EMP + EMR + EMPC + EMI + EMO

3
The overall response rate (ORR) is calculated as:

ORR = HRR * EMRR/100

266 | Appendix A
Table A.3 Coverage of HIV testing among eligible respondents by social and demographic
characteristics: women

Percent distribution of women age 15-49 by HIV testing status, according to social and
demographic characteristics (unweighted), Ethiopia 2005
Absent/
other/
Characteristic Tested Refused missing Total Number
Marital status
Never married 84.9 13.8 1.3 100.0 1,834
Ever had sexual intercourse 85.3 13.3 1.4 100.0 1,651
Never had sexual intercourse 81.4 18.0 0.5 100.0 183
Married / living together 88.7 10.4 0.9 100.0 4,189
Divorced or separated 85.1 13.5 1.4 100.0 289
Widowed 84.6 14.8 0.6 100.0 500

Type of union
In polygynous union 91.5 7.3 1.1 100.0 531
Not in polygynous union 88.4 10.8 0.8 100.0 3,606
Not currently in union 84.9 14.0 1.2 100.0 2,623

Ever had sexual intercourse


Yes 87.8 11.3 0.9 100.0 5,150
No 85.3 13.3 1.4 100.0 1,662

Currently pregnant
Yes 90.5 9.2 0.4 100.0 524
Not pregnant/not sure 87.0 12.0 1.0 100.0 6.288

Total 87.2 11.8 1.0 100.0 6,812

Note: Totals include a small number of cases missing data on a particular characteristic. Table
is based only on respondents who were interviewed, since these characteristics are obtained
from the individual interview.

Appendix A | 267
Table A.4 Coverage of HIV testing among eligible respondents by social and demographic
characteristics: men

Percent distribution of men age 15-59 by testing status, according to social and demographic
characteristics (unweighted), Ethiopia 2005
Absent/
other/
Characteristic Tested Refused missing Total Number
Marital status
Never married 82.7 16.0 1.3 100.0 2,460
Ever had sexual intercourse 84.6 14.1 1.3 100.0 1,838
Never had sexual intercourse 77.0 21.4 1.6 100.0 622
Married/living together 86.4 12.6 1.0 100.0 3,332
Divorced or separated 74.6 25.4 0.0 100.0 59
Widowed 83.5 15.4 1.1 100.0 182

Type of union
In polygynous union 86.9 12.6 0.5 100.0 222
Not in polygynous union 86.3 12.6 1.1 100.0 3,110
Not currently in union 82.6 16.1 1.3 100.0 2,701

Ever had sexual intercourse


Yes 84.7 14.2 1.1 100.0 4,189
No 84.6 14.2 1.2 100.0 1,844

Circumcision status
Circumcised 84.2 14.7 1.1 100.0 5,575
Not circumcised 90.8 8.3 0.9 100.0 445

Times slept away from home in


past 12 months
0 84.8 14.1 1.1 100.0 4,107
1-2 86.2 12.5 1.3 100.0 1,029
3-5 81.2 18.0 0.8 100.0 490
6+ 84.1 14.4 1.5 100.0 396

Time away in past 12 months


More than 1 month 81.4 17.2 1.4 100.0 431
Less than 1 month 85.7 13.2 1.2 100.0 1,459
Never away 84.8 14.1 1.1 100.0 4,107

Total 75.5 17.1 7.3 100.0 6,778

Note: Totals include a small number of cases missing data on a particular characteristic. Table
is based only on respondents who were interviewed, since these characteristics are obtained
from the individual interview.

268 | Appendix A
Table A.5 Coverage of HIV testing by sexual behaviour characteristics: women

Percent distribution of women who ever had sexual intercourse by HIV test status, according to
sexual behaviour characteristics (unweighted), Ethiopia 2005
Absent/
Sexual behaviour other/
characteristic Tested Refused missing Total Number
Age at first sexual intercourse
15 or less 88.5 10.4 1.0 100.0 2,480
16-17 89.7 9.7 0.6 100.0 1,057
18-19 86.9 12.3 0.9 100.0 800
20+ 84.3 14.9 0.7 100.0 804
Non numeric 88.9 11.1 0.0 100.0 9
Higher-risk intercourse in past
12 months
Had higher risk sex 84.8 14.5 0.6 100.0 165
Had sex, not higher risk 89.2 10.0 0.7 100.0 4,034
No sex in past 12 months 82.5 16.0 1.5 100.0 951
Number of actual partners in
past 12 months
0 83.3 15.9 0.9 100.0 933
1 89.1 10.1 0.7 100.0 4,184
2+ 80.0 20.0 0.0 100.0 15
Number of higher-risk partners
in past 12 months
0 88.1 11.1 0.8 100.0 4,926
1 86.4 13.1 0.5 100.0 199
2+ 85.7 14.3 0.0 100.0 7
Condom use
Ever used condom 78.9 21.1 0.0 100.0 152
Never used condom 88.1 11.0 0.9 100.0 4,998
Condom used at first sexual
intercourse1
Used at first sex 84.2 15.8 0.0 100.0 57
Did not use at first sex 87.7 11.4 1.0 100.0 1,239
Missing 81.6 15.8 2.6 100.0 76
Condom use at last sexual
intercourse in past 12 months2
Used condom last sex 80.8 19.2 0.0 100.0 73
No condom at last sex 89.2 10.1 0.8 100.0 4,124
No sex past 12 months 82.6 15.9 1.5 100.0 953
Condom use at last higher-risk
intercourse in past 12 months2
Used condom 80.4 19.6 0.0 100.0 46
Did not use condom 86.6 12.6 0.8 100.0 119
Number of lifetime partners
1 87.6 11.6 0.7 100.0 3,752
2 88.9 10.2 0.9 100.0 1,011
3-4 90.1 8.8 1.0 100.0 294
5-9 91.5 8.5 0.0 100.0 47
10+ 77.8 22.2 0.0 100.0 9
HIV testing status3
Previously tested 81.4 17.8 0.8 100.0 258
Previously tested, received result
of last test 81.8 17.4 0.8 100.0 253
Previously tested, did not receive
result of last test 60.0 40.0 0.0 100.0 5
Not tested previously 89.3 10.1 0.6 100.0 4,084

Total 87.8 11.3 0.9 100.0 5,150

Note: Totals include a small number of cases missing data on a particular characteristic. Table is
based only on respondents who were interviewed, since these characteristics are obtained from
the individual interview.
1
Based on those age 15-24 only
2
Based on respondents who had sexual intercourse in the past 12 months
3
Excludes women who have not heard of AIDS

Appendix A | 269
Table A.6 Coverage of HIV testing by sexual behaviour characteristics: men

Percent distribution of men who ever had sexual intercourse by HIV test status, according to sexual
behaviour characteristics (unweighted), Ethiopia 2005
Absent/
Sexual behaviour other/
characteristic Tested Refused missing Total Number
Age at first sexual intercourse
15 or less 88.2 11.0 0.8 100.0 382
16-17 81.4 17.6 1.0 100.0 598
18-19 82.2 16.6 1.1 100.0 963
20+ 86.1 12.7 1.2 100.0 2,173
Non numeric 83.6 15.1 1.4 100.0 73
Higher-risk intercourse in past
12 months
Had higher risk sex 76.0 22.6 1.3 100.0 446
Had sex, not higher risk 86.7 12.2 1.1 100.0 3,237
No sex in past 12 months 79.6 19.4 1.0 100.0 506
Number of partners in past
12 months
0 78.6 20.1 1.2 100.0 1,236
1 87.3 11.7 1.1 100.0 2,941
2+ 90.0 10.0 0.0 100.0 10
Number of higher-risk partners
in past 12 months
0 85.8 13.2 1.1 100.0 3,723
1 76.3 22.2 1.5 100.0 401
2+ 75.9 24.1 0.0 100.0 58
Condom used at first sexual
intercourse2
Used at first sex 76.7 21.8 1.5 100.0 133
Did not use at first sex 86.9 12.5 0.6 100.0 489
Condom use at last sexual
intercourse in past 12 months1
Used condom last sex 70.2 28.7 1.1 100.0 282
No condom at last sex 86.7 12.2 1.1 100.0 3,402
No sex past 12 months 79.6 19.4 1.0 100.0 505
Condom use at last higher-risk
intercourse in past 12 months1
Used condom 69.8 28.9 1.2 100.0 242
Did not use condom 83.3 15.2 1.5 100.0 204
Paid for sexual intercourse in past
12 months
Used condom 82.6 17.4 0.0 100.0 46
Did not use condom 90.3 6.5 3.2 100.0 31
No paid sex 84.7 14.2 1.1 100.0 4,111
Number of lifetime partners
1 85.0 13.9 1.1 100.0 1,728
2 85.6 13.7 0.7 100.0 890
3-4 84.6 14.2 1.2 100.0 830
5-9 84.0 14.0 2.0 100.0 406
10+ 82.9 16.0 1.1 100.0 263
HIV testing status
Previously tested 79.2 19.5 1.4 100.0 370
Previously tested, received result
of last test 77.9 20.6 1.4 100.0 349
Previously tested, did not receive
result of last test 100.0 0.0 0.0 100.0 21
Not tested previously 85.5 13.5 1.0 100.0 3,677

Total 84.7 14.2 1.1 100.0 4,189

Note: Totals include a small number of cases missing data on a particular characteristic. Table is based
only on respondents who were interviewed, since these characteristics are obtained from the
individual interview.
1
Based on respondents who had sexual intercourse in the past 12 months
2
Based on those age 15-24 only

270 | Appendix A
ESTIMATES OF SAMPLING ERRORS Appendix B
The estimates from a sample survey are affected by two types of errors: (1) nonsampling er-
rors, and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing
data collection and data processing, such as failure to locate and interview the correct household, mis-
understanding of the questions on the part of either the interviewer or the respondent, and data entry
errors. Although numerous efforts were made during the implementation of the 2005 Ethiopia Demo-
graphic and Health Survey (EDHS) to minimize this type of error, nonsampling errors are impossible
to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents
selected in the 2005 EDHS is only one of many samples that could have been selected from the same
population, using the same design and expected size. Each of these samples would yield results that
differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the
variability between all possible samples. Although the degree of variability is not known exactly, it
can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic
(mean, percentage, etc.), which is the square root of the variance. The standard error can be used to
calculate confidence intervals within which the true value for the population can reasonably be as-
sumed to fall. For example, for any given statistic calculated from a sample survey, the value of that
statistic will fall within a range of plus or minus two times the standard error of that statistic in 95
percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have
been possible to use straightforward formulas for calculating sampling errors. However, the 2005
EDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to
use more complex formulae. The computer software used to calculate sampling errors for the 2005
EDHS is the ISSA Sampling Error Module. This module used the Taylor linearization method of
variance estimation for survey estimates that are means or proportions. The Jackknife repeated repli-
cation method is used for variance estimation of more complex statistics such as fertility and mortality
rates.

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x,
where y represents the total sample value for variable y, and x represents the total number of cases in
the group or subgroup under consideration. The variance of r is computed using the formula given
below, with the standard error being the square root of the variance:

1− f H ⎡ mh ⎛ mh 2 z h2 ⎞⎤
SE (r ) = var ( r ) = 2
2

x
∑ ⎢ ⎜⎜ ∑ z hi −
h =1 ⎣ mh − 1 ⎝ i =1
⎟⎥
mh ⎟⎠⎦

in which

z hi = y hi − rx hi , and z h = y h − rx h

where h represents the stratum which varies from 1 to H,


mh is the total number of clusters selected in the hth stratum,

Appendix B | 271
yhi is the sum of the weighted values of variable y in the ith cluster in the hth stratum,
xhi is the sum of the weighted number of cases in the ith cluster in the hth stratum, and
f is the overall sampling fraction, which is so small that it is ignored.

The Jackknife repeated replication method derives estimates of complex rates from each of
several replications of the parent sample, and calculates standard errors for these estimates using sim-
ple formulae. Each replication considers all but one clusters in the calculation of the estimates.
Pseudo-independent replications are thus created. In the 2005 EDHS, there were 535 non-empty clus-
ters. Hence, 535 replications were created. The variance of a rate r is calculated as follows:

k
1
SE (r ) = var (r ) =
2

k ( k − 1) i =1
(ri − r ) 2

in which

ri = kr − ( k − 1) r( i )

where r is the estimate computed from the full sample of 535 clusters,
r(i) is the estimate computed from the reduced sample of 534 clusters (ith cluster
excluded), and
k is the total number of clusters.

In addition to the standard error, ISSA computes the design effect (DEFT) for each estimate,
which is defined as the ratio between the standard error using the given sample design and the stan-
dard error that would result if a simple random sample had been used. A DEFT value of 1.0 indicates
that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indi-
cates the increase in the sampling error due to the use of a more complex and less statistically efficient
design. ISSA also computes the relative error and confidence limits for the estimates.

Sampling errors for the 2005 EDHS are calculated for selected variables considered to be of
primary interest for the woman’s survey and the man’s surveys, respectively. The results are pre-
sented in this appendix for the country as a whole, for urban and rural areas, and for each of the 9 re-
gions (Tigray, Affar, Amhara, Oromiya, Somali, Benishangul-Gumuz, SNNP, Gambela and Harari)
and the two city administration areas (Addis Ababa and Dire Dawa). For each variable, the type of
statistic (mean, proportion, or rate) and the base population are given in Table B.1. Tables B.2 to B.14
present the value of the statistic (R), its standard error (SE), the number of unweighted (N) and
weighted (WN) cases, the design effect (DEFT), the relative standard error (SE/R), and the 95 percent
confidence limits (R±2SE), for each variable. The DEFT is considered undefined when the standard
error considering simple random sample is zero (when the estimate is close to 0 or 1). In the case of
the total fertility rate, the number of unweighted cases is not relevant, as there is no known un-
weighted value for woman-years of exposure to childbearing.

The confidence interval (e.g., as calculated for children ever born to women aged 40-49) can
be interpreted as follows: the overall average from the national sample is 6.931 and its standard error
is 0.071. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the stan-
dard error to the sample estimate, i.e., 6.931±2×0.071. There is a high probability (95 percent) that the
true average number of children ever born to all women aged 40 to 49 is between 6.788 and 7.074.

Sampling errors are analyzed for the national woman sample and for two separate groups of
estimates: (1) means and proportions, and (2) complex demographic rates. The relative standard errors
(SE/R) for the means and proportions range between 0.6 percent and 36.9 percent with an average of
6.3 percent; the highest relative standard errors are for estimates of very low values (e.g., currently
using

272 | Appendix B
female sterilization). If estimates of very low values (less than 10 percent) were removed, then the
average drops to 3.6 percent. So in general, the relative standard error for most estimates for the coun-
try as a whole is small, except for estimates of very small proportions. The relative standard error for
the total fertility rate is small, 2.6 percent. However, for the mortality rates, the average relative stan-
dard error is much higher, 6.0 percent.

There are differentials in the relative standard error for the estimates of sub-populations. For
example, for the variable want no more children, the relative standard errors as a percent of the esti-
mated mean for the whole country, and for the urban areas are 1.9 percent and 5.3 percent, respec-
tively.

For the total sample, the value of the design effect (DEFT), averaged over all variables, is
1.67 which means that, due to multi-stage clustering of the sample, the average standard error is in-
creased by a factor of 1.67 over that in an equivalent simple random sample.

Appendix B | 273
Table B.1 List of selected variables for sampling errors, Ethiopia 2005
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Variable Estimate Base population
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence Proportion All women 15-49
Literate Proportion All women 15-49
No education Proportion All women 15-49
Secondary education or higher Proportion All women 15-49
Net attendance ratio for primary school Ratio Children 7-12 years
Never married Proportion All women 15-49
Currently married/in union Proportion All women 15-49
Married before age 20 Proportion Women age 20-49
Currently pregnant Proportion All women 15-49
Children ever born Mean All women 15-49
Children surviving Mean All women 15-49
Children ever born to women age 40-49 Mean Women age 40-49
Knows any contraceptive method Proportion All women 15-49
Ever using contraceptive method Proportion Currently married women 15-49
Currently using any contraceptive method Proportion Currently married women 15-49
Currently using pill Proportion Currently married women 15-49
Currently using IUD Proportion Currently married women 15-49
Currently using female sterilization Proportion Currently married women 15-49
Currently using rythm method Proportion Currently married women 15-49
Obtained method from public sector source Proportion Currently married women 15-49
Want no more children Proportion Currently married women 15-49
Want to delay birth at least 2 years Proportion Currently married women 15-49
Ideal family size Mean All women 15-49
Perinatal mortality (0-6 years) Rate Births in last 5 years
Mothers received tetanus injection for last birth Proportion Women with at least 1 live birth in past 5 years
Mothers received medical assistance at delivery Proportion Births in last 5 years
Had diarrhoea in two weeks before survey Proportion Children under 5 years
Treated with oral rehydration salts (ORS) Proportion Children under 5 years with diarrhoea in past two weeks
Taken to a health provider Proportion Children with diarrhoea in past two weeks
Vaccination card seen Proportion Children age 12-23 months
Received BCG Proportion Children age 12-23 months
Received DPT (3 doses) Proportion Children age 12-23 months
Received polio (3 doses) Proportion Children age 12-23 months
Received measles Proportion Children age 12-23 months
Fully immunized Proportion Children age 12-23 months
Height-for-age (below -2SD) Proportion Children under 5 years who were measured
Weight-for-height (below -2SD) Proportion Children under 5 years who were measured
Weight-for-age (below -2SD) Proportion Children under 5 years who were measured
Anaemic (children) Proportion Children under 5 years
Anaemic (women) Proportion All women 15-49
BMI <18.5 Proportion All women 15-49
Has heard of HIV/AIDS Proportion All women 15-49
Knows about condoms Proportion All women 15-49
Knows about limiting partners Proportion All women 15-49
Had 2+ sex partners in past 12 months Proportion All women 15-49
High-risk sex Proportion All women 15-49 with sexual intercourse in past 12 months
Condom use at high-risk sex Proportion All women 15-49 with high-risk intercourse in past 12 months
Abstinence among youth Proportion Women 15-24
Sexually active in past 12 months among youth Proportion Women 15-24
Had an injection in past 12 months Proportion Women 15-24
Had HIV test and received results in past 12 months Proportion All women 15-49
Accepting attitudes towards people with HIV Proportion All women 15-49 who have heard of HIV/AIDS
HIV prevalence among tested for HIV 15-49 Proportion All women 15-49 with blood sample tested at lab
Total Fetility Rate (3 years) Rate All women 15-49
Neonatal NN rate (0-4 years) Rate Children exposed to the risk of mortality
Postneonatal PNN rate (0-4 years) Rate Children exposed to the risk of mortality
Infant 1q0 rate (0-4 years) Rate Children exposed to the risk of mortality
Infant 1q0rate (5-9 years_ Rate Children exposed to the risk of mortality
Infant 1q0 rate (10-14 years) Rate Children exposed to the risk of mortality
Child 4q1 rate (0-4 years) Rate Children exposed to the risk of mortality
Under five 5q0 (0-4 years) Rate Children exposed to the risk of mortality
Maternal mortality rate (0-6 years) Rate All women 15-49
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence Proportion All men 15-59
Literate Proportion All men 15-59
No education Proportion All men 15-59
Secondary education or higher Proportion All men 15-59
Never married Proportion All men 15-59
Currently married (in union) Proportion All men 15-59
Married before age 20 Proportion All men 20-54
Want no more children Proportion Currently married men 15-59
Want to delay birth at least 2 years Proportion Currently married men 15-59
Ideal family size Mean All men 15-59
Has heard of HIV/AIDS (15-49) Proportion All men 15-49
Knows about condoms (15-49) Proportion All men 15-49
Knows about limiting partners (15-49) Proportion All men 15-49
Had two+ sex partners in past 12 months (15-49) Proportion All men 15-49
High-risk sex (15-49) Proportion All men 15-49 with sexual intercourse in past 12 months
High-risk sex (15-59) Proportion All men 15-59 with sexual intercourse in past 12 months
Condom use at high-risk sex (age 15-49) Proportion All men 15-49 with sexual intercourse in past 12 months
Condom use at high-risk sex (age 15-59) Proportion All men 15-59 with sexual intercourse in past 12 months
Abstinence among youth Proportion All men 15-24
Sexually active in past 12 months among youth Proportion All men 15-24
Paid for sexual intercourse in past 12 months Proportion All men 15-49
Had an injection in past 12 months (age15-49) Proportion All men 15-49
Had an injection in past 12 months (age 15-59) Proportion All men 15-59
HIV test and received results past 12 months (15-49) Proportion All men 15-49
Accepting attitudes towards people with HIV (15-49) Proportion All men 15-49 who have heard of HIV/AIDS
HIV prevalence among tested for HIV 15-49 Proportion All men 15-49 with blood sample tested at lab
HIV prevalence among tested for HIV 15-59 Proportion All men 15-59 with blood sample tested at lab

274 | Appendix B
Table B.2 Sampling errors for national sample, Ethiopia 2005

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.178 0.007 14070 14070 2.317 0.042 0.163 0.193
Literate 0.292 0.009 14070 14070 2.278 0.030 0.274 0.309
No education 0.659 0.010 14070 14070 2.465 0.015 0.639 0.679
Secondary education or higher 0.119 0.006 14070 14070 2.143 0.049 0.107 0.131
Net attendance ratio for primary school 0.423 0.010 12462 13485 2.128 0.024 0.403 0.443
Never married 0.250 0.006 14070 14070 1.759 0.026 0.237 0.263
Currently married/in union 0.644 0.007 14070 14070 1.692 0.011 0.631 0.658
Married before age 20 0.748 0.007 10818 10804 1.668 0.009 0.734 0.762
Currently pregnant 0.084 0.003 14070 14070 1.420 0.039 0.077 0.091
Children ever born 3.141 0.038 14070 14070 1.437 0.012 3.065 3.216
Children surviving 2.586 0.032 14070 14070 1.494 0.013 2.522 2.651
Children ever born to women age 40-49 6.931 0.071 2261 2330 1.180 0.010 6.788 7.074
Knows any contraceptive method 0.875 0.006 8644 9066 1.810 0.007 0.862 0.888
Ever using contraceptive method 0.241 0.009 8644 9066 1.881 0.036 0.224 0.258
Currently using any contraceptive method 0.147 0.007 8644 9066 1.716 0.044 0.134 0.160
Currently using pill 0.031 0.003 8644 9066 1.659 0.100 0.025 0.037
Currently using IUD 0.002 0.000 8644 9066 0.954 0.220 0.001 0.003
Currently using female sterilization 0.002 0.000 8644 9066 0.999 0.266 0.001 0.003
Currently using rhythm method 0.006 0.001 8644 9066 1.093 0.158 0.004 0.007
Obtained method from public sector source 0.795 0.020 1496 1324 1.960 0.026 0.754 0.836
Want no more children 0.421 0.008 8644 9066 1.539 0.019 0.404 0.437
Want to delay birth at least 2 years 0.354 0.008 8644 9066 1.588 0.023 0.337 0.370
Ideal family size 4.498 0.055 12728 12602 1.949 0.012 4.389 4.607
Perinatal mortality (0-6 years) 37.241 2.698 9955 11280 1.400 0.072 31.845 42.636
Mothers received tetanus injection for last birth 0.322 0.011 6589 7307 1.963 0.033 0.301 0.344
Mothers received medical assistance at delivery 0.057 0.004 9861 11163 1.608 0.070 0.049 0.065
Had diarrhoea in two weeks before survey 0.180 0.006 9002 10109 1.579 0.035 0.167 0.193
Treated with oral rehydration salts (ORS) 0.199 0.016 1545 1819 1.586 0.078 0.168 0.230
Taken to a health provider 0.222 0.016 1545 1819 1.509 0.070 0.191 0.254
Vaccination card seen 0.369 0.017 1697 1877 1.478 0.045 0.336 0.402
Received BCG 0.604 0.020 1697 1877 1.787 0.034 0.564 0.645
Received DPT (3 doses) 0.319 0.019 1697 1877 1.718 0.058 0.281 0.356
Received polio (3 doses) 0.447 0.020 1697 1877 1.734 0.045 0.407 0.487
Received measles 0.349 0.018 1697 1877 1.617 0.051 0.313 0.384
Fully immunized 0.204 0.015 1697 1877 1.615 0.074 0.173 0.234
Height-for-age (below -2SD) 0.465 0.011 4130 4586 1.433 0.024 0.443 0.487
Weight-for-height (below -2SD) 0.105 0.006 4130 4586 1.375 0.061 0.092 0.118
Weight-for-age (below -2SD) 0.384 0.011 4130 4586 1.476 0.029 0.362 0.406
Anaemic (children) 0.535 0.011 3580 4138 1.371 0.020 0.514 0.557
Anaemic (women) 0.266 0.009 5963 6141 1.576 0.033 0.248 0.283
BMI <18.5 0.265 0.009 5988 5901 1.512 0.033 0.247 0.282
Has heard of HIV/AIDS 0.899 0.006 14070 14070 2.249 0.006 0.887 0.910
Knows about condoms 0.402 0.009 14070 14070 2.235 0.023 0.383 0.420
Knows about limiting partners 0.625 0.009 14070 14070 2.308 0.015 0.606 0.643
Had 2+ sex partners in past 12 months 0.002 0.001 4203 4354 1.179 0.369 0.001 0.004
High-risk sex 0.027 0.004 4203 4354 1.424 0.131 0.020 0.034
Condom use at high-risk sex 0.236 0.052 165 119 1.577 0.222 0.131 0.340
Abstinence among youth 0.957 0.007 3283 3165 1.944 0.007 0.943 0.971
Sexually active in past 12 months among youth 0.015 0.003 3283 3165 1.494 0.210 0.009 0.022
Had an injection in past 12 months 0.256 0.008 14070 14070 2.247 0.032 0.240 0.273
Had HIV test and received results in past 12 months 0.019 0.002 6812 6751 1.055 0.093 0.015 0.022
Accepting attitudes towards people with HIV 0.107 0.006 12414 12643 2.059 0.053 0.096 0.119
HIV prevalence among tested for HIV 15-49 0.019 0.002 5942 5736 1.230 0.116 0.014 0.023
Total fertility rate (3 years) 5.409 0.141 na 38974 2.300 0.026 5.127 5.692
Neonatal mortality (0-4 years) 39.328 2.851 9900 11217 1.439 0.072 33.626 45.029
Postneonatal mortality (0-4 years) 37.681 2.726 9920 11242 1.430 0.072 32.228 43.133
Infant mortality (0-4 years) 77.008 3.852 9925 11248 1.431 0.050 69.304 84.712
Infant mortality (5-9 years) 83.389 4.042 10359 11557 1.366 0.048 75.304 91.473
Infant mortality (10-14 years) 94.619 5.085 8346 9105 1.475 0.054 84.449 104.789
Child mortality (0-4 years) 50.318 3.149 10115 11446 1.408 0.063 44.020 56.616
Under-five mortallity (0-4 years) 123.451 5.141 10145 11482 1.525 0.042 113.170 133.732
Maternal mortality (0-6 years) 673.386 62.900 na na na 0.093 547.586 799.187
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.152 0.006 6033 6033 1.306 0.040 0.140 0.164
Literate 0.589 0.010 6033 6033 1.586 0.017 0.569 0.609
No education 0.429 0.010 6033 6033 1.567 0.023 0.409 0.449
Secondary education or higher 0.198 0.007 6033 6033 1.365 0.035 0.184 0.212
Want no more children 0.341 0.013 3332 3424 1.552 0.037 0.316 0.367
Want to delay birth at least 2 years 0.415 0.012 3332 3424 1.464 0.030 0.390 0.440
Ideal family size 5.243 0.080 5632 5615 1.421 0.015 5.084 5.402
Has heard of HIV/AIDS (15-49) 0.965 0.004 5472 5464 1.730 0.004 0.957 0.974
Knows about condoms (15-49) 0.643 0.011 5472 5464 1.701 0.017 0.620 0.665
Knows about limiting partners (15-49) 0.790 0.010 5472 5464 1.830 0.013 0.770 0.811
Had 2+ sex partners in past 12 months (15-49) 0.041 0.005 3199 3121 1.356 0.115 0.032 0.051
High-risk sex (15-49) 0.085 0.006 3199 3121 1.256 0.073 0.072 0.097
High-risk sex (15-59) 0.073 0.005 3686 3630 1.274 0.075 0.062 0.084
Condom use at high-risk sex (age 15-49) 0.519 0.038 440 264 1.593 0.073 0.443 0.595
Condom use at high-risk sex (age 15-59) 0.517 0.038 446 266 1.591 0.073 0.442 0.593
Abstinence among youth 0.876 0.009 2014 2081 1.233 0.010 0.858 0.894
Sexually active in past 12 months among youth 0.075 0.007 2014 2081 1.143 0.090 0.061 0.088
Paid for sexual intercourse in past 12 months 0.008 0.001 6033 6033 1.301 0.188 0.005 0.011
Had an injection in past 12 months (age 15-49) 0.189 0.008 5472 5464 1.461 0.041 0.174 0.205
Had an injection in past 12 months (age 15-59) 0.191 0.007 6033 6033 1.473 0.039 0.177 0.206
HIV test and received results past 12 months (15-49) 0.023 0.003 5472 5464 1.421 0.126 0.017 0.028
Accepting attitudes towards people with HIV (15-49) 0.167 0.009 5245 5273 1.812 0.056 0.148 0.185
HIV prevalence among tested for HIV 15-49 0.009 0.002 4631 4804 1.240 0.187 0.006 0.013
HIV prevalence among tested for HIV 15-59 0.009 0.002 5108 5306 1.259 0.183 0.006 0.013
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 275
Table B.3 Sampling errors for urban sample, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 1.000 0.000 4423 2499 na 0.000 1.000 1.000
Literate 0.736 0.015 4423 2499 2.325 0.021 0.705 0.767
No education 0.247 0.016 4423 2499 2.470 0.065 0.215 0.279
Secondary education or higher 0.509 0.021 4423 2499 2.795 0.041 0.467 0.551
Net attendance ratio for primary school 0.788 0.017 2043 1186 1.773 0.022 0.754 0.822
Currently pregnant 0.025 0.004 4423 2499 1.640 0.155 0.017 0.032
Children ever born to women age 40-49 5.113 0.143 612 351 1.232 0.028 4.827 5.399
Currently using any contraceptive method 0.467 0.017 1708 959 1.418 0.037 0.432 0.501
Currently using pill 0.107 0.015 1708 959 1.945 0.136 0.078 0.136
Currently using IUD 0.018 0.004 1708 959 1.225 0.216 0.011 0.026
Currently using female sterilization 0.013 0.004 1708 959 1.298 0.272 0.006 0.020
Currently using rhythm method 0.037 0.005 1708 959 1.205 0.149 0.026 0.048
Want no more children 0.478 0.025 1708 959 2.100 0.053 0.427 0.528
Ideal family size 3.442 0.072 4188 2387 1.964 0.021 3.299 3.585
Perinatal mortality (0-6 years) 44.897 12.143 1368 822 2.158 0.270 20.611 69.182
Mothers received tetanus injection for last birth 0.605 0.023 1054 634 1.578 0.038 0.559 0.651
Mothers received medical assistance at delivery 0.446 0.042 1358 815 2.778 0.095 0.362 0.531
Had diarrhoea in two weeks before survey 0.121 0.015 1275 752 1.653 0.123 0.091 0.151
Treated with oral rehydration salts (ORS) 0.457 0.073 155 91 1.820 0.160 0.311 0.604
Taken to a health provider 0.350 0.044 155 91 1.156 0.126 0.262 0.438
Vaccination card seen 0.620 0.044 249 147 1.470 0.071 0.532 0.709
Received BCG 0.840 0.057 249 147 2.532 0.068 0.726 0.955
Received DPT (3 doses) 0.657 0.048 249 147 1.649 0.074 0.560 0.754
Received polio (3 doses) 0.693 0.048 249 147 1.689 0.070 0.597 0.790
Received measles 0.654 0.078 249 147 2.634 0.119 0.499 0.809
Fully immunized 0.493 0.062 249 147 1.997 0.125 0.369 0.616
Height-for-age (below -2SD) 0.298 0.037 605 362 1.984 0.125 0.224 0.372
Weight-for-height (below -2SD) 0.063 0.025 605 362 2.733 0.401 0.012 0.113
Weight-for-age (below -2SD) 0.229 0.031 605 362 1.770 0.134 0.168 0.291
Anaemic (children) 0.468 0.038 426 270 1.651 0.080 0.393 0.543
Anaemic (women) 0.178 0.018 1636 948 1.950 0.102 0.141 0.214
BMI <18.5 0.188 0.019 1955 1112 2.153 0.101 0.150 0.226
Has heard of HIV/AIDS 0.986 0.004 4423 2499 2.303 0.004 0.977 0.994
Knows about condoms 0.722 0.012 4423 2499 1.853 0.017 0.697 0.747
Knows about limiting partners 0.818 0.013 4423 2499 2.155 0.015 0.793 0.843
Had 2+ sex partners in past 12 months 0.004 0.002 875 492 0.944 0.481 0.000 0.009
High-risk sex 0.135 0.020 875 492 1.772 0.152 0.094 0.176
Condom use at high-risk sex 0.399 0.089 109 66 1.884 0.223 0.221 0.577
Abstinence among youth 0.905 0.021 1602 938 2.836 0.023 0.864 0.947
Sexually active in past 12 months among youth 0.033 0.009 1602 938 1.990 0.270 0.015 0.051
Had an injection in past 12 months 0.304 0.021 4423 2499 2.967 0.068 0.262 0.345
Had HIV test and received results in past 12 months 0.078 0.008 2079 1173 1.323 0.100 0.062 0.093
Accepting attitudes towards people with HIV 0.373 0.020 4341 2463 2.779 0.055 0.332 0.414
HIV prevalence among tested for HIV 15-49 0.077 0.011 1628 980 1.591 0.136 0.056 0.098
Total fertility rate (3 years) 2.375 0.205 na 6868 2.289 0.086 1.966 2.785
Neonatal mortality (0-9 years) 34.668 7.129 2818 1702 1.938 0.206 20.410 48.925
Postneonatal mortality (0-9 years) 31.703 5.645 2820 1702 1.619 0.178 20.412 42.993
Infant mortality (0-9 years) 66.370 8.006 2820 1702 1.655 0.121 50.357 82.383
Child mortality (0-9 years) 33.898 5.687 2846 1716 1.490 0.168 22.523 45.272
Under-five mortality (0-9 years) 98.018 9.184 2848 1716 1.513 0.094 79.651 116.385
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 1.000 0.000 1628 916 na 0.000 1.000 1.000
Literate 0.937 0.008 1628 916 1.364 0.009 0.920 0.953
No education 0.079 0.010 1628 916 1.488 0.126 0.059 0.099
Secondary education or higher 0.718 0.019 1628 916 1.682 0.026 0.680 0.755
Want no more children 0.456 0.044 614 344 2.201 0.097 0.367 0.545
Want to delay birth at least 2 years 0.288 0.042 614 344 2.278 0.145 0.205 0.371
Ideal family size 3.579 0.124 1573 895 1.560 0.035 3.330 3.828
Has heard of HIV/AIDS (15-49) 0.997 0.001 1511 854 0.970 0.001 0.994 1.000
Knows about condoms (15-49) 0.825 0.018 1511 854 1.797 0.021 0.789 0.860
Knows about limiting partners (15-49) 0.890 0.016 1511 854 2.014 0.018 0.857 0.922
Had 2+ sex partners in past 12 months (15-49) 0.032 0.007 751 393 1.086 0.218 0.018 0.046
High-risk sex (15-49) 0.299 0.021 751 393 1.239 0.069 0.258 0.341
Condom use at high-risk sex (age 15-49) 0.799 0.029 267 118 1.168 0.036 0.741 0.856
Abstinence among youth 0.765 0.018 654 410 1.070 0.023 0.730 0.801
Sexually active in past 12 months among youth 0.152 0.015 654 410 1.098 0.101 0.121 0.183
Paid for sexual intercourse in past 12 months 0.010 0.003 1628 916 1.187 0.287 0.004 0.016
Had an injection in past 12 months (age 15-49) 0.203 0.017 1511 854 1.690 0.086 0.168 0.238
HIV test and received results past 12 months (15-49) 0.078 0.013 1511 854 1.825 0.161 0.053 0.103
Accepting attitudes towards people with HIV (15-49) 0.453 0.035 1502 851 2.744 0.078 0.382 0.523
HIV prevalence among tested for HIV 15-49 0.024 0.007 1080 684 1.442 0.279 0.011 0.038
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

276 | Appendix B
Table B.4 Sampling errors for rural sample, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.000 0.000 9647 11571 na na 0.000 0.000
Literate 0.196 0.009 9647 11571 2.199 0.045 0.178 0.213
No education 0.748 0.011 9647 11571 2.406 0.014 0.727 0.769
Secondary education or higher 0.035 0.004 9647 11571 1.881 0.101 0.028 0.042
Net attendance ratio for primary school 0.388 0.011 10419 12299 2.010 0.027 0.367 0.409
Currently pregnant 0.097 0.004 9647 11571 1.294 0.040 0.089 0.105
Children ever born to women age 40-49 7.253 0.078 1649 1980 1.155 0.011 7.097 7.409
Currently using any contraceptive method 0.109 0.007 6936 8107 1.843 0.063 0.096 0.123
Currently using pill 0.022 0.003 6936 8107 1.747 0.140 0.016 0.028
Currently using IUD 0.000 0.000 6936 8107 1.281 0.999 0.000 0.001
Currently using female sterilization 0.000 0.000 6936 8107 1.201 0.873 0.000 0.001
Currently using rhythm method 0.002 0.001 6936 8107 1.292 0.362 0.001 0.003
Want no more children 0.414 0.009 6936 8107 1.452 0.021 0.397 0.431
Ideal family size 4.745 0.063 8540 10215 1.775 0.013 4.619 4.870
Perinatal mortality (0-6 years) 36.639 2.752 8587 10458 1.260 0.075 31.136 42.143
Mothers received tetanus injection for last birth 0.295 0.011 5535 6674 1.856 0.038 0.272 0.318
Mothers received medical assistance at delivery 0.026 0.003 8503 10348 1.603 0.116 0.020 0.032
Had diarrhoea in two weeks before survey 0.185 0.007 7727 9357 1.455 0.037 0.171 0.198
Treated with oral rehydration salts (ORS) 0.186 0.016 1390 1727 1.482 0.086 0.154 0.217
Taken to a health provider 0.216 0.016 1390 1727 1.399 0.075 0.183 0.248
Vaccination card seen 0.347 0.018 1448 1729 1.385 0.050 0.312 0.382
Received BCG 0.584 0.021 1448 1729 1.626 0.036 0.542 0.626
Received DPT (3 doses) 0.290 0.020 1448 1729 1.620 0.067 0.251 0.329
Received polio (3 doses) 0.426 0.021 1448 1729 1.622 0.050 0.383 0.468
Received measles 0.322 0.018 1448 1729 1.432 0.055 0.287 0.358
Fully immunized 0.179 0.015 1448 1729 1.507 0.085 0.148 0.209
Height-for-age (below -2SD) 0.479 0.012 3525 4224 1.329 0.024 0.456 0.503
Weight-for-height (below -2SD) 0.109 0.007 3525 4224 1.234 0.060 0.095 0.122
Weight-for-age (below -2SD) 0.397 0.012 3525 4224 1.370 0.029 0.374 0.420
Anaemic (children) 0.540 0.011 3154 3868 1.276 0.021 0.518 0.563
Anaemic (women) 0.282 0.010 4327 5193 1.463 0.036 0.262 0.302
BMI <18.5 0.283 0.010 4033 4789 1.384 0.035 0.263 0.302
Has heard of HIV/AIDS 0.880 0.007 9647 11571 2.065 0.008 0.866 0.893
Knows about condoms 0.333 0.011 9647 11571 2.193 0.032 0.312 0.354
Knows about limiting partners 0.583 0.011 9647 11571 2.160 0.019 0.561 0.605
Had 2+ sex partners in past 12 months 0.002 0.001 3328 3862 1.204 0.447 0.000 0.004
High-risk sex 0.014 0.003 3328 3862 1.313 0.194 0.008 0.019
Condom use at high-risk sex 0.030 0.026 56 53 1.132 0.872 0.000 0.082
Abstinence among youth 0.979 0.004 1681 2228 1.183 0.004 0.971 0.987
Sexually active in past 12 months among youth 0.008 0.002 1681 2228 1.153 0.318 0.003 0.013
Had an injection in past 12 months 0.246 0.009 9647 11571 2.044 0.036 0.228 0.264
Had HIV test and received results in past 12 months 0.006 0.001 4733 5579 1.203 0.222 0.003 0.009
Accepting attitudes towards people with HIV 0.043 0.004 8073 10180 1.682 0.088 0.035 0.050
HIV prevalence among tested for HIV 15-49 0.006 0.002 4314 4756 1.278 0.241 0.003 0.010
Total fertility rate (3 years) 6.024 0.140 na 32106 1.901 0.023 5.743 6.304
Neonatal mortality (0-9 years) 41.038 2.194 17417 21045 1.264 0.053 36.651 45.425
Postneonatal mortality (0-9 years) 40.383 2.362 17434 21067 1.495 0.058 35.659 45.108
Infant mortality (0-9 years) 81.421 3.060 17439 21072 1.309 0.038 75.302 87.540
Child mortality (0-9 years) 58.084 3.018 17618 21294 1.445 0.052 52.049 64.120
Under-five mortality (0-9 years) 134.776 4.300 17645 21327 1.435 0.032 126.177 143.376
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.000 0.000 4405 5117 na na 0.000 0.000
Literate 0.527 0.011 4405 5117 1.521 0.022 0.504 0.550
No education 0.492 0.011 4405 5117 1.495 0.023 0.469 0.514
Secondary education or higher 0.104 0.006 4405 5117 1.292 0.057 0.092 0.116
Want no more children 0.329 0.013 2718 3080 1.474 0.040 0.302 0.355
Want to delay birth at least 2 years 0.429 0.013 2718 3080 1.371 0.030 0.403 0.455
Ideal family size 5.558 0.090 4059 4720 1.330 0.016 5.379 5.738
Has heard of HIV/AIDS (15-49) 0.959 0.005 3961 4610 1.609 0.005 0.949 0.969
Knows about condoms (15-49) 0.609 0.012 3961 4610 1.608 0.020 0.584 0.634
Knows about limiting partners (15-49) 0.772 0.011 3961 4610 1.715 0.015 0.749 0.795
Had 2+ sex partners in past 12 months (15-49) 0.043 0.005 2448 2728 1.313 0.126 0.032 0.053
High-risk sex (15-49) 0.054 0.006 2448 2728 1.416 0.120 0.041 0.067
Condom use at high-risk sex (age 15-49) 0.294 0.055 173 146 1.581 0.187 0.185 0.404
Abstinence among youth 0.904 0.010 1360 1672 1.309 0.012 0.883 0.925
Sexually active in past 12 months among youth 0.056 0.007 1360 1672 1.199 0.134 0.041 0.071
Paid for sexual intercourse in past 12 months 0.007 0.002 4405 5117 1.284 0.223 0.004 0.011
Had an injection in past 12 months (age 15-49) 0.187 0.009 3961 4610 1.384 0.046 0.169 0.204
HIV test and received results past 12 months (15-49) 0.012 0.002 3961 4610 1.388 0.197 0.008 0.017
Accepting attitudes towards people with HIV (15-49) 0.112 0.008 3743 4422 1.504 0.069 0.096 0.127
HIV prevalence among tested for HIV 15-49 0.007 0.002 3551 4120 1.232 0.247 0.004 0.010
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 277
Table B.5 Sampling errors for Tigray Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.207 0.023 1257 919 1.973 0.109 0.162 0.253
Literate 0.337 0.023 1257 919 1.696 0.067 0.292 0.382
No education 0.635 0.023 1257 919 1.712 0.037 0.588 0.681
Secondary education or higher 0.165 0.021 1257 919 2.030 0.129 0.122 0.207
Net attendance ratio for primary school 0.506 0.029 1167 833 1.760 0.057 0.448 0.564
Currently pregnant 0.086 0.007 1257 919 0.915 0.084 0.072 0.101
Children ever born to women age 40-49 6.768 0.191 225 156 1.142 0.028 6.385 7.150
Currently using any contraceptive method 0.165 0.015 798 570 1.176 0.094 0.134 0.196
Currently using pill 0.029 0.005 798 570 0.801 0.165 0.019 0.038
Currently using IUD 0.000 0.000 798 570 na na 0.000 0.000
Currently using female sterilization 0.000 0.000 798 570 na na 0.000 0.000
Currently using rhythm method 0.003 0.000 798 570 0.072 0.050 0.002 0.003
Want no more children 0.285 0.014 798 570 0.906 0.051 0.256 0.314
Ideal family size 4.700 0.107 1208 886 1.411 0.023 4.486 4.913
Perinatal mortality (0-6 years) 19.981 4.507 985 702 1.009 0.226 10.967 28.994
Mothers received tetanus injection for last birth 0.398 0.027 671 480 1.438 0.069 0.343 0.453
Mothers received medical assistance at delivery 0.060 0.012 980 698 1.491 0.200 0.036 0.084
Had diarrhoea in two weeks before survey 0.128 0.012 915 653 1.089 0.096 0.104 0.153
Treated with oral rehydration salts (ORS) 0.211 0.046 122 84 1.175 0.216 0.120 0.303
Taken to a health provider 0.188 0.043 122 84 1.156 0.230 0.101 0.274
Vaccination card seen 0.584 0.040 193 135 1.098 0.068 0.505 0.664
Received BCG 0.774 0.033 193 135 1.069 0.043 0.709 0.840
Received DPT (3 doses) 0.516 0.039 193 135 1.061 0.076 0.438 0.594
Received polio (3 doses) 0.566 0.039 193 135 1.071 0.069 0.488 0.644
Received measles 0.633 0.032 193 135 0.896 0.050 0.570 0.697
Fully immunized 0.329 0.041 193 135 1.181 0.124 0.248 0.411
Height-for-age (below -2SD) 0.410 0.030 442 316 1.220 0.072 0.351 0.469
Weight-for-height (below -2SD) 0.116 0.017 442 316 1.045 0.149 0.081 0.151
Weight-for-age (below -2SD) 0.419 0.034 442 316 1.351 0.081 0.351 0.486
Anaemic (children) 0.565 0.027 407 288 1.088 0.048 0.510 0.620
Anaemic (women) 0.293 0.021 566 411 1.073 0.070 0.252 0.334
BMI <18.5 0.375 0.021 524 390 0.987 0.055 0.334 0.417
Has heard of HIV/AIDS 0.970 0.008 1257 919 1.611 0.008 0.955 0.986
Knows about condoms 0.523 0.020 1257 919 1.442 0.039 0.482 0.564
Knows about limiting partners 0.721 0.028 1257 919 2.221 0.039 0.665 0.777
Had 2+ sex partners in past 12 months 0.000 0.000 405 290 na na 0.000 0.000
High-risk sex 0.052 0.013 405 290 1.163 0.248 0.026 0.077
Condom use at high-risk sex 0.000 0.000 21 15 na na 0.000 0.000
Abstinence among youth 0.955 0.015 261 200 1.186 0.016 0.925 0.986
Sexually active in past 12 months among youth 0.013 0.008 261 200 1.134 0.606 0.000 0.029
Had an injection in past 12 months 0.165 0.012 1257 919 1.155 0.073 0.141 0.190
Had HIV test and received results in past 12 months 0.019 0.004 610 448 0.655 0.192 0.011 0.026
Accepting attitudes towards people with HIV 0.142 0.022 1219 892 2.182 0.153 0.099 0.186
HIV prevalence among tested for HIV 15-49 0.026 0.013 564 387 2.005 0.522 0.000 0.052
Total fertility rate (3 years) 5.125 0.303 na 2514 1.353 0.059 4.519 5.731
Neonatal mortality (0-9 years) 40.362 4.716 1953 1384 0.959 0.117 30.930 49.794
Postneonatal mortality (0-9 years) 26.211 3.981 1955 1386 0.982 0.152 18.250 34.172
Infant mortality (0-9 years) 66.573 6.219 1955 1386 1.007 0.093 54.136 79.010
Child mortality (0-9 years) 42.492 5.661 1970 1396 1.121 0.133 31.169 53.815
Under-five mortality (0-9 years) 106.236 7.890 1972 1397 1.071 0.074 90.456 122.017
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.189 0.024 512 366 1.387 0.127 0.141 0.237
Literate 0.675 0.029 512 366 1.404 0.043 0.617 0.733
No education 0.469 0.036 512 366 1.611 0.076 0.398 0.540
Secondary education or higher 0.231 0.024 512 366 1.282 0.104 0.183 0.279
Want no more children 0.280 0.029 297 206 1.115 0.104 0.222 0.338
Want to delay birth at least 2 years 0.490 0.023 297 206 0.787 0.047 0.445 0.536
Ideal family size 4.771 0.135 482 346 1.181 0.028 4.501 5.040
Has heard of HIV/AIDS (15-49) 0.997 0.002 439 315 0.932 0.002 0.992 1.002
Knows about condoms (15-49) 0.779 0.027 439 315 1.356 0.035 0.725 0.833
Knows about limiting partners (15-49) 0.923 0.015 439 315 1.194 0.017 0.892 0.953
Had 2+ sex partners in past 12 months (15-49) 0.045 0.014 262 187 1.084 0.310 0.017 0.072
High-risk sex (15-49) 0.159 0.028 262 187 1.224 0.174 0.104 0.215
Condom use at high-risk sex (age 15-49) 0.537 0.077 36 30 0.915 0.144 0.382 0.691
Abstinence among youth 0.843 0.035 178 132 1.283 0.042 0.773 0.913
Sexually active in past 12 months among youth 0.118 0.027 178 132 1.103 0.227 0.064 0.171
Paid for sexual intercourse in past 12 months 0.017 0.008 512 366 1.312 0.440 0.002 0.032
Had an injection in past 12 months (age 15-49) 0.162 0.015 439 315 0.872 0.095 0.132 0.193
HIV test and received results i past 12 months (15-49) 0.025 0.007 439 315 0.911 0.270 0.012 0.039
Accepting attitudes towards people with HIV (15-49) 0.275 0.025 437 314 1.153 0.090 0.225 0.324
HIV prevalence among tested for HIV 15-49 0.016 0.007 407 274 1.156 0.455 0.001 0.030
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

278 | Appendix B
Table B.6 Sampling errors for Affar Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.200 0.030 789 146 2.119 0.151 0.140 0.260
Literate 0.156 0.036 789 146 2.795 0.232 0.084 0.228
No education 0.848 0.037 789 146 2.898 0.044 0.774 0.922
Secondary education or higher 0.068 0.027 789 146 2.958 0.389 0.015 0.122
Net attendance ratio for primary school 0.153 0.023 958 159 1.619 0.149 0.108 0.199
Currently pregnant 0.089 0.016 789 146 1.545 0.176 0.058 0.120
Children ever born to women age 40-49 5.783 0.232 149 27 0.970 0.040 5.319 6.247
Currently using any contraceptive method 0.066 0.017 616 109 1.694 0.257 0.032 0.100
Currently using pill 0.013 0.006 616 109 1.188 0.411 0.002 0.024
Currently using IUD 0.000 0.000 616 109 na na 0.000 0.000
Currently using female sterilization 0.000 0.000 616 109 na na 0.000 0.000
Currently using rhythm method 0.006 0.004 616 109 1.368 0.725 0.000 0.014
Want no more children 0.198 0.030 616 109 1.867 0.152 0.138 0.258
Ideal family size 7.828 0.416 729 137 2.339 0.053 6.996 8.660
Perinatal mortality (0-6 years) 16.007 5.968 577 108 1.155 0.373 4.072 27.943
Mothers received tetanus injection for last birth 0.109 0.027 377 68 1.637 0.244 0.056 0.162
Mothers received medical assistance at delivery 0.045 0.017 574 107 1.687 0.369 0.012 0.078
Had diarrhoea in two weeks before survey 0.137 0.023 521 96 1.357 0.168 0.091 0.183
Treated with oral rehydration salts (ORS) 0.088 0.061 65 13 1.805 0.697 0.000 0.211
Taken to a health provider 0.092 0.043 65 13 1.222 0.460 0.007 0.177
Vaccination card seen 0.040 0.020 107 18 1.024 0.508 0.000 0.081
Received BCG 0.276 0.048 107 18 1.056 0.174 0.180 0.372
Received DPT (3 doses) 0.028 0.013 107 18 0.767 0.456 0.002 0.054
Received polio (3 doses) 0.199 0.043 107 18 1.053 0.214 0.114 0.284
Received measles 0.081 0.031 107 18 1.130 0.386 0.018 0.144
Fully immunized 0.006 0.006 107 18 0.788 1.015 0.000 0.019
Height-for-age (below -2SD) 0.408 0.046 251 46 1.518 0.112 0.317 0.499
Weight-for-height (below -2SD) 0.099 0.025 251 46 1.282 0.254 0.049 0.149
Weight-for-age (below -2SD) 0.341 0.061 251 46 1.994 0.180 0.218 0.463
Anaemic (children) 0.585 0.035 176 32 1.045 0.061 0.514 0.656
Anaemic (women) 0.404 0.038 283 55 1.324 0.093 0.329 0.480
BMI <18.5 0.330 0.036 329 61 1.407 0.110 0.257 0.402
Has heard of HIV/AIDS 0.854 0.022 789 146 1.730 0.025 0.810 0.898
Knows about condoms 0.272 0.032 789 146 2.031 0.118 0.208 0.337
Knows about limiting partners 0.369 0.037 789 146 2.160 0.101 0.295 0.444
Had 2+ sex partners in past 12 months 0.007 0.007 304 55 1.407 0.981 0.000 0.020
High-risk sex 0.020 0.009 304 55 1.138 0.458 0.002 0.038
Condom use at high-risk sex 0.584 0.214 6 1 0.971 0.366 0.156 1.012
Abstinence among youth 0.944 0.020 97 21 0.841 0.021 0.904 0.983
Sexually active in past 12 months among youth 0.026 0.012 97 21 0.721 0.451 0.003 0.049
Had an injection in past 12 months 0.153 0.021 789 146 1.644 0.138 0.111 0.195
Had HIV test and received results in past 12 months 0.018 0.011 384 72 1.598 0.609 0.000 0.039
Accepting attitudes towards people with HIV 0.051 0.015 661 125 1.768 0.298 0.021 0.081
HIV prevalence among tested for HIV 15-49 0.033 0.012 295 61 1.144 0.364 0.009 0.056
Total fertility rate (3 years) 4.934 0.383 na 407 1.495 0.078 4.167 5.700
Neonatal mortality (0-9 years) 33.117 5.913 1343 243 1.017 0.179 21.291 44.943
Postneonatal mortality (0-9 years) 28.016 6.016 1343 243 1.376 0.215 15.984 40.048
Infant mortality (0-9 years) 61.134 8.521 1343 243 1.151 0.139 44.091 78.176
Child mortality (0-9 years) 65.843 13.403 1348 243 1.446 0.204 39.037 92.649
Under-five mortality (0-9 years) 122.951 17.443 1348 243 1.485 0.142 88.066 157.837
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.197 0.042 314 65 1.855 0.212 0.113 0.280
Literate 0.270 0.054 314 65 2.160 0.200 0.162 0.379
No education 0.714 0.054 314 65 2.104 0.075 0.607 0.822
Secondary education or higher 0.115 0.036 314 65 1.971 0.309 0.044 0.186
Want no more children 0.151 0.029 205 42 1.145 0.190 0.094 0.209
Want to delay birth at least 2 years 0.257 0.021 205 42 0.701 0.084 0.214 0.300
Ideal family size 11.282 0.894 296 62 1.973 0.079 9.494 13.070
Has heard of HIV/AIDS (15-49) 0.964 0.014 281 59 1.286 0.015 0.935 0.992
Knows about condoms (15-49) 0.606 0.036 281 59 1.243 0.060 0.534 0.679
Knows about limiting partners (15-49) 0.735 0.060 281 59 2.259 0.081 0.616 0.854
Had 2+ sex partners in past 12 months (15-49) 0.071 0.018 216 45 1.008 0.248 0.036 0.107
High-risk sex (15-49) 0.159 0.027 216 45 1.074 0.168 0.106 0.213
Condom use at high-risk sex (age 15-49) 0.387 0.097 31 7 1.095 0.251 0.193 0.582
Abstinence among youth 0.653 0.083 67 15 1.409 0.127 0.487 0.818
Sexually active in past 12 months among youth 0.301 0.083 67 15 1.461 0.274 0.136 0.466
Paid for sexual intercourse in past 12 months 0.021 0.011 314 65 1.376 0.528 0.000 0.044
Had an injection in past 12 months (age 15-49) 0.147 0.032 281 59 1.491 0.215 0.084 0.210
HIV test and received results past 12 months (15-49) 0.012 0.008 281 59 1.151 0.623 0.000 0.027
Accepting attitudes towards people with HIV (15-49) 0.150 0.032 268 57 1.452 0.211 0.087 0.214
HIV prevalence among tested for HIV 15-49 0.024 0.005 212 46 0.503 0.221 0.013 0.035
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 279
Table B.7 Sampling errors for Amhara Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.112 0.009 1943 3482 1.260 0.080 0.094 0.130
Literate 0.251 0.015 1943 3482 1.570 0.062 0.220 0.282
No education 0.756 0.016 1943 3482 1.643 0.021 0.724 0.788
Secondary education or higher 0.085 0.013 1943 3482 2.032 0.151 0.059 0.111
Net attendance ratio for primary school 0.504 0.018 1817 3283 1.535 0.037 0.467 0.541
Currently pregnant 0.072 0.006 1943 3482 1.051 0.085 0.060 0.085
Children ever born to women age 40-49 6.971 0.141 363 657 1.033 0.020 6.688 7.253
Currently using any contraceptive method 0.161 0.013 1295 2330 1.268 0.081 0.135 0.186
Currently using pill 0.036 0.007 1295 2330 1.361 0.196 0.022 0.050
Currently using IUD 0.002 0.001 1295 2330 1.085 0.705 0.000 0.004
Currently using female sterilization 0.001 0.001 1295 2330 1.134 0.996 0.000 0.003
Currently using rhythm method 0.003 0.001 1295 2330 1.059 0.583 0.000 0.005
Want no more children 0.475 0.014 1295 2330 1.014 0.030 0.447 0.503
Ideal family size 4.123 0.088 1790 3206 1.389 0.021 3.946 4.299
Perinatal mortality (0-6 years) 55.744 6.458 1493 2685 1.005 0.116 42.829 68.660
Mothers received tetanus injection for last birth 0.298 0.023 1032 1856 1.625 0.078 0.252 0.344
Mothers received medical assistance at delivery 0.037 0.007 1458 2621 1.285 0.188 0.023 0.052
Had diarrhoea in two weeks before survey 0.146 0.008 1289 2312 0.787 0.053 0.130 0.161
Treated with oral rehydration salts (ORS) 0.199 0.031 191 337 1.070 0.156 0.137 0.261
Taken to a health provider 0.271 0.044 191 337 1.352 0.162 0.184 0.359
Vaccination card seen 0.333 0.030 267 482 1.045 0.091 0.272 0.393
Received BCG 0.623 0.041 267 482 1.369 0.065 0.541 0.704
Received DPT (3 doses) 0.315 0.036 267 482 1.269 0.115 0.243 0.388
Received polio (3 doses) 0.456 0.038 267 482 1.257 0.084 0.379 0.533
Received measles 0.348 0.032 267 482 1.096 0.092 0.283 0.412
Fully immunized 0.171 0.025 267 482 1.094 0.147 0.120 0.221
Height-for-age (below -2SD) 0.566 0.024 538 973 1.103 0.042 0.519 0.614
Weight-for-height (below -2SD) 0.142 0.017 538 973 1.124 0.123 0.107 0.177
Weight-for-age (below -2SD) 0.489 0.023 538 973 1.032 0.047 0.442 0.535
Anaemic (children) 0.520 0.025 472 858 1.076 0.048 0.471 0.570
Anaemic (women) 0.310 0.023 827 1486 1.412 0.073 0.265 0.355
BMI <18.5 0.270 0.018 821 1471 1.164 0.067 0.234 0.307
Has heard of HIV/AIDS 0.879 0.013 1943 3482 1.774 0.015 0.853 0.905
Knows about condoms 0.359 0.017 1943 3482 1.552 0.047 0.326 0.393
Knows about limiting partners 0.568 0.017 1943 3482 1.550 0.031 0.534 0.603
Had 2+ sex partners in past 12 months 0.001 0.001 635 1140 0.944 0.999 0.000 0.004
High-risk sex 0.029 0.008 635 1140 1.239 0.286 0.012 0.045
Condom use at high-risk sex 0.128 0.089 19 33 1.136 0.699 0.000 0.307
Abstinence among youth 0.959 0.010 295 523 0.881 0.011 0.938 0.979
Sexually active in past 12 months among youth 0.009 0.006 295 523 1.045 0.623 0.000 0.021
Had an injection in past 12 months 0.234 0.015 1943 3482 1.570 0.064 0.204 0.264
Had HIV test and received results in past 12 months 0.010 0.002 917 1640 0.716 0.232 0.005 0.015
Accepting attitudes towards people with HIV 0.086 0.011 1711 3061 1.609 0.126 0.065 0.108
HIV prevalence among tested for HIV 15-49 0.018 0.005 822 1411 0.978 0.250 0.009 0.027
Total fertility rate (3 years) 5.085 0.202 na 9828 1.242 0.040 4.680 5.490
Neonatal mortality (0-9 years) 50.103 4.308 2979 5376 0.948 0.086 41.487 58.720
Postneonatal mortality (0-9 years) 44.311 4.648 2981 5379 1.203 0.105 35.014 53.607
Infant mortality (0-9 years) 94.414 6.195 2982 5381 1.035 0.066 82.024 106.805
Child mortality (0-9 years) 66.162 5.726 3021 5454 1.052 0.087 54.711 77.613
Under-five mortality (0-9 years) 154.330 8.877 3025 5461 1.173 0.058 136.576 172.084
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.085 0.007 897 1521 0.757 0.083 0.071 0.099
Literate 0.540 0.019 897 1521 1.154 0.036 0.502 0.579
No education 0.605 0.022 897 1521 1.359 0.037 0.560 0.649
Secondary education or higher 0.126 0.016 897 1521 1.425 0.125 0.095 0.158
Want no more children 0.356 0.028 534 913 1.346 0.078 0.301 0.412
Want to delay birth at least 2 years 0.397 0.025 534 913 1.176 0.063 0.347 0.447
Ideal family size 4.898 0.121 868 1470 0.970 0.025 4.657 5.139
Has heard of HIV/AIDS (15-49) 0.962 0.007 795 1347 1.100 0.008 0.947 0.977
Knows about condoms (15-49) 0.749 0.025 795 1347 1.625 0.033 0.699 0.799
Knows about limiting partners (15-49) 0.797 0.020 795 1347 1.368 0.024 0.758 0.836
Had 2+ sex partners in past 12 months (15-49) 0.020 0.007 456 775 1.105 0.363 0.005 0.034
High-risk sex (15-49) 0.035 0.007 456 775 0.870 0.214 0.020 0.050
Condom use at high-risk sex (age 15-49) 0.563 0.123 17 27 0.992 0.218 0.317 0.809
Abstinence among youth 0.932 0.012 296 497 0.821 0.013 0.908 0.956
Sexually active in past 12 months among youth 0.034 0.009 296 497 0.822 0.254 0.017 0.052
Paid for sexual intercourse in past 12 months 0.006 0.003 897 1521 1.038 0.456 0.001 0.011
Had an injection in past 12 months (age 15-49) 0.155 0.015 795 1347 1.177 0.098 0.125 0.185
HIV test and received results past 12 months (15-49) 0.025 0.008 795 1347 1.395 0.312 0.009 0.040
Accepting attitudes towards people with HIV (15-49) 0.197 0.023 765 1295 1.601 0.117 0.151 0.243
HIV prevalence among tested for HIV 15-49 0.016 0.005 720 1212 1.113 0.324 0.006 0.027
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

280 | Appendix B
Table B.8 Sampling errors for Oromiya Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.151 0.017 2230 5010 2.183 0.110 0.118 0.184
Literate 0.295 0.019 2230 5010 1.952 0.064 0.257 0.332
No education 0.644 0.022 2230 5010 2.130 0.034 0.601 0.687
Secondary education or higher 0.100 0.012 2230 5010 1.853 0.118 0.076 0.124
Net attendance ratio for primary school 0.427 0.020 2196 4940 1.691 0.046 0.388 0.466
Currently pregnant 0.090 0.007 2230 5010 1.087 0.073 0.077 0.103
Children ever born to women age 40-49 7.053 0.123 367 816 0.762 0.017 6.808 7.299
Currently using any contraceptive method 0.136 0.012 1468 3300 1.311 0.086 0.113 0.160
Currently using pill 0.034 0.006 1468 3300 1.289 0.179 0.022 0.046
Currently using IUD 0.002 0.001 1468 3300 0.527 0.318 0.001 0.003
Currently using female sterilization 0.002 0.001 1468 3300 0.650 0.343 0.001 0.004
Currently using rhythm method 0.004 0.002 1468 3300 1.062 0.462 0.000 0.007
Want no more children 0.471 0.016 1468 3300 1.227 0.034 0.439 0.503
Ideal family size 4.210 0.100 1932 4338 1.460 0.024 4.010 4.410
Perinatal mortality (0-6 years) 34.162 5.092 1948 4433 1.118 0.149 23.978 44.346
Mothers received tetanus injection for last birth 0.311 0.019 1211 2723 1.441 0.062 0.273 0.350
Mothers received medical assistance at delivery 0.048 0.007 1938 4411 1.226 0.140 0.035 0.062
Had diarrhoea in two weeks before survey 0.177 0.012 1769 4017 1.317 0.070 0.152 0.201
Treated with oral rehydration salts (ORS) 0.226 0.032 317 709 1.308 0.139 0.163 0.289
Taken to a health provider 0.235 0.030 317 709 1.184 0.128 0.175 0.295
Vaccination card seen 0.388 0.032 304 691 1.161 0.084 0.323 0.453
Received BCG 0.578 0.041 304 691 1.448 0.071 0.497 0.660
Received DPT (3 doses) 0.285 0.037 304 691 1.443 0.131 0.211 0.360
Received polio (3 doses) 0.411 0.041 304 691 1.458 0.100 0.329 0.493
Received measles 0.294 0.038 304 691 1.445 0.129 0.218 0.370
Fully immunized 0.202 0.033 304 691 1.433 0.163 0.136 0.268
Height-for-age (below -2SD) 0.410 0.021 831 1867 1.158 0.050 0.369 0.452
Weight-for-height (below -2SD) 0.096 0.010 831 1867 1.040 0.110 0.075 0.117
Weight-for-age (below -2SD) 0.344 0.021 831 1867 1.279 0.062 0.301 0.387
Anaemic (children) 0.560 0.019 768 1717 1.059 0.035 0.521 0.599
Anaemic (women) 0.249 0.015 971 2177 1.053 0.059 0.220 0.278
BMI <18.5 0.243 0.016 902 2036 1.114 0.065 0.211 0.275
Has heard of HIV/AIDS 0.947 0.007 2230 5010 1.435 0.007 0.933 0.960
Knows about condoms 0.410 0.018 2230 5010 1.746 0.044 0.374 0.446
Knows about limiting partners 0.683 0.015 2230 5010 1.559 0.022 0.653 0.714
Had 2+ sex partners in past 12 months 0.002 0.002 694 1558 0.912 0.723 0.000 0.006
High-risk sex 0.028 0.007 694 1558 1.132 0.255 0.014 0.042
Condom use at high-risk sex 0.307 0.118 19 43 1.087 0.385 0.071 0.544
Abstinence among youth 0.960 0.016 536 1210 1.923 0.017 0.927 0.993
Sexually active in past 12 months among youth 0.021 0.007 536 1210 1.173 0.346 0.007 0.036
Had an injection in past 12 months 0.266 0.018 2230 5010 1.896 0.067 0.230 0.301
Had HIV test and received results in past 12 months 0.014 0.003 1052 2368 0.871 0.224 0.008 0.021
Accepting attitudes towards people with HIV 0.080 0.011 2114 4742 1.914 0.141 0.058 0.103
HIV prevalence among tested for HIV 15-49 0.022 0.004 965 2000 0.881 0.188 0.014 0.031
Total fertility rate (3 years) 6.175 0.316 na 13861 1.959 0.051 5.544 6.806
Neonatal mortality (0-9 years) 39.681 3.940 3865 8769 1.101 0.099 31.800 47.562
Postneonatal mortality (0-9 years) 35.853 4.028 3871 8783 1.277 0.112 27.798 43.909
Infant mortality (0-9 years) 75.534 4.863 3872 8785 1.024 0.064 65.808 85.261
Child mortality (0-9 years) 50.596 5.179 3908 8860 1.260 0.102 40.238 60.954
Under-five mortality (0-9 years) 122.309 6.645 3916 8879 1.095 0.054 109.019 135.598
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.124 0.012 1041 2222 1.178 0.097 0.100 0.148
Literate 0.615 0.018 1041 2222 1.188 0.029 0.579 0.651
No education 0.367 0.016 1041 2222 1.054 0.043 0.336 0.399
Secondary education or higher 0.203 0.012 1041 2222 0.989 0.061 0.178 0.227
Want no more children 0.397 0.025 572 1228 1.204 0.062 0.348 0.446
Want to delay birth at least 2 years 0.409 0.025 572 1228 1.228 0.062 0.358 0.459
Ideal family size 4.755 0.135 971 2057 1.365 0.028 4.485 5.025
Has heard of HIV/AIDS (15-49) 0.984 0.005 953 2041 1.325 0.005 0.973 0.995
Knows about condoms (15-49) 0.618 0.017 953 2041 1.082 0.028 0.584 0.652
Knows about limiting partners (15-49) 0.815 0.017 953 2041 1.322 0.020 0.782 0.848
Had 2+ sex partners in past 12 months (15-49) 0.035 0.009 530 1147 1.159 0.263 0.017 0.054
High-risk sex (15-49) 0.088 0.013 530 1147 1.059 0.148 0.062 0.114
Condom use at high-risk sex (age 15-49) 0.460 0.073 46 101 0.982 0.158 0.315 0.606
Abstinence among youth 0.857 0.019 382 807 1.069 0.022 0.819 0.895
Sexually active in past 12 months among youth 0.090 0.014 382 807 0.985 0.160 0.061 0.119
Paid for sexual intercourse in past 12 months 0.010 0.003 1041 2222 1.052 0.329 0.003 0.016
Had an injection in past 12 months (age 15-49) 0.224 0.014 953 2041 1.068 0.064 0.195 0.253
HIV test and received results past 12 months (15-49) 0.017 0.005 953 2041 1.167 0.290 0.007 0.026
Accepting attitudes towards people with HIV (15-49) 0.136 0.017 938 2009 1.483 0.122 0.103 0.170
HIV prevalence among tested for HIV 15-49 0.004 0.002 878 1812 1.000 0.506 0.000 0.009
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 281
Table B.9 Sampling errors for Somali Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.177 0.070 669 486 4.770 0.398 0.036 0.317
Literate 0.098 0.044 669 486 3.855 0.452 0.009 0.187
No education 0.906 0.044 669 486 3.900 0.049 0.817 0.994
Secondary education or higher 0.052 0.031 669 486 3.601 0.598 0.000 0.113
Net attendance ratio for primary school 0.138 0.034 988 647 2.322 0.245 0.070 0.206
Currently pregnant 0.100 0.015 669 486 1.333 0.155 0.069 0.130
Children ever born to women age 40-49 6.690 0.196 113 73 0.769 0.029 6.299 7.082
Currently using any contraceptive method 0.031 0.028 508 363 3.634 0.897 0.000 0.088
Currently using pill 0.000 0.000 508 363 na na 0.000 0.000
Currently using IUD 0.000 0.000 508 363 na na 0.000 0.000
Currently using female sterilization 0.000 0.000 508 363 na na 0.000 0.000
Currently using rhythm method 0.004 0.004 508 363 1.397 0.954 0.000 0.012
Want no more children 0.103 0.020 508 363 1.458 0.191 0.064 0.143
Ideal family size 9.743 0.633 547 400 2.806 0.065 8.478 11.009
Perinatal mortality (0-6 years) 29.815 7.857 666 480 0.996 0.264 14.101 45.530
Mothers received tetanus injection for last birth 0.094 0.032 398 288 2.195 0.342 0.030 0.159
Mothers received medical assistance at delivery 0.052 0.031 663 477 2.977 0.601 0.000 0.115
Had diarrhoea in two weeks before survey 0.122 0.015 604 432 1.097 0.124 0.092 0.152
Treated with oral rehydration salts (ORS) 0.158 0.053 68 53 1.153 0.338 0.051 0.264
Taken to a health provider 0.085 0.041 68 53 1.099 0.481 0.003 0.166
Vaccination card seen 0.081 0.049 101 78 1.705 0.605 0.000 0.178
Received BCG 0.171 0.055 101 78 1.453 0.321 0.061 0.280
Received DPT (3 doses) 0.056 0.039 101 78 1.759 0.699 0.000 0.134
Received polio (3 doses) 0.102 0.040 101 78 1.377 0.393 0.022 0.183
Received measles 0.064 0.036 101 78 1.354 0.559 0.000 0.135
Fully immunized 0.028 0.019 101 78 1.226 0.699 0.000 0.067
Height-for-age (below -2SD) 0.452 0.036 255 177 1.144 0.081 0.379 0.525
Weight-for-height (below -2SD) 0.237 0.020 255 177 0.721 0.084 0.197 0.277
Weight-for-age (below -2SD) 0.509 0.038 255 177 1.177 0.074 0.434 0.585
Anaemic (children) 0.856 0.032 176 124 1.242 0.037 0.792 0.920
Anaemic (women) 0.398 0.042 257 181 1.362 0.106 0.314 0.483
BMI <18.5 0.349 0.039 272 202 1.375 0.113 0.271 0.428
Has heard of HIV/AIDS 0.500 0.051 669 486 2.635 0.102 0.398 0.602
Knows about condoms 0.106 0.055 669 486 4.642 0.521 0.000 0.217
Knows about limiting partners 0.262 0.051 669 486 2.995 0.194 0.160 0.364
Had 2+ sex partners in past 12 months 0.000 0.000 226 161 na na 0.000 0.000
High-risk sex 0.000 0.000 226 161 na na 0.000 0.000
Abstinence among youth 1.000 0.000 102 77 na 0.000 1.000 1.000
Sexually active in past 12 months among youth 0.000 0.000 102 77 na na 0.000 0.000
Had an injection in past 12 months 0.057 0.010 669 486 1.140 0.179 0.037 0.078
Had HIV test and received results in past 12 months 0.013 0.012 333 243 1.903 0.924 0.000 0.036
Accepting attitudes towards people with HIV 0.086 0.047 340 243 3.091 0.546 0.000 0.181
HIV prevalence among tested for HIV 15-49 0.013 0.009 258 189 1.281 0.697 0.000 0.031
Total fertility rate (3 years) 5.959 0.517 na 1370 1.569 0.087 4.925 6.993
Neonatal mortality (0-9 years) 27.037 4.956 1438 1030 0.983 0.183 17.125 36.950
Postneonatal mortality (0-9 years) 29.586 6.382 1439 1030 1.218 0.216 16.821 42.350
Infant mortality (0-9 years) 56.623 7.241 1440 1031 1.004 0.128 42.141 71.105
Child mortality (0-9 years) 39.043 8.745 1452 1039 1.594 0.224 21.553 56.534
Under-five mortality (0-9 years) 93.455 9.669 1455 1041 1.029 0.103 74.118 112.793
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.128 0.039 281 202 1.951 0.304 0.050 0.206
Literate 0.220 0.047 281 202 1.887 0.212 0.127 0.313
No education 0.819 0.028 281 202 1.223 0.034 0.762 0.875
Secondary education or higher 0.079 0.026 281 202 1.588 0.324 0.028 0.130
Want no more children 0.040 0.012 184 137 0.833 0.300 0.016 0.065
Want to delay birth at least 2 years 0.216 0.030 184 137 0.985 0.139 0.156 0.276
Ideal family size 12.912 0.587 221 166 1.070 0.045 11.737 14.087
Has heard of HIV/AIDS (15-49) 0.643 0.058 250 180 1.914 0.090 0.527 0.760
Knows about condoms (15-49) 0.158 0.034 250 180 1.480 0.216 0.090 0.226
Knows about limiting partners (15-49) 0.320 0.046 250 180 1.547 0.143 0.229 0.412
Had 2+ sex partners in past 12 months (15-49) 0.032 0.020 158 116 1.399 0.617 0.000 0.071
High-risk sex (15-49) 0.026 0.013 158 116 1.000 0.493 0.000 0.051
Condom use at high-risk sex (age 15-49) 0.000 0.000 7 3 na na 0.000 0.000
Abstinence among youth 0.928 0.032 80 52 1.099 0.034 0.864 0.992
Sexually active in past 12 months among youth 0.054 0.027 80 52 1.044 0.490 0.001 0.108
Paid for sexual intercourse in past 12 months 0.002 0.002 281 202 0.715 1.000 0.000 0.005
Had an injection in past 12 months (age 15-49) 0.038 0.012 250 180 1.008 0.323 0.013 0.062
HIV test and received results past 12 months (15-49) 0.000 0.000 250 180 na na 0.000 0.000
Accepting attitudes towards people with HIV (15-49) 0.130 0.028 170 116 1.103 0.220 0.073 0.187
HIV prevalence among tested for HIV 15-49 0.000 0.000 168 140 na na 0.000 0.000
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

282 | Appendix B
Table B.10 Sampling errors for Benishangul-Gumuz, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.104 0.023 846 124 2.148 0.217 0.059 0.149
Literate 0.232 0.021 846 124 1.437 0.090 0.191 0.274
No education 0.732 0.024 846 124 1.562 0.033 0.684 0.780
Secondary education or higher 0.064 0.011 846 124 1.327 0.174 0.042 0.087
Net attendance ratio for primary school 0.484 0.049 818 125 2.546 0.101 0.386 0.582
Currently pregnant 0.102 0.009 846 124 0.904 0.092 0.083 0.121
Children ever born to women age 40-49 6.736 0.247 132 21 1.104 0.037 6.242 7.230
Currently using any contraceptive method 0.111 0.017 632 92 1.352 0.152 0.077 0.145
Currently using pill 0.013 0.003 632 92 0.646 0.225 0.007 0.019
Currently using IUD 0.000 0.000 632 92 na na 0.000 0.000
Currently using female sterilization 0.003 0.002 632 92 0.997 0.701 0.000 0.008
Currently using rhythm method 0.006 0.003 632 92 0.997 0.503 0.000 0.012
Want no more children 0.408 0.026 632 92 1.336 0.064 0.356 0.460
Ideal family size 4.990 0.293 803 119 2.463 0.059 4.403 5.576
Perinatal mortality (0-6 years) 41.647 7.187 710 107 0.905 0.173 27.273 56.020
Mothers received tetanus injection for last birth 0.205 0.025 460 69 1.364 0.124 0.154 0.256
Mothers received medical assistance at delivery 0.051 0.007 698 105 0.842 0.146 0.036 0.065
Had diarrhoea in two weeks before survey 0.213 0.024 634 95 1.423 0.111 0.166 0.261
Treated with oral rehydration salts (ORS) 0.249 0.042 130 20 1.112 0.168 0.165 0.333
Taken to a health provider 0.296 0.052 130 20 1.227 0.177 0.191 0.401
Vaccination card seen 0.287 0.070 114 16 1.613 0.243 0.147 0.427
Received BCG 0.535 0.073 114 16 1.512 0.136 0.390 0.680
Received DPT (3 doses) 0.307 0.067 114 16 1.491 0.218 0.173 0.440
Received polio (3 doses) 0.367 0.060 114 16 1.293 0.164 0.247 0.488
Received measles 0.334 0.063 114 16 1.387 0.190 0.207 0.460
Fully immunized 0.185 0.044 114 16 1.150 0.237 0.097 0.273
Height-for-age (below -2SD) 0.397 0.036 312 46 1.249 0.091 0.325 0.469
Weight-for-height (below -2SD) 0.160 0.029 312 46 1.419 0.184 0.101 0.219
Weight-for-age (below -2SD) 0.446 0.039 312 46 1.288 0.087 0.369 0.523
Anaemic (children) 0.543 0.048 268 39 1.549 0.088 0.447 0.639
Anaemic (women) 0.313 0.037 398 59 1.588 0.117 0.240 0.387
BMI <18.5 0.329 0.027 361 53 1.100 0.083 0.274 0.383
Has heard of HIV/AIDS 0.677 0.040 846 124 2.514 0.060 0.596 0.758
Knows about condoms 0.290 0.031 846 124 1.991 0.107 0.228 0.352
Knows about limiting partners 0.433 0.040 846 124 2.340 0.092 0.353 0.513
Had 2+ sex partners in past 12 months 0.007 0.004 324 47 0.782 0.503 0.000 0.015
High-risk sex 0.020 0.008 324 47 0.988 0.383 0.005 0.036
Condom use at high-risk sex 0.551 0.183 9 1 1.039 0.332 0.185 0.917
Abstinence among youth 0.956 0.014 127 19 0.790 0.015 0.928 0.985
Sexually active in past 12 months among youth 0.011 0.008 127 19 0.897 0.755 0.000 0.028
Had an injection in past 12 months 0.253 0.034 846 124 2.271 0.134 0.185 0.321
Had HIV test and received results in past 12 months 0.008 0.004 423 62 0.862 0.477 0.000 0.015
Accepting attitudes towards people with HIV 0.107 0.016 598 84 1.252 0.148 0.075 0.138
HIV prevalence among tested for HIV 15-49 0.009 0.004 389 55 0.867 0.462 0.001 0.017
Total fertility rate (3 years) 5.189 0.381 na 352 1.511 0.073 4.427 5.951
Neonatal mortality (0-9 years) 43.804 5.530 1403 210 0.931 0.126 32.744 54.863
Postneonatal mortality (0-9 years) 40.387 9.721 1405 210 1.636 0.241 20.946 59.828
Infant mortality (0-9 years) 84.191 10.399 1405 210 1.253 0.124 63.393 104.988
Child mortality (0-9 years) 79.603 11.381 1425 214 1.337 0.143 56.841 102.365
Under-five mortality (0-9 years) 157.092 16.281 1427 214 1.439 0.104 124.529 189.655
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.073 0.019 382 54 1.392 0.255 0.036 0.110
Literate 0.474 0.041 382 54 1.608 0.087 0.392 0.556
No education 0.499 0.031 382 54 1.205 0.062 0.437 0.561
Secondary education or higher 0.126 0.017 382 54 1.025 0.138 0.091 0.161
Want no more children 0.254 0.044 265 37 1.648 0.174 0.165 0.342
Want to delay birth at least 2 years 0.420 0.038 265 37 1.247 0.090 0.344 0.495
Ideal family size 6.671 0.459 369 51 1.687 0.069 5.753 7.589
Has heard of HIV/AIDS (15-49) 0.946 0.023 348 50 1.894 0.024 0.900 0.992
Knows about condoms (15-49) 0.582 0.040 348 50 1.502 0.068 0.503 0.662
Knows about limiting partners (15-49) 0.721 0.051 348 50 2.121 0.071 0.619 0.824
Had 2+ sex partners in past 12 months (15-49) 0.127 0.042 240 34 1.935 0.328 0.044 0.211
High-risk sex (15-49) 0.050 0.014 240 34 1.029 0.290 0.021 0.079
Condom use at high-risk sex (age 15-49) 0.600 0.207 11 2 1.339 0.345 0.186 1.015
Condom use at high-risk sex (age 15-59) 0.600 0.207 11 2 1.339 0.345 0.186 1.015
Abstinence among youth 0.913 0.028 94 14 0.960 0.031 0.857 0.969
Sexually active in past 12 months among youth 0.073 0.027 94 14 0.989 0.366 0.020 0.126
Paid for sexual intercourse in past 12 months 0.018 0.010 382 54 1.418 0.537 0.000 0.037
Had an injection in past 12 months (age 15-49) 0.285 0.054 348 50 2.223 0.189 0.178 0.393
HIV test and received results past 12 months (15-49) 0.015 0.005 348 50 0.755 0.327 0.005 0.025
Accepting attitudes towards people with HIV (15-49) 0.146 0.025 329 47 1.287 0.172 0.095 0.196
HIV prevalence among tested for HIV 15-49 0.000 0.000 304 45 na na 0.000 0.000
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 283
Table B.11 Sampling errors for SNNP Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.068 0.010 2087 2995 1.791 0.145 0.048 0.088
Literate 0.224 0.016 2087 2995 1.766 0.072 0.192 0.256
No education 0.657 0.019 2087 2995 1.865 0.030 0.618 0.695
Secondary education or higher 0.067 0.007 2087 2995 1.344 0.110 0.052 0.082
Net attendance ratio for primary school 0.345 0.020 2109 3129 1.770 0.059 0.304 0.386
Currently pregnant 0.102 0.008 2087 2995 1.170 0.076 0.087 0.118
Children ever born to women age 40-49 7.511 0.180 309 450 1.198 0.024 7.150 7.872
Currently using any contraceptive method 0.119 0.015 1366 1988 1.682 0.124 0.089 0.148
Currently using pill 0.019 0.005 1366 1988 1.268 0.247 0.010 0.028
Currently using IUD 0.000 0.000 1366 1988 na na 0.000 0.000
Currently using female sterilization 0.000 0.000 1366 1988 na na 0.000 0.000
Currently using rhythm method 0.003 0.002 1366 1988 1.160 0.585 0.000 0.006
Want no more children 0.378 0.019 1366 1988 1.456 0.051 0.340 0.416
Ideal family size 4.687 0.138 1860 2655 2.051 0.030 4.410 4.964
Perinatal mortality (0-6 years) 29.644 4.083 1741 2517 1.005 0.138 21.477 37.810
Mothers received tetanus injection for last birth 0.369 0.021 1129 1632 1.446 0.056 0.327 0.410
Mothers received medical assistance at delivery 0.042 0.006 1730 2500 1.197 0.153 0.029 0.054
Had diarrhoea in two weeks before survey 0.251 0.015 1568 2273 1.217 0.058 0.222 0.280
Treated with oral rehydration salts (ORS) 0.159 0.021 396 571 1.039 0.134 0.116 0.201
Taken to a health provider 0.186 0.019 396 571 0.898 0.105 0.147 0.225
Vaccination card seen 0.355 0.033 277 408 1.161 0.094 0.288 0.421
Received BCG 0.642 0.034 277 408 1.175 0.053 0.575 0.710
Received DPT (3 doses) 0.332 0.034 277 408 1.214 0.104 0.263 0.401
Received polio (3 doses) 0.502 0.034 277 408 1.136 0.068 0.434 0.570
Received measles 0.377 0.030 277 408 1.026 0.079 0.318 0.436
Fully immunized 0.203 0.024 277 408 0.993 0.118 0.155 0.250
Height-for-age (below -2SD) 0.516 0.021 729 1057 1.077 0.040 0.475 0.558
Weight-for-height (below -2SD) 0.065 0.010 729 1057 1.084 0.156 0.045 0.086
Weight-for-age (below -2SD) 0.347 0.017 729 1057 0.929 0.050 0.313 0.382
Anaemic (children) 0.462 0.019 687 1004 0.955 0.040 0.424 0.499
Anaemic (women) 0.235 0.018 1003 1437 1.371 0.078 0.198 0.271
BMI <18.5 0.267 0.020 910 1295 1.375 0.076 0.227 0.308
Has heard of HIV/AIDS 0.873 0.016 2087 2995 2.161 0.018 0.841 0.904
Knows about condoms 0.359 0.021 2087 2995 2.046 0.060 0.316 0.402
Knows about limiting partners 0.579 0.027 2087 2995 2.515 0.047 0.525 0.633
Had 2+ sex partners in past 12 months 0.004 0.003 647 942 0.999 0.611 0.000 0.009
High-risk sex 0.005 0.003 647 942 0.898 0.485 0.000 0.010
Condom use at high-risk sex 0.444 0.240 5 5 0.964 0.539 0.000 0.923
Abstinence among youth 0.987 0.005 543 765 0.967 0.005 0.978 0.997
Sexually active in past 12 months among youth 0.005 0.003 543 765 0.990 0.627 0.000 0.010
Had an injection in past 12 months 0.316 0.016 2087 2995 1.593 0.051 0.283 0.348
Had HIV test and received results in past 12 months 0.014 0.004 1049 1504 1.146 0.293 0.006 0.023
Accepting attitudes towards people with HIV 0.057 0.007 1842 2613 1.335 0.126 0.043 0.072
HIV prevalence among tested for HIV 15-49 0.001 0.001 997 1290 0.721 0.716 0.000 0.002
Total fertility rate (3 years) 5.638 0.218 na 8308 1.428 0.039 5.202 6.074
Neonatal mortality (0-9 years) 36.448 4.033 3586 5219 1.064 0.111 28.382 44.514
Postneonatal mortality (0-9 years) 48.702 4.583 3587 5221 1.157 0.094 39.536 57.868
Infant mortality (0-9 years) 85.150 6.517 3588 5222 1.220 0.077 72.115 98.185
Child mortality (0-9 years) 62.515 5.812 3629 5279 1.165 0.093 50.892 74.139
Under-five mortality (0-9 years) 142.343 8.821 3632 5284 1.256 0.062 124.700 159.985
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.064 0.010 880 1244 1.248 0.161 0.043 0.084
Literate 0.570 0.024 880 1244 1.460 0.043 0.521 0.619
No education 0.326 0.024 880 1244 1.536 0.074 0.278 0.375
Secondary education or higher 0.153 0.013 880 1244 1.062 0.084 0.127 0.178
Want no more children 0.295 0.021 514 730 1.052 0.072 0.252 0.337
Want to delay birth at least 2 years 0.495 0.023 514 730 1.027 0.046 0.449 0.540
Ideal family size 5.737 0.175 787 1116 1.067 0.031 5.386 6.087
Has heard of HIV/AIDS (15-49) 0.972 0.010 811 1143 1.766 0.011 0.952 0.992
Knows about condoms (15-49) 0.572 0.027 811 1143 1.581 0.048 0.517 0.627
Knows about limiting partners (15-49) 0.771 0.027 811 1143 1.796 0.034 0.718 0.824
Had 2+ sex partners in past 12 months (15-49) 0.065 0.011 464 657 1.002 0.176 0.042 0.088
High-risk sex (15-49) 0.046 0.012 464 657 1.226 0.258 0.022 0.070
Condom use at high-risk sex (age 15-49) 0.365 0.137 21 31 1.269 0.375 0.091 0.638
Abstinence among youth 0.924 0.014 300 425 0.889 0.015 0.897 0.951
Sexually active in past 12 months among youth 0.036 0.009 300 425 0.850 0.254 0.018 0.054
Paid for sexual intercourse in past 12 months 0.002 0.001 880 1244 0.951 0.720 0.000 0.005
Had an injection in past 12 months (age 15-49) 0.177 0.018 811 1143 1.336 0.101 0.141 0.213
HIV test and received results past 12 months (15-49) 0.013 0.004 811 1143 0.990 0.305 0.005 0.021
Accepting attitudes towards people with HIV (15-49) 0.083 0.013 789 1111 1.273 0.150 0.058 0.108
HIV prevalence among tested for HIV 15-49 0.004 0.002 758 1010 1.023 0.582 0.000 0.009
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

284 | Appendix B
Table B.12 Sampling errors for Gambela Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.149 0.024 729 44 1.797 0.159 0.102 0.197
Literate 0.228 0.027 729 44 1.748 0.119 0.174 0.283
No education 0.595 0.036 729 44 1.960 0.060 0.524 0.667
Secondary education or higher 0.084 0.017 729 44 1.623 0.199 0.051 0.117
Net attendance ratio for primary school 0.422 0.037 646 37 1.653 0.088 0.348 0.497
Currently pregnant 0.083 0.014 729 44 1.328 0.164 0.056 0.110
Children ever born to women age 40-49 5.304 0.188 97 6 0.648 0.036 4.927 5.681
Currently using any contraceptive method 0.159 0.026 511 31 1.577 0.160 0.108 0.211
Currently using pill 0.025 0.011 511 31 1.569 0.436 0.003 0.046
Currently using IUD 0.000 0.000 511 31 na na 0.000 0.000
Currently using female sterilization 0.000 0.000 511 31 na na 0.000 0.000
Currently using rhythm method 0.001 0.001 511 31 0.735 1.019 0.000 0.003
Want no more children 0.435 0.036 511 31 1.641 0.083 0.363 0.507
Ideal family size 4.667 0.176 662 40 1.592 0.038 4.314 5.020
Perinatal mortality (0-6 years) 23.939 7.986 517 31 1.183 0.334 7.967 39.911
Mothers received tetanus injection for last birth 0.242 0.033 385 23 1.497 0.136 0.176 0.307
Mothers received medical assistance at delivery 0.153 0.025 515 31 1.426 0.166 0.102 0.203
Had diarrhoea in two weeks before survey 0.151 0.012 480 29 0.670 0.077 0.127 0.174
Treated with oral rehydration salts (ORS) 0.276 0.071 74 4 1.312 0.259 0.133 0.418
Taken to a health provider 0.402 0.059 74 4 0.932 0.147 0.284 0.521
Vaccination card seen 0.225 0.052 85 5 1.099 0.233 0.120 0.330
Received BCG 0.493 0.071 85 5 1.288 0.145 0.350 0.636
Received DPT (3 doses) 0.203 0.051 85 5 1.113 0.254 0.100 0.306
Received polio (3 doses) 0.414 0.055 85 5 1.012 0.134 0.303 0.525
Received measles 0.307 0.083 85 5 1.598 0.270 0.142 0.473
Fully immunized 0.159 0.039 85 5 0.911 0.246 0.081 0.237
Height-for-age (below -2SD) 0.293 0.054 189 11 1.487 0.183 0.186 0.400
Weight-for-height (below -2SD) 0.068 0.015 189 11 0.808 0.218 0.038 0.098
Weight-for-age (below -2SD) 0.267 0.033 189 11 0.988 0.123 0.202 0.333
Anaemic (children) 0.618 0.048 176 10 1.282 0.078 0.522 0.715
Anaemic (women) 0.420 0.042 339 21 1.608 0.101 0.335 0.505
BMI <18.5 0.385 0.035 327 20 1.303 0.091 0.315 0.455
Has heard of HIV/AIDS 0.629 0.060 729 44 3.337 0.095 0.509 0.748
Knows about condoms 0.253 0.029 729 44 1.827 0.116 0.194 0.312
Knows about limiting partners 0.340 0.036 729 44 2.076 0.107 0.267 0.413
Had 2+ sex partners in past 12 months 0.006 0.006 222 14 1.145 0.988 0.000 0.018
High-risk sex 0.050 0.019 222 14 1.322 0.388 0.011 0.089
Condom use at high-risk sex 0.000 0.000 11 1 na na 0.000 0.000
Abstinence among youth 0.845 0.040 109 7 1.147 0.047 0.765 0.925
Sexually active in past 12 months among youth 0.073 0.040 109 7 1.581 0.541 0.000 0.153
Had an injection in past 12 months 0.252 0.026 729 44 1.600 0.102 0.201 0.304
Had HIV test and received results in past 12 months 0.006 0.004 381 23 0.903 0.577 0.000 0.014
Accepting attitudes towards people with HIV 0.151 0.021 472 28 1.272 0.139 0.109 0.192
HIV prevalence among tested for HIV 15-49 0.055 0.022 342 19 1.750 0.392 0.012 0.098
Total fertility rate (3 years) 3.999 0.468 na 126 1.130 0.117 3.064 4.934
Neonatal mortality (0-9 years) 41.603 13.631 1072 65 2.090 0.328 14.341 68.866
Postneonatal mortality (0-9 years) 50.616 8.138 1074 65 1.007 0.161 34.341 66.891
Infant mortality (0-9 years) 92.219 16.259 1074 65 1.612 0.176 59.700 124.738
Child mortality (0-9 years) 69.784 17.930 1086 66 1.817 0.257 33.924 105.644
Under-five mortality (0-9 years) 155.567 29.589 1088 66 2.308 0.190 96.389 214.746
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.135 0.027 339 21 1.429 0.197 0.082 0.188
Literate 0.575 0.045 339 21 1.674 0.078 0.485 0.665
No education 0.275 0.045 339 21 1.843 0.163 0.186 0.365
Secondary education or higher 0.317 0.051 339 21 2.025 0.162 0.215 0.420
Want no more children 0.242 0.044 186 12 1.409 0.183 0.153 0.331
Want to delay birth at least 2 years 0.471 0.059 186 12 1.618 0.126 0.353 0.590
Ideal family size 5.999 0.620 330 20 2.140 0.103 4.759 7.239
Has heard of HIV/AIDS (15-49) 0.877 0.032 317 19 1.728 0.036 0.813 0.941
Knows about condoms (15-49) 0.542 0.049 317 19 1.760 0.091 0.443 0.640
Knows about limiting partners (15-49) 0.609 0.052 317 19 1.900 0.086 0.504 0.713
Had 2+ sex partners in past 12 months (15-49) 0.124 0.021 201 12 0.890 0.167 0.082 0.165
High-risk sex (15-49) 0.282 0.033 201 12 1.029 0.116 0.216 0.347
Condom use at high-risk sex (age 15-49) 0.453 0.063 60 4 0.966 0.138 0.327 0.578
Abstinence among youth 0.499 0.060 113 6 1.260 0.119 0.380 0.618
Sexually active in past 12 months among youth 0.371 0.060 113 6 1.313 0.161 0.251 0.491
Paid for sexual intercourse in past 12 months 0.044 0.012 339 21 1.046 0.265 0.021 0.067
Had an injection in past 12 months (age 15-49) 0.250 0.034 317 19 1.375 0.134 0.183 0.318
HIV test and received results past 12 months (15-49) 0.006 0.005 317 19 1.096 0.783 0.000 0.016
Accepting attitudes towards people with HIV (15-49) 0.325 0.050 284 17 1.790 0.153 0.226 0.425
HIV prevalence among tested for HIV 15-49 0.067 0.016 277 16 1.070 0.241 0.035 0.099
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 285
Table B.13 Sampling errors for Harari Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.673 0.030 844 39 1.876 0.045 0.612 0.734
Literate 0.549 0.031 844 39 1.837 0.057 0.486 0.612
No education 0.399 0.025 844 39 1.491 0.063 0.349 0.449
Secondary education or higher 0.427 0.027 844 39 1.584 0.063 0.373 0.481
Net attendance ratio for primary school 0.543 0.048 565 23 1.890 0.088 0.448 0.639
Currently pregnant 0.067 0.011 844 39 1.228 0.157 0.046 0.089
Children ever born to women age 40-49 5.246 0.374 109 5 1.203 0.071 4.498 5.993
Currently using any contraceptive method 0.335 0.034 486 22 1.567 0.100 0.268 0.402
Currently using pill 0.058 0.016 486 22 1.465 0.268 0.027 0.089
Currently using IUD 0.016 0.007 486 22 1.140 0.405 0.003 0.029
Currently using female sterilization 0.000 0.000 486 22 na na 0.000 0.000
Currently using rhythm method 0.042 0.015 486 22 1.663 0.359 0.012 0.073
Want no more children 0.408 0.027 486 22 1.207 0.066 0.354 0.461
Ideal family size 4.196 0.218 658 31 1.852 0.052 3.760 4.632
Perinatal mortality (0-6 years) 24.634 7.402 516 22 1.073 0.300 9.830 39.437
Mothers received tetanus injection for last birth 0.378 0.039 337 15 1.440 0.103 0.301 0.456
Mothers received medical assistance at delivery 0.314 0.027 514 22 1.084 0.087 0.259 0.369
Had diarrhoea in two weeks before survey 0.188 0.024 482 21 1.197 0.125 0.141 0.235
Treated with oral rehydration salts (ORS) 0.226 0.049 91 4 1.052 0.216 0.128 0.324
Taken to a health provider 0.313 0.056 91 4 1.052 0.179 0.201 0.425
Vaccination card seen 0.410 0.057 93 4 1.119 0.139 0.296 0.523
Received BCG 0.674 0.057 93 4 1.166 0.084 0.561 0.787
Received DPT (3 doses) 0.458 0.048 93 4 0.921 0.104 0.363 0.553
Received polio (3 doses) 0.520 0.038 93 4 0.741 0.074 0.443 0.597
Received measles 0.399 0.044 93 4 0.871 0.110 0.311 0.488
Fully immunized 0.349 0.034 93 4 0.681 0.096 0.281 0.416
Height-for-age (below -2SD) 0.387 0.034 231 10 1.009 0.087 0.320 0.454
Weight-for-height (below -2SD) 0.091 0.019 231 10 0.985 0.212 0.052 0.129
Weight-for-age (below -2SD) 0.267 0.052 231 10 1.639 0.195 0.163 0.371
Anaemic (children) 0.561 0.053 175 7 1.267 0.094 0.455 0.667
Anaemic (women) 0.224 0.027 345 16 1.203 0.121 0.170 0.279
BMI <18.5 0.206 0.023 376 17 1.129 0.114 0.159 0.253
Has heard of HIV/AIDS 0.982 0.009 844 39 1.962 0.009 0.964 1.000
Knows about condoms 0.607 0.023 844 39 1.361 0.038 0.561 0.653
Knows about limiting partners 0.775 0.020 844 39 1.412 0.026 0.735 0.816
Had 2+ sex partners in past 12 months 0.004 0.004 255 12 0.980 0.998 0.000 0.011
High-risk sex 0.037 0.011 255 12 0.968 0.309 0.014 0.060
Condom use at high-risk sex 0.216 0.155 9 0 1.063 0.715 0.000 0.526
Abstinence among youth 0.918 0.020 212 10 1.037 0.021 0.879 0.957
Sexually active in past 12 months among youth 0.032 0.012 212 10 0.949 0.359 0.009 0.055
Had an injection in past 12 months 0.262 0.020 844 39 1.336 0.077 0.221 0.302
Had HIV test and received results in past 12 months 0.078 0.017 435 20 1.329 0.219 0.044 0.113
Accepting attitudes towards people with HIV 0.424 0.019 827 38 1.093 0.044 0.387 0.462
HIV prevalence among tested for HIV 15-49 0.046 0.013 345 16 1.135 0.279 0.020 0.072
Total fertility rate (3 years) 3.772 0.494 na 106 2.145 0.131 2.785 4.760
Neonatal mortality (0-9 years) 35.459 6.951 956 41 0.957 0.196 21.557 49.361
Postneonatal mortality (0-9 years) 30.165 7.371 959 41 1.094 0.244 15.424 44.906
Infant mortality (0-9 years) 65.624 11.921 959 41 1.159 0.182 41.783 89.466
Child mortality (0-9 years) 39.957 10.547 963 42 1.296 0.264 18.863 61.052
Under-five mortality (0-9 years) 102.959 16.570 966 42 1.274 0.161 69.820 136.099
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.622 0.035 359 16 1.385 0.057 0.551 0.693
Literate 0.784 0.035 359 16 1.610 0.045 0.714 0.854
No education 0.205 0.036 359 16 1.684 0.175 0.133 0.277
Secondary education or higher 0.516 0.035 359 16 1.307 0.067 0.447 0.585
Want no more children 0.309 0.037 193 9 1.113 0.120 0.235 0.384
Want to delay birth at least 2 years 0.465 0.035 193 9 0.978 0.076 0.395 0.536
Ideal family size 4.173 0.143 316 15 0.895 0.034 3.888 4.459
Has heard of HIV/AIDS (15-49) 0.998 0.002 337 15 0.800 0.002 0.994 1.002
Knows about condoms (15-49) 0.740 0.030 337 15 1.241 0.040 0.681 0.799
Knows about limiting partners (15-49) 0.959 0.014 337 15 1.333 0.015 0.930 0.988
Had 2+ sex partners in past 12 months (15-49) 0.022 0.011 216 10 1.072 0.488 0.001 0.043
High-risk sex (15-49) 0.208 0.027 216 10 0.972 0.130 0.154 0.261
Condom use at high-risk sex (age 15-49) 0.769 0.069 43 2 1.068 0.090 0.631 0.908
Abstinence among youth 0.762 0.060 100 4 1.413 0.079 0.641 0.883
Sexually active in past 12 months among youth 0.171 0.049 100 4 1.305 0.289 0.072 0.270
Paid for sexual intercourse in past 12 months 0.013 0.005 359 16 0.775 0.363 0.003 0.022
Had an injection in past 12 months (age 15-49) 0.195 0.032 337 15 1.479 0.164 0.131 0.258
HIV test and received results past 12 months (15-49) 0.074 0.015 337 15 1.058 0.205 0.043 0.104
Accepting attitudes towards people with HIV (15-49) 0.430 0.035 336 15 1.285 0.081 0.361 0.500
HIV prevalence among tested for HIV 15-49 0.022 0.009 262 13 0.939 0.389 0.005 0.039
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

286 | Appendix B
Table B.14 Sampling errors for Addis Ababa Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.990 0.002 1869 756 1.016 0.002 0.985 0.994
Literate 0.799 0.012 1869 756 1.335 0.016 0.774 0.824
No education 0.176 0.012 1869 756 1.382 0.069 0.152 0.200
Secondary education or higher 0.581 0.015 1869 756 1.296 0.025 0.552 0.611
Net attendance ratio for primary school 0.806 0.020 663 264 1.263 0.025 0.766 0.847
Currently pregnant 0.015 0.003 1869 756 1.013 0.191 0.009 0.020
Children ever born to women age 40-49 4.365 0.284 265 107 1.689 0.065 3.797 4.933
Currently using any contraceptive method 0.569 0.022 544 224 1.021 0.038 0.525 0.612
Currently using pill 0.106 0.016 544 224 1.194 0.149 0.074 0.138
Currently using IUD 0.039 0.010 544 224 1.183 0.253 0.019 0.058
Currently using female sterilization 0.018 0.007 544 224 1.262 0.402 0.004 0.032
Currently using rhythm method 0.092 0.011 544 224 0.892 0.120 0.070 0.115
Want no more children 0.477 0.021 544 224 0.980 0.044 0.435 0.519
Ideal family size 3.275 0.064 1795 727 1.372 0.020 3.147 3.402
Perinatal mortality (0-6 years) 48.451 12.107 389 158 1.139 0.250 24.238 72.665
Mothers received tetanus injection for last birth 0.677 0.031 315 129 1.166 0.045 0.616 0.738
Mothers received medical assistance at delivery 0.788 0.045 380 153 1.923 0.058 0.697 0.878
Had diarrhoea in two weeks before survey 0.129 0.021 360 146 1.202 0.166 0.086 0.172
Treated with oral rehydration salts (ORS) 0.453 0.077 46 19 1.034 0.169 0.300 0.607
Taken to a health provider 0.446 0.063 46 19 0.855 0.142 0.320 0.573
Vaccination card seen 0.683 0.051 78 32 0.980 0.075 0.580 0.785
Received BCG 0.935 0.041 78 32 1.476 0.044 0.853 1.017
Received DPT (3 doses) 0.838 0.052 78 32 1.241 0.062 0.735 0.941
Received polio (3 doses) 0.855 0.048 78 32 1.213 0.056 0.758 0.951
Received measles 0.788 0.056 78 32 1.208 0.071 0.676 0.899
Fully immunized 0.699 0.058 78 32 1.130 0.084 0.582 0.816
Height-for-age (below -2SD) 0.184 0.040 170 67 1.239 0.215 0.105 0.263
Weight-for-height (below -2SD) 0.017 0.010 170 67 1.033 0.599 0.000 0.038
Weight-for-age (below -2SD) 0.110 0.032 170 67 1.274 0.287 0.047 0.173
Anaemic (children) 0.375 0.056 119 45 1.170 0.148 0.264 0.487
Anaemic (women) 0.146 0.016 676 271 1.191 0.111 0.114 0.179
BMI <18.5 0.154 0.012 803 325 0.937 0.078 0.130 0.178
Has heard of HIV/AIDS 0.992 0.004 1869 756 1.765 0.004 0.985 0.999
Knows about condoms 0.785 0.012 1869 756 1.280 0.016 0.760 0.809
Knows about limiting partners 0.874 0.011 1869 756 1.392 0.012 0.853 0.895
Had 2+ sex partners in past 12 months 0.003 0.003 289 117 0.991 1.005 0.000 0.010
High-risk sex 0.157 0.031 289 117 1.444 0.197 0.095 0.219
Condom use at high-risk sex 0.349 0.061 46 18 0.861 0.175 0.227 0.472
Abstinence among youth 0.870 0.017 780 314 1.397 0.019 0.836 0.903
Sexually active in past 12 months among youth 0.030 0.008 780 314 1.301 0.266 0.014 0.046
Had an injection in past 12 months 0.319 0.013 1869 756 1.212 0.041 0.293 0.345
Had HIV test and received results in past 12 months 0.109 0.010 840 339 0.967 0.095 0.088 0.130
Accepting attitudes towards people with HIV 0.469 0.017 1846 750 1.468 0.036 0.435 0.503
HIV prevalence among tested for HIV 15-49 0.061 0.011 673 280 1.193 0.181 0.039 0.083
Total fertility rate (3 years) 1.377 0.130 na 2110 1.283 0.094 1.117 1.636
Neonatal mortality (0-9 years) 22.923 6.091 813 336 1.135 0.266 10.742 35.105
Postneonatal mortality (0-9 years) 21.927 6.648 813 336 1.144 0.303 8.630 35.223
Infant mortality (0-9 years) 44.850 10.162 813 336 1.290 0.227 24.525 65.175
Child mortality (0-9 years) 27.939 9.366 823 341 1.418 0.335 9.208 46.670
Under-five mortality (0-9 years) 71.536 16.039 823 341 1.531 0.224 39.459 103.613
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.987 0.007 698 292 1.576 0.007 0.973 1.000
Literate 0.936 0.012 698 292 1.288 0.013 0.912 0.960
No education 0.072 0.011 698 292 1.084 0.148 0.051 0.093
Secondary education or higher 0.732 0.024 698 292 1.440 0.033 0.684 0.780
Want no more children 0.533 0.046 228 97 1.396 0.087 0.440 0.625
Want to delay birth at least 2 years 0.216 0.028 228 97 1.015 0.128 0.161 0.272
Ideal family size 3.263 0.120 677 283 0.982 0.037 3.024 3.502
Has heard of HIV/AIDS (15-49) 0.994 0.004 635 266 1.279 0.004 0.986 1.002
Knows about condoms (15-49) 0.778 0.025 635 266 1.501 0.032 0.728 0.827
Knows about limiting partners (15-49) 0.831 0.019 635 266 1.298 0.023 0.793 0.870
Had 2+ sex partners in past 12 months (15-49) 0.061 0.014 289 123 1.002 0.231 0.033 0.090
High-risk sex (15-49) 0.444 0.030 289 123 1.024 0.068 0.384 0.504
Condom use at high-risk sex (age 15-49) 0.709 0.042 131 55 1.048 0.059 0.625 0.792
Abstinence among youth 0.673 0.024 276 116 0.845 0.036 0.625 0.721
Sexually active in past 12 months among youth 0.183 0.021 276 116 0.900 0.115 0.141 0.225
Paid for sexual intercourse in past 12 months 0.015 0.004 698 292 0.954 0.297 0.006 0.023
Had an injection in past 12 months (age 15-49) 0.265 0.018 635 266 1.029 0.068 0.229 0.301
HIV test and received results past 12 months (15-49) 0.110 0.016 635 266 1.295 0.146 0.078 0.142
Accepting attitudes towards people with HIV (15-49) 0.440 0.029 629 265 1.478 0.067 0.381 0.498
HIV prevalence among tested for HIV 15-49 0.030 0.008 472 214 1.014 0.265 0.014 0.046
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

Appendix B | 287
Table B.15 Sampling errors for Dire Dawa Region, Ethiopia 2005

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Number of cases
Stand- –––––––––––––––– Rela-
ard Un- Weight- Design tive Confidence limits
Value error weighted ed effect error ––––––––––––––––
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
WOMEN
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.713 0.018 807 69 1.133 0.025 0.677 0.750
Literate 0.530 0.045 807 69 2.548 0.084 0.441 0.620
No education 0.467 0.043 807 69 2.471 0.093 0.381 0.554
Secondary education or higher 0.337 0.040 807 69 2.394 0.118 0.258 0.417
Net attendance ratio for primary school 0.548 0.043 535 46 1.771 0.079 0.461 0.634
Currently pregnant 0.039 0.007 807 69 1.045 0.184 0.024 0.053
Children ever born to women age 40-49 5.627 0.227 132 12 0.816 0.040 5.173 6.081
Currently using any contraceptive method 0.340 0.039 420 37 1.671 0.114 0.262 0.417
Currently using pill 0.067 0.013 420 37 1.093 0.199 0.041 0.094
Currently using IUD 0.006 0.004 420 37 0.967 0.591 0.000 0.014
Currently using female sterilization 0.003 0.003 420 37 1.034 0.994 0.000 0.008
Currently using rhythm method 0.022 0.007 420 37 0.920 0.297 0.009 0.036
Want no more children 0.360 0.037 420 37 1.557 0.101 0.287 0.433
Ideal family size 5.272 0.276 744 63 2.080 0.052 4.720 5.824
Perinatal mortality (0-6 years) 24.023 11.010 413 38 1.394 0.458 2.003 46.042
Mothers received tetanus injection for last birth 0.517 0.035 274 25 1.197 0.068 0.446 0.587
Mothers received medical assistance at delivery 0.267 0.036 411 37 1.366 0.134 0.195 0.338
Had diarrhoea in two weeks before survey 0.116 0.015 380 34 0.960 0.130 0.086 0.146
Treated with oral rehydration salts (ORS) 0.313 0.069 45 4 0.986 0.222 0.174 0.452
Taken to a health provider 0.257 0.042 45 4 0.653 0.163 0.173 0.341
Vaccination card seen 0.548 0.069 78 7 1.246 0.125 0.411 0.685
Received BCG 0.754 0.051 78 7 1.049 0.067 0.653 0.856
Received DPT (3 doses) 0.614 0.065 78 7 1.205 0.106 0.484 0.745
Received polio (3 doses) 0.651 0.053 78 7 0.990 0.081 0.546 0.756
Received measles 0.557 0.049 78 7 0.889 0.088 0.459 0.655
Fully immunized 0.434 0.057 78 7 1.043 0.131 0.320 0.548
Height-for-age (below -2SD) 0.308 0.027 182 16 0.775 0.089 0.254 0.363
Weight-for-height (below -2SD) 0.114 0.021 182 16 0.939 0.188 0.071 0.157
Weight-for-age (below -2SD) 0.296 0.039 182 16 1.148 0.131 0.218 0.373
Anaemic (children) 0.607 0.051 156 14 1.286 0.083 0.506 0.708
Anaemic (women) 0.258 0.031 298 26 1.236 0.121 0.195 0.321
BMI <18.5 0.242 0.018 363 31 0.790 0.074 0.207 0.278
Has heard of HIV/AIDS 0.969 0.009 807 69 1.504 0.010 0.950 0.987
Knows about condoms 0.567 0.028 807 69 1.625 0.050 0.510 0.624
Knows about limiting partners 0.693 0.034 807 69 2.112 0.050 0.624 0.761
Had 2+ sex partners in past 12 months 0.015 0.011 202 18 1.311 0.742 0.000 0.038
High-risk sex 0.092 0.023 202 18 1.106 0.245 0.047 0.137
Condom use at high-risk sex 0.437 0.134 20 2 1.174 0.306 0.170 0.704
Abstinence among youth 0.891 0.020 221 19 0.961 0.023 0.851 0.931
Sexually active in past 12 months among youth 0.029 0.010 221 19 0.902 0.352 0.009 0.049
Had an injection in past 12 months 0.249 0.017 807 69 1.130 0.069 0.215 0.284
Had HIV test and received results in past 12 months 0.052 0.011 388 33 0.948 0.207 0.030 0.073
Accepting attitudes towards people with HIV 0.371 0.028 784 67 1.624 0.076 0.315 0.427
HIV prevalence among tested for HIV 15-49 0.044 0.015 292 28 1.250 0.343 0.014 0.073
Total fertility rate (3 years) 3.623 0.534 na 192 2.073 0.147 2.556 4.691
Neonatal mortality (0-9 years) 29.139 6.908 827 74 1.166 0.237 15.322 42.956
Postneonatal mortality (0-9 years) 42.050 10.827 827 74 1.506 0.257 20.397 63.704
Infant mortality (0-9 years) 71.189 15.811 828 75 1.627 0.222 39.567 102.811
Child mortality (0-9 years) 70.188 14.943 839 76 1.464 0.213 40.301 100.074
Under-five mortality (0-9 years) 136.380 19.671 841 76 1.528 0.144 97.038 175.722
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
MEN
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Urban residence 0.672 0.025 330 30 0.964 0.037 0.622 0.721
Literate 0.766 0.034 330 30 1.476 0.045 0.697 0.835
No education 0.228 0.033 330 30 1.424 0.145 0.162 0.294
Secondary education or higher 0.525 0.033 330 30 1.215 0.064 0.458 0.592
Want no more children 0.370 0.053 154 14 1.348 0.142 0.265 0.475
Want to delay birth at least 2 years 0.452 0.038 154 14 0.944 0.084 0.376 0.528
Ideal family size 3.986 0.278 315 28 1.657 0.070 3.429 4.542
Has heard of HIV/AIDS (15-49) 0.978 0.010 306 27 1.232 0.011 0.957 0.999
Knows about condoms (15-49) 0.709 0.031 306 27 1.198 0.044 0.647 0.772
Knows about limiting partners (15-49) 0.856 0.032 306 27 1.587 0.037 0.792 0.920
Had 2+ sex partners in past 12 months (15-49) 0.076 0.020 167 15 0.959 0.260 0.036 0.115
High-risk sex (15-49) 0.223 0.042 167 15 1.305 0.189 0.138 0.307
Condom use at high-risk sex (age 15-49) 0.709 0.091 37 3 1.208 0.129 0.526 0.892
Abstinence among youth 0.758 0.047 128 11 1.243 0.062 0.663 0.852
Sexually active in past 12 months among youth 0.166 0.049 128 11 1.495 0.297 0.067 0.265
Paid for sexual intercourse in past 12 months 0.014 0.006 330 30 0.973 0.455 0.001 0.026
Had an injection in past 12 months (age 15-49) 0.176 0.019 306 27 0.858 0.106 0.139 0.214
HIV test and received results past 12 months (15-49) 0.073 0.015 306 27 1.042 0.213 0.042 0.104
Accepting attitudes towards people with HIV (15-49) 0.433 0.028 300 27 0.976 0.065 0.377 0.489
HIV prevalence among tested for HIV 15-49 0.019 0.010 173 22 1.012 0.559 0.000 0.040
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
na = Not applicable

288 | Appendix B
DATA QUALITY TABLES Appendix C
Table C.1 Household age distribution

Single-year age distribution of the de facto household population by sex (weighted), Ethiopia 2005
Female Male Female Male
Age Number Percent Number Percent Age Number Percent Number Percent
0 1,090 3.2 1,194 3.5 36 226 0.7 220 0.7
1 956 2.8 999 3.0 37 229 0.7 198 0.6
2 942 2.8 1,027 3.1 38 354 1.0 301 0.9
3 1,124 3.3 1,119 3.3 39 145 0.4 118 0.4
4 1,153 3.4 1,086 3.2 40 569 1.7 624 1.9
5 933 2.8 922 2.7 41 141 0.4 99 0.3
6 1,230 3.6 1,288 3.8 42 208 0.6 208 0.6
7 1,271 3.7 1,336 4.0 43 140 0.4 119 0.4
8 1,232 3.6 1,261 3.7 44 132 0.4 128 0.4
9 972 2.9 980 2.9 45 448 1.3 500 1.5
10 1,193 3.5 1,343 4.0 46 186 0.5 137 0.4
11 789 2.3 816 2.4 47 139 0.4 142 0.4
12 1,163 3.4 1,131 3.4 48 243 0.7 180 0.5
13 1,009 3.0 982 2.9 49 140 0.4 82 0.2
14 708 2.1 975 2.9 50 252 0.7 425 1.3
15 781 2.3 827 2.5 51 157 0.5 99 0.3
16 690 2.0 752 2.2 52 238 0.7 144 0.4
17 585 1.7 602 1.8 53 170 0.5 98 0.3
18 892 2.6 890 2.6 54 157 0.5 72 0.2
19 461 1.4 441 1.3 55 409 1.2 258 0.8
20 1,070 3.2 911 2.7 56 167 0.5 105 0.3
21 309 0.9 397 1.2 57 96 0.3 67 0.2
22 500 1.5 543 1.6 58 143 0.4 93 0.3
23 416 1.2 358 1.1 59 44 0.1 44 0.1
24 357 1.1 318 0.9 60 432 1.3 373 1.1
25 947 2.8 722 2.1 61 52 0.2 64 0.2
26 393 1.2 320 1.0 62 94 0.3 117 0.3
27 422 1.2 329 1.0 63 82 0.2 119 0.4
28 605 1.8 476 1.4 64 75 0.2 108 0.3
29 242 0.7 171 0.5 65 154 0.5 236 0.7
30 847 2.5 871 2.6 66 49 0.1 47 0.1
31 223 0.7 193 0.6 67 61 0.2 93 0.3
32 304 0.9 321 1.0 68 62 0.2 105 0.3
33 222 0.7 215 0.6 69 40 0.1 51 0.2
34 229 0.7 189 0.6 70+ 710 2.1 874 2.6
35 688 2.0 690 2.1 Don't know/
missing 8 0.0 11 0.0

Total 33,900 100.0 33,656 100.0

Appendix C | 289
Table C.2.1 Age distribution of eligible and interviewed women

De facto household population of women age 10-54, interviewed


women age 15-49, and percentage of eligible women interviewed
(weighted), by five-year age groups, Ethiopia 2005
Household Interviewed women Percentage
popoulation of eligible
age 15-49
of women women
Age group age 10-54 Number Percent interviewed
10-14 4,861 na na na
15-19 3,409 3,247 23.2 95.2
20-24 2,652 2,535 18.1 95.6
25-29 2,609 2,530 18.1 97.0
30-34 1,825 1,787 12.8 97.9
25-39 1,642 1,602 11.4 97.6
40-44 1,190 1,160 8.3 97.5
45-49 1,156 1,134 8.1 98.1
50-54 975 na na na

15-49 14,484 13,996 100.0 96.6

Note: The de facto population includes all residents and nonresidents


who stayed in the household the night before the interview. Weights
for both household population of women and interviewed women are
household weights. Age is based on the household schedule.
na = Not applicable

Table C.2.2 Age distribution of eligible and interviewed men

De facto household population of men age 10-64, interviewed men


age 15-59, and percentage of eligible men interviewed (weighted),
Ethiopia 2005
Household Interviewed men Percentage
popoulation of eligible
age 15-59
of men men
Age group age 10-64 Number Percent interviewed
10-14 2,614 na na na
15-19 1,551 1,384 22.2 89.3
20-24 1,184 1,081 17.3 91.3
25-29 885 779 12.5 88.0
30-34 836 783 12.5 93.7
25-39 717 675 10.8 94.1
40-44 532 504 8.1 94.6
45-49 480 438 7.0 91.3
50-54 368 345 5.5 93.6
55-59 260 254 4.1 97.8
60-64 363 na na na

15-49 6,813 6,243 100.0 91.6

Note: The de facto population includes all residents and nonresidents


who stayed in the household the night before the interview. Weights
for both household population of men and interviewed men are
household weights. Age is based on the household schedule.
na = Not applicable

290 | Appendix C
Table C.3 Completeness of reporting

Percentage of cases for which information on age-specific demographic and health characteristics is missing
(weighted), Ethiopia 2005

Percentage
with missing Number
Characteristic Reference group information of cases
Birth date Births in the 15 years preceding the survey
Month only 1.19 31,814
Month and year 0.05 31,814

Age at death Deceased children born in the 15 years preceding


the survey 0.29 4,371

Age/date at first union1 Ever-married women age 15-49 and ever-married


men age 15-59 0.16 10.554

Respondent's education All women age 15-49 and all men age 15-59 0.00 14,070

Diarrhoea in past 2 weeks Living children age 0-59 months 0.70 10,109

Anthropometry Living children age 0-59 months (from household


Height questionnaire) 5.28 5,280
Weight 3.92 5,280
Height or weight 5.28 5,280

Anaemia
Children Living children age 6-59 months (from household
questionnaire) 11.79 4,691
Women All women (from household questionnaire) 11.94 6,963
1
Both year and age missing

Appendix C | 291
Table C.4 Births by calendar years

Number of births, percentage with complete birth date, sex ratio at birth, and calendar year ratio, by calendar year and status of child
at birth (living (L), dead (D), and total (T)) (weighted), Ethiopia 2005

Percentage with complete


Calendar Number of births birth date1 Sex ratio at birth2 Calendar year ratio3
year L D T L D T L D T L D T
2005 1,168 70 1,239 100.0 100.0 100.0 113.2 210.9 117.1 na na na
2004 2,167 195 2,362 99.9 100.0 99.9 104.4 127.7 106.2 na na na
2003 1,779 203 1,982 99.9 100.0 99.9 101.3 137.9 104.5 86.2 105.5 87.8
2002 1,963 189 2,152 99.8 100.0 99.8 109.6 133.5 111.5 101.3 84.7 99.5
2001 2,097 245 2,342 99.9 98.8 99.8 93.2 136.7 97.0 110.8 109.7 110.7
2000 1,822 257 2,078 99.9 100.0 99.9 101.7 68.7 96.9 88.4 89.8 88.6
1999 2,024 327 2,351 98.9 96.2 98.5 102.5 126.0 105.5 100.7 103.4 101.1
1998 2,199 375 2,574 99.0 97.3 98.7 104.1 138.6 108.5 107.8 104.5 107.3
1997 2,054 392 2,446 97.8 95.9 97.5 112.0 98.6 109.8 102.2 105.8 102.7
1996 1,822 365 2,187 98.4 95.9 98.0 92.6 126.9 97.6 92.5 98.0 93.4
2001-2005 9,175 903 10,077 99.9 99.7 99.9 103.2 138.7 106.0 na na na
1996-2000 9,920 1,715 11,636 98.8 96.9 98.5 102.7 111.2 103.9 na na na
1991-1995 7,755 1,607 9,362 98.2 96.3 97.9 105.3 116.1 107.1 na na na
1986-1990 4,721 1,510 6,231 98.2 96.0 97.7 103.9 146.7 112.8 na na na
<1986 4,818 2,065 6,884 97.6 96.3 97.2 108.7 125.1 113.4 na na na

All 36,390 7,800 44,190 98.7 96.8 98.4 104.3 125.2 107.7 na na na

na = Not applicable
1
Both year and month of birth given
2
(Bm/Bf)*100, where Bm and Bf are the numbers of male and female births, respectively
3
[2Bx/(Bx-1+Bx+1)]*100, where Bx is the number births in calendar year x

292 | Appendix C
Table C.5 Reporting of age at death in days

Distribution of reported deaths under one month of age by age at death in days and the
percentage of neonatal deaths reported to occur at ages 0-6 days, for five-year periods
preceding the survey (weighted), Ethiopia 2005

Age at death Number of years preceding the survey


(days) 0-4 5-9 10-14 15-19 Total 0-19
<1 84 82 59 52 277
1 118 161 119 98 496
2 44 27 35 35 142
3 36 42 42 38 159
4 6 11 2 13 32
5 16 11 18 7 52
6 0 4 5 2 11
7 32 47 29 38 146
8 10 9 15 10 43
9 6 6 3 3 18
10 8 7 10 7 32
11 2 2 2 2 8
12 10 3 4 7 24
13 2 0 0 1 3
14 10 4 5 10 27
15 24 34 28 21 107
18 3 0 1 0 4
19 0 2 1 0 4
20 5 5 11 4 25
21 15 14 20 4 53
22 2 0 0 0 2
23 0 1 0 0 1
24 1 1 1 1 4
25 0 4 1 2 8
27 2 2 0 2 5
28 3 2 0 0 5
31+ 3 1 2 1 7

Total 0-30 437 484 411 356 1,687


Percent early neonatal1 69.3 70.1 68.5 68.9 69.3
1
≤6 days/≤30 days

Appendix C | 293
Table C.6 Reporting of age at death in months

Distribution of reported deaths under two years of age by age at death in


months and the percentage of infant deaths reported at age under one month,
for five-year periods preceding the survey, Ethiopia 2005

Age at death Number of years preceding the survey


(months) 0-4 5-9 10-14 15-19 Total 0-19
a
<1 437 484 412 356 1,688
1 89 96 85 59 329
2 63 62 65 51 241
3 48 52 67 50 217
4 34 33 22 26 116
5 26 37 21 15 100
6 53 64 59 44 220
7 23 34 35 30 123
8 27 35 21 36 119
9 10 30 23 21 83
10 12 14 12 14 52
11 4 14 17 14 49
12 25 86 78 43 233
13 4 6 2 6 18
14 7 4 6 0 17
15 4 2 0 4 10
16 0 4 7 1 11
17 3 3 3 0 9
18 8 16 18 7 49
19 1 2 0 2 5
20 2 3 0 0 5
21 0 4 0 0 4
23 3 0 0 0 3
24+ 3 1 0 3 7
1 Year 47 89 83 80 300

Total 0-11 827 956 839 715 3,338


Percent neonatal1 52.8 50.6 49.0 49.8 50.6
a
Includes deaths under one month reported in days
1
Under one month / under one year

294 | Appendix C
Table C.7 Data on siblings

Number of sisters and brothers reported by interviewed women and completeness of age data for living siblings
and age at death (AD) and years since death (YSD), data for dead siblings, Ethiopia 2005
Sibling status Sisters Brothers Total
and completeness
of reporting Number Percent Number Percent Number Percent
All siblings 38,392 100.0 42,138 100.0 80,530 100.0
Living 30,367 79.1 32,385 76.9 62,752 77.9
Dead 7,989 20.8 9,659 22.9 17,648 21.9
Status unknown 36 0.1 94 0.2 129 0.2
Living siblings 30,367 100.0 32,385 100.0 62,752 100.0
Age reported 30,234 99.6 32,241 99.6 62,475 99.6
Age missing 133 0.4 144 0.4 277 0.4
Dead siblings 7,989 100.0 9,659 100.0 17,648 100.0
AD and YSD reported 7,833 98.1 9,452 97.9 17,285 97.9
Missing only AD 59 0.7 81 0.8 140 0.8
Missing only YSD 9 0.1 12 0.1 21 0.1
Missing both AD and YSD 87 1.1 115 1.2 202 1.1

Table C.8 Indicators of data quality Table C.9 Sibship size and sex ratio of
siblings
Percent distribution of respondents and
siblings by year of birth, Ethiopia 2005 Mean sibship size and sex ratio of
siblings, Ethiopia 2005
Year of birth Respondents Siblings
Mean Sex ratio
Before 1945 0.0 3.4 Year of birth sibship of siblings
1945-49 2.9 3.7 of respondents size at birth
1950-54 7.4 5.2
<1950 6.1 104.9
1955-59 9.9 8.5
1950-54 6.3 111.9
1960-64 11.2 10.8
1955-59 6.4 109.3
1965-69 15.6 13.5
1960-64 6.6 110.7
1970-74 17.3 15.0
1965-69 6.8 105.2
1975 or later 35.7 39.9
1970-74 6.8 111.4
Total 100.0 100.0
1975-79 6.9 108.5
1980-84 6.9 114.7
Lower range 1947 1914
Upper range 1982 1997
Median 1971 1971

No. of cases 14,070 80,484

Appendix C | 295
 
PERSONS INVOLVED IN THE 2005 ETHIOPIA
DEMOGRAPHIC AND HEALTH SURVEY Appendix D
CENTRAL STATISTICAL AGENCY
Mrs. Samia Zekaria, Director General
Mr. Gebeyehu Abelti, A/ Deputy Director General, Demographic and Health Statistics
Mr. Amare Isaias, Project Director (the then PHCCO)
Mr. Genene Bizuneh, Survey Director
Mr. Behailu G/Medhin, Department Head
Mrs. Gezu Birhanu, Department Head
Mr. Keffene Asfaw, Department Head
Mrs. Alemtsehay Biru, Experts Team Leader
Mr. Yehualashet Mekonen, Senior Expert
Mr. Gezahign Shimelise, Senior Expert
Mr. Girum Haile, Expert
Mr. Kassahun Mengistu, Expert
Mr. Hagi Metissa, Expert
Mr. Dereje Shiferaw, Expert
Mr. Alemakef Tasew, Expert
Mr. Gedamu Ayalneh, Expert Team Leader
Mr. Tilaye Geresu, Expert Team Leader
Ms. Asmeret Moges, Expert
Ms. Nuria Mohammed Nur, Expert

UNITED NATIONS POPULATION FUND

Nibret Gobeze

ETHIOPIAN HEALTH AND NUTRITION RESEARCH INSTITUTE

Dr. Tsehaynesh Messele Asfaw Beyene


Dr. Dawit Wolday Asfaw Adane
Hailu Meles Mekashaw Tebeje
Desta Kassa Zenet Ahmedin
Ermias Hailu Nugussie Gezahegn
Mulu Girma Wegene Tamene
Tesfaye Tilahun Desalegn Tesema

PRIVATE LABORATORIES COLLABORATIVE UNIT


Regional Biomarker Coordinators

Metasebia Getachew
Meseret Girma
Sara Zewdie
Rahel Bogale
Anteneh Alene
Fisiha Tsegaye
Daniel Eshetu
Sofia Shewarega
Fikre Mariam Bayu
Abreham Girma
Feven Yalew

Appendix D | 297
ORC MACRO

Dr. Pav Govindasamy, Senior Country Coordinator


Dr. Ann Way, Vice President and Deputy Director
Dr. Alfredo Aliaga, Senior Sampling Specialist
Mr. Albert Themme, Data Processing Specialist
Ms. Joy Fishel, Country Manager
Ms. Reena Sethi, Research Associate
Dr. Chanda Mulenga, Consultant
Mr. Lovemore Kaetano, Consultant
Mr. Bernard Ghaleb, Consultant
Mr. Daniel Vadnais, Data Dissemination Coordinator
Ms. Erica Nybro, Dissemination Specialist
Ms. Stephanie Gorin, Country Manager
Dr. Kristi Fair, Education Data Specialist
Dr. Sidney Moore, Editor
Ms. Kaye Mitchell, Document Production
Ms. Arlinda Zhuzhuni, Research Associate
Ms. Anne Cross, Regional Coordinator
Ms. Adrienne Cox, Monitoring and Evaluation Specialist

CENTRAL STATISTICAL AGENCY

Head Office Staff

Esaias Muleta Eshetu Merid


Ayele Menbere Wondu Yemaneberihan
Kifle Gebre Menilik Tsega
Dawit Getenet Wondosen Kasahun
Kifelew Fentahunegn Mekdim Jemberae
Salih Mohammed

Regional Coordinators

Legesse Hadish Damtew Berhanu


Hibret Bereda Dereje Shiferaw
Girum Haile Berhanu Gamew
Kassahun Mengistu Alemakef Tasew
Hagi Metissa Dawit Berhanu
Abate Sidelil

Field Supervisors

Ablelome Kahesaye Negash Bacha Gebeyhu Girma


Dawit Helufe Hussen Kedero Serkalem Debebe
Tsehaye G/kidan Asheber Gemechu Seyoum Negash
Mulugeta G/wolde Tensaye Tirunhe Mekonnen Mengesha
Dawit Berhane Tesfaye Azemeraw Yonas Asefa
Derese Getachew Abraham Tefera Shibiru Ayana
Ayana Bezabeh Tilahun Mulugeta Ahmed Amid
Begizew Tsehaye Tena Gebeyhu Yilfashewa Zewde
Fikeru Kefetew Mulugeta Nadew Anteneh Dagnew
Beri Aljera Hailu Kunura Sorry Dadi

298 | Appendix D
Field Editors

Genet G/kidan Mestwet Abera Etsegenet Alemayehu


Brehana Mirutse Rahel Taye Tirunesh Ketema
Selamawit Kahesaye Lidet Milkesa Fikerte Regassa
Aminate Eshetu Mahlet Berhanu Kidist Tegegn
Fatuma Abegaz Abenet Tamerat Seada Abdurahman
Almaz Yemere Biftu Feyessa Munira Shafi
Dereb Mola Atsede Tilahun Helen Kebede
Elisabet Haile Tigist Getenet Tirsit Seyoum
Yodit Adeferse Aster Eyob Meseret Getachew
Lula Mohamed Lemlem Hailu Endanchyelem Ketema

Biomarkers

Mehari G/Medhin Yirgalem Abdissa Tekalegn Demo


Aster Solomon Abdulkadir Kedir Berhanu Demeke
Meberhit G/kirstos Genet Tadesse Yodit Yeshiwork
Muluberhan G/kiros Seleshi Yegezu Yohannes Berhanu
G/Michael Wegayehu Alima Mohammed Bilen Hassen
Meberhit Tsegaye Samuel Beyra Dawit Tadesse
Seada Idris Yemiserach Admasu Samuel Mebratu
Jemal Idris Reshid Ebrahim Tadelech Adenew
Alem Abebe Selamawit Wegayhu Tesgaye Melaku
Arage Ahmed Dawit Bizuneh Munira Sultan
Lebsework Abebaw Chemdesa Kenea Wondwosen Tefera
Hiwot Asfaw Mulu Adane Asresash Mekonnen
Negussie Beshae Esrael Tucho Abezash Gashaw
Wosene Abegaze Ruth Asfaw Bedilu Alemayehu
Wosen Merene Meron G/Michael Aregash Yigezu
Woyinshet Worku Mengistu Lakew Wakene Biru
Asefa Desta Aster Tadesse Hiwot Abera
Desta Aye Abraham Webeshet Lema Alemayehu
Etsegenet Tedela Zenebe Legesse Alem Taddesse
Abdella Eresa Kiyare kitesa Hayliye Fiseha

Interviewers

Kidane Tesfaye Yeshimebet Mengistu Roman Abebe


Molach Amare Worknesh Boka Meseret Gebre
Amarech Gezae Meskerem Abera Minda Dasalegn
Ferewoine Abera Zadige Seyoum Mahider Solomon
Muluberhan Tesfaye Samra Negashe Aynalem Atisub
Saba G/selasse Beletu Meaza Abebech Gudasa
Hiwot Tadese Meskerem Negashe Hagare Hailu
Zemariyam Tekele Ayane Tahere Senait Dejene
Kaleayu Halefome Seid Abdella Abebech Tesgaw
Meaza Yohannse Hymanot H/meskel Fuad Ali
Serkalem Mekonnen Wolansa Kibret Tigist Ambaw
Meaza G/medhin Tigist Zerihun Rumiya Abdi
Samuel Haile Arab Ali Meskerem Berhanu
Temere Seid Shawel Bekele Wondwosen Kebede
Hawa Mohammed Miheret G/michale Dawit Mona
Aselefe Abdurahman Genet Habtamu Kasech Asrat
Nega Hailu Ayehu Shumet Mintewab Abdissa
Hawa Ahmed Solomon Kumera Tayitu Wakshum
Birtukan Dibaba Abiyot Saketa Tewoflos Tome

Appendix D | 299
Zinet Jemal Zenebech Dibaba Eyerusalem Getachew
Mezgebu Mersha Sewmehone Lebeza Aynalem Tessema
Felgushe Dereje Negussie Gudissa Yeshumnesh Aseres
Yirgalem Tesfaye Elias Lenjeso Girma Yemane
Anguach Derbew Lemlem Yohannse Senait T/Michael
Shewangezaw Tesfaye Adanech Solmon Beza Niqodimos
Alemberhan Tesfaye Senaiet Maseresha Getenesh Degefa
Alemitu Ayalew Seid Sware Lukas Mebrahten
Alemtsehy H/mariyam Fetelwork Melaku Seada Seid
Tesfaye Gebere Asmeret Asamnew Zenebech Ashebir
Atekelt Zemene Meseret Kare Belaynesh Lebelo
Yemata Asefa Tariku Degu Almaz Mulat
Yealga Abera Genet Kebede Elisabeth Teshome
Eyob Kahesay Emebet Seyoum Fekadu Birara
Alemneshe Abera Ferehiwot Muluegeta Ambachew Kasa
Azenu Mersha Gemechu Meta Habtamu Negussie
Bemenet Admasu Etalemahu Tafesse Misrak Fantahun
Tesfaye Ajema Tiru Bekele Sirata Mengesha
Ytaktu Kefyalew Mekedese Mesfin Tolosa Gemechu
Meskerem Setotaw Getaneh Belete Mulunesh Bekele
Etenesh Dabi Webayhu Mesfin Dereje Merga
Hirpasa Mentefa Tejetu Shiferaw Bizunesh Tolosa
Fikerte Senknhe Mulugojam Alemu Addis Tachbele
Sentayhu Negussie Ugala Uchan Misrak Getachew
Meskerem Tamene Mesay Ketsela Mohammed Adem
Mohammed Kumbi Eyerusalem Mamo Zehara Elias
Amina Teso Netsanet Beyene Tariku Kitaw
Ferezer Asfaw Olana Kena Genet Asfaw
Kuri Kumsa Mesfin Teshome Talk Gagne
Garedew Negasa Menen Demisse

Office Editing Personnel

Fekadu Birara Mamo Ambachew Kassa


Mulualem Asfaw Beyene Mulugeta Nadew
Tariku Kitaw Wondimu Bedilu Alemayehu
Elizabet Teshome Mekonnen

Data Entry Operators

Abraham Godefa Genet Befekadu Tigist Estifanos


Askale Worku Haymanot Tesfaye Woinishet G/Hana
Asqual Getachew Hiwot Fisseha Yeshihareg Tadesse
Berhane Goshu Hiwot Kassahune Addis Gebeyehu
Biniyam Debesay Mihiret Zemedhun Tesfaye Alemayehu
Birtukan Yimer Rahel Belete Selamawit Mengistu
Ehetmolagne Alayou Sara Firew Kibrua Kinfe
Ejigayehu Alemu Serkalem Tadesse Habtamu Asfaw
Fikirte K/Mariam Sosina Woldetsadik

300 | Appendix D
QUESTIONNAIRES Appendix E

Appendix E | 301
 
2005 ETHIOPIA DEMOGRAPHIC AND HEALTH SURVEY 15 APRIL 2005
HOUSEHOLD QUESTIONNAIRE
IMPLEMENTING ORGANIZATION: PHCCO

IDENTIFICATION

LOCALITY NAME

NAME OF HOUSEHOLD HEAD

CLUSTER NUMBER ................................................................

HOUSEHOLD NUMBER ..............................................................

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LARGE CITY/SMALL CITY/TOWN/RURAL


(LARGE CITY=1, SMALL CITY=2, TOWN=3, RURAL=4) ..................................

ALTITUDE .........................................................................

HOUSEHOLD SELECTED FOR MALE INTERVIEW? ......................................


(YES= 1, NO = 2)

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR

INTERVIEWER'S NAME INT. NUMBER

RESULT* RESULT

NEXT VISIT: DATE


TOTAL NUMBER
TIME OF VISITS

*RESULT CODES: TOTAL PERSONS


1 COMPLETED IN HOUSEHOLD
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT
HOME AT TIME OF VISIT TOTAL ELIGIBLE
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME WOMEN
4 POSTPONED
5 REFUSED TOTAL ELIGIBLE
6 DWELLING VACANT OR ADDRESS NOT A DWELLING MEN
7 DWELLING DESTROYED
8 DWELLING NOT FOUND LINE NO. OF
9 OTHER RESPONDENT TO
(SPECIFY) HOUSEHOLD
QUESTIONNAIRE

LANGUAGE OF QUESTIONNAIRE: LANGUAGE OF INTERVIEW: LANGUAGE OF RESPONDENT:

LANGUAGE CODES: AMARIGNA = 1, OROMIGNA = 2, TIGRIGNA = 3, OTHER = 6

TRANSLATOR USED:
(YES = 1, NO = 2)

SUPERVISOR FIELD EDITOR OFFICE KEYED BY


EDITOR
NAME NAME

DATE DATE

Appendix E | 303
HOUSEHOLD SCHEDULE
Now we would like some information about the people who usually live in your household or who are staying with you now.

LINE USUAL RESIDENTS AND RELATIONSHIP SEX RESIDENCE AGE ELIGIBILITY


NO. VISITORS TO HEAD OF
HOUSEHOLD

Please give me the names of What is the Is Does Did How old is CIRCLE CHECK CIRCLE
the persons who usually live relationship of (NAME) (NAME) (NAME) (NAME)? LINE COVER LINE
in your household and guests (NAME) to the male or usually stay here NUMBER PAGE. NUMBER
of the household who stayed head of the female? live last OF ALL IF HOUSE- OF ALL
here last night, starting with household?* here? night? WOMEN HOLD CHILDREN
the head of the household. AGE SELECTED UNDER
15-49 FOR MALE AGE 6
INTERVIEW:
CIRCLE
LINE
NUMBER
OF ALL
MEN
AGE
15-59

(1) (2) (3) (4) (5) (6) (7) (8) (8A) (9)

M F YES NO YES NO IN YEARS

01 1 2 1 2 1 2 01 01 01

02 1 2 1 2 1 2 02 02 02

03 1 2 1 2 1 2 03 03 03

04 1 2 1 2 1 2 04 04 04

05 1 2 1 2 1 2 05 05 05

06 1 2 1 2 1 2 06 06 06

07 1 2 1 2 1 2 07 07 07

08 1 2 1 2 1 2 08 08 08

09 1 2 1 2 1 2 09 09 09

10 1 2 1 2 1 2 10 10 10

* CODES FOR Q. 3
RELATIONSHIP TO HEAD OF HOUSEHOLD:
01 = HEAD
02 = WIFE OR HUSBAND 09 = NIECE/NEPHEW BY BLOOD
03 = SON OR DAUGHTER 10 = NIECE/NEPHEW BY MARRIAGE
04 = SON-IN-LAW OR 11 = OTHER RELATIVE
DAUGHTER-IN-LAW 12 = ADOPTED/FOSTER/STEPCHILD
05 = GRANDCHILD 13 = NOT RELATED
06 = PARENT 98 = DON'T KNOW
07 = PARENT-IN-LAW
08 = BROTHER OR SISTER

304 | Appendix E
SURVIVORSHIP AND RESIDENCE EDUCATION BIRTH LINE
OF BIOLOGICAL PARENTS REGIS- NO.
TRATION

IF AGE 0-17 YEARS IF AGE 5 YEARS IF AGE 5-24 YEARS IF AGE 0-4
OR OLDER
Is Does Is Does Has Did During Did During that Does
(NAME)'s (NAME)'s (NAME)'s (NAME)'s (NAME) What is the (NAME) this/that (NAME) school (NAME)
biological biological biological biological ever highest attend school year, attend year, have a birth
mother mother father father live attended grade school what grade school what certificate?
alive? live in this alive? in this school? (NAME) at any [is/was] at any grade IF NO,
house- house- completed? time (NAME) time did (NAME) PROBE:
hold? hold? *** during attending? during the attend?*** Has
IF YES: IF YES: the *** previous (NAME)'s
What is What is 1997 E.C. school birth ever
her name? his name? school year, been regis-
RECORD RECORD year? that is, tered with
MOTHER'S FATHER'S 1996 E.C.? the munici-
LINE LINE pality/local
NUMBER** NUMBER** authorities?
****

(10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20)

Y N DK Y N DK YES NO GRADE YES NO GRADE YES NO GRADE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 01

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 02

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 03

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 04

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 05

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 06

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 07

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 08

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 09

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 10

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

**Qs. 11 AND 13 ***CODES FOR Qs. 15, 17 AND 19 ****CODES FOR Q.20
RECORD '00' IF PARENT NOT LISTED EDUCATION LEVEL: 1 = CERTIFICATE
IN THE HOUSEHOLD SCHEDULE. 00=LESS THAN 1 YEAR COMPLETED 2 = REGISTRATION
(FOR Q. 15 ONLY. THIS CODE IS 3 = NEITHER
NOT ALLOWED FOR Qs. 17 AND 19) 8 = DON'T KNOW
01-12=GRADE COMPLETED
13=TECHNICAL/VOCATIONAL CERTIFICATE
14=UNIVERSITY/COLLEGE DIPLOMA
15=UNIVERSITY/COLLEGE DEGREE OR HIGHER
98=DON'T KNOW

Appendix E | 305
LINE USUAL RESIDENTS AND RELATIONSHIP SEX RESIDENCE AGE ELIGIBILITY
NO. VISITORS TO HEAD OF
HOUSEHOLD

Please give me the names of What is the Is Does Did How old is CIRCLE CHECK CIRCLE
the persons who usually live relationship of (NAME) (NAME) (NAME) (NAME)? LINE COVER LINE
in your household and guests (NAME) to the male or usually stay here NUMBER PAGE. NUMBER
of the household who stayed head of the female? live last OF ALL IF HOUSE- OF ALL
here last night, starting with household?* here? night? WOMEN HOLD CHILDREN
the head of the household. AGE SELECTED UNDER
15-49 FOR MALE AGE 6
INTERVIEW:
CIRCLE
LINE
NUMBER
OF ALL
MEN
AGE
15-59

(1) (2) (3) (4) (5) (6) (7) (8) (8A) (9)

M F YES NO YES NO IN YEARS

11 1 2 1 2 1 2 11 11 11

12 1 2 1 2 1 2 12 12 12

13 1 2 1 2 1 2 13 13 13

14 1 2 1 2 1 2 14 14 14

15 1 2 1 2 1 2 15 15 15

16 1 2 1 2 1 2 16 16 16

17 1 2 1 2 1 2 17 17 17

18 1 2 1 2 1 2 18 18 18

19 1 2 1 2 1 2 19 19 19

20 1 2 1 2 1 2 20 20 20

*CODES FOR Q. 3 **Qs.11 AND 13 ***CODES FOR ****CODES FOR Q.20


RELATIONSHIP TO HEAD OF HOUSEHOLD: RECORD '00' IF Qs.15, 17, AND 19 1 = CERTIFICATE
01 = HEAD PARENT NOT EDUCATION GRADE: 2 = REGISTRATION
02 = WIFE OR HUSBAND 09 = NIECE/NEPHEW LISTED IN THE 00 = LESS THAN 1 YEAR COMPLETED 3 = NEITHER
03 = SON OR DAUGHTER BY BLOOD HOUSEHOLD (FOR Q. 15 ONLY. THIS 8 = DON'T KNOW
04 = SON-IN-LAW OR 10 = NIECE/NEPHEW SCHEDULE. CODE IS NOT ALLOWED
DAUGHTER-IN-LAW BY MARRIAGE FOR Qs. 17 AND 19)
05 = GRANDCHILD 11 = OTHER RELATIVE 01-12=GRADE COMPLETED
06 = PARENT 12 = ADOPTED/FOSTER/ 13=TECHNICAL/VOCATIONAL CERTIFICATE
07 = PARENT-IN-LAW STEPCHILD 14=UNIVERSITY/COLLEGE DIPLOMA
08 = BROTHER OR SISTER 13 = NOT RELATED 15=UNIVERSITY/COLLEGE DEGREE OR HIGHER
98 = DON'T KNOW 98=DON'T KNOW

306 | Appendix E
SURVIVORSHIP AND RESIDENCE EDUCATION BIRTH LINE
OF BIOLOGICAL PARENTS REGIS- NO.
TRATION

IF AGE 0-17 YEARS IF AGE 5 YEARS IF AGE 5-24 YEARS IF AGE 0-4
OR OLDER
Is Does Is Does Has Did During Did During that Does
(NAME)'s (NAME)'s (NAME)'s (NAME)'s (NAME) What is the (NAME) this/that (NAME) school (NAME)
biological biological biological biological ever highest attend school year, attend year, have a birth
mother mother father father live attended grade school what grade school what certificate?
alive? live in this alive? in this school? (NAME) at any [is/was] at any grade IF NO,
house- house- completed? time (NAME) time did (NAME) PROBE:
hold? hold? *** during attending? during the attend?*** Has
IF YES: IF YES: the *** previous (NAME)'s
What is What is 1997 E.C. school birth ever
her name? his name? school year, been regis-
RECORD RECORD year? that is, tered with
MOTHER'S FATHER'S 1996 E.C.? the munici-
LINE LINE pality/local
NUMBER** NUMBER** authorities?
****

(10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20)

Y N DK Y N DK YES NO GRADE YES NO GRADE YES NO GRADE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 11

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 12

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 13

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 14

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 15

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 16

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 17

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 18

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 19

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

1 2 8 1 2 8 1 2 1 2 1 2 1 2 3 8 20

GO TO 12 GO TO 14 NEXT LINE GO TO 18 NEXT LINE

TICK HERE IF CONTINUATION SHEET USED

Just to make sure that I have a complete household listing:

1) Are there any other persons such as small children or infants that we have ENTER EACH
not listed? YES IN TABLE NO

2) Are there any other people who may not be members of your family, ENTER EACH
such as domestic servants, lodgers or friends who usually live here? YES IN TABLE NO

3) Are there any guests or temporary visitors staying here, or anyone else who ENTER EACH
slept here last night, who have not been listed? YES IN TABLE NO

Appendix E | 307
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

21 What is the main source of drinking water for members of your PIPED WATER
household? PIPED INTO DWELLING . . . . . . . . 11
PIPED INTO COMPOUND . . . . . . 12 26
PIPED OUTSIDE COMPOUND . 13
TUBE WELL OR BOREHOLE . . . . . . 21
DUG WELL
PROTECTED WELL .......... 31 23
UNPROTECTED WELL . . . . . . . . 32
WATER FROM SPRING
PROTECTED SPRING ........ 41
UNPROTECTED SPRING ...... 42
RAINWATER . . . . . . . . . . . . . . . . . . . 51 26
TANKER TRUCK . . . . . . . . . . . . . . . . . 61
SURFACE WATER (RIVER/DAM/
LAKE/POND/STREAM/CANAL/ 23
IRRIGATION CHANNEL) . . . . . . 81
BOTTLED WATER . . . . . . . . . . . . . . 91

OTHER _______________________ 96 23
(SPECIFY)

22 What is the main source of water used by your household for PIPED WATER
other purposes such as cooking and handwashing? PIPED INTO DWELLING . . . . . . . . 11
PIPED INTO COMPOUND ...... 12 26
PIPED OUTSIDE COMPOUND . 13
TUBE WELL OR BOREHOLE . . . . . . 21
DUG WELL
PROTECTED WELL .......... 31
UNPROTECTED WELL . . . . . . . . 32
WATER FROM SPRING
PROTECTED SPRING ........ 41
UNPROTECTED SPRING ...... 42
RAINWATER . . . . . . . . . . . . . . . . . . . 51 26
TANKER TRUCK . . . . . . . . . . . . . . . . . 61
SURFACE WATER (RIVER/DAM/
LAKE/POND/STREAM/CANAL/
IRRIGATION CHANNEL) . . . . . . 81

OTHER _______________________ 96
(SPECIFY)

23 Where is that water source located? IN OWN DWELLING .............. 1


IN OWN COMPOUND . . . . . . . . . . . . . . 2 26
ELSEWHERE . . . . . . . . . . . . . . . . . . . . . 3

24 How long does it take to go there, get water, and come back?
MINUTES . . . . . . . . . . . . . .

ON PREMISES . . . . . . . . . . . . . . . . . 996 26
DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

25 Who usually goes to this source to fetch the water for your ADULT WOMAN . . . . . . . . . . . . . . . . . . . 1
household? ADULT MAN . . . . . . . . . . . . . . . . . . . . . 2
FEMALE CHILD
UNDER 15 YEARS OLD . . . . . . . . . . 3
MALE CHILD
UNDER 15 YEARS OLD . . . . . . . . . . 4

OTHER _________________________ 6
(SPECIFY)

308 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

26 Do you treat your water in any way to make it safer to drink? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8 27A

27 What do you usually do to the water to make it safer to drink? BOIL . . . . . . . . . . . . . . . . . . . . . . . . . . . A


ADD BLEACH/CHLORINE . . . . . . . . . . B
Anything else? STRAIN THROUGH A CLOTH . . . . . . . . C
USE WATER FILTER (CERAMIC/
RECORD ALL MENTIONED. SAND/COMPOSITE/ETC.) . . . . . . . . D
SOLAR DISINFECTION . . . . . . . . . . . . E
LET IT STAND AND SETTLE . . . . . . . . F

OTHER _______________________ X
(SPECIFY)

27A How does your household primarily dispose of household waste? COLLECTED BY MUNICIPALITY . . . . . . 1
COLLECTED BY PRIVATE
ESTABLISHMENT . . . . . . . . . . . . . . . . . 2
DUMPED IN STREET/OPEN SPACE . 3
DUMPED IN RIVER . . . . . . . . . . . . . . . . 4
BURNED . . . . . . . . . . . . . . . . . . . . . . . . . 5
OTHER _______________________ 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

28 What kind of toilet facility do members of your household usually FLUSH OR POUR FLUSH TOILET
use? FLUSH TO PIPED SEWER
SYSTEM . . . . . . . . . . . . . . . . . . . 11
FLUSH TO SEPTIC TANK . . . . . . 12
FLUSH TO PIT LATRINE . . . . . . . . 13
FLUSH TO SOMEWHERE ELSE . 14
FLUSH, DON'T KNOW WHERE . 15
PIT LATRINE
VENTILATED IMPROVED
PIT LATRINE (VIP) . . . . . . . . . . 21
PIT LATRINE WITH SLAB ...... 22
PIT LATRINE WITHOUT SLAB/
OPEN PIT ............ 23
COMPOSTING TOILET . . . . . . . . . . 31
BUCKET TOILET . . . . . . . . . . . . . . . . . 41
HANGING TOILET/HANGING
LATRINE ................... 51
NO FACILITY/BUSH/FIELD . . . . . . . . 61 31

OTHER _______________________ 96
(SPECIFY)

29 Do you share this toilet facility with other households? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 31

30 How many households use this toilet facility? NO. OF HOUSEHOLDS


IF LESS THAN 10 ........
0

10 OR MORE HOUSEHOLDS ... 95


DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

31 Does your household have:


YES NO
Electricity? ELECTRICITY . . . . . . . . . . . . . . 1 2
A watch? WATCH . . . . . . . . . . . . . . . . . . . 1 2
A radio? RADIO . . . . . . . . . . . . . . . . . . . . . 1 2
A television? TELEVISION . . . . . . . . . . . . . . 1 2
A mobile telephone? MOBILE TELEPHONE . . . . . . . . 1 2
A non-mobile telephone? NON-MOBILE TELEPHONE . . . 1 2
A refrigerator? REFRIGERATOR . . . . . . . . . . . . 1 2
A table? TABLE . . . . . . . . . . . . . . . . . . . . . 1 2
A chair? CHAIR . . . . . . . . . . . . . . . . . . . . . 1 2
A bed? BED . . . . . . . . . . . . . . . . . . . . . . . 1 2
An electric mitad? ELECTRIC MITAD . . . . . . . . . . 1 2
A kerosene lamp/pressure lamp? KEROSENE/PRESSURE LAMP 1 2

Appendix E | 309
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

32 What type of fuel does your household mainly use for cooking? ELECTRICITY . . . . . . . . . . . . . . . . . . . 01
LPG . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 34
NATURAL GAS . . . . . . . . . . . . . . . . . 03
BIOGAS . . . . . . . . . . . . . . . . . . . . . . . 04
KEROSENE . . . . . . . . . . . . . . . . . . . . . 05
CHARCOAL . . . . . . . . . . . . . . . . . . . . . 07
WOOD ....................... 08
STRAW/SHRUBS/GRASS . . . . . . . . 09
ANIMAL DUNG ................. 11

OTHER _______________________ 96
(SPECIFY)

33 In this household, is food cooked on a stove or an open fire? OPEN FIRE OR STOVE
WITHOUT CHIMNEY/HOOD ...... 1
PROBE FOR TYPE. OPEN FIRE OR STOVE
WITH CHIMNEY/HOOD . . . . . . . . . . 2
CLOSED STOVE WITH CHIMNEY . . . 3

OTHER _________________________ 6
(SPECIFY)

34 Is the cooking usually done in the house, in a separate building, IN THE HOUSE . . . . . . . . . . . . . . . . . . . 1
or outdoors? IN A SEPARATE BUILDING ........ 2
OUTDOORS . . . . . . . . . . . . . . . . . . . . . 3 36

OTHER _________________________ 6
(SPECIFY)

35 Do you have a separate room which is used as a kitchen? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

36 MAIN MATERIAL OF THE FLOOR. NATURAL FLOOR


EARTH/SAND . . . . . . . . . . . . . . . . . 11
RECORD OBSERVATION. DUNG . . . . . . . . . . . . . . . . . . . . . . . 12
RUDIMENTARY FLOOR
WOOD PLANKS . . . . . . . . . . . . . . 21
REED/BAMBOO . . . . . . . . . . . . . . 22
FINISHED FLOOR
PARQUET OR POLISHED
WOOD . . . . . . . . . . . . . . . . . . . . . 31
VINYL . . . . . . . . . . . . . . . . . . . . . . . 32
CERAMIC TILES . . . . . . . . . . . . . . 33
CEMENT/BRICKS . . . . . . . . . . . . 34
CARPET . . . . . . . . . . . . . . . . . . . . . 35

OTHER _______________________ 96
(SPECIFY)

310 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

37 MAIN MATERIAL OF THE ROOF. NATURAL ROOFING


THATCH/LEAF . . . . . . . . . . . . . . . . . 12
RECORD OBSERVATION. RUDIMENTARY ROOFING
RUSTIC MAT/PLASTIC SHEETS . 21
REED/BAMBOO . . . . . . . . . . . . . . 22
WOOD PLANKS . . . . . . . . . . . . . . 23
FINISHED ROOFING
CORRUGATED IRON . . . . . . . . . . 31
WOOD ..................... 32
CALAMINE/CEMENT FIBER ... 33
CEMENT/CONCRETE . . . . . . . . . . 35
ROOFING SHINGLES . . . . . . . . . . 36

OTHER _______________________ 96
(SPECIFY)

38 MAIN MATERIAL OF THE WALLS. NATURAL WALLS


NO WALLS . . . . . . . . . . . . . . . . . . . 11
RECORD OBSERVATION. CANE/TRUNKS/BAMBOO/REED . 12
RUDIMENTARY WALLS
BAMBOO/WOOD WITH . . . . . . . . . . 21
STONE WITH MUD . . . . . . . . . . . . 22
UNCOVERED ADOBE ........ 23
PLYWOOD . . . . . . . . . . . . . . . . . . . 24
CARTON . . . . . . . . . . . . . . . . . . . . . 25

FINISHED WALLS
CEMENT . . . . . . . . . . . . . . . . . . . . . 31
STONE WITH LIME/CEMENT . . . 32
BRICKS . . . . . . . . . . . . . . . . . . . . . 33
CEMENT BLOCKS . . . . . . . . . . . . 34
COVERED ADOBE .......... 35
WOOD PLANKS/SHINGLES ... 36

OTHER _______________________ 96
(SPECIFY)

39 TYPE OF WINDOWS. YES NO


ANY WINDOWS . . . . . . . . . . . . 1 2
RECORD OBSERVATION. WINDOWS WITH GLASS ... 1 2
WINDOWS WITH SCREENS . 1 2
WINDOWS WITH CURTAINS
OR SHUTTERS . . . . . . . . . . 1 2

40 How many rooms in this household are used for sleeping?


ROOMS ...................

41 Does any member of this household own:


YES NO
A bicycle? BICYCLE . . . . . . . . . . . . . . . . . . . 1 2
A motorcycle or motor scooter? MOTORCYCLE/SCOOTER . . . 1 2
An animal-drawn cart? ANIMAL-DRAWN CART . . . . . . 1 2
A car or truck? CAR/TRUCK . . . . . . . . . . . . . . 1 2
A boat without a motor? BOAT WITHOUT MOTOR . . . . . . 1 2
A boat with a motor? BOAT WITH MOTOR . . . . . . . . 1 2

Appendix E | 311
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

42 Does any member of this household own any land YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


that can be used for agriculture? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 44

43 How many (LOCAL UNITS) of agricultural land do members


of this household own? LOCAL UNITS . . . . . . . . . . . . . .

IF MORE THAN 97, ENTER '97'.


IF UNKNOWN, ENTER '98'. (SPECIFY)

44 Does this household own any livestock, herds, or farm animals? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 46

45 How many of the following animals does this household own?

Cattle? CATTLE . . . . . . . . . . . . . . . . . . .

Milk cows, oxen, or bulls? COWS/OXEN/BULLS ........

Horses, donkeys, or mules? HORSES/DONKEYS/MULES .

Camels? CAMELS . . . . . . . . . . . . . . . . . . .

Goats? GOATS ...................

Sheep? SHEEP ...................

Chickens? CHICKENS . . . . . . . . . . . . . . . . .

IF NONE, ENTER '00'.


IF MORE THAN 97, ENTER '97'.
IF UNKNOWN, ENTER '98'.

46 Does any member of this household have an account with a YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


bank/credit association/micro finance? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

48 Does your household have any mosquito nets that can be YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
used while sleeping? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 48K

48A How many mosquito nets does your household have? NUMBER OF NETS ............

IF 7 OR MORE NETS, RECORD '7'.

312 | Appendix E
MALARIA

48B ASK RESPONDENT TO SHOW YOU THE NET(S) IN THE NET # 1 NET # 2 NET # 3
HOUSEHOLD. IF MORE THAN 3 NETS, USE ADDITIONAL OBSERVED . . . . . 1 OBSERVED . . . . . 1 OBSERVED . . . . . 1
QUESTIONNAIRE(S). NOT OBSERVED . 2 NOT OBSERVED . 2 NOT OBSERVED . 2

48C How long ago did your household obtain the mosquito MOS. MOS. MOS.
net? AGO… . AGO….. AGO…..

MORE THAN 3 MORE THAN 3 MORE THAN 3


YEARS AGO . . . 95 YEARS AGO . . . 95 YEARS AGO . . . 95

48D OBSERVE OR ASK THE BRAND OF MOSQUITO NET. PERMANENT NET PERMANENT NET PERMANENT NET
PERMANET 2 . 1 PERMANET 2 . 1 PERMANET 2 . 1
(SKIP TO 48H) (SKIP TO 48H) (SKIP TO 48H)

PRETREATED NET PRETREATED NET PRETREATED NET


SIAM DUTCH SIAM DUTCH SIAM DUTCH
THAILAND . . . 2 THAILAND . . . 2 THAILAND . . . 2
(SKIP TO 48F) (SKIP TO 48F) (SKIP TO 48F)

UNTREATED NET UNTREATED NET UNTREATED NET


A TO Z A TO Z A TO Z
TANZANIA 3 TANZANIA 3 TANZANIA . 3
OTHER . . . . . . . 6 OTHER . . . . . . . 6 OTHER . . . . . . . 6
UNSURE . . . . . . . 8 UNSURE . . . . . . . 8 UNSURE . . . . . . . 8

48E When you got the net, was it already treated with an YES . . . . . . . . . 1 YES . . . . . . . . . 1 YES . . . . . . . . . . . . 1
insecticide to kill or repel mosquitos? NO . . . . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . . . . 2
NOT SURE . . . . . 8 NOT SURE . . . 8 NOT SURE . . . . . 8

48F Since you got the mosquito net, was it ever soaked or YES . . . . . . . . . 1 YES . . . . . . . . . 1 YES . . . . . . . . . . . . 1
dipped in a liquid to repel mosquitos or bugs? NO . . . . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . . . . 2
(SKIP TO 48H) (SKIP TO 48H) (SKIP TO 48H)
NOT SURE . . . . . 8 NOT SURE . . . 8 NOT SURE . . . . . 8

48G How long ago was the net last soaked or dipped? MOS. MOS. MOS.
AGO . . . . . AGO . . . AGO…..

MORE THAN 2 MORE THAN 2 MORE THAN 2


IF LESS THAN 1 MONTH, RECORD '00'. YEARS AGO . 95 YEARS AGO . 95 YEARS AGO . 95

NOT SURE . . . 98 NOT SURE . . . 98 NOT SURE . . . 98

48H Did anyone sleep under this mosquito net last night? YES . . . . . . . . . . . . 1 YES . . . . . . . . . 1 YES . . . . . . . . . 1
NO . . . . . . . . . . . . 2 NO . . . . . . . . . 2 NO . . . . . . . . . 2
(SKIP TO 48J) (SKIP TO 48J) (SKIP TO 48J)
NOT SURE . . . . . 8 NOT SURE . . . 8 NOT SURE . . . 8

Appendix E | 313
QUESTIONS AND FILTERS NET #1 NET#2 NET #3

48I Who slept under this mosquito net last night? NAME NAME NAME

LINE LINE LINE


NO. . . NO. . . NO. . .

NAME NAME NAME

LINE LINE LINE


NO. . . NO. . . NO. . .

NAME NAME NAME

LINE LINE LINE


NO. . . NO. . . NO. . .

NAME NAME NAME

LINE LINE LINE


NO. . . NO. . . NO. . .

48J GO BACK TO Q.48B GO BACK TO Q.48B GO BACK TO Q.48B


FOR NEXT NET; OR, FOR NEXT NET; OR, FOR NEXT NET; OR,
IF NO MORE NETS, IF NO MORE NETS, IF NO MORE NETS,
GO TO Q.48K. GO TO Q.48K. GO TO Q.48K.

48K Has your house ever been sprayed with insecticide for YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
malaria prevention by spraymen from the District Health NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Office? NOT SURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 49

48L How many months ago was your house sprayed? MONTHS AGO .....................

IF LESS THAN 1 MONTH, RECORD '00'.


NOT SURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

48M OBSERVE THE INNER WALLS OF THE ROOMS VISIBLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


USUALLY USED FOR SLEEPING FOR VISIBLE NOT VISIBLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
WHITE INSECTICIDE POWDER.

49 ASK RESPONDENT FOR A TEASPOONFUL OF 0 PPM (NO IODINE) .................................. 1


COOKING SALT. LESS THAN 15 PPM .................................. 2
TEST SALT FOR IODINE. MORE THAN 15 PPM .................................. 3
NO SALT IN HH .................................. 4
RECORD PPM (PARTS PER MILLION) SALT NOT TESTED _______________________________ 5
(SPECIFY REASON)

314 | Appendix E
WEIGHT AND HEIGHT MEASUREMENT

CHECK COVER PAGE:


HOUSEHOLD NOT
HOUSEHOLD SELECTED SELECTED FOR SKIP TO INTERVIEWER'S
FOR MALE SURVEY MALE SURVEY OBSERVATION ON LAST PAGE

CHECK COLUMNS (8) AND (9): RECORD THE LINE NUMBER, NAME AND AGE OF ALL WOMEN AGE 15-49 AND ALL CHILDREN UNDER AGE 6.

WOMEN 15-49 WEIGHT AND HEIGHT MEASUREMENT OF WOMEN 15-49

LINE NAME AGE What is (NAME'S) date of birth? WEIGHT HEIGHT MEASURED RESULT
NO. (KILOGRAMS) (CENTIMETERS) LYING DOWN 1 MEASURED
FROM FROM OR 2 NOT PRESENT
FROM COL. (2) COL. (7) STANDING 3 REFUSED
COL. (8) UP 6 OTHER

(50) (51) (52) (53) (54) (55) (56) (57)

YEARS

. .

. .

. .

WEIGHT AND HEIGHT MEASUREMENT OF CHILDREN BORN IN


CHILDREN UNDER AGE 6
1992 OR LATER

LINE NAME AGE What is (NAME'S) date of birth?* WEIGHT HEIGHT MEASURED RESULT
NO. (KILOGRAMS) (CENTIMETERS) LYING DOWN 1 MEASURED
FROM FROM OR 2 NOT PRESENT
FROM COL. (2) COL. (7) STANDING 3 REFUSED
COL. (9) UP 6 OTHER

DAY MONTH YEAR LYING STAND.

0
. . 1 2

0
. . 1 2

0
. . 1 2

0
. . 1 2

0
. . 1 2

0
. . 1 2

TICK HERE IF CONTINUATION SHEET USED

* FOR CHILDREN NOT INCLUDED IN ANY BIRTH HISTORY, ASK DAY, MONTH AND YEAR. FOR ALL OTHER CHILDREN, COPY
MONTH AND YEAR FROM 215 IN MOTHER'S BIRTH HISTORY AND ASK DAY.

Appendix E | 315
HEMOGLOBIN MEASUREMENT

CHECK COVER PAGE:


HOUSEHOLD NOT
HOUSEHOLD SELECTED SELECTED FOR SKIP TO INTERVIEWER'S
FOR MALE SURVEY MALE SURVEY OBSERVATION ON LAST PAGE

HEMOGLOBIN MEASUREMENT OF WOMEN 15-49

CHECK COLUMN (52): LINE NO. OF PARENT/ READ CONSENT STATEMENT TO HEMOGLOBIN CURRENTLY RESULT
RESPONSIBLE ADULT. WOMAN/PARENT/RESPONSIBLE ADULT* LEVEL PREGNANT 1 MEASURED
RECORD '00' IF NOT (G/DL) 2 NOT PRESENT
LISTED IN HOUSEHOLD CIRCLE CODE (AND SIGN) 3 REFUSED
SCHEDULE 6 OTHER

(58) (59) (60) (61) (62) (63)

AGE 15-17 AGE 18-49 GRANTED REFUSED YES NO/DK

1 2 1 2
GO TO 60 SIGN NEXT LINE . 1 2

1 2 1 2
GO TO 60 SIGN NEXT LINE . 1 2

1 2 1 2
GO TO 60 SIGN NEXT LINE . 1 2

HEMOGLOBIN MEASUREMENT OF CHILDREN BORN IN 1992 E.C. OR LATER

CHECK COLUMN (53): LINE NO. OF PARENT/ READ CONSENT STATEMENT TO HEMOGLOBIN RESULT
BORN IN MONTH RESPONSIBLE ADULT. PARENT/RESPONSIBLE ADULT* LEVEL 1 MEASURED
OF INTERVIEW RECORD '00' IF NOT (G/DL) 2 NOT PRESENT
OR PREVIOUS LISTED IN HOUSEHOLD CIRCLE CODE (AND SIGN) 3 REFUSED
5 MONTHS OTHER SCHEDULE 6 OTHER

1 2 GRANTED REFUSED

NEXT 1 2
CHILD SIGN NEXT LINE .

1 2 1 2
NEXT CHILD SIGN NEXT LINE .

1 2 1 2
NEXT CHILD SIGN NEXT LINE .

1 2 1 2
NEXT CHILD SIGN NEXT LINE .

1 2 1 2
NEXT CHILD SIGN NEXT LINE .

1 2 1 2
NEXT CHILD SIGN NEXT LINE .

316 | Appendix E
2005 Ethiopia Demographic and Health Survey
Informed Consent
Anemia Testing

Hello, my name is ___________ and I am from the Population and Housing Census Commission Office,
which, in collaboration with the Federal Ministry of Health is currently carrying out Demographic and Health
Survey, all over the country, in scientifically, sampled enumeration areas. As part of this survey we
are collecting information on Anemia prevalence among women and children in the sampled households by
conducting Anemia testing.

Anemia is a serious health problem that results from poor nutrition. The Anemia testing is being done
to help the government to find out how common it is. This enables the government to develop programs to
prevent and treat anemia. But to do this it needs reliable information. That is why we are now collecting
a few drops of blood from a finger from women and from children under six years of age for the test.
The instruments I use for taking the blood are completely clean, sterile and safe. The blood will be
analyzed with new equipment and the results of the test will be given to you right after the blood is taken.
The results will be kept confidential.

Do you have any questions?

May I now ask that you and your child _________ participate in the anemia test? However, if you
decide not to have the test done, it is your right and I will respect your decision. Now please tell me
if you agree to have the test done.

Yes__________ No ____________

Signature of interviewer ___________________________

Appendix E | 317
64 CHECK 61 AND 62:

NUMBER OF PERSONS WITH HEMOGLOBIN LEVEL BELOW THE CUTOFF POINT*

ONE OR MORE NONE

GIVE EACH WOMAN/PARENT/RESPONSIBLE ADULT GIVE EACH WOMAN/PARENT/RESPONSIBLE ADULT


RESULT OF HEMOGLOBIN MEASUREMENT AND RESULT OF HEMOGLOBIN MEASUREMENT AND
CONTINUE WITH 65.** END INTERVIEW.

65 We detected a low level of hemoglobin in (your blood/the blood of NAME OF CHILD(REN)). This indicates that (you/NAME OF
CHILD(REN)) have developed severe anemia, which is a serious health problem. We would like to inform the doctor at
________________________ about (your condition/the condition of NAME OF CHILD(REN)). This will assist you in obtaining
appropriate treatment for the condition. Do you agree that the information about the level of hemoglobin in (your blood/the
blood of NAME OF CHILD(REN)) may be given to the doctor?

NAME OF PERSON WITH HEMOGLOBIN NAME OF PARENT/RESPONSIBLE


AGREES TO REFERRAL?
BELOW THE CUTOFF POINT ADULT

WOMEN AGE 18-49

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

WOMEN AGE 15-17 AND CHILDREN

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

* The cutoff point is 9 g/dl for pregnant women and ____ g/dl for children and for women who are not pregnant (or who don't know if
they are pregnant), based on the altitude from the coverpage and the adjustment factor in the Editor's and Supervisor's Manual.
** If more than one woman or child is below the cutoff point, read the statement in Q.65 to each woman who is below the cutoff point
and to each parent/responsible adult of a child who is below the cutoff point.

318 | Appendix E
HIV TESTING - WOMEN AND MEN

CHECK COVER PAGE:


HOUSEHOLD NOT
HOUSEHOLD SELECTED SELECTED FOR SKIP TO INTERVIEWER'S
FOR MALE SURVEY MALE SURVEY OBSERVATION ON LAST PAGE

CHECK COLUMNS (8) AND (8A): RECORD THE LINE NUMBER, SEX AND AGE OF ALL WOMEN AGE 15-49 AND MEN AGE 15-59. THIS PAGE WILL BE DESTROYED IN OFFICE BEFORE TEST RESULTS ARE ADDED TO DATA FILE.

LINE SEX AGE CHECK AGE LINE NO. OF PARENT/ READ CONSENT STATEMENT TO READ CONSENT STATEMENT RESULT
NO. FROM COL. (68): RESPONSIBLE ADULT. WOMAN/PARENT/RESPONSIBLE TO WOMAN/MAN 1 SAMPLE TAKEN
FROM FROM RECORD '00' IF NOT ADULT* 2 REFUSED
FROM COL. (4) COL. (7) LISTED IN HOUSEHOLD CIRCLE CODE (AND SIGN) CIRCLE CODE (AND SIGN) 3 NOT PRESENT SAMPLE BAR CODE
COL. (8) SCHEDULE 4 TECH. PROBLEM
OR (8A) 6 OTHER (SPECIFY)

(66) (67) (68) (69) (70) (71) (72) (73) (74)

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

M F YEARS AGE 15-17 AGE 18+ GRANTED REFUSED GRANTED REFUSED PASTE FIRST LABEL HERE
PASTE SECOND LABEL ON FILTER PAPER

Appendix E
1 2 1 2 1 2 1 2 PASTE THIRD LABEL ON BLOOD
GO TO 72 SIGN NEXT LINE SIGN NEXT LINE SAMPLE TRANSMITTAL FORM

|
319
2005 Ethiopia Demographic and Health Survey
Informed Consent
HIV testing

Hello, my name is ___________ and I am from the Population and Housing Census Commission Office,
which, in collaboration with the Federal Ministry of Health, is currently carrying out the Demographic
and Health Survey, all over the country, in scientifically, sampled enumeration areas. As part of this
survey we are collecting information on HIV prevalence among women and men in the
sampled households by collecting blood for conducting an HIV test.

HIV is the virus that causes AIDS. The HIV test is being done to help the government to find out
how common it is and its rate of spreading. This enables the government to devise means of
controlling and preventing the spread of the disease and also provide care and support for those who
have it. But to do this it needs reliable information. That is why we are now collecting a few drops of
blood from a finger for the HIV test.

The instruments I use for taking the blood are completely clean, sterile and safe. The samples will be
coded so that all the information will be kept anonymous.

The blood sample will be sent to the Ethiopian Health and Nutrition Research Institute (EHNRI) Laboratory,
in Addis Ababa. No identifiers such as names will be attached to the test. So we will not be able to tell
you the test result. No one else will be able to know your test results either.

If you want to know whether you have HIV, I can provide a voucher for you to go to the nearest health
institution, which provides VCT, that is, counseling and a test for HIV.

Do you have any questions so far?

May I now ask you to participate in the test? You can say yes to the test or you can say no.
It is up to you to decide.

Will you take the test?

Yes__________ No ____________

Signature of interviewer ___________________________

320 | Appendix E
INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

NAME OF THE SUPERVISOR: DATE:

Appendix E | 321
322 | Appendix E
14 APRIL 2005
2005 ETHIOPIA DEMOGRAPHIC AND HEALTH SURVEY
WOMAN'S QUESTIONNAIRE
IMPLEMENTING ORGANIZATION:
PHCCO

IDENTIFICATION
LOCALITY NAME

NAME OF HOUSEHOLD HEAD

CLUSTER NUMBER .................................................................

HOUSEHOLD NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LARGE CITY/SMALL CITY/TOWN/RURAL


(LARGE CITY=1, SMALL CITY=2, TOWN=3, RURAL=4) ..................................

NAME AND LINE NUMBER OF WOMAN

HOUSEHOLD SELECTED FOR MALE INTERVIEW? ....................................


(YES= 1, NO = 2)

INTERVIEWER VISITS

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR
INTERVIEWER'S
NAME INT. NUMBER

RESULT* RESULT

NEXT VISIT: DATE


TOTAL NUMBER
TIME OF VISITS

*RESULT CODES:
1 COMPLETED 4 REFUSED
2 NOT AT HOME 5 PARTLY COMPLETED 7 OTHER
3 POSTPONED 6 INCAPACITATED (SPECIFY)

LANGUAGE OF QUESTIONNAIRE: LANGUAGE OF INTERVIEW: LANGUAGE OF RESPONDENT

LANGUAGE CODES: AMARIGNA = 1, OROMIGNA = 2, TIGRIGNA = 3, OTHER = 6

TRANSLATOR USED:
(YES = 1, NO = 2)

SUPERVISOR FIELD EDITOR OFFICE KEYED BY


EDITOR
NAME NAME

DATE DATE

Appendix E | 323
SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION

Hello. My name is _______________________________________ and I am working with the Population and Housing Census
Commission Office (PHCCO). We are conducting a national survey about the health of women, men and children. We would very
much appreciate your participation in this survey. I would like to ask you about your health (and the health of your children). This
information will help the government to plan health services. The survey usually takes about 45 minutes to complete.
Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

At this time, do you want to ask me anything about the survey?


May I begin the interview now?

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

101 RECORD THE TIME.


MORNING/EVENING ........
MORNING = 1
EVENING = 2 HOUR . . . . . . . . . . . . . . . . . . . . .

MINUTES . . . . . . . . . . . . . . . . . .

101A COLLECT ANY RELEVANT DOCUMENTS THAT MAY HAVE


INFORMATION ON THE RESPONDENT'S AND HER
CHILDREN'S AGE AND IMMUNIZATIONS.

102 How long have you been living continuously in (NAME OF


CURRENT PLACE OF RESIDENCE)? YEARS ...................

IF LESS THAN ONE YEAR, RECORD '00' YEARS. ALWAYS . . . . . . . . . . . . . . . . . . . . . . . 95


VISITOR . . . . . . . . . . . . . . . . . . . . . . . 96 104

103 Just before you moved here, did you live in a city, in a town, or in CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the countryside? TOWN . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
COUNTRYSIDE . . . . . . . . . . . . . . . . . . . 3

104 In what month and year were you born?


MONTH ...................

DON'T KNOW MONTH . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . .

DON'T KNOW YEAR . . . . . . . . . . . . 9998

105 How old were you at your last birthday?


AGE IN COMPLETED YEARS
COMPARE AND CORRECT 104 AND/OR 105 IF INCONSISTENT.

106 Have you ever attended school? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 110

108 What is the highest grade you completed?


GRADE ...................

TECH./VOC. CERTIFICATE . . . . . . . . . . 13
UNIVERSITY/COLLEGE DIPLOMA . . . 14
UNIVERSITY/COLLEGE DEGREE OR
HIGHER . . . . . . . . . . . . . . . . . . . . . . . 15

324 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

109 CHECK 108:

GRADE 00-06 GRADE 07


AND ABOVE 113

110 Now I would like you to read this sentence to me. CANNOT READ AT ALL . . . . . . . . . . . . 1
ABLE TO READ ONLY PARTS OF
SHOW CARD TO RESPONDENT. SENTENCE . . . . . . . . . . . . . . . . . . . . . 2
ABLE TO READ WHOLE SENTENCE 3
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: NO CARD WITH REQUIRED
Can you read any part of the sentence to me? LANGUAGE 4
(SPECIFY LANGUAGE)
BLIND/VISUALLY IMPAIRED . . . . . . . 5

111 Have you ever participated in a Basic Education Program or


any other program that involves learning to read or write YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
(not including primary school)? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

112 CHECK 110:

CODE '2', '3' CODE '1' OR '5'


OR '4' CIRCLED 114
CIRCLED

113 Do you read a newspaper or magazine almost every day, at least ALMOST EVERY DAY . . . . . . . . . . . . . . 1
once a week, less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

114 Do you listen to the radio almost every day, at least once a week, ALMOST EVERY DAY . . . . . . . . . . . . . . 1
less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

115 Do you watch television almost every day, at least once a week, ALMOST EVERY DAY . . . . . . . . . . . . . . 1
less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

115A In the last 12 months, on how many separate occasions have you
traveled away from your home community and slept away? NUMBER OF TRIPS ........

NONE . . . . . . . . . . . . . . . . . . . . . . . . . 00 116

115B In the last 12 months, have you been away from your home YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
community for more than one month at a time? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

116 What is your religion? ORTHODOX ..................... 1


CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . 2
PROTESTANT ................... 3
MOSLEM ....................... 4
TRADITIONAL ................... 5
OTHER _________________________ 6
(SPECIFY)

117 What is your ethnicity?


RECORD THE MAJOR ETHNIC GROUP. _________________________

Appendix E | 325
SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

201 Now I would like to ask about all the births you have had during YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
your life. Have you ever given birth? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 206

202 Do you have any sons or daughters to whom you have given YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
birth who are now living with you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 204

203 How many sons live with you? SONS AT HOME . . . . . . . . . . . .

And how many daughters live with you? DAUGHTERS AT HOME ......

IF NONE, RECORD '00'.

204 Do you have any sons or daughters to whom you have given YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
birth who are alive but do not live with you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 206

205 How many sons are alive but do not live with you? SONS ELSEWHERE ........

And how many daughters are alive but do not live with you? DAUGHTERS ELSEWHERE .

IF NONE, RECORD '00'.

206 Have you ever given birth to a boy or girl who was born alive
but later died?
YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
IF NO, PROBE: Any baby who cried or showed signs of life but NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 208
did not survive?

207 How many boys have died? BOYS DEAD ..............

And how many girls have died? GIRLS DEAD ..............

IF NONE, RECORD '00'.

208 SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'. TOTAL . . . . . . . . . . . . . . . . . . . . .

209 CHECK 208:

Just to make sure that I have this right: you have had in TOTAL
_____ births during your life. Is that correct?
PROBE AND
YES NO CORRECT
201-208 AS
NECESSARY.

210 CHECK 208:

ONE OR MORE NO BIRTHS


BIRTHS 226

326 | Appendix E
211 Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
(IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE).

212 213 214 215 216 217 218 219 220 221
IF ALIVE: IF ALIVE: IF ALIVE: IF DEAD:

What name Were Is In what month Is How old was Is (NAME) RECORD How old was (NAME) Were there
was given to any of (NAME) and year was (NAME) (NAME) at living with HOUSE- when he/she died? any other
your these a boy or (NAME) born? still his/her last you? HOLD LINE live births
(first/next) births a girl? alive? birthday? NUMBER OF IF '1 YR', PROBE: between
baby? twins? PROBE: CHILD How many months old (NAME OF
What is his/her RECORD (RECORD '00' was (NAME)? PREVIOUS
birthday? AGE IN IF CHILD NOT RECORD DAYS IF BIRTH) and
COM- LISTED IN LESS THAN 1 (NAME),
PLETED HOUSE- MONTH; MONTHS IF including
YEARS. HOLD). LESS THAN TWO any children
YEARS; OR YEARS. who died
(NAME) after birth?

01 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2
(NEXT BIRTH) YEARS . . 3
220

02 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

03 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

04 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

05 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

06 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

07 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

Appendix E | 327
212 213 214 215 216 217 218 219 220 221
IF ALIVE: IF ALIVE: IF ALIVE: IF DEAD:

What name Were Is In what month Is How old was Is (NAME) RECORD How old was (NAME) Were there
was given to any of (NAME) and year was (NAME) (NAME) at living with HOUSE- when he/she died? any other
your next these a boy or (NAME) born? still his/her last you? HOLD LINE live births
baby? births a girl? alive? birthday? NUMBER OF IF '1 YR', PROBE: between
twins? PROBE: CHILD How many months old (NAME OF
What is his/her RECORD (RECORD '00' was (NAME)? PREVIOUS
birthday? AGE IN IF CHILD NOT RECORD DAYS IF BIRTH) and
COM- LISTED IN LESS THAN 1 (NAME),
PLETED HOUSE- MONTH; MONTHS IF including
YEARS. HOLD). LESS THAN TWO any children
YEARS; OR YEARS. who died
(NAME) after birth?

08 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

09 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

10 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

11 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

12 MONTH AGE IN LINE NUMBER DAYS . . . 1


SING 1 BOY 1 YES . . 1 YEARS YES . . . 1 YES . . . . 1
YEAR MONTHS 2
MULT 2 GIRL 2 NO . . . 2 NO . . . . 2 NO . . . . . 2
(GO TO 221) YEARS . . 3
220

222 Have you had any live births since the birth of (NAME OF LAST YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
BIRTH)? IF YES, RECORD BIRTH(S) IN TABLE. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

223 COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

NUMBERS NUMBERS ARE


ARE SAME DIFFERENT (PROBE AND RECONCILE)

CHECK: FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED IN Q.215.

FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED IN Q.217.

FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED IN Q.220.

FOR AGE AT DEATH 12 MONTHS OR 1 YEAR: PROBE TO DETERMINE EXACT


NUMBER OF MONTHS.

224 CHECK 215 AND ENTER THE NUMBER OF BIRTHS IN 1992 E.C. OR LATER.
IF NONE, RECORD '0'.

328 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

225 FOR EACH BIRTH SINCE MESKEREM 1992, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE
CALENDAR. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD
'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE
NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE.

226 Are you pregnant now? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . 8 229

227 How many months pregnant are you?


MONTHS . . . . . . . . . . . . . . . . . . .
RECORD NUMBER OF COMPLETED MONTHS.
ENTER 'P's IN COLUMN 1 OF CALENDAR, BEGINNING WITH
THE MONTH OF INTERVIEW AND FOR THE TOTAL NUMBER
OF COMPLETED MONTHS.

228 At the time you became pregnant did you want to become THEN . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
pregnant then, did you want to wait until later, or did you LATER . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
not want to have any (more) children at all? NOT AT ALL ..................... 3

229 Have you ever had a pregnancy that miscarried, was aborted, or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
ended in a stillbirth? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 237

230 When did the last such pregnancy end?


MONTH ...................

YEAR . . . . . . . . . . . .

231 CHECK 230:

LAST PREGNANCY LAST PREGNANCY


ENDED IN ENDED BEFORE 237
MESKEREM 1992 OR LATER MESKEREM 1992

232 How many months pregnant were you when the last such
pregnancy ended? MONTHS . . . . . . . . . . . . . . . . . . .

RECORD NUMBER OF COMPLETED MONTHS. ENTER 'T' IN


COLUMN 1 OF CALENDAR IN THE MONTH THAT THE
PREGNANCY TERMINATED AND 'P' FOR THE REMAINING
NUMBER OF COMPLETED MONTHS.

233 Since Meskerem 1992, have you had any other pregnancies YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
that did not result in a live birth? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 237

234 ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY
BACK TO MESKEREM 1992.

ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P'
FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

235 Did you have any pregnancies that terminated before YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1992 E.C. that did not result in a live birth? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 237

236 When did the last such pregnancy that terminated before
1992 E.C. end? MONTH ...................

YEAR . . . . . . . . . . . .

Appendix E | 329
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

237 When did your last menstrual period start?


DAYS AGO . . . . . . . . . . . . 1

WEEKS AGO .......... 2

MONTHS AGO ........ 3

(DATE, IF GIVEN) YEARS AGO .......... 4

IN MENOPAUSE/
HAS HAD HYSTERECTOMY ... 994

BEFORE LAST BIRTH . . . . . . . . . . . . 995

NEVER MENSTRUATED . . . . . . . . . . 996

238 From one menstrual period to the next, are there certain days YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
when a woman is more likely to become pregnant if she has NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
sexual relations? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8 239A

239 Is this time just before her period begins, during her period, right JUST BEFORE HER PERIOD
after her period has ended, or halfway between two periods? BEGINS . . . . . . . . . . . . . . . . . . . . . . . 1
DURING HER PERIOD ............ 2
RIGHT AFTER HER
PERIOD HAS ENDED . . . . . . . . . . . . 3
HALFWAY BETWEEN
TWO PERIODS . . . . . . . . . . . . . . . . 4

OTHER _______________________ 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

239A Are you the primary care giver for any children? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 301

239B Are any of these children for whom you are the primary YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
caregiver under the age of 18?
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 301

239C Now I would like to ask you about the children who are under
the age of 18 and for whom you are the primary caregiver.

Have you made arrangements for someone to care for these YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
children in the event that you fall sick or are unable to care NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
for them? UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . 8

330 | Appendix E
SECTION 3. CONTRACEPTION

301 Now I would like to talk about family planning - the various ways or methods that a couple 302 Have you ever used
can use to delay or avoid a pregnancy. (METHOD)?

Which ways or methods have you heard about?


FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.


THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF
EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD
IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD
WITH CODE 1 CIRCLED IN 301, ASK 302.

01 FEMALE STERILIZATION Women can have an operation to avoid YES . . . . . . . . . . . . . . 1 Have you ever had an operation to
having any more children. NO . . . . . . . . . . . . . . 2 avoid having any more children?
YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . 2

02 MALE STERILIZATION Men can have an operation to avoid having YES . . . . . . . . . . . . . . 1 Have you ever had a partner who had
any more children. NO . . . . . . . . . . . . . . 2 an operation to avoid having any more
children?
YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . 2

03 PILL Women can take a pill every day to avoid becoming pregnant. YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . 2
NO ................... 2

04 IUD Women can have a loop or coil placed inside their uterus YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
by a doctor or a nurse. NO . . . . . . . . . . . . . . 2
NO ................... 2

05 INJECTABLES Women can have an injection by a health provider YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1


that stops them from becoming pregnant for one or more months. NO . . . . . . . . . . . . . . 2
NO ................... 2

06 IMPLANTS (or NORPLANTS) Women can have several small rods YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
placed in their upper arm by a doctor or nurse which can prevent NO . . . . . . . . . . . . . . 2
pregnancy for five or moreyears. NO ................... 2

07 CONDOM Men can put a rubber sheath on their penis before sexual YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
intercourse. NO . . . . . . . . . . . . . . 2
NO ................... 2

08 DIAPHRAGM/FOAM/JELLY Women can place a sheath and/or a YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1


suppository/tablet/jelly/cream in their vagina before intercourse. NO . . . . . . . . . . . . . . 2
NO ................... 2

09 STANDARD DAYS METHOD Women can use a cycle of beads to YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
count the days they are most likely to get pregnant and avoid sexual NO . . . . . . . . . . . . . . 2
intercourse during those days. NO ................... 2

10 LACTATIONAL AMENORRHEA METHOD (LAM) YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . 2
NO ................... 2

11 RHYTHM METHOD Every month that a woman is sexually active YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
she can avoid pregnancy by not having sexual intercourse NO . . . . . . . . . . . . . . 2
on the days of the month she is most likely to get pregnant. NO ................... 2

12 WITHDRAWAL Men can be careful and pull out before climax. YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . 2
NO ................... 2

13 Have you heard of any other ways or methods that women or men YES . . . . . . . . . . . . . . 1
can use to avoid pregnancy?
YES . . . . . . . . . . . . . . . . . . . 1
(SPECIFY) NO . . . . . . . . . . . . . . . . . . . 2

YES . . . . . . . . . . . . . . . . . . . 1
(SPECIFY) NO . . . . . . . . . . . . . . . . . . . 2
NO .............. 2

303 CHECK 302:


NOT A SINGLE AT LEAST ONE
"YES" "YES" 307
(NEVER USED) (EVER USED)

Appendix E | 331
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

304 Have you ever used anything or tried in any way to delay or avoid YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 306
getting pregnant? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

305 ENTER '0' IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH. 331

306 What have you used or done?

CORRECT 302 AND 303 (AND 301 IF NECESSARY).

307 Now I would like to ask you about the first time that you did
something or used a method to avoid getting pregnant. NUMBER OF CHILDREN . . . . . .

How many living children did you have at that time, if any?

IF NONE, RECORD '00'.

308 CHECK 302 (01):

WOMAN NOT WOMAN


STERILIZED STERILIZED 311A

309 CHECK 226:

NOT PREGNANT PREGNANT


OR UNSURE 322

310 Are you currently doing something or using any method to delay YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
or avoid getting pregnant? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 322

311 Which method are you using? FEMALE STERILIZATION .......... A


MALE STERILIZATION ............ B 319
CIRCLE ALL MENTIONED. PILL ......................... C
IUD ......................... D
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INJECTABLES ................ E 315
INSTRUCTION FOR HIGHEST METHOD ON LIST. IMPLANTS ..................... F
CONDOM ..................... G
DIAPHRAGM/FOAM/JELLY . . . . . . . . . . H 315
311A CIRCLE 'A' FOR FEMALE STERILIZATION. STANDARD DAYS METHOD . . . . . . . . I
LACTATIONAL AMEN. METHOD . . . . . . J
RHYTHM METHOD . . . . . . . . . . . . . . . . K
WITHDRAWAL ................... L 319A

OTHER _______________________ X
(SPECIFY)

312 May I see the package of (pills/condoms) you are using? PACKAGE SEEN ................ 1

RECORD NAME OF BRAND. 314


BRAND NAME
(SPECIFY)

PACKAGE NOT SEEN ............ 2

313 Do you know the brand name of the (pills/condoms) you are using?
BRAND NAME
RECORD NAME OF BRAND. (SPECIFY)

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

314 How many (pill cycles/packages of condoms) did you get NUMBER OF
the last time? CYCLES/PACKAGES

DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

315 The last time you obtained (CURRENT METHOD IN 311),


how much did you pay in total, including the cost of the method COST . . . . . . .
and any consultation you may have had? 319A
FREE . . . . . . . . . . . . . . . . . . . . . . . . . 995
DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

332 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

319 In what month and year was the sterilization performed?

319A In what month and year did you start using (CURRENT
METHOD) continuously? MONTH ...................

PROBE: For how long have you been using (CURRENT YEAR . . . . . . . . . . . .
METHOD) now without stopping?

321 CHECK 319/319A:

YEAR IS 1992 E.C. OR LATER YEAR IS 1991 E.C. OR EARLIER

ENTER CODE FOR METHOD USED IN MONTH OF ENTER CODE FOR METHOD USED IN MONTH OF
INTERVIEW IN COLUMN 1 OF THE CALENDAR AND IN INTERVIEW IN COLUMN 1 OF THE CALENDAR AND
EACH MONTH BACK TO THE DATE STARTED USING. EACH MONTH BACK TO MESKEREM 1992.

ENTER METHOD SOURCE CODE IN COLUMN 2 OF THEN SKIP TO 329


CALENDAR IN MONTH STARTED USING.

THEN CONTINUE WITH 322.

Appendix E | 333
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

322 I would like to ask you some questions about the times you or your partner may have used a method to avoid getting
pregnant during the last few years.

USE CALENDAR TO PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH MOST RECENT
USE, BACK TO MESKEREM 1992.
USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS.

IN COLUMN 1, ENTER METHOD USE CODE OR '0' FOR NONUSE IN EACH BLANK MONTH.

ILLUSTRATIVE QUESTIONS:
COLUMN 1: * When was the last time you used a method? Which method was that?
* When did you start using that method? How long after the birth of (NAME)?
* How long did you use the method then?

IN COLUMN 2, ENTER METHOD SOURCE CODE IN FIRST MONTH OF EACH USE.

ILLUSTRATIVE QUESTIONS:
COLUMN 2: * Where did you obtain the method when you started using it?
* Where did you get advice on how to use the method [for LAM or rhythm]?

IN COLUMN 3, ENTER CODES FOR DISCONTINUATION NEXT TO LAST MONTH OF USE.


NUMBER OF CODES IN COLUMN 3 MUST BE SAME AS NUMBER OF INTERRUPTIONS OF METHOD USE IN
COLUMN 1.

ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME
PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET
PREGNANT.

ILLUSTRATIVE QUESTIONS:
COLUMN 3: * Why did you stop using the (METHOD)?
* Did you become pregnant while using (METHOD), did you stop using to get pregnant,
or did you stop for some other reason?

IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK:


* How many months did it take you to get pregnant after you stopped using (METHOD)?
AND ENTER '0' IN EACH SUCH MONTH IN COLUMN 1.

323 CHECK 311/311A: NO CODE CIRCLED ............ 00 331


FEMALE STERILIZATION ........ 01
CIRCLE METHOD CODE: MALE STERILIZATION .......... 02 333
PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
IF NO CODE CIRCLED IN 311/311A, CIRCLE '00'. INJECTABLES . . . . . . . . . . . . . . . . . . . 05
IMPLANTS . . . . . . . . . . . . . . . . . . . . . 06
IF MORE THAN ONE METHOD CODE CIRCLED IN 311/311A, CONDOM ..................... 07 330
CIRCLE CODE FOR HIGHEST METHOD IN LIST. DIAPHRAGM/FOAM/JELLY . . . . . . . . 08
STANDARD DAYS METHOD . . . . . . 09 327
LACTATIONAL AMEN. METHOD . . . 10
RHYTHM METHOD . . . . . . . . . . . . . . 11
WITHDRAWAL ................ 12 333
OTHER METHOD .............. 96

324 You obtained (CURRENT METHOD) from (SOURCE OF METHOD YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 326
FROM CALENDAR) in (DATE). At that time, were you told NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
about side effects or problems you might have with the method?

325 Were you ever told by a health facility/family planning worker/ YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
reproductive health agent about side effects or problems you NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 327
might have with the method?

326 Were you told what to do if you experienced side effects YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
or problems? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

334 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

327 CHECK 324:

CODE '1' CODE '1'


CIRCLED NOT
CIRCLED

At that time, were you told When you obtained (CURRENT


about other methods of family METHOD) from (SOURCE OF
planning that you could use? METHOD FROM CALENDAR) in
(DATE), were you told about YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 329
other methods of family NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
planning that you could use?

328 Were you ever told by a health facility/family planning worker/ YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
reproductive health agent about other methods of family planning NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
that you could use?

329 CHECK 311/311A: FEMALE STERILIZATION ........ 01


MALE STERILIZATION .......... 02 333
CIRCLE METHOD CODE: PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
IF MORE THAN ONE METHOD CODE CIRCLED IN 311/311A, INJECTABLES . . . . . . . . . . . . . . . . . . . 05
CIRCLE CODE FOR HIGHEST METHOD IN LIST. IMPLANTS . . . . . . . . . . . . . . . . . . . . . 06
CONDOM ..................... 07
DIAPHRAGM/FOAM/JELLY . . . . . . . . 08
STANDARD DAYS METHOD . . . . . . 09
LACTATIONAL AMEN. METHOD . . . 10
RHYTHM METHOD . . . . . . . . . . . . . . 11
WITHDRAWAL ................ 12 333
OTHER METHOD .............. 96

330 Where did you obtain (CURRENT METHOD) the last time? PUBLIC SECTOR
GOVT. HOSPITAL . . . . . . . . . . . . 11
GOVT. HEALTH CENTER ...... 12
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, GOVT. HEALTH POST ........ 13
WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE GOVT. HEALTH STATION/CLINIC 14
TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. CBD ....................... 15
OTHER PUBLIC ________________ 16
(SPECIFY)
(NAME OF PLACE) NON GOVT (NGO)
NGO HEALTH FACILITY . . . . . . . . 21
CBD/CBRHA . . . . . . . . . . . . . . . . 22
OTHER NGO ________________ 26
(SPECIFY)
333
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . 31
PHARMACY . . . . . . . . . . . . . . . . . . . 32
OTHER PRIVATE
MEDICAL 36
(SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . 41
SHOP ..................... 42
FRIEND/RELATIVE . . . . . . . . . . . . 43
OTHER _______________________ 96
(SPECIFY)

331 Do you know of a place where you can obtain a method of family YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
planning? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 333

Appendix E | 335
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

332 Where is that? PUBLIC SECTOR


GOVT. HOSPITAL . . . . . . . . . . . . A
GOVT. HEALTH CENTER ...... B
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, GOVT. HEALTH POST ........ C
WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE GOVT. HEALTH STATION/CLINIC D
TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. CBD ....................... E
OTHER PUBLIC ________________ F
(SPECIFY)
NON GOVT (NGO)
NGO HEALTH FACILITY . . . . . . . . G
(NAME OF PLACE) CBD/CBRHA . . . . . . . . . . . . . . . . H
OTHER NGO ________________ I
(SPECIFY)
Any other place?
PRIVATE MEDICAL SECTOR
RECORD ALL PLACES MENTIONED. PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . J
PHARMACY . . . . . . . . . . . . . . . . . . . K
OTHER PRIVATE
MEDICAL L
(SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . M
SHOP ..................... N
FRIEND/RELATIVE . . . . . . . . . . . . O
OTHER _______________________ X
(SPECIFY)

333 In the last 12 months, were you visited by a community YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


based health agent/distributor who talked to you about NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
family planning?

334 In the last 12 months, have you visited a health facility for care YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
for yourself (or your children)? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 401

335 Did any staff member at the health facility speak to you about YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
family planning methods? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

336 | Appendix E
SECTION 4. PREGNANCY, DELIVERY, POSTNATAL CARE AND NUTRITION

401 CHECK 224:


ONE OR MORE NO 550
BIRTHS BIRTHS
IN MESKEREM 1992 IN MESKEREM 1992
OR LATER OR LATER

402 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 1992 E.C. OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

Now I would like to ask you some questions about the health of all your children born in the last five years. (We will talk
about each separately.)

403 LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

LINE NUMBER FROM 212 LINE LINE LINE


NUMBER . . . NUMBER . . . NUMBER . . .

404 NAME ________________ NAME ________________ NAME ________________


FROM 212 AND 216
LIVING DEAD LIVING DEAD LIVING DEAD

405 At the time you became pregnant THEN . . . . . . . . . . . . 1 THEN . . . . . . . . . . . . 1 THEN . . . . . . . . . . . . 1


with (NAME), did you want to (SKIP TO 407) (SKIP TO 429) (SKIP TO 429)
become pregnant then, did you LATER . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . 2
want to wait until later, or did
you not want to have any (more) NOT AT ALL ...... 3 NOT AT ALL ...... 3 NOT AT ALL ...... 3
children at all? (SKIP TO 407) (SKIP TO 429) (SKIP TO 429)

406 How much longer would you have


liked to wait? MONTHS 1 MONTHS 1 MONTHS 1

YEARS 2 YEARS 2 YEARS 2

DON'T KNOW . . . 998 DON'T KNOW . . . 998 DON'T KNOW . . . 998

407 Did you see anyone for antenatal HEALTH PROF. ... A
care for this pregnancy? OTHER PERSON
TRAINED TRAD
BIRTH ATTEN. . . . B
IF YES: Whom did you see? UNTRAINED TRAD.
Anyone else? BIRTH ATTEN. . . . C
COMM. HEALTH
PROBE FOR THE TYPE OF AGENT . . . . . . . . D
PERSON AND RECORD ALL
PERSONS SEEN. OTHER X
(SPECIFY)
NO ONE . . . . . . . . . . . . Y
(SKIP TO 414)

Appendix E | 337
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

408 Where did you receive antenatal HOME


care for this pregnancy? YOUR HOME . . . A
OTHER HOME . . . B
CIRCLE ALL MENTIONED.
PUBLIC SECTOR
IF SOURCE IS HOSPITAL, GOVT. HOSPITAL/
HEALTH CENTER, OR CLINIC, CLINIC . . . . . . . . C
WRITE THE NAME OF THE GOVT. HEALTH
PLACE. PROBE TO IDENTIFY CENTER . . . . . . D
THE TYPE OF SOURCE AND GOVT. HEALTH
CIRCLE THE APPROPRIATE POST . . . . . . . . E
CODE. OTHER PUBLIC
F
(SPECIFY)
(NAME OF PLACE) NON-GOVT. (NGO)
HEALTH FACILITY G

PRIVATE MED. SECTOR


PVT. HOSPITAL/
CLINIC . . . . . . . . H
OTHER PRIVATE
MED. I
(SPECIFY)

OTHER X
(SPECIFY)

409 How many months pregnant were


you when you first received MONTHS . . .
antenatal care for this pregnancy?
DON'T KNOW . . . . . . 98

410 How many times did you receive NUMBER


antenatal care during this OF TIMES .
pregnancy?
DON'T KNOW . . . . . . 98

411 As part of your antenatal care


during this pregnancy, were any of
the following done at least once? YES NO

Were you weighed? WEIGHT . . . 1 2


Was your blood pressure
measured? BP . . . . . . . . 1 2
Did you give a urine sample? URINE . . . . . . 1 2
Did you give a blood sample? BLOOD . . . 1 2

412 During (any of) your antenatal YES . . . . . . . . . . . . . . 1


care visit(s), were you told about NO . . . . . . . . . . . . . . 2
the signs of pregnancy (SKIP TO 414)
complications? DON'T KNOW . . . . . . 8

413 Were you told where to go if you YES . . . . . . . . . . . . . . 1


had any of these complications? NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8

414 During this pregnancy, were you YES . . . . . . . . . . . . . . 1


given an injection in the arm NO . . . . . . . . . . . . . . 2
to prevent the baby from getting (SKIP TO 417)
tetanus, that is, convulsions DON'T KNOW . . . . . . 8
after birth?

415 During this pregnancy, how many


times did you get this tetanus TIMES . . . . . . . . . .
injection?
DON'T KNOW . . . . 8

338 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

416 CHECK 415: 2 OR MORE OTHER


TIMES

(SKIP TO 421)

417 At any time before this pregnancy, YES . . . . . . . . . . . . . . 1


did you receive any tetanus NO . . . . . . . . . . . . . . 2
injections? (SKIP TO 421)
DON'T KNOW . . . . . . 8

418 Before this pregnancy, how many


times did you get a tetanus TIMES . . . . . . . . . .
injection?
IF 7 OR MORE TIMES, DON'T KNOW . . . . 8
RECORD '7'.

419 In what month and year did you


receive the last tetanus injection MONTH ...
before this pregnancy?
DK MONTH . . . . . . . . 98

YEAR

(SKIP TO 421)

DK YEAR . . . . . . . . 9998

420 How many years ago did you YEARS


receive that tetanus injection? AGO . . . . . .

421 During this pregnancy, were you YES . . . . . . . . . . . . . . 1


given or did you buy any iron
tablets? NO . . . . . . . . . . . . . . 2
(SKIP TO 422A)
SHOW TABLETS. DON'T KNOW . . . . . . 8

422 During the whole pregnancy, for NUMBER


how many days did you take the OF DAYS
tablets?
DON'T KNOW . . . 998
IF ANSWER IS NOT NUMERIC,
PROBE FOR APPROXIMATE
NUMBER OF DAYS.

422A During this pregnancy, did you YES . . . . . . . . . . . . . . 1


receive any drug for intestinal NO . . . . . . . . . . . . . . 2
parasites? DON'T KNOW . . . . . . 8

423 During this pregnancy, did you YES . . . . . . . . . . . . . . 1


have difficulty with your vision NO . . . . . . . . . . . . . . 2
during daylight? DON'T KNOW . . . . . . 8

424 During this pregnancy, did you YES . . . . . . . . . . . . . . 1


suffer from night blindness NO . . . . . . . . . . . . . . 2
[USE LOCAL TERM]? DON'T KNOW . . . . . . 8

425 During this pregnancy, did you take YES . . . . . . . . . . . . . . 1


any drugs to prevent you from
getting malaria? NO . . . . . . . . . . . . . . 2
(SKIP TO 429)
DON'T KNOW . . . . . . 8

Appendix E | 339
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

426 What drugs did you take? FANSIDAR/SP . . . . . . A


CHLOROQUINE . . . B
RECORD ALL MENTIONED.
IF TYPE OF DRUG IS NOT OTHER X
DETERMINED, SHOW TYPICAL (SPECIFY)
ANTIMALARIAL DRUGS TO DON'T KNOW . . . . . . Z
RESPONDENT.

427 CHECK 426: CODE 'A' CODE


CIRCLED A' NOT
DRUGS TAKEN FOR MALARIA CIRCLED
PREVENTION. (SKIP TO 429)

428 How many times did you take


Fansidar/SP during this pregnancy? TIMES . . . . . .

428A CHECK 407: CODE 'A', OTHER


CIRCLED
ANTENATAL CARE FROM A
HEALTH PROFESSIONAL
RECEIVED DURING THIS (SKIP TO 429)
PREGNANCY

428B Did you get the Fansidar/SP during ANTENATAL VISIT . 1


an antenatal visit to a health ANOTHER FACILITY .
facility or from some other source? VISIT . . . . . . . . . . . . 2
OTHER
SOURCE 6
(SPECIFY)

429 When (NAME) was born, was VERY LARGE . . . . . . 1 VERY LARGE . . . . . . 1 VERY LARGE . . . . . . 1
he/she very large, larger than LARGER THAN LARGER THAN LARGER THAN
average, average, smaller than AVERAGE . . . . . . . . 2 AVERAGE . . . . . . . . 2 AVERAGE . . . . . . . . 2
average, or very small? AVERAGE . . . . . . . . 3 AVERAGE . . . . . . . . 3 AVERAGE . . . . . . . . 3
SMALLER THAN SMALLER THAN SMALLER THAN
AVERAGE ...... 4 AVERAGE ...... 4 AVERAGE ...... 4
VERY SMALL . . . . . . 5 VERY SMALL . . . . . . 5 VERY SMALL . . . . . . 5
DON'T KNOW ... 8 DON'T KNOW ... 8 DON'T KNOW ... 8

430 Was (NAME) weighed at birth? YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1

NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 432) (SKIP TO 432) (SKIP TO 432)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

431 How much did (NAME) weigh? KG FROM CARD KG FROM CARD KG FROM CARD

RECORD WEIGHT IN 1 . 1 . 1 .
KILOGRAMS FROM HEALTH
CARD, IF AVAILABLE.
KG FROM RECALL KG FROM RECALL KG FROM RECALL

2 . 2 . 2 .

DON'T KNOW . 99.998 DON'T KNOW . 99.998 DON'T KNOW . 99.998

340 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

432 Who assisted with the delivery HEALTH PROF. ... A HEALTH PROF. ... A HEALTH PROF. . . . A
of (NAME)? OTHER PERSON OTHER PERSON OTHER PERSON
TRAINED TRAD TRAINED TRAD TRAINED TRAD
Anyone else? BIRTH ATTEN. . . . B BIRTH ATTEN. . . . B BIRTH ATTEN. . B
UNTRAINED TRAD. UNTRAINED TRAD. UNTRAINED TRAD.
PROBE FOR THE TYPE OF BIRTH ATTEN. . . . C BIRTH ATTEN. . . . C BIRTH ATTEN. . C
PERSON AND RECORD ALL COMM. HEALTH COMM. HEALTH COMM. HEALTH
PERSONS ASSISTING. AGENT . . . . . . . . D AGENT . . . . . . . . D AGENT ...... D
RELATIVE/FRIEND . . E RELATIVE/FRIEND . . E RELATIVE/FRIEND . E
IF RESPONDENT SAYS NO ONE
ASSISTED, PROBE TO OTHER X OTHER X OTHER X
DETERMINE WHETHER ANY (SPECIFY) (SPECIFY) (SPECIFY)
ADULTS WERE PRESENT AT NO ONE . . . . . . . . . . Y NO ONE . . . . . . . . . . Y NO ONE . . . . . . . . . . Y
THE DELIVERY.

433 Where did you give birth to HOME HOME HOME


(NAME)? YOUR HOME . . . 11 YOUR HOME . . . 11 YOUR HOME . . . 11
(SKIP TO 440) (SKIP TO 441) (SKIP TO 441)
IF SOURCE IS HOSPITAL, OTHER HOME . . . 12 OTHER HOME . . . 12 OTHER HOME . . . 12
HEALTH CENTER, OR CLINIC,
WRITE THE NAME OF THE PUBLIC SECTOR PUBLIC SECTOR PUBLIC SECTOR
PLACE. PROBE TO IDENTIFY GOVT. HOSPITAL/ GOVT. HOSPITAL/ GOVT. HOSPITAL/
CLINIC . . . . . . . . 21 CLINIC . . . . . . . . 21 CLINIC . . . . . . . . 21
THE TYPE OF SOURCE AND GOVT. HEALTH GOVT. HEALTH GOVT. HEALTH
CIRCLE THE APPROPRIATE CENTER . . . . . . 22 CENTER . . . . . . 22 CENTER . . . . . . 22
CODE. GOVT. HEALTH GOVT. HEALTH GOVT. HEALTH
POST . . . . . . . . 23 POST . . . . . . . . 23 POST . . . . . . . . 23
OTHER PUBLIC OTHER PUBLIC OTHER PUBLIC
(NAME OF PLACE) 26 26 26
(SPECIFY) (SPECIFY) (SPECIFY)

NON-GOVT. (NGO) NON-GOVT. (NGO) NON-GOVT. (NGO)


HEALTH FACILITY 31 HEALTH FACILITY 31 HEALTH FACILITY 31

PRIVATE MED. SECTOR PRIVATE MED. SECTOR PRIVATE MED. SECTOR


PVT. HOSPITAL/ PVT. HOSPITAL/ PVT. HOSPITAL/
CLINIC . . . . . . . . 41 CLINIC . . . . . . . . 31 CLINIC . . . . . . . . 31
OTHER PRIVATE OTHER PRIVATE OTHER PRIVATE
MED. 46 MED. 36 MED. 36
(SPECIFY) (SPECIFY) (SPECIFY)

OTHER 96 OTHER 96 OTHER 96


(SPECIFY) (SPECIFY) (SPECIFY)
(SKIP TO 440) (SKIP TO 441) (SKIP TO 441)

434 How long after (NAME) was


delivered did you stay there? HOURS 1 HOURS 1 HOURS 1

IF LESS THAN ONE DAY, DAYS 2 DAYS 2 DAYS 2


RECORD HOURS.
IF LESS THAN ONE WEEK, WEEKS 3 WEEKS 3 WEEKS 3
RECORD DAYS.
DON'T KNOW . . . 998 DON'T KNOW . . . 998 DON'T KNOW . . . 998

435 Was (NAME) delivered by YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


caesarean section? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2

436 Before you were discharged after YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


(NAME) was born, did a health NO . . . . . . . . . . . . . . 2 (SKIP TO 451) (SKIP TO 451)
professional check on your health? (SKIP TO 439) NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2

Appendix E | 341
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

437 How many hours, days or weeks


after delivery did the first check HOURS 1
take place?
DAYS 2
IF LESS THAN ONE DAY,
RECORD HOURS. WEEKS 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . 998

438 Who checked on your health HEALTH PROF. . . . 11


at that time? OTHER PERSON
TRAINED TRAD.
PROBE FOR MOST QUALIFIED BIRTH ATTEN. 12
PERSON. UNTRAINED TRAD.
BIRTH ATTEN. 13
COMM. HEALTH
AGENT . . . . 15
OTHER 96
(SPECIFY)
(SKIP TO 449)

439 After you were discharged, did a YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


health professional or a traditional (SKIP TO 442) (SKIP TO 451) (SKIP TO 451)
birth attendant check on your NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
health? (SKIP TO 449)

440 Why didn't you deliver in a health COST TOO MUCH . . A


facility? FACILITY NOT OPEN . B
TOO FAR/ NO
TRANSPORTATION C
PROBE: Any other reason? DON'T TRUST
FACILITY/POOR
RECORD ALL MENTIONED. QUALITY SERVICE D
NO FEMALE PROVID-
ER AT FACILITY . . E
HUSBAND/FAMILY
DID NOT ALLOW . . F
NOT NECESSARY . . G
NOT CUSTOMARY . . H
OTHER
(SPECIFY) X

441 After (NAME) was born, did a YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


health professional or a traditional
birth attendant check on your NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
health? (SKIP TO 445)

442 How many hours, days or weeks


after delivery did the first check HOURS 1
take place?
DAYS 2
IF LESS THAN ONE DAY,
RECORD HOURS. WEEKS 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . 998

342 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

443 Who checked on your health HEALTH PROF. . . . 11


at that time? OTHER PERSON
TRAINED TRAD.
PROBE FOR MOST QUALIFIED BIRTH ATTEN. 12
PERSON. UNTRAINED TRAD.
BIRTH ATTEN. 13
COMM. HEALTH
AGENT . . . . . 15
OTHER 96
(SPECIFY)

444 Where did this first check HOME


take place? YOUR HOME . . . . . . 11
OTHER HOME . . . . . . 12
IF SOURCE IS HOSPITAL,
HEALTH CENTER, OR CLINIC, PUBLIC SECTOR
WRITE THE NAME OF THE GOVT. HOSPITAL/
CLINIC . . . . . . . . . . 21
PLACE. PROBE TO IDENTIFY GOVT. HEALTH
THE TYPE OF SOURCE AND CENTER . . . . . . . . 22
CIRCLE THE APPROPRIATE GOVT. HEALTH
CODE. POST . . . . . . . . . . 23
OTHER PUBLIC
26
(NAME OF PLACE) (SPECIFY)
NON-GOVT. (NGO)
HEALTH FACILITY . 31

PRIVATE MED. SECTOR


PVT. HOSPITAL/
CLINIC . . . . . . . . . . 41
OTHER PRIVATE
MED. 46
(SPECIFY)

OTHER 96
(SPECIFY)

444A CHECK 439:

NOT ASKED YES


OR NO

(SKIP TO 449)

445 In the two months after (NAME) YES . . . . . . . . . . . . . . 1


was born, did a health professional NO . . . . . . . . . . . . . . 2
or traditional birth attendant check (SKIP TO 449)
on his/her health? DON'T KNOW . . . . . . 8

446 How many hours, days or weeks


after the birth of (NAME) did the HOURS 1
first check take place?
DAYS 2
IF LESS THAN ONE DAY,
RECORD HOURS. WEEKS 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . 998

Appendix E | 343
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

447 Who checked on (NAME)'s health HEALTH PROF. . . . 11


at that time? OTHER PERSON . . .
TRAINED TRAD.
PROBE FOR MOST QUALIFIED BIRTH ATTEN. . 12
PERSON. UNTRAINED TRAD.
BIRTH ATTEN. . 13
COMM. HEALTH
AGENT . . . . . . 15
OTHER 96
(SPECIFY)

448 Where did this first check of HOME


(NAME) take place? YOUR HOME . . . 11
OTHER HOME . . . 12
IF SOURCE IS HOSPITAL,
HEALTH CENTER, OR CLINIC, PUBLIC SECTOR
WRITE THE NAME OF THE GOVT. HOSPITAL/
PLACE. PROBE TO IDENTIFY CLINIC 21
THE TYPE OF SOURCE AND GOVT. HEALTH
CIRCLE THE APPROPRIATE CENTER . . . . . . 22
CODE. GOVT. HEALTH
POST . . . . . . . . 23
OTHER PUBLIC
26
(SPECIFY)

(NAME OF PLACE) NON-GOVT. (NGO)


HEALTH FACILITY 31

PRIVATE MED. SECTOR


PVT. HOSPITAL/
CLINIC . . . . . . . . 41
OTHER PRIVATE
MED. 46
(SPECIFY)

OTHER 96
(SPECIFY)

449 In the first two months after


delivery, did you receive a YES . . . . . . . . . . . . . . 1
vitamin A dose like this?
NO . . . . . . . . . . . . . . 2

SHOW CAPSULE.

450 Has your menstrual period returned YES . . . . . . . . . . . . . . 1


since the birth of (NAME)? (SKIP TO 452)
NO . . . . . . . . . . . . . . 2
(SKIP TO 453)

451 Did your period return between YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


the birth of (NAME) and your NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
next pregnancy? (SKIP TO 455) (SKIP TO 455)

452 For how many months after the


birth of (NAME) did you not have MONTHS . . . MONTHS . . . MONTHS . . .
a period?
DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98

453 CHECK 226: NOT PREGNANT


PREG- OR
IS RESPONDENT PREGNANT? NANT UNSURE
(SKIP TO 455)

344 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

454 Have you resumed sexual YES . . . . . . . . . . . . . . 1


relations since the birth of NO . . . . . . . . . . . . . . 2
(NAME)? (SKIP TO 456)

455 For how many months after the


birth of (NAME) did you not have MONTHS . . . MONTHS . . . MONTHS . . .
sexual relations?
DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98

456 Did you ever breastfeed (NAME)? YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 463) (SKIP TO 463) (SKIP TO 463)

457 How long after birth did you first


put (NAME) to the breast?
IMMEDIATELY . . . 000
IF LESS THAN 1 HOUR,
RECORD ‘00' HOURS.
IF LESS THAN 24 HOURS, HOURS 1
RECORD HOURS.
OTHERWISE, RECORD DAYS. DAYS 2

457A Did you squeeze out and throw YES . . . . . . . . . . . . . . 1


away the first milk? NO . . . . . . . . . . . . . . 2

458 In the first three days after YES . . . . . . . . . . . . . . 1


delivery, was (NAME) given NO . . . . . . . . . . . . . . 2
anything to drink other than (SKIP TO 460)
breast milk?

459 What was (NAME) given to drink? MILK (OTHER THAN


BREAST MILK ) . A
PLAIN WATER ... B
SUGAR OR GLU-
Anything else? COSE WATER . . . C
GRIPE WATER . . . D
RECORD ALL LIQUIDS SUGAR-SALT-WATER
MENTIONED. SOLUTION . . . . . . E
FRUIT JUICE . . . . . . F
INFANT FORMULA . G
TEA/INFUSIONS . . . H
HONEY . . . . . . . . . . I
FRESH BUTTER . . . J
FENUGREEK . . . . . . K

OTHER X
(SPECIFY)

460 CHECK 404: LIVING DEAD LIVING DEAD LIVING DEAD

IS CHILD LIVING? (SKIP TO 462) (SKIP TO 462) (SKIP TO 462)

461 Are you still breastfeeding YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


(NAME)? (SKIP TO 464) (SKIP TO 466) (SKIP TO 466)
NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2

462 For how many months did you


breastfeed (NAME)? MONTHS . . . MONTHS . . . MONTHS . . .

DON'T KNOW . . . 98 DON'T KNOW . . . 98 DON'T KNOW . . . 98

Appendix E | 345
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________

463 CHECK 404: LIVING DEAD LIVING DEAD LIVING DEAD

IS CHILD LIVING?
(GO BACK TO (GO BACK TO (GO BACK TO 405
405 IN NEXT 405 IN NEXT IN NEXT-TO-LAST
COLUMN; OR, COLUMN; OR, COLUMN OF NEW
IF NO MORE IF NO MORE QUESTIONNAIRE; OR,
BIRTHS, GO BIRTHS, GO IF NO MORE
(SKIP TO 466) TO 468) (SKIP TO 466) TO 468) (SKIP TO 466) BIRTHS,
GO TO 468)

464 How many times did you


breastfeed last night between NUMBER OF
sunset and sunrise? NIGHTTIME
FEEDINGS .
IF ANSWER IS NOT NUMERIC,
PROBE FOR APPROXIMATE
NUMBER.

465 How many times did you


breastfeed yesterday during NUMBER OF
the daylight hours? DAYLIGHT
FEEDINGS .
IF ANSWER IS NOT NUMERIC,
PROBE FOR APPROXIMATE
NUMBER.

466 Did (NAME) drink anything from YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


a bottle with a nipple yesterday NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
or last night? DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

467 GO BACK TO 405 IN GO BACK TO 405 IN GO BACK TO 405 IN


NEXT COLUMN; OR, IF NEXT COLUMN; OR, IF NEXT-TO-LAST
NO MORE BIRTHS, GO NO MORE BIRTHS, GO COLUMN OF NEW
TO 468. TO 468. QUESTIONNAIRE; OR,
IF NO MORE BIRTHS,
GO TO 468.

346 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

468 CHECK 215 AND 218:

HAS AT LEAST ONE CHILD DOES NOT HAVE ANY CHILDREN


BORN IN 1994 E.C. OR LATER BORN IN 1994 E.C. OR LATER 501
AND LIVING WITH HER AND LIVING WITH HER

RECORD NAME OF YOUNGEST CHILD LIVING


WITH HER (AND CONTINUE WITH 469)

(NAME)

469 Now I would like to ask you about liquids (NAME FROM 468)
drank yesterday during the day or at night.
Did (NAME FROM 468) drink: YES NO DK

Plain water? PLAIN WATER . . . . . . . . . . . . 1 2 8


Commercially produced infant formula? FORMULA . . . . . . . . . . . . . . 1 2 8
Any other milk such as powdered, or fresh animal milk? MILK . . . . . . . . . . . . . . . . . . . 1 2 8
Fruit juice? JUICE . . . . . . . . . . . . . . . . . . . 1 2 8
Tea or coffee? TEA/COFFEE . . . . . . . . . . . . 1 2 8
Any other liquids? OTHER LIQUIDS . . . . . . . . . . 1 2 8

470 Now I would like to ask you about the food (NAME FROM 468)
ate yesterday during the day or at night, either separately or
combined with other foods.
Did (NAME FROM 468) eat: YES NO DK

a. Any porridge or gruel (made from grains other than teff)? a ....................... 1 2 8

b. Any Cerifam, Fafa, Milupa, Babylac, Mother's Choice


or other commercially fortified baby food? b ....................... 1 2 8

c. Bread, pasta, rice, noodles, biscuits, cookies or any other


food made from oats, maize, barley, wheat, sorghum,millet,
or other grain? c ....................... 1 2 8

d. Any food made from teff, like injera, kita or porridge? d ....................... 1 2 8

e. Any white potatoes, white yams, bulla, kocho, cassava, or any


other foods made from roots? e ....................... 1 2 8

f. Any pumpkin, carrots, squash or sweet potatoes that are


yellow or orange inside? f ....................... 1 2 8

g. Any dark green, leafy vegetables like kale, spinach or


amaranth leaves? g ....................... 1 2 8

h. Any ripe mangoes, papayas? h ....................... 1 2 8

i. Any other fruits or vegetables? i ....................... 1 2 8

j. Any liver, kidney, heart or other organ meats? j ....................... 1 2 8

k. Any beef, pork, lamb, goat, rabbit [or wild game meat such as
antelope or deer]? k ....................... 1 2 8

l. Any chicken, duck or other birds? l ....................... 1 2 8

m. Any eggs? m....................... 1 2 8

n. Any fresh or dried fish or shellfish? n ....................... 1 2 8

o. Any foods made from beans, peas, lentils or pulses? o ....................... 1 2 8

p. Any nuts or seeds such as peanuts, sesame or sunflower seeds? p ....................... 1 2 8

q. Any cheese or yogurt? q ....................... 1 2 8

r. Any foods made with oil, fat, or butter? r ....................... 1 2 8

s. Any other solid or semi-solid food? s ....................... 1 2 8

Appendix E | 347
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

471 CHECK 470: AT LEAST ONE "YES" NOT A SINGLE "YES"


501

472 How many times did (NAME) eat solid, semisolid, or soft foods NUMBER OF
other than liquids yesterday during the day or at night? TIMES .....................

IF 7 OR MORE TIMES, RECORD ‘7'. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

348 | Appendix E
SECTION 5. IMMUNIZATION, HEALTH, AND WOMEN'S NUTRITION

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 1992 E.C. OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

502 LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH


LINE NUMBER
FROM 212 LINE LINE LINE
NUMBER . . . . . . . . NUMBER . . . . . . . . NUMBER . . . . . . .

503 NAME NAME NAME


FROM 212
AND 216 LIVING DEAD LIVING DEAD LIVING DEAD

(GO TO 503 (GO TO 503 (GO TO 503


IN NEXT COLUMN IN NEXT COLUMN IN NEXT-TO-LAST
OR, IF NO MORE OR, IF NO MORE COLUMN OF NEW
BIRTHS, GO TO 547) BIRTHS, GO TO 547) QUESTIONNAIRE;
OR IF NO MORE
BIRTHS, GO TO 547)

504 Has (NAME) ever YES . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . 1


received a vitamin A
dose like this? NO . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . 2
SHOW CAPSULE. (SKIP TO 507) (SKIP TO 507) (SKIP TO 507)
DON'T KNOW . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . 8

505 How many months ago


did (NAME) take the MONTHS AGO . . MONTHS AGO . . MONTHS AGO . .
last dose? DON'T KNOW . . . . . . . . 98 DON'T KNOW . . . . . . . . 98 DON'T KNOW . . . . . . . . 98

507 Do you have a card


where (NAME'S) YES, SEEN . . . . . . . . . . . . 1 YES, SEEN . . . . . . . . . . . . 1 YES, SEEN . . . . . . . . . . . 1
vaccinations are (SKIP TO 509) (SKIP TO 509) (SKIP TO 509)
written down? YES, NOT SEEN . . . . . . . . 2 YES, NOT SEEN . . . . . . . . 2 YES, NOT SEEN . . . . . . . 2
IF YES: (SKIP TO 511) (SKIP TO 511) (SKIP TO 511)
May I see it please? NO CARD . . . . . . . . . . . . . 3 NO CARD . . . . . . . . . . . . . 3 NO CARD . . . . . . . . . . . . 3

508 Did you ever have YES . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . 1


a vaccination (SKIP TO 511) (SKIP TO 511) (SKIP TO 511)
card for (NAME)? NO . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . 2

509 (1) COPY VACCINATION DATE FOR EACH VACCINE FROM THE CARD.
(2) WRITE ‘44' IN ‘DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH


DAY MONTH YEAR DAY MONTH YEAR DAY MONTH YEAR
BCG BCG BCG
POLIO 0 (POLIO
P0 P0
GIVEN AT BIRTH)
POLIO 1 P1 P1

POLIO 2 P2 P2

POLIO 3 P3 P3

DPT 1 D1 D1

DPT 2 D2 D2

DPT 3 D3 D3

MEASLES MEA MEA


VITAMIN A
VIT A VIT A
(MOST RECENT)
VITAMIN A (2nd
VIT A VIT A
MOST RECENT)

Appendix E | 349
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

510 Has (NAME) received any YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


vaccinations that are not recorded (PROBE FOR (PROBE FOR (PROBE FOR
on this card? VACCINATIONS AND VACCINATIONS AND VACCINATIONS AND
WRITE ‘66' IN THE WRITE ‘66' IN THE WRITE ‘66' IN THE
RECORD ‘YES' ONLY IF CORRESPONDING CORRESPONDING CORRESPONDING
RESPONDENT MENTIONS BCG, DAY COLUMN IN 509) DAY COLUMN IN 509) DAY COLUMN IN 509)
POLIO 0-3, DPT 1-3, AND/OR (SKIP TO 515) (SKIP TO 515) (SKIP TO 515)
MEASLES VACCINES.
NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 515) (SKIP TO 515) (SKIP TO 515)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

511 Did (NAME) ever receive any YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


vaccinations to prevent him/her
from getting diseases? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 515) (SKIP TO 515) (SKIP TO 515)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

512 Please tell me if (NAME) received


any of the following vaccinations:
512A A BCG vaccination against YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
tuberculosis, that is, an injection NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
in the arm or shoulder that usually DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
causes a scar?

512B Polio vaccine, that is, drops in the YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
mouth? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 512E) (SKIP TO 512E) (SKIP TO 512E)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

512C Was the first polio vaccine FIRST 2 WEEKS . . . 1 FIRST 2 WEEKS . . . 1 FIRST 2 WEEKS . . . 1
received in the first two weeks LATER . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . 2 LATER . . . . . . . . . . . . 2
after birth or later?

512D How many times was the polio NUMBER NUMBER NUMBER
vaccine received? OF TIMES ...... OF TIMES ...... OF TIMES ......

512E A DPT vaccination, that is, an YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


injection given in the thigh or NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
buttocks, sometimes at the (SKIP TO 512G) (SKIP TO 512G) (SKIP TO 512G)
same time as polio drops? DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

512F How many times was a DPT NUMBER NUMBER NUMBER


vaccination received? OF TIMES ...... OF TIMES ...... OF TIMES ......

512G An injection to prevent measles? YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

515 Has (NAME) had diarrhea in the YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


last 2 weeks? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 530) (SKIP TO 530) (SKIP TO 530)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

516 Was there any blood in the stools? YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

517 Now I would like to know how MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1
much (NAME) was given to drink SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2
during the diarrhea. Was he/she ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3
given less than usual to drink, MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4
about the same amount, or more NOTHING TO DRINK 5 NOTHING TO DRINK 5 NOTHING TO DRINK 5
than usual to drink? DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
IF LESS, PROBE: Was he/she
given much less than usual to
drink or somewhat less?

350 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

518 When (NAME) had diarrhea, was MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1
he/she given less than usual to SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2
eat, about the same amount, more ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3
than usual, or nothing to eat? MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4
STOPPED FOOD . 5 STOPPED FOOD . 5 STOPPED FOOD . 5
IF LESS, PROBE: Was he/she NEVER GAVE FOOD 6 NEVER GAVE FOOD 6 NEVER GAVE FOOD 6
given much less than usual to DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
eat or somewhat less?

519 Did you seek advice or treatment YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


for the diarrhea from any source? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 524) (SKIP TO 524) (SKIP TO 524)

520 Where did you seek advice or PUBLIC SECTOR PUBLIC SECTOR PUBLIC SECTOR
treatment? GOVT HOSPITAL/ A GOVT HOSPITAL/ A GOVT HOSPITAL/ A
CLINIC CLINIC CLINIC
GOVT HEALTH GOVT HEALTH GOVT HEALTH
IF SOURCE IS A HOSPITAL, CENTER . . . . . . B CENTER . . . . . . B CENTER . . . . . . B
HEALTH CENTER, OR CLINIC, GOVT HEALTH GOVT HEALTH GOVT HEALTH
WRITE THE NAME OF THE POST . . . . . . . . C POST . . . . . . . . C POST . . . . . . . . C
PLACE. PROBE TO IDENTIFY COMM. HEALTH . COMM. HEALTH . COMM. HEALTH .
THE TYPE OF SOURCE AND AGENT . . . . . . D AGENT . . . . . . D AGENT . . . . . . D
CIRCLE THE APPROPRIATE OTHER PUBLIC OTHER PUBLIC OTHER PUBLIC
CODE. E E E
(SPECIFY) (SPECIFY) (SPECIFY)
NON-GOVT. (NGO) NON-GOVT. (NGO) NON-GOVT. (NGO)
HEALTH FACILITY F HEALTH FACILITY F HEALTH FACILITY F
PRIVATE MEDICAL PRIVATE MEDICAL PRIVATE MEDICAL
(NAME OF PLACE) SECTOR SECTOR SECTOR
PVT. HOSPITAL/ PVT. HOSPITAL/ PVT. HOSPITAL/
Anywhere else? CLINIC/ CLINIC/ CLINIC/
DOCTOR ... G DOCTOR ... G DOCTOR ... G
RECORD ALL PLACES PHARMACY . . . H PHARMACY . . . H PHARMACY . . . H
MENTIONED. OTHER PRIVATE OTHER PRIVATE OTHER PRIVATE
MED. I MED. I MED. I
(SPECIFY) (SPECIFY) (SPECIFY)
OTHER SOURCE OTHER SOURCE OTHER SOURCE
DRUG VENDOR . J DRUG VENDOR . J DRUG VENDOR . J
SHOP . . . . . . . . . . K SHOP . . . . . . . . . . K SHOP . . . . . . . . . . K
TRADITIONAL TRADITIONAL TRADITIONAL
HEALER . . . . . . L HEALER . . . . . . L HEALER . . . . . . L
OTHER X OTHER X OTHER X
(SPECIFY) (SPECIFY) (SPECIFY)

521 CHECK 520: TWO OR ONLY TWO OR ONLY TWO OR ONLY


MORE ONE MORE ONE MORE ONE
CODES CODE CODES CODE CODES CODE
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 523) (SKIP TO 523) (SKIP TO 523)

522 Where did you first seek advice or


treatment?
FIRST PLACE . . . FIRST PLACE . . . FIRST PLACE . . .
USE LETTER CODE FROM 520.

523 How many days after the diarrhea


began did you first seek advice
or treatment for (NAME)? DAYS . . . . . . DAYS . . . . . . DAYS . . . . . .
IF THE SAME DAY, RECORD '00'.

524 Does (NAME) still have diarrhea? YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

Appendix E | 351
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

525 Was he/she given any of the


following to drink at any time since
he/she started having the diarrhea:
YES NO DK YES NO DK YES NO DK

a A fluid made from an ORS FLUID FROM FLUID FROM FLUID FROM
packet like LEMLEM? ORS PKT 1 2 8 ORS PKT 1 2 8 ORS PKT 1 2 8

b Home made sugar and salt solution? SUGAR/SALT 1 2 8 SUGAR/SALT 1 2 8 SUGAR/SALT 1 2 8

c Other homemade fluid? HOMEMADE HOMEMADE HOMEMADE


FLUID 1 2 8 FLUID 1 2 8 FLUID 1 2 8

526 Was anything (else) given to YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


treat the diarrhea? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 530) (SKIP TO 530) (SKIP TO 530)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

527 What (else) was given to treat PILL OR SYRUP PILL OR SYRUP PILL OR SYRUP
the diarrhea? ANTIBIOTIC . . . . . . A ANTIBIOTIC . . . . . . A ANTIBIOTIC . . . . . . A
ANTIMOTILITY . . . B ANTIMOTILITY . . . B ANTIMOTILITY . . . B
Anything else? ZINC . . . . . . . . . . C ZINC . . . . . . . . . . C ZINC . . . . . . . . . . C
OTHER (NOT ANTI- OTHER (NOT ANTI- OTHER (NOT ANTI-
RECORD ALL TREATMENTS BIOTIC, ANTI- BIOTIC, ANTI- BIOTIC, ANTI-
GIVEN. MOTILITY, OR MOTILITY, OR MOTILITY, OR
ZINC) . . . . . . . . D ZINC) . . . . . . . . D ZINC) . . . . . . . . D
UNKNOWN PILL UNKNOWN PILL UNKNOWN PILL
OR SYRUP . . . E OR SYRUP . . . E OR SYRUP . . . E

INJECTION INJECTION INJECTION


ANTIBIOTIC . . . . . . F ANTIBIOTIC . . . . . . F ANTIBIOTIC . . . . . . F
NON-ANTIBIOTIC . G NON-ANTIBIOTIC . G NON-ANTIBIOTIC . G
UNKNOWN UNKNOWN UNKNOWN
INJECTION . . . H INJECTION . . . H INJECTION . . . H

(IV) INTRAVENOUS . I (IV) INTRAVENOUS . I (IV) INTRAVENOUS . I


HOME REMEDY/ HOME REMEDY/ HOME REMEDY/
HERBAL MED- HERBAL MED- HERBAL MED-
ICINE . . . . . . . . . . J ICINE . . . . . . . . . . J ICINE . . . . . . . . . . J

OTHER X OTHER X OTHER X


(SPECIFY) (SPECIFY) (SPECIFY)

528 CHECK 527: CODE "C" CODE "C" CODE "C" CODE "C" CODE "C" CODE "C"
CIRCLED NOT CIRCLED NOT CIRCLED NOT
CIRCLED CIRCLED CIRCLED

GIVEN ZINC?
(SKIP TO 530) (SKIP TO 530) (SKIP TO 530)

529 How many times was


(NAME) given zinc? TIMES . . . . . .

DON'T KNOW . . . . . . 98

530 Has (NAME) been ill with a fever YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
at any time in the last 2 weeks? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

531 Has (NAME) had an illness with YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


a cough at any time in the NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
last 2 weeks? (SKIP TO 534) (SKIP TO 534) (SKIP TO 534)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

352 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

532 When (NAME) had an illness with YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


a cough, did he/she breathe faster NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
than usual with short, rapid breaths (SKIP TO 535) (SKIP TO 535) (SKIP TO 535)
or have difficulty breathing? DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

533 When (NAME) had this illness, did CHEST ONLY . . . . . . 1 CHEST ONLY . . . . . . 1 CHEST ONLY . . . . . . 1
he/she have a problem in the chest NOSE ONLY ...... 2 NOSE ONLY ...... 2 NOSE ONLY ...... 2
or a blocked or runny nose? BOTH . . . . . . . . . . . . 3 BOTH . . . . . . . . . . . . 3 BOTH . . . . . . . . . . . . 3
OTHER 6 OTHER 6 OTHER 6
(SPECIFY) (SPECIFY) (SPECIFY)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
(SKIP TO 535) (SKIP TO 535) (SKIP TO 535)

534 CHECK 530: YES NO OR DK YES NO OR DK YES NO OR DK

HAD FEVER?
(SKIP TO 546) (SKIP TO 546) (SKIP TO 546)

535 Now I would like to know how MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1
much (NAME) was given to drink SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2
during the illness with a ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3
(fever/cough). MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4
Was he/she given less than usual NOTHING TO DRINK 5 NOTHING TO DRINK 5 NOTHING TO DRINK 5
to drink, about the same amount, DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
or more than usual to drink?
IF LESS, PROBE: Was he/she
given much less than usual to
drink or somewhat less?

536 When (NAME) had a (fever/cough), MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1 MUCH LESS . . . . . . 1
was he/she given less than usual SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2
to eat, about the same amount, ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3
more than usual, or nothing to eat? MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4
STOPPED FOOD . 5 STOPPED FOOD . 5 STOPPED FOOD . 5
IF LESS, PROBE: Was he/she NEVER GAVE FOOD 6 NEVER GAVE FOOD 6 NEVER GAVE FOOD 6
given much less than usual to DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8
eat or somewhat less?

537 Did you seek advice or treatment YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


for the illness from any source? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 542) (SKIP TO 542) (SKIP TO 542)

Appendix E | 353
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

538 Where did you seek advice or PUBLIC SECTOR PUBLIC SECTOR PUBLIC SECTOR
treatment? GOVT HOSPITAL/ A GOVT HOSPITAL/ A GOVT HOSPITAL/ A
CLINIC CLINIC CLINIC
Anywhere else? GOVT HEALTH GOVT HEALTH GOVT HEALTH
CENTER . . . . . . B CENTER . . . . . . B CENTER . . . . . . B
RECORD ALL SOURCES GOVT HEALTH GOVT HEALTH GOVT HEALTH
MENTIONED. POST . . . . . . . . C POST . . . . . . . . C POST . . . . . . . . C
COMM. HEALTH . COMM. HEALTH . COMM. HEALTH .
AGENT . . . . . . D AGENT . . . . . . D AGENT . . . . . . D
OTHER PUBLIC OTHER PUBLIC OTHER PUBLIC
E E E
(SPECIFY) (SPECIFY) (SPECIFY)
NON-GOVT. (NGO) NON-GOVT. (NGO) NON-GOVT. (NGO)
HEALTH FACILITY F HEALTH FACILITY F HEALTH FACILITY F
PRIVATE MEDICAL PRIVATE MEDICAL PRIVATE MEDICAL
SECTOR SECTOR SECTOR
PVT. HOSPITAL/ PVT. HOSPITAL/ PVT. HOSPITAL/
CLINIC/ CLINIC/ CLINIC/
DOCTOR ... G DOCTOR ... G DOCTOR ... G
PHARMACY . . . H PHARMACY . . . H PHARMACY . . . H
OTHER PRIVATE OTHER PRIVATE OTHER PRIVATE
MED. I MED. I MED. I
(SPECIFY) (SPECIFY) (SPECIFY)
OTHER SOURCE OTHER SOURCE OTHER SOURCE
DRUG VENDOR . J DRUG VENDOR . J DRUG VENDOR . J
SHOP . . . . . . . . . . K SHOP . . . . . . . . . . K SHOP . . . . . . . . . . K
TRADITIONAL TRADITIONAL TRADITIONAL
HEALER . . . . . . L HEALER . . . . . . L HEALER . . . . . . L
OTHER X OTHER X OTHER X
(SPECIFY) (SPECIFY) (SPECIFY)

539 CHECK 538: TWO OR ONLY TWO OR ONLY TWO OR ONLY


MORE ONE MORE ONE MORE ONE
CODES CODE CODES CODE CODES CODE
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 541) (SKIP TO 541) (SKIP TO 541)

540 Where did you first seek advice


or treatment?
FIRST PLACE . . . FIRST PLACE . . . FIRST PLACE . . .
USE LETTER CODE FROM 538.

541 How many days after the illness


began did you first seek advice
or treatment for (NAME)? DAYS . . . . . . DAYS . . . . . . DAYS . . . . . .
IF THE SAME DAY, RECORD '00'.

542 Is (NAME) still sick with a (fever/ YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


cough)? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

543 At any time during the illness, did YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
(NAME) take any drugs for the NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
illness? (SKIP TO 546) (SKIP TO 546) (SKIP TO 546)
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

354 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

544 What drugs did (NAME) take? ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS
FANSIDAR/SP . . . A FANSIDAR/SP . . . A FANSIDAR/SP . . . A
CHLOROQUINE . B CHLOROQUINE . B CHLOROQUINE . B
Any other drugs? ARTEMETHER- ARTEMETHER- ARTEMETHER-
LUMEFANTRINE C LUMEFANTRINE C LUMEFANTRINE C
RECORD ALL MENTIONED. QUININE . . . . . . . . D QUININE . . . . . . . . D QUININE . . . . . . . . D
OTHER ANTI- OTHER ANTI- OTHER ANTI-
IF THE RESPONDANT HAS GIVEN MALARIAL . . . G MALARIAL . . . G MALARIAL . . . G
A DRUG FOR THE CHILD BUT
DOESN'T KNOW THE NAME OF ANTIBIOTIC ANTIBIOTIC ANTIBIOTIC
THE DRUG, ASK TO SEE THE BACTRIM . . . . . . . . H BACTRIM . . . . . . . . H BACTRIM . . . . . . . . H
PACKET OF DRUGS SHE GAVE AMPICILIN . . . . . . I AMPICILIN . . . . . . I AMPICILIN . . . . . . I
THE CHILD. BUT IF SHE DOESN'T AMOXYCILIN . . . J AMOXYCILIN . . . J AMOXYCILIN . . . J
HAVE ANY SAMPLE LEFT, THE CHLORIAM- CHLORIAM- CHLORIAM-
INTERVIEWER HAS TO SHOW PHENICOL . . . K PHENICOL . . . K PHENICOL . . . K
TETRACYCLINE . L TETRACYCLINE . L TETRACYCLINE . L
THE SAMPLES SHE HAS TO THE OTHER OTHER OTHER
RESPONDANT IN ORDER TO ANTIBIOTIC . . . M ANTIBIOTIC . . . M ANTIBIOTIC . . . M
HELP IDENTIFY.
OTHER DRUGS OTHER DRUGS OTHER DRUGS
ASPIRIN . . . . . . . . N ASPIRIN . . . . . . . . N ASPIRIN . . . . . . . . N
IBUPROFEN . . . O IBUPROFEN . . . O IBUPROFEN . . . O
PARACETAMOL . P PARACETAMOL . P PARACETAMOL . P
OTHER X OTHER X OTHER X
(SPECIFY) (SPECIFY) (SPECIFY)
DON'T KNOW . . . . . . Z DON'T KNOW . . . . . . Z DON'T KNOW . . . . . . Z

544A CHECK 544: ANY CODE A-M YES NO YES NO YES NO


CIRCLED

(SKIP TO 546) (SKIP TO 546) (SKIP TO 546)

545 Did you already have (NAME OF ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS
DRUG FROM 544) at home when FANSIDAR/SP . . . A FANSIDAR/SP . . . A FANSIDAR/SP . . . A
the child became ill? CHLOROQUINE . B CHLOROQUINE . B CHLOROQUINE . B
ARTEMETHER- ARTEMETHER- ARTEMETHER-
LUMEFANTRINE C LUMEFANTRINE C LUMEFANTRINE C
IF YES, CIRCLE CODE FOR QUININE . . . . . . . . D QUININE . . . . . . . . D QUININE . . . . . . . . D
THAT DRUG.
OTHER ANTI- OTHER ANTI- OTHER ANTI-
ASK SEPARATELY FOR EACH MALARIAL . . . G MALARIAL . . . G MALARIAL . . . G
DRUG (A-M) GIVEN IN 544.
ANTIBIOTIC ANTIBIOTIC ANTIBIOTIC
BACTRIM . . . . . . . . H BACTRIM . . . . . . . . H BACTRIM . . . . . . . . H
AMPICILIN . . . . . . I AMPICILIN . . . . . . I AMPICILIN . . . . . . I
AMOXYCILIN . . . J AMOXYCILIN . . . J AMOXYCILIN . . . J
CHLORIAM- CHLORIAM- CHLORIAM-
PHENICOL . . . K PHENICOL . . . K PHENICOL . . . K
TETRACYCLINE . L TETRACYCLINE . L TETRACYCLINE . L
OTHER OTHER OTHER
ANTIBIOTIC . . . M ANTIBIOTIC . . . M ANTIBIOTIC . . . M

NO DRUG AT HOME Y NO DRUG AT HOME Y NO DRUG AT HOME Y

545A CHECK 544: CODE CODE CODE CODE CODE CODE


A A NOT A A NOT A A NOT
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 545D) (SKIP TO 545D) (SKIP TO 545D)

Appendix E | 355
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

545B How long after the fever/cough SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0
started did (NAME) first take NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1
Fansidar/SP? TWO DAYS AFTER TWO DAYS AFTER TWO DAYS AFTER
FEVER STARTED . 2 FEVER STARTED . 2 FEVER STARTED . 2
THREE DAYS AFTER THREE DAYS AFTER THREE DAYS AFTER
FEVER STARTED . 3 FEVER STARTED . 3 FEVER STARTED . 3
FOUR OR MORE DAYS FOUR OR MORE DAYS FOUR OR MORE DAYS
AFTER FEVER AFTER FEVER AFTER FEVER
STARTED . . . . . . . . 4 STARTED . . . . . . . . 4 STARTED . . . . . . . . 4
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545C For how many days did (NAME)


take the Fansidar/SP? DAYS . . . . . . . . . . DAYS . . . . . . . . . . DAYS . . . . . . . . . .

IF 7 OR MORE DAYS RECORD '7'. DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545D CHECK 544: CODE CODE CODE CODE CODE CODE


B B NOT B B NOT B B NOT
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 545G) (SKIP TO 545G) (SKIP TO 545G)

545E How long after the fever/cough SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0
started did (NAME) first take NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1
Chloroquine? TWO DAYS AFTER TWO DAYS AFTER TWO DAYS AFTER
FEVER STARTED . 2 FEVER STARTED . 2 FEVER STARTED . 2
THREE DAYS AFTER THREE DAYS AFTER THREE DAYS AFTER
FEVER STARTED . 3 FEVER STARTED . 3 FEVER STARTED . 3
FOUR OR MORE DAYS FOUR OR MORE DAYS FOUR OR MORE DAYS
AFTER FEVER AFTER FEVER AFTER FEVER
STARTED . . . . . . . . 4 STARTED . . . . . . . . 4 STARTED . . . . . . . . 4
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545F For how many days did (NAME)


take the Chloroquine? DAYS . . . . . . . . . . DAYS . . . . . . . . . . DAYS . . . . . . . . . .

IF 7 OR MORE DAYS RECORD '7'. DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545G CHECK 544: CODE CODE CODE CODE CODE CODE


C C NOT C C NOT C C NOT
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 545J) (SKIP TO 545J) (SKIP TO 545J)

545H How long after the fever/cough SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0
started did (NAME) first take NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1
Artemether-Lumefantrine? TWO DAYS AFTER TWO DAYS AFTER TWO DAYS AFTER
FEVER STARTED . 2 FEVER STARTED . 2 FEVER STARTED . 2
THREE DAYS AFTER THREE DAYS AFTER THREE DAYS AFTER
FEVER STARTED . 3 FEVER STARTED . 3 FEVER STARTED . 3
FOUR OR MORE DAYS FOUR OR MORE DAYS FOUR OR MORE DAYS
AFTER FEVER AFTER FEVER AFTER FEVER
STARTED . . . . . . . . 4 STARTED . . . . . . . . 4 STARTED . . . . . . . . 4
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545I For how many days did (NAME)


take the Artemether-Lumefantrine? DAYS . . . . . . . . . . DAYS . . . . . . . . . . DAYS . . . . . . . . . .

IF 7 OR MORE DAYS RECORD '7'. DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545J CHECK 544: CODE CODE CODE CODE CODE CODE


D D NOT D D NOT D D NOT
CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED

(SKIP TO 546) (SKIP TO 546) (SKIP TO 546)

356 | Appendix E
LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH

NAME ________________ NAME ________________ NAME ________________

545K How long after the fever/cough SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0 SAME DAY . . . . . . . . 0
started did (NAME) first take NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1 NEXT DAY . . . . . . . . 1
Quinine? TWO DAYS AFTER TWO DAYS AFTER TWO DAYS AFTER
FEVER STARTED . 2 FEVER STARTED . 2 FEVER STARTED . 2
THREE DAYS AFTER THREE DAYS AFTER THREE DAYS AFTER
FEVER STARTED . 3 FEVER STARTED . 3 FEVER STARTED . 3
FOUR OR MORE DAYS FOUR OR MORE DAYS FOUR OR MORE DAYS
AFTER FEVER AFTER FEVER AFTER FEVER
STARTED . . . . . . . . 4 STARTED . . . . . . . . 4 STARTED . . . . . . . . 4
DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

545L For how many days did (NAME)


take the Quinine? DAYS . . . . . . . . . . DAYS . . . . . . . . . . DAYS . . . . . . . . . .

IF 7 OR MORE DAYS RECORD '7'. DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8 DON'T KNOW . . . . . . 8

546 GO BACK TO 503 IN GO BACK TO 503 IN GO TO 503 IN


NEXT COLUMN; OR, IF NEXT COLUMN; OR, IF NEXT-TO-LAST
NO MORE BIRTHS, GO NO MORE BIRTHS, GO COLUMN OF NEW
TO 547. TO 547. QUESTIONNAIRE; OR,
IF NO MORE BIRTHS,
GO TO 547.

Appendix E | 357
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

547 CHECK 215 AND 218, ALL ROWS:

NUMBER OF CHILDREN BORN IN 1992 E.C. OR LATER LIVING WITH THE RESPONDENT

ONE OR MORE NONE 550

548 The last time (NAME OF YOUNGEST CHILD) passed stools, CHILD USED TOILET OR LATRINE . . . 01
what was done to dispose of the stools? PUT/RINSED
INTO TOILET OR LATRINE . . . . . . . . 02
PUT/RINSED
INTO DRAIN OR DITCH . . . . . . . . . 03
THROWN INTO GARBAGE ... 04
BURIED . . . . . . . . . . . . . . . . . . . . . . . . . 05
LEFT IN THE OPEN . . . . . . . . . . . . . . . . . 06

OTHER 96
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

549 CHECK 525(a) ALL COLUMNS:

NO CHILD ANY CHILD


RECEIVED FLUID RECEIVED FLUID 551
FROM ORS PACKET FROM ORS PACKET

550 Have you ever heard of a special product called ORS YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
(like LEMLEM) that you can get for the treatment of NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
diarrhea?

551 Now I would like to ask you some questions about medical
care for you yourself.

Many different factors can prevent women from getting medical


advice or treatment for themselves. When you are sick and BIG NOT A BIG
want to get medical advice or treatment, is each of the following PROB- PROB-
a big problem or not? LEM LEM

Getting permission to go. PERMISSION TO GO ... 1 2

Getting money needed for treatment. GETTING MONEY ...... 1 2

The distance to the health facility. DISTANCE . . . . . . . . . . . . 1 2

Getting transport. GETTING TRANSPORT . 1 2

Not wanting to go alone. GO ALONE . . . . . . . . . . . . 1 2

Concern that there may not be a female health provider. NO FEMALE PROV. . . . 1 2

Concern that there may not be any health provider. NO PROVIDER ........ 1 2

No one to complete household chores. HOUSEHOLD CHORES . 1 2

554 Now I would like to ask you some questions about any injections
you have had in the last 12 months. Have you had an injection
for any reason in the last 12 months? NUMBER OF INJECTIONS ...

IF YES: How many injections have you had?


IF NUMBER OF INJECTIONS IS GREATER THAN 90, NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 557A
OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

358 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

555 Among these injections, how many were administered by a


doctor, a nurse, a pharmacist, a dentist, or any other NUMBER OF INJECTIONS ...
health worker?
IF NUMBER OF INJECTIONS IS GREATER THAN 90,
OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 557A
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

556 The last time you had an injection given to you by a health worker, PUBLIC SECTOR
where did you go to get the injection? GOVERNMENT HOSPITAL/CLINIC . 11
GOVT. HEALTH CENTER ........ 12
GOVT. HEALTH POST ........ 13
COMM. HEALTH AGENT ........ 14

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, OTHER PUBLIC 16


WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE (SPECIFY)
TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
NON-GOVT. (NGO) HEALTH FACILITY 21

PRIVATE MEDICAL SECTOR


PRIVATE HOSPITAL/CLINIC/
(NAME OF PLACE) DOCTOR ................... 31
DENTAL CLINIC/OFFICE ........ 32
PHARMACY ................... 33
OFFICE OR HOME OF NURSE/
HEALTH WORKER . . . . . . . . . . . . 34
OTHER PRIVATE
MEDICAL 36
(SPECIFY)
OTHER PLACE
AT HOME . . . . . . . . . . . . . . . . . . . . . 41

OTHER 96
(SPECIFY)

557 Did the person who gave you that injection take the syringe and YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
needle from a new, unopened package? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

557A Do you have a tetanus injection card(s)? YES, SEEN . . . . . . . . . . . . . . . . . . . . . . . 1


YES, NOT SEEN . . . . . . . . . . . . . . . . . . . 2
IF YES: NO CARD . . . . . . . . . . . . . . . . . . . . . . . 3 558
May I see it please?

557B (1) COPY VACCINATION DATE FOR EACH VACCINE FROM DAY MONTH YEAR
THE CARD STARTING WITH THE MOST RECENT.
(2) WRITE ‘44' IN ‘DAY' COLUMN IF CARD SHOWS THAT A
VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

Appendix E | 359
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

558 Do you currently smoke cigarettes? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 560

559 In the last 24 hours, how many cigarettes did you smoke?
CIGARETTES . . . . . . . . . . . . . .

560 Do you currently smoke or use any other type of tobacco YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
like gaya, shisha or suret? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 562

561 What (other) type of tobacco do you currently smoke or use? PIPE . . . . . . . . . . . . . . . . . . . . . . . . . . . A
CHEWING TOBACCO . . . . . . . . . . . . . . B
SNUFF/SURET . . . . . . . . . . . . . . . . . . . . . C
RECORD ALL MENTIONED SHISHA . . . . . . . . . . . . . . . . . . . . . . . . . D
GAYA ......................... E
OTHER X
(SPECIFY)

562 Have you ever heard of an illness called tuberculosis or TB? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 566

563 How does tuberculosis spread from one person to another? THROUGH THE AIR WHEN
COUGHING OR SNEEZING . . . . . . . . A
PROBE: Any other ways? THROUGH SHARING UTENSILS . . . . . . B
THROUGH TOUCHING A PERSON
RECORD ALL MENTIONED. WITH TB . . . . . . . . . . . . . . . . . . . . . . . C
THROUGH FOOD . . . . . . . . . . . . . . . . . D
THROUGH SEXUAL CONTACT . . . . . . E
THROUGH MOSQUITO BITES . . . . . . . . F

OTHER X
(SPECIFY)
DON’T' KNOW . . . . . . . . . . . . . . . . . . . . . Z

564 Can tuberculosis be cured? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

565 If a member of your family got tuberculosis, would you want it to YES, REMAIN A SECRET .......... 1
remain a secret or not? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/NOT SURE/
DEPENDS ..................... 8

360 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

566 CHECK 468:

HAS AT LEAST ONE CHILD DOES NOT HAVE ANY CHILDREN


BORN IN 1994 E.C. OR LATER BORN IN 1994 E.C.OR LATER 601
AND LIVING WITH HER AND LIVING WITH HER

567 Now I would like to ask you about the foods and liquids
you had yesterday during the day or at night, either separately
or combined with other foods or liquids.

Did (YOU) eat or drink: YES NO DK

a. Any porridge or gruel (made from grains other than teff)? a ....................... 1 2 8

b. Bread, pasta, rice, noodles, biscuits, cookies or any other


food made from oats, maize, barley, wheat, sorghum,millet,
or other grain? b ....................... 1 2 8

c. Any food made from teff, like injera, kita, or porridge? c ....................... 1 2 8

d. Any white potatoes, white yams, bulla, kocho, cassava, or any


other foods made from roots? d ....................... 1 2 8

e. Any pumpkin, carrots, squash, or sweet potatoes that


are yellow or orange inside? e ....................... 1 2 8

f. Any dark green, leafy vegetables like kale, spinach or


amaranth leaves? f ....................... 1 2 8

g. Any ripe mangoes, ripe papayas? g ....................... 1 2 8

h. Any other fruits or vegetables? h ....................... 1 2 8

i. Any liver, kidney, heart or other organ meats? i ....................... 1 2 8

j. Any beef, pork, lamb, goat, rabbit [or wild game meat such as
antelope or deer]? j ....................... 1 2 8

k. Any chicken, duck or other birds? k ....................... 1 2 8

l. Any eggs? l ....................... 1 2 8

m. Any fresh or dried fish or shellfish? m....................... 1 2 8

n. Any foods made from beans, peas, lentils or pulses? n ....................... 1 2 8

o. Any nuts or seeds such as peanuts, sesame or sunflower seeds? o ....................... 1 2 8

p. Any cheese, yogurt, milk or other milk products? p ....................... 1 2 8

q. Any foods made with oil, fat, or butter? q ....................... 1 2 8

r. Any tea or coffee? r ....................... 1 2 8

s. Any sugary foods or drinks, such as pastry, cakes,


chocolates, sweets or candies, sodas, fruit juices or drinks? s ....................... 1 2 8

Appendix E | 361
SECTION 6. MARRIAGE AND SEXUAL ACTIVITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

601 Are you currently married or living together with a man as if YES, CURRENTLY MARRIED . . . . . . . 1
married? YES, LIVING WITH A MAN . . . . . . . . . 2 605
NO, NOT IN UNION . . . . . . . . . . . . . . . . 3

602 Have you ever been married or lived together with a man YES, FORMERLY MARRIED . . . . . . . 1
as if married? YES, LIVED WITH A MAN . . . . . . . . . 2 604
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

603 ENTER '0' IN COLUMN 4 OF CALENDAR IN THE MONTH OF INTERVIEW, AND IN EACH MONTH BACK TO
MESKEREM 1992. 614

604 What is your marital status now: are you widowed, WIDOWED . . . . . . . . . . . . . . . . . . . . . . 1
divorced, or separated? DIVORCED . . . . . . . . . . . . . . . . . . . . . . 2 610
SEPARATED . . . . . . . . . . . . . . . . . . . . 3

605 Is your husband/partner living with you now or is he staying LIVING TOGETHER . . . . . . . . . . . . . . . . 1
elsewhere? STAYING ELSEWHERE . . . . . . . . . . . . 2

606 RECORD THE HUSBAND'S/PARTNER'S NAME AND LINE


NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NAME _____________________________
NOT LISTED IN THE HOUSEHOLD, RECORD '00'.
LINE NO. . . . . . . . . . . . . . . . . . .

607 Besides yourself, does your husband/partner have other YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


wives or does he live with women other than his wives NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
as if married? DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 610

608 How many other wives or partners does your husband OTHER NUMBER OF WIVES
live with now? AND LIVE-IN PARTNERS . . .

DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

609 Are you the first, second, … wife?


RANK . . . . . . . . . . . . . . . . . . . .
IF Q. 608 IS DON'T KNOW: Do you know your rank?
IF YES: Are you the first, second, … wife? DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

610 Have you been married or lived with a man only once or more ONLY ONCE . . . . . . . . . . . . . . . . . . . . 1
than once? MORE THAN ONCE .............. 2

611 CHECK 610:

MARRIED/ MARRIED/
LIVED WITH A MAN LIVED WITH A MAN MONTH ................
ONLY ONCE MORE THAN ONCE

In what month and year Now I would like to ask about DON'T KNOW MONTH . . . . . . . . . . . . 98
did you start living with when you started living with
your husband/partner? your first husband/partner.
In what month and year was that? YEAR . . . . . . . . . . . . 613

DON'T KNOW YEAR . . . . . . . . . . . . 9998

612 How old were you when you first started living with him?
AGE ....................

362 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

613 DETERMINE MONTHS MARRIED OR LIVING WITH A MAN SINCE MESKEREM 1992. ENTER 'X'
IN COLUMN 4 OF CALENDAR FOR EACH MONTH MARRIED OR LIVING WITH A MAN, AND ENTER 'O'
FOR EACH MONTH NOT MARRIED/NOT LIVING WITH A MAN, SINCE MESKEREM 1992.

FOR WOMEN WITH MORE THAN ONE UNION: PROBE FOR DATE WHEN CURRENT UNION STARTED AND,
IF APPROPRIATE, FOR STARTING AND TERMINATION DATES OF ANY PREVIOUS UNIONS.

FOR WOMEN NOT CURRENTLY IN UNION: PROBE FOR DATE WHEN LAST UNION STARTED AND FOR
TERMINATION DATE AND, IF APPROPRIATE, FOR THE STARTING AND TERMINATION DATES OF ANY
PREVIOUS UNIONS.

613A CHECK 604: IS RESPONDENT CURRENTLY WIDOWED?

NOT ASKED OR
NOT WIDOWED WIDOWED 613D

613B CHECK 610. MARRIED MORE MARRIED


THAN ONCE ONLY ONCE 614

613C How did your previous marriage or union end? DEATH/WIDOWHOOD ............ 1
DIVORCE . . . . . . . . . . . . . . . . . . . . . . 2
614
SEPARATION . . . . . . . . . . . . . . . . . . . . 3

613D Who did most of your late husband's property go to? RESPONDENT . . . . . . . . . . . . . . . . . . 1 614
OTHER WIFE . . . . . . . . . . . . . . . . . . . 2
SPOUSE'S CHILDREN . . . . . . . . . . . . 3
SPOUSE'S FAMILY . . . . . . . . . . . . . . . . 4
EQUAL SHARE WITH OTHERS . . . . . 5
OTHER _________________________ 6
(SPECIFY)
NO PROPERTY . . . . . . . . . . . . . . . . . . 7

613E Did you receive any of your late husband's assets YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
or valuables? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

614 CHECK FOR THE PRESENCE OF OTHERS.

BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

615 Now I need to ask you some questions about sexual activity in NEVER HAD SEX .............. 00
order to gain a better understanding of some family life issues.

How old were you when you had sexual intercourse for the AGE IN YEARS ............ 616A
very first time (if ever)?
FIRST TIME WHEN STARTED
LIVING WITH (FIRST)
HUSBAND/PARTNER . . . . . . . . . . . . 95 616A

616 Do you intend to wait until you get married to have sexual YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
intercourse for the first time? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 637
DON'T KNOW/UNSURE . . . . . . . . . . . . 8

616A CHECK COVER PAGE:

HOUSEHOLD HOUSEHOLD
SELECTED NOT SELECTED
FOR MALE SURVEY FOR MALE SURVEY 637

617 CHECK 105: 15-24 25-49


YEARS OLD YEARS OLD 622

618 The first time you had sexual intercourse, was a condom YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
used? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/DON'T REMEMBER . . . 8

619 How old was the person you first had sexual intercourse with?
AGE OF PARTNER . . . . . . . . . 622

DON'T KNOW . . . . . . . . . . . . . . . . . . 98

Appendix E | 363
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

620 Was this person older than you, younger than you, or about OLDER . . . . . . . . . . . . . . . . . . . . . . . . 1
the same age as you? YOUNGER . . . . . . . . . . . . . . . . . . . . . . 2
ABOUT THE SAME AGE ......... 3 622
DON'T KNOW/DON'T REMEMBER . . . 8

621 Would you say this person was ten or more years older than TEN OR MORE YEARS OLDER . . . . . 1
you or less than ten years older than you? LESS THAN TEN YEARS OLDER . . . 2
OLDER, UNSURE HOW MUCH . . . . . 3

622 When was the last time you had sexual intercourse?
DAYS AGO . . . . . . . . . . . . 1
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE 624
WAS ONE OR MORE YEARS AGO. WEEKS AGO ......... 2

IF 12 MONTHS OR MORE, ANSWER MUST BE MONTHS AGO ....... 3


RECORDED IN YEARS.
YEARS AGO ......... 4 636

364 | Appendix E
LAST SECOND-TO-LAST
NO. QUESTIONS AND FILTERS SEXUAL PARTNER SEXUAL PARTNER

623 When was the last time you had sexual


intercourse with this other person? DAYS AGO . . . . . 1

WEEKS AGO . . . . 2

MONTHS AGO . . . 3

624 The last time you had sexual intercourse YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1
(with this other person), was a condom NO . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . 2
used? (SKIP TO 626) (SKIP TO 626)

625 Did you use a condom every time YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1


you had sexual intercourse with this NO . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . 2
person in the last 12 months?

626 What was your relationship to this person SPOUSE . . . . . . . . . . . . . . . . . . 01 SPOUSE . . . . . . . . . . . . . . . . . . 01


with whom you had sexual intercourse? (SKIP TO 632) (SKIP TO 632)
LIVE-IN PARTNER . . . . . . . . . 02 LIVE-IN PARTNER . . . . . . . . . 02
BOYFRIEND/GIRLFRIEND BOYFRIEND/GIRLFRIEND
IF BOYFRIEND/GIRLFRIEND: NOT LIVING WITH NOT LIVING WITH
Were you living together as if RESPONDENT . . . . . . . . . . . . 03 RESPONDENT . . . . . . . . . . . . 03
married? CASUAL CASUAL
IF YES, CIRCLE '02' ACQUAINTANCE . . . . . . . . . 04 ACQUAINTANCE . . . . . . . . . 04
IF NO, CIRCLE '03' COMMERCIAL COMMERCIAL
SEX WORKER . . . . . . . . . . . . 05 SEX WORKER . . . . . . . . . . . . 05
OTHER __________________ 96 OTHER __________________ 96
(SPECIFY) (SPECIFY)

627 For how long (have you had/did you have) a


sexual relationship with this person? DAYS . . . . . . . . . 1 DAYS . . . . . . . . . 1

IF ONLY HAD SEXUAL MONTHS . . . . . . . 2 MONTHS . . . . . . . 2


RELATIONS WITH THIS PERSON
ONCE, RECORD '01' DAYS. YEARS ....... 3 YEARS ....... 3

628 CHECK 105: 15 - 24 YEARS 25 - 49 15 - 24 YEARS 25 - 49


OLD YEARS OLD YEARS
OLD OLD
(SKIP TO 632) (SKIP TO 632)

629 How old is this person? AGE AGE


OF PARTNER . . . . . . . OF PARTNER . . . . . . .
(SKIP TO 632) (SKIP TO 632)
DON'T KNOW . . . . . . . . . . . . . . 98 DON'T KNOW . . . . . . . . . . . . . . 98

630 Is this person older than you, OLDER . . . . . . . . . . . . . . . . 1 OLDER . . . . . . . . . . . . . . . . 1


younger than you, or about the YOUNGER . . . . . . . . . . . . . . 2 YOUNGER . . . . . . . . . . . . . . 2
same age? ABOUT THE SAME AGE . 3 ABOUT THE SAME AGE . 3
DON'T KNOW . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . 8
(SKIP TO 632) (SKIP TO 632)

631 Would you say this person is ten TEN OR MORE TEN OR MORE
or more years older than you or YEARS OLDER . . . . . . . . . 1 YEARS OLDER . . . . . . . . . 1
less than ten years older than you? LESS THAN TEN LESS THAN TEN
YEARS OLDER . . . . . . . . . 2 YEARS OLDER . . . . . . . . . 2
OLDER, UNSURE OLDER, UNSURE
HOW MUCH . . . . . . . . . . . . 3 HOW MUCH . . . . . . . . . . . . 3

Appendix E | 365
LAST SECOND-TO-LAST
NO. QUESTIONS AND FILTERS SEXUAL PARTNER SEXUAL PARTNER

632 The last time you had sexual intercourse YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1
(with this other person), did you or this NO . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . 2
person drink alcohol? (SKIP TO 634) (SKIP TO 635)

633 Were you or your partner drunk RESPONDENT ONLY ..... 1 RESPONDENT ONLY ...... 1
at that time? PARTNER ONLY ......... 2 PARTNER ONLY .......... 2
RESPONDENT AND RESPONDENT AND
IF YES: Who was drunk? PARTNER BOTH ....... 3 PARTNER BOTH ........ 3
NEITHER . . . . . . . . . . . . . . . . . . 4 NEITHER ................ 4

634 Apart from this person, have you had YES . . . . . . . . . . . . . . . . . . . . . . 1


sexual intercourse with any other person (GO BACK TO 623
in the last 12 months? IN NEXT COLUMN)
NO . . . . . . . . . . . . . . . . . . . . . . 2
(SKIP TO 636)

366 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

635 In total, with how many different people have you had sexual NUMBER OF PARTNERS
intercourse in the last 12 months? LAST 12 MONTHS . . . . . . . . . .

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

IF NUMBER OF PARTNERS IS GREATER THAN 95,


WRITE '95.'

636 In total, with how many different people have you had sexual NUMBER OF PARTNERS
intercourse in your lifetime? IN LIFETIME . . . . . . . . . . . . . . . .

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

IF NUMBER OF PARTNERS IS GREATER THAN 95,


WRITE '95.'

637 Do you know of a place where a person can get condoms? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 701

638 Where is that? PUBLIC SECTOR


GOVT. HOSPITAL . . . . . . . . . . . . A
GOVT. HEALTH CENTER ...... B
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, GOVT. HEALTH POST ........ C
WRITE THE NAME OF THE PLACE. GOVT. HEALTH STATION/CLINIC D
PROBE TO IDENTIFY THE TYPE OF SOURCE CBD ....................... E
AND CIRCLE THE APPROPRIATE CODE. OTHER PUBLIC ________________ F
(SPECIFY)
NON GOVT (NGO)
NGO HEALTH FACILITY . . . . . . . . G
CBD/CBRHA . . . . . . . . . . . . . . . . H
OTHER NGO ________________ I
(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . . . J
Any other place? PHARMACY . . . . . . . . . . . . . . . . . . . . . K
OTHER PRIVATE
MEDICAL L
RECORD ALL SOURCES MENTIONED. (SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . M
SHOP ..................... N
FRIEND/RELATIVE . . . . . . . . . . . . O
OTHER _____________________ X
(SPECIFY)

639 If you wanted to, could you yourself get a condom? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/UNSURE . . . . . . . . . . . . 8

Appendix E | 367
SECTION 7. FERTILITY PREFERENCES

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

701 CHECK 311/311A:

NEITHER HE OR SHE
STERILIZED STERILIZED 713
OR NOT ASKED

702 CHECK 226:

NOT PREGNANT PREGNANT


OR UNSURE

Now I have some questions Now I have some questions HAVE (A/ANOTHER) CHILD ........ 1
about the future. about the future. NO MORE/NONE ................ 2 704
Would you like to have After the child you are SAYS SHE CAN'T GET PREGNANT . 3 713
(a/another) child, or would you expecting now, would you like UNDECIDED/DON'T KNOW:
prefer not to have any (more) to have another child, or would AND PREGNANT . . . . . . . . . . . . . . . . 4 709
children? you prefer not to have any AND NOT PREGNANT
more children? OR UNSURE . . . . . . . . . . . . . . . . 5 708

703 CHECK 226:


MONTHS . . . . . . . . . . . . . . 1
NOT PREGNANT PREGNANT
OR UNSURE YEARS .............. 2

How long would you like to wait After the birth of the child you SOON/NOW . . . . . . . . . . . . . . . . . . . 993 708
from now before the birth of are expecting now, how long SAYS SHE CAN'T GET PREGNANT 994 713
(a/another) child? would you like to wait before AFTER MARRIAGE . . . . . . . . . . . . . . 995
the birth of another child?
OTHER _______________________ 996 708
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

704 CHECK 226:

NOT PREGNANT PREGNANT


OR UNSURE 709

705 CHECK 310: USING A CONTRACEPTIVE METHOD?

NOT NOT CURRENTLY


ASKED CURRENTLY USING 713
USING

706 CHECK 703:

NOT 24 OR MORE MONTHS 00-23 MONTHS


ASKED OR 02 OR MORE YEARS OR 00-01 YEAR 709

368 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

707 CHECK 702: NOT MARRIED ................... A

WANTS TO HAVE WANTS NO MORE/ FERTILITY-RELATED REASONS


A/ANOTHER CHILD NONE NOT HAVING SEX . . . . . . . . . . . . . . B
INFREQUENT SEX . . . . . . . . . . . . . . C
MENOPAUSAL/HYSTERECTOMY . D
You have said that you do not You have said that you do not SUBFECUND/INFECUND ........ E
want (a/another) child soon, but want any (more) children, but POSTPARTUM AMENORRHEIC . . . F
you are not using any method to you are not using any method to BREASTFEEDING . . . . . . . . . . . . . . G
avoid pregnancy. avoid pregnancy. FATALISTIC ................... H

Can you tell me why you are Can you tell me why you are OPPOSITION TO USE
not using a method? not using a method? RESPONDENT OPPOSED . . . . . . . . I
HUSBAND/PARTNER OPPOSED . J
Any other reason? Any other reason? OTHERS OPPOSED ............ K
RELIGIOUS PROHIBITION . . . . . . . . L

RECORD ALL REASONS MENTIONED. LACK OF KNOWLEDGE


KNOWS NO METHOD . . . . . . . . . . . . M
KNOWS NO SOURCE . . . . . . . . . . . . N

METHOD-RELATED REASONS
HEALTH CONCERNS . . . . . . . . . . . . O
FEAR OF SIDE EFFECTS ........ P
LACK OF ACCESS/TOO FAR . . . . . . Q
COSTS TOO MUCH ............ R
INCONVENIENT TO USE ........ S
INTERFERES WITH BODY'S
NORMAL PROCESSES . . . . . . . . T
METHOD NOT AVAILABLE . . . . . . . . U

OTHER _______________________ X
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . Z

708 CHECK 310: USING A CONTRACEPTIVE METHOD?

NOT NO, YES,


ASKED NOT CURRENTLY USING CURRENTLY USING 713

709 Do you think you will use a contraceptive method to delay or avoid YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
pregnancy at any time in the future? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8 711

710 Which contraceptive method would you prefer to use? FEMALE STERILIZATION .......... 01
MALE STERILIZATION ............ 02
PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
INJECTABLES . . . . . . . . . . . . . . . . . . . . . 05
IMPLANTS . . . . . . . . . . . . . . . . . . . . . . . 06
CONDOM ....................... 07
DIAPHRAGM/FOAM/JELLY . . . . . . . . . . 09 713
STANDARD DAYS METHOD . . . . . . . . 10
LACTATIONAL AMEN. METHOD . . . . . . 11
RHYTHM METHOD . . . . . . . . . . . . . . . . 12
WITHDRAWAL ................... 13

OTHER _______________________ 96
(SPECIFY)
UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . 98

Appendix E | 369
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

711 What is the main reason that you think you will not use a NOT MARRIED ................ 11
contraceptive method at any time in the future?
FERTILITY-RELATED REASONS
INFREQUENT SEX/NO SEX ... 22
MENOPAUSAL/HYSTERECTOMY 23
SUBFECUND/INFECUND ...... 24
WANTS AS MANY CHILDREN AS
POSSIBLE . . . . . . . . . . . . . . . . 26

OPPOSITION TO USE
RESPONDENT OPPOSED . . . . . . 31
HUSBAND/PARTNER OPPOSED 32
OTHERS OPPOSED .......... 33
RELIGIOUS PROHIBITION . . . . . . 34

LACK OF KNOWLEDGE
KNOWS NO METHOD . . . . . . . . . . 41 713
KNOWS NO SOURCE . . . . . . . . . . 42

METHOD-RELATED REASONS
HEALTH CONCERNS . . . . . . . . . . 51
FEAR OF SIDE EFFECTS ...... 52
LACK OF ACCESS/TOO FAR . . . 53
COSTS TOO MUCH .......... 54
INCONVENIENT TO USE . . . . . . . . 55
INTERFERES WITH BODY'S
NORMAL PROCESSES . . . . . . 56
METHOD NOT AVAILABLE . . . . . . 57

OTHER _______________________ 96
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

712 Would you ever use a contraceptive method if you were married? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

713 CHECK 216:

HAS LIVING CHILDREN NO LIVING CHILDREN


NONE . . . . . . . . . . . . . . . . . . . . . . . . . 00 715
If you could go back to the time If you could choose exactly the
you did not have any children number of children to have in NUMBER . . . . . . . . . . . . . . . . . . .
and could choose exactly the your whole life, how many
number of children to have in would that be?
your whole life, how many OTHER _______________________ 96 715
would that be? (SPECIFY)
PROBE FOR A NUMERIC RESPONSE.

714 How many of these children would you like to be boys, how many BOYS GIRLS EITHER
would you like to be girls and for how many would the sex not
matter? NUMBER

OTHER _______________________ 96
(SPECIFY)

715 In the last few months have you heard about family planning: YES NO

On the radio? RADIO . . . . . . . . . . . . . . . . . . . . . . . 1 2


On the television? TELEVISION . . . . . . . . . . . . . . . . 1 2
In a newspaper or magazine? NEWSPAPER OR MAGAZINE . . . 1 2
In a pamphlet/poster/leaflets/booklets? PAMPHLET, ETC. . . . . . . . . . . . . 1 2
At a community event? COMMUNITY EVENT . . . . . . . . . . 1 2

370 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

717 CHECK 601:

YES, YES, NO,


CURRENTLY LIVING NOT IN 723
MARRIED WITH A MAN UNION

718 CHECK 311/311A:

NEITHER CODE B, NOR CODE B, OR G, OR L


NOR CODE G, NOR CODE L CIRCLED
CIRCLED, BUT ANY OTHER 720
CODE(S) NO CODE
CIRCLED CIRCLED 722

719 Does your husband/partner know that you are using YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
a method of family planning? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

720 Would you say that using contraception is mainly your MAINLY RESPONDENT .......... 1
decision, mainly your husband's/partner's decision, or did MAINLY HUSBAND/PARTNER ...... 2
you both decide together? JOINT DECISION ................ 3
OTHER 6
(SPECIFY)

721 CHECK 311/311A:

NEITHER HE OR SHE
STERILIZED STERILIZED 723
OR NOT ASKED

722 Do you think your husband/partner wants the same number of SAME NUMBER . . . . . . . . . . . . . . . . . . . 1
children that you want, or does he want more or fewer than you MORE CHILDREN . . . . . . . . . . . . . . . . 2
want? FEWER CHILDREN . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

723 Husbands and wives do not always agree on everything. Please


tell me if you think a wife is justified in refusing to have sex with
her husband when:
YES NO DK
She knows her husband has a disease that can be
transmitted through sexual contact? DISEASE SEXUAL CONTACT 1 2 8
She knows her husband has sex with other women? OTHER WOMEN . . . . . . . . . . 1 2 8
She is tired or not in the mood? TIRED/NOT IN MOOD . . . . . . 1 2 8

723A When a wife knows her husband has a disease that can YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
be transmitted through sexual contact, is she justified in NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
asking that they use a condom when they have sex? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

723B CHECK 601:


CURRENTLY MARRIED/ NOT IN UNION 801
LIVING WITH A MAN

723C Can you say no to your husband/partner if you do not YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


want to have sexual intercourse? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DEPENDS/UNSURE .............. 8

723D Could you ask your husband/partner to use a condom YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


it you wanted him to? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DEPENDS/UNSURE .............. 8

Appendix E | 371
SECTION 8. HUSBAND'S BACKGROUND AND WOMAN'S WORK

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

801 CHECK 601 AND 602:

CURRENTLY FORMERLY 803


MARRIED/ MARRIED/ NEVER MARRIED
LIVING WITH LIVED WITH AND NEVER 807
A MAN A MAN LIVED WITH A MAN

802 How old was your husband/partner on his last birthday?


AGE IN COMPLETED YEARS

803 Did your (last) husband/partner ever attend school? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 806

805 What was the highest grade he completed?


GRADE ................

TECH./VOC. CERTIFICATE . . . . . . . . . . 13
UNIVERSITY/COLLEGE DIPLOMA . . . 14
UNIVERSITY/COLLEGE DEGREE . . . . . . 15
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

806 CHECK 801:

CURRENTLY MARRIED/ FORMERLY MARRIED/


LIVING WITH A MAN LIVED WITH A MAN

What is your husband's/partner's What was your (last) husband's/


occupation? partner's occupation?
That is, what kind of work does That is, what kind of work did he
he mainly do? mainly do?

807 Aside from your own housework, have you done any work YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 811
in the last seven days? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

808 As you know, some women take up jobs for which they are paid
in cash or kind. Others sell things, have a small business or
work on the family farm or in the family business. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 811
In the last seven days, have you done any of these things NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
or any other work?

809 Although you did not work in the last seven days, do you have
any job or business from which you were absent for leave, YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 811
illness, vacation, maternity leave or any other such reason? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

810 Have you done any work in the last 12 months? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 811
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

810A What have you been doing for most of the time over the last GOING TO SCHOOL/STUDYING . . . . . . 01
12 months? LOOKING FOR WORK ............ 02
RETIRED . . . . . . . . . . . . . . . . . . . . . . . . . 03
TOO ILL TO WORK .............. 04 818
HANDICAPPED, CANNOT WORK ... 05
HOUSEWORK/CHILD CARE ........ 06

OTHER _________________________ 96
(SPECIFY)

811 What is your occupation, that is, what kind of work do you mainly
do?

372 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

812 CHECK 811:

WORKS IN DOES NOT WORK


AGRICULTURE IN AGRICULTURE 814

813 Do you work mainly on your own land or on family land, or do you OWN LAND . . . . . . . . . . . . . . . . . . . . . . . 1
work on land that you rent from someone else, or do you work on FAMILY LAND . . . . . . . . . . . . . . . . . . . . . 2
someone else's land? RENTED LAND . . . . . . . . . . . . . . . . . . . 3
SOMEONE ELSE'S LAND .......... 4
DOES NOT WORK ON LAND . . . . . . . . 5

814 Do you do this work for a member of your family, for someone FOR FAMILY MEMBER ............ 1
else, or are you self-employed? FOR SOMEONE ELSE ............ 2
SELF-EMPLOYED ............ 3

815 Do you usually work at home or away from home? HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


AWAY . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

816 Do you usually work throughout the year, or do you work THROUGHOUT THE YEAR . . . . . . . . . . 1
seasonally, or only once in a while? SEASONALLY/PART OF THE YEAR . 2
ONCE IN A WHILE . . . . . . . . . . . . . . . . 3

817 Are you paid in cash or kind for this work or are you not paid at all? CASH ONLY . . . . . . . . . . . . . . . . . . . . . 1
CASH AND KIND . . . . . . . . . . . . . . . . . . . 2
IN KIND ONLY . . . . . . . . . . . . . . . . . . . . . 3
NOT PAID . . . . . . . . . . . . . . . . . . . . . . . 4

818 CHECK 601:


CURRENTLY
MARRIED/LIVING NOT IN UNION
WITH A MAN 825

819 CHECK 817:

CODE 1 OR 2 OTHER/
CIRCLED NOT ASKED 822

820 Who decides how the money you earn will be used: RESPONDENT ................... 1
mainly you, mainly your husband/partner, or you and your HUSBAND/PARTNER . . . . . . . . . . . . . . 2
husband/partner jointly? RESPONDENT AND
HUSBAND/PARTNER JOINTLY . . . 3
OTHER . . . . . . . . . . . . . . . . . . . . . . . . . 6

821 Would you say that the money that you bring into the household MORE THAN HIM . . . . . . . . . . . . . . . . . . . 1
is more than what your husband/partner brings in, less than LESS THAN HIM . . . . . . . . . . . . . . . . . . . 2
what he brings in, or about the same? ABOUT THE SAME . . . . . . . . . . . . . . . . 3
HUSBAND/PARTNER DOESN'T
BRING IN ANY MONEY . . . . . . . . . . 4 823
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

Appendix E | 373
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

822 Who decides how your husband's/partner's earnings will be used: RESPONDENT ................... 1
mainly you, mainly your husband/partner, or you and your HUSBAND/PARTNER . . . . . . . . . . . . . . 2
husband/partner jointly? RESPONDENT AND
HUSBAND/PARTNER JOINTLY . . . 3
HUSBAND/PARTNER DOESN'T
BRING IN ANY MONEY . . . . . . . . . . 4
OTHER . . . . . . . . . . . . . . . . . . . . . . . . . 6

RESPONDENT = 1
HUSBAND/PARTNER = 2
RESPONDENT & HUSBAND/PARTNER JOINTLY = 3
823 Who usually makes decisions about health care for yourself: SOMEONE ELSE = 4
OTHER = 5
mainly you, mainly your husband/partner, you and your
husband/partner jointly, or someone else? 1 2 3 4 5

Who usually makes decisions about making major


household purchases? 1 2 3 4 5

Who usually makes decisions about making purchases


for daily household needs? 1 2 3 4 5

Who usually makes decisions about visits to your family


or relatives? 1 2 3 4 5

825 Sometimes a husband is annoyed or angered by things that his


wife does. In your opinion, is a husband justified in hitting or
beating his wife in the following situations: YES NO DK

If she goes out without telling him? GOES OUT . . . . . . . . . . 1 2 8


If she neglects the children? NEGL. CHILDREN . . . 1 2 8
If she argues with him? ARGUES . . . . . . . . . . . . 1 2 8
If she refuses to have sex with him? REFUSES SEX . . . . . . 1 2 8
If she burns the food? BURNS FOOD . . . . . . . . 1 2 8

374 | Appendix E
SECTION 9. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

901 Now I would like to talk about something else. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


Have you ever heard of an illness called AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 917

902 Can people reduce their chances of getting the AIDS virus YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
by having just one sex partner who is not infected and who has NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
no other partners? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

903 Can people get the AIDS virus from mosquito bites? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

904 Can people reduce their chances of getting the AIDS virus by YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
using a condom every time they have sex? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

905 Can people get the AIDS virus by sharing food with a person who YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
has AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

906 Can people reduce their chance of getting the AIDS virus by YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
abstaining from sexual intercourse? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

907 Can people get the AIDS virus because of the curse of God or other YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
supernatural means? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

908 Is there anything else a person can do to avoid or reduce the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
chances of getting the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8 910

909 What can a person do? ABSTAIN FROM SEX . . . . . . . . . . . . . . A


USE CONDOMS . . . . . . . . . . . . . . . . . . . B
LIMIT SEX TO ONE PARTNER/STAY
FAITHFUL TO ONE PARTNER ... C
LIMIT NUMBER OF SEXUAL
Anything else? PARTNERS . . . . . . . . . . . . . . . . . . . . . D
AVOID SEX WITH PROSTITUTES . . . E
AVOID SEX WITH PERSONS WHO
HAVE MANY PARTNERS ........ F
AVOID SEX WITH HOMOSEXUALS . G
RECORD ALL WAYS MENTIONED. AVOID SEX WITH PERSONS WHO
INJECT DRUGS . H
AVOID BLOOD TRANSFUSIONS . . . . . . I
AVOID INJECTIONS .............. J
AVOID SHARING RAZORS/BLADES . K
AVOID KISSING . . . . . . . . . . . . . . . . . . . L
AVOID MOSQUITO BITES . . . . . . . . . . M
SEEK PROTECTION FROM
TRADITIONAL PRACTITIONER . . . N

OTHER _______________________ W
(SPECIFY)

OTHER _______________________ X
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . Z

910 Is it possible for a healthy-looking person to have the AIDS virus? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

Appendix E | 375
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

910A CHECK COVER PAGE:

HOUSEHOLD HOUSEHOLD
SELECTED NOT SELECTED
FOR MALE SURVEY FOR MALE SURVEY 911

910B Can the virus that causes AIDS be transmitted from a mother to
her baby: YES NO DK
During pregnancy? DURING PREG. . . . . . . 1 2 8
During delivery? DURING DELIVERY . . . 1 2 8
By breastfeeding? BREASTFEEDING . . . 1 2 8

910C CHECK 910B:


AT LEAST OTHER
ONE 'YES' 910E

910D Are there any special medications that a doctor or a nurse can YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
give to a woman infected with the AIDS virus to reduce the risk NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
of transmission to the baby? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

910E Is there any special medication that people infected with YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the AIDS virus can get from a doctor or a nurse? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

910F CHECK 215: NO BIRTHS


910O
LAST BIRTH SINCE LAST BIRTH BEFORE
MESKEREM 1995 MESKEREM 1995 910O

910G CHECK 407: SEE ANYONE FOR ANTENATAL CARE DURING THAT PREGNANCY?

YES,
PERSON SEEN NO ONE 910O

910H During any of the antenatal visits for that pregnancy, did
anyone talk to you about: YES NO DK

Babies getting the AIDS virus from their mother? AIDS FROM MOTHER 1 2 8
Things that you can do to prevent getting the AIDS virus? THINGS TO DO . 1 2 8
Getting tested for the AIDS virus? TESTED FOR AIDS . 1 2 8

910I Were you offered a test for the AIDS virus as part of your YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
antenatal care? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

910J I don't want to know the results, but were you tested for the AIDS YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
virus as part of your antenatal care? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 910O

910K I don't want to know the results, but did you get the results of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the test? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

376 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

910L Where was the test done? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC 11
GOVT. HEALTH CENTER . . . . . . . 12
VCT CENTER . . . . . . . . . . . . . . . . 13
GOVT. HEALTH POST . . . . . . . . . 14
FAMILY PLANNING CLINIC . . . . . . . 15
STAND ALONE VCT CENTER . . . . . . 16
OTHER PUBLIC 17
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY 21


STAND ALONE VCT CENTER . . . . . . . . 22

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, PRIVATE MEDICAL SECTOR


WRITE THE NAME OF THE SOURCE. PRIVATE HOSPITAL/CLINIC/
PROBE TO IDENTIFY THE TYPE OF SOURCE AND DOCTOR . . . . . . . . . . . . . . . . . . . . . 31
CIRCLE THE APPROPRIATE CODE. STAND ALONE VCT CENTER . . . . . . 32
OTHER PRIVATE
MEDICAL 36
(NAME OF PLACE) (SPECIFY)
OTHER 96
(SPECIFY)

910M Have you been tested for the AIDS virus since that time you YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 910P
were tested during your pregnancy? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

910N When was the last time you were tested for the AIDS virus? LESS THAN 12 MONTHS AGO ...... 1
12 - 23 MONTHS AGO . . . . . . . . . . . . . . 2 912A
2 OR MORE YEARS AGO .......... 3

910O I don't want to know the results, but have you ever been tested YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
to see if you have the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 911

910P When was the last time you were tested? LESS THAN 12 MONTHS AGO ...... 1
12 - 23 MONTHS AGO . . . . . . . . . . . . . . 2
2 OR MORE YEARS AGO .......... 3

910Q The last time you had the test, did you yourself ask for the test, ASKED FOR THE TEST . . . . . . . . . . . . 1
was it offered to you and you accepted, or was it required? OFFERED AND ACCEPTED ........ 2
REQUIRED . . . . . . . . . . . . . . . . . . . . . . . 3

910R I don't want to know the results, but did you get the results of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the test? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

910S Where was the test done? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC 11
GOVT. HEALTH CENTER . . . . . . . 12
VCT CENTER . . . . . . . . . . . . . . . . 13
GOVT. HEALTH POST . . . . . . . . . 14
FAMILY PLANNING CLINIC . . . . . . . 15
STAND ALONE VCT CENTER . . . . . . 16
OTHER PUBLIC 17
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY 21 912A


STAND ALONE VCT CENTER . . . . . . . . 22

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, PRIVATE MEDICAL SECTOR


WRITE THE NAME OF THE PLACE. PRIVATE HOSPITAL/CLINIC/
PROBE TO IDENTIFY THE TYPE OF SOURCE AND DOCTOR . . . . . . . . . . . . . . . . . . . . . 31
CIRCLE THE APPROPRIATE CODE. STAND ALONE VCT CENTER . . . . . . 32
OTHER PRIVATE
MEDICAL 36
(NAME OF PLACE) (SPECIFY)
OTHER 96
(SPECIFY)

Appendix E | 377
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

911 Do you know of a place where people can go to get tested for YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the virus that causes AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 912A

912 Where is that? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC A
GOVT. HEALTH CENTER ....... B
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, VCT CENTER . . . . . . . . . . . . . . . . C
WRITE THE NAME OF THE PLACE. GOVT. HEALTH POST ......... D
PROBE TO IDENTIFY THE TYPE OF SOURCE FAMILY PLANNING CLINIC . . . . . . . E
AND CIRCLE THE APPROPRIATE CODE. STAND ALONE VCT CENTER . . . F
OTHER PUBLIC G
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY H


STAND ALONE VCT CENTER . . . . . . . . I
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/
Any other place? DOCTOR . . . . . . . . . . . . . . . . . . . . . J
STAND ALONE VCT CENTER . . . . K
OTHER PRIVATE
RECORD ALL SOURCES MENTIONED. MEDICAL L
(SPECIFY)
OTHER M
(SPECIFY)

912A In the last few months have you heard or seen the following media YES NO
messages on HIV/AIDS?
Value your life! VALUE YOUR LIFE . . . . . . . . . . . . 1 2
Stop stigma and discrimination! STOP STIGMA . . . . . . . . . . . . . . . . 1 2
Harmful traditional practices expose to HIV/AIDS! HARMFUL TRAD. PRACTICES . . . 1 2
Live and let live! LIVE AND LET LIVE . . . . . . . . . . . . 1 2
Care and support people living with HIV/AIDS! CARE AND SUPPORT . . . . . . . . . . 1 2
I care, do you? I CARE DO YOU . . . . . . . . . . . . . . 1 2
Let us take care of each other! LET US TAKE CARE . . . . . . . . . . 1 2
Let us fight HIV/AIDS together! LET US FIGHT HIV/AIDS . . . . . . . . 1 2
Abstain from sex before marriage! ABSTAIN FROM SEX . . . . . . . . . . 1 2

913 Would you buy fresh vegetables from a shopkeeper or vendor YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
if you knew that this person had the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

914 If a member of your family got infected with the AIDS virus, YES, REMAIN A SECRET .......... 1
would you want it to remain a secret or not? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . . 8

915 If a relative of yours became sick with the virus that causes AIDS, YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
would you be willing to care for her or him in your own household? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . . 8

916 In your opinion, if a female teacher has the AIDS virus but SHOULD BE ALLOWED . . . . . . . . . . . . 1
is not sick, should she be allowed to continue teaching SHOULD NOT BE ALLOWED . . . . . . . . 2
in the school? DK/NOT SURE/DEPENDS . . . . . . . . . . 8

916A CHECK COVER PAGE:

HOUSEHOLD HOUSEHOLD
SELECTED NOT SELECTED
FOR MALE SURVEY FOR MALE SURVEY 917

916B Do you personally know someone who is suspected YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


to have the AIDS virus or who has the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 916F

916C Do you personally know someone who has been denied YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
health services in the last 12 months because he or she NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
is suspected to have the AIDS virus or has the AIDS virus?

378 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

916D Do you personally know someone who has been denied YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
involvement in social events, religious services, or community NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
events in the last 12 months because he or she is
suspected to have the AIDS virus or has the AIDS virus?

916E Do you personally know someone who has been verbally YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
abused or teased in the last 12 months because he or she NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
is suspected to have the AIDS virus or has the AIDS virus?

916F Do you agree or disagree with the following statement: AGREE . . . . . . . . . . . . . . . . . . . . . . . . . 1


People with the AIDS virus should be ashamed of themselves. DISAGREE . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/NO OPINION ........ 8

916G Do you agree or disagree with the following statement: AGREE . . . . . . . . . . . . . . . . . . . . . . . . . 1


People with the AIDS virus should be blamed for bringing the DISAGREE . . . . . . . . . . . . . . . . . . . . . . . 2
disease into the community. DON'T KNOW/NO OPINION ........ 8

916H Should children age 12-14 be taught about using a condom YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
to avoid AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . . 8

916I Should children age 12-14 be taught to wait until they get YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
married to have sexual intercourse in order to avoid AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . . 8

917 CHECK 901:

HEARD ABOUT NOT HEARD


AIDS ABOUT AIDS

Apart from AIDS, have you Have you heard about infections YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
heard about other infections that can be transmitted through
that can be transmitted sexual contact? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
through sexual contact?

918 CHECK 615:


HAS HAD SEXUAL HAS NOT HAD SEXUAL
INTERCOURSE INTERCOURSE 1001

919 CHECK 917: HEARD ABOUT OTHER SEXUALLY TRANSMITTED INFECTIONS?

YES NO 921

920 Now I would like to ask you some questions about your health in YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the last 12 months. During the last 12 months, have you had a NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
disease which you got through sexual contact? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

921 Sometimes women experience a bad smelling abnormal genital YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


discharge. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
During the last 12 months, have you had a bad smelling abnormal DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8
genital discharge?

922 Sometimes women have a genital sore or ulcer. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


During the last 12 months, have you had a genital sore or ulcer? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

Appendix E | 379
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

923 CHECK 920, 921, AND 922:


HAS HAD AN HAS NOT HAD AN
INFECTION INFECTION OR 1001
(ANY 'YES') DOES NOT KNOW

924 The last time you had (PROBLEM FROM 920/921/922), YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
did you seek any kind of advice or treatment? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1001

925 Where did you go? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC A
GOVT. HEALTH CENTER ....... B
Any other place? VCT CENTER . . . . . . . . . . . . . . . . C
GOVT. HEALTH POST ......... D
RECORD ALL SOURCES MENTIONED. FAMILY PLANNING CLINIC . . . . . . . E
STAND ALONE VCT CENTER . . . . . . F
OTHER PUBLIC G
(SPECIFY)
NON-GOVT. (NGO) HEALTH FACILITY H
STAND ALONE VCT CENTER . . . . . . . . I

PRIVATE MEDICAL SECTOR


PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . . . J
STAND ALONE VCT CENTER K
PHARMACY ................ L
OTHER PRIVATE
MEDICAL M
(SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . . . N
SHOP . . . . . . . . . . . . . . . . . . . . . . . . . O
TRADITIONAL HEALER . . . . . . . . . . P
OTHER X
(SPECIFY)

380 | Appendix E
SECTION 10. HARMFUL TRADITIONAL PRACTICES
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

1001 Have you ever heard of female circumcision? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1011
IF NO PROBE: Have you ever heard of the practice in which a
girl may have parts of her genitals cut?

1002 Have you yourself ever been circumcised? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1004
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1003 In some parts of Ethiopia, there is a type of circumcision where the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
genital area is sewn closed. Was this done to you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1004 CHECK 214 AND 216:

HAS ONE HAS MORE THAN HAS NO LIVING


LIVING DAUGHTER ONE LIVING DAUGHTER DAUGHTER 1010

1005 CHECK 1004:

ONE LIVING MORE THAN ONE


DAUHTER LIVING DAUGHTER

Has your daughter Have any of your daughters NUMBER CIRCUMCISED ...
been circumcised? been circumcised?
NO DAUGHTER CIRCUMCISED . . . . . . 95 1010
IF YES: RECORD '01' IF YES: How many?
RECORD NUMBER

1006 To which of your daughters did this happen (most recently)?


DAUGHTER'S LINE NUMBER
_____________________________ FROM 212 .................
(DAUGHTER'S NAME)

CHECK 212 AND RECORD THE LINE NUMBER FOR THE


DAUGHTER.

1007 Was (NAME OF DAUGHTER FROM 1006) genital area sewn YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
closed? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1008 How old was (NAME) when this occurred?


AGE IN COMPLETED YEARS .
IF THE RESPONDENT DOES NOT KNOW THE AGE, PROBE TO
GET AN ESTIMATE. DURING INFANCY . . . . . . . . . . . . . . . . 95
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

1009 Who did the circumcision? TRADITIONAL


TRAD. CIRCUMCISER ...... 1
TRAD. BIRTH ATTENDANT . . . . . . . . 2
OTHER TRAD. 3
(SPECIFY)
HEALTH PROFESSIONAL . . . . . . . . 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1010 Do you think that this practice should be continued or should it CONTINUED . . . . . . . . . . . . . . . . . . . . . 1
be discontinued? DISCONTINUED . . . . . . . . . . . . . . . . . . . 2
DEPENDS . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1011 Have you ever heard of uvulectomy/tonsillectomy? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1016
IF NO PROBE: Have you ever heard of the practice in which a
child may have parts of her or his uvula cut or tonsils scraped?

1012 Have you yourself ever had an uvulectomy or tonsillectomy? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

Appendix E | 381
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

1013 CHECK 216:

HAS AT LEAST HAS NO


ONE LIVING CHILD LIVING CHILD 1015

1014 Have any of your children ever had an uvulectomy or tonsillectomy?


NUMBER . . . . . . . . . . . . . . . . . . .
IF YES: How many?
NO CHILD . . . . . . . . . . . . . . . . . . . . . . . 95

1015 Do you think that this practice should be continued or should it CONTINUED . . . . . . . . . . . . . . . . . . . . . 1
be discontinued? DISCONTINUED . . . . . . . . . . . . . . . . . . . 2
DEPENDS . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1016 Have you ever heard of marriage by abduction? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1021
IF NO PROBE: Have you ever heard of the practice in which a girl
is abducted and forced into marriage?

1016A CHECK 601 AND 602:


EVER MARRIED/ NEVER MARRIED/
EVER IN UNION NEVER IN UNION
1018

1017 Were you yourself married by abduction? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

1018 CHECK 214, 215 AND 216:

HAS AT LEAST HAS NO


ONE LIVING DAUGHTER LIVING DAUGHTER/ 1020
AGE 10 AND ABOVE DAUGHTER BELOW AGE 10

1019 Have any of your daughters ever been married by abduction?


NUMBER .................
IF YES: How many?
NO DAUGHTER . . . . . . . . . . . . . . . . . 95

1020 Do you think that this practice should be continued or should it CONTINUED . . . . . . . . . . . . . . . . . . . . . 1
be discontinued? DISCONTINUED . . . . . . . . . . . . . . . . . . . 2
DEPENDS . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

1021 Have you ever heard of obstetric fistula (USE LOCAL TERM)? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1101
IF NO PROBE: Have you ever heard of a condition in which a
woman continuously leaks urine and/or faeces following
childbirth?

1022 Have you yourself experienced obstetric fistula? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1024

1023 Have you ever been treated for obstetric fistula? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

1024 Are there any (other) women in your household who suffer from YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
obstetric fistula? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1101

1025 How many (other) women in your household suffer from


obstetric fistula? NUMBER .................

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

382 | Appendix E
SECTION 11. MATERNAL MORTALITY
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

1101 Now I would like to ask you some questions about your NUMBER OF BIRTHS TO
brothers and sisters, that is, all of the children born to your NATURAL MOTHER . . . . . . . . .
natural mother, including those who are living with you,
those living elsewhere and those who have died.
How many children did your mother give birth to, including you?

1102 CHECK 1101:


TWO OR MORE BIRTHS ONLY ONE BIRTH
(RESPONDENT ONLY) 1114

1103 How many of these births did your mother have before NUMBER OF
you were born? PRECEDING BIRTHS . . . . . . . . .

1104 What was the (1) (2) (3) (4) (5) (6)
name given to
your oldest
(next oldest)
brother or sister?

1105 Is (NAME) MALE 1 MALE 1 MALE 1 MALE 1 MALE 1 MALE 1


male or female? FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2

1106 Is (NAME) still YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


alive? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2
GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108
DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8
GO TO (2) GO TO (3) GO TO (4) GO TO (5) GO TO (6) GO TO (7)

1107 How old is


(NAME)?
GO TO (2) GO TO (3) GO TO (4) GO TO (5) GO TO (6) GO TO (7)

1108 How many years ago


did (NAME) die?

1109 How old was


(NAME) when
he/she died?
IF MALE IF MALE IF MALE IF MALE IF MALE IF MALE
OR DIED OR DIED OR DIED OR DIED OR DIED OR DIED
BEFORE BEFORE BEFORE BEFORE BEFORE BEFORE
12 YEARS 12 YEARS 12 YEARS 12 YEARS 12 YEARS 12 YEARS
OF AGE OF AGE OF AGE OF AGE OF AGE OF AGE
GO TO (2) GO TO (3) GO TO (4) GO TO (5) GO TO (6) GO TO (7)

1110 Was (NAME) YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


pregnant when GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113
she died? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2

1111 Did (NAME) YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


die during GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO1113 GO TO 1113
childbirth? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2

1112 Did (NAME) die YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1
within two months NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2
after the end of a
pregnancy or
childbirth?

1113 How many live


born children did
(NAME) give birth
to during her
lifetime (before
this pregnancy)?

IF NO MORE BROTHERS OR SISTERS, GO TO 1114.

Appendix E | 383
1104 What was the (7) (8) (9) (10) (11) (12)
name given to
your oldest (next
oldest) brother
or sister?

1105 Is (NAME) male MALE 1 MALE 1 MALE 1 MALE 1 MALE 1 MALE 1


or female? FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2 FEMALE 2

1106 Is (NAME) YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


still alive? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2
GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108 GO TO 1108
DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8 DK . . . 8
GO TO (8) GO TO (9) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

1107 How old is


(NAME)?
GO TO (8) GO TO (9) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

1108 How many years ago


did (NAME) die?

1109 How old was


(NAME) when
he/she died?
IF MALE IF MALE IF MALE IF MALE IF MALE IF MALE
OR DIED OR DIED OR DIED OR DIED OR DIED OR DIED
BEFORE BEFORE BEFORE BEFORE BEFORE BEFORE
12 YEARS 12 YEARS 12 YEARS 12 YEARS 12 YEARS 12 YEARS
OF AGE OF AGE OF AGE OF AGE OF AGE OF AGE
GO TO [8] GO TO (9) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

1110 Was (NAME) YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


pregnant when GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113
she died? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2

1111 Did (NAME) YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1


die during GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113 GO TO 1113
childbirth? NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2

1112 Did (NAME) die YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1 YES . . . 1
within two months NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2 NO . . . 2
after the end of a
pregnancy or
childbirth?

1113 How many live


born children did
(NAME) give birth
to during her
lifetime (before
this pregnancy)?

IF NO MORE BROTHERS OR SISTERS, GO TO 1114.

1114 RECORD THE TIME.


MORNING/EVENING ........
MORNING = 1
EVENING = 2 HOUR . . . . . . . . . . . . . . . . . . . . .

MINUTES .......... ......

384 | Appendix E
INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

NAME OF SUPERVISOR: DATE:

EDITOR'S OBSERVATIONS

NAME OF EDITOR: DATE:

Appendix E | 385
INSTRUCTIONS: 1 2 3 4
ONLY ONE CODE SHOULD APPEAR IN ANY BOX. 13 PAG 01 01 PAG
FOR COLUMNS 1 AND 4, ALL MONTHS SHOULD BE FILLED IN. 12 NEH 02 02 NEH
11 HAM 03 03 HAM
INFORMATION TO BE CODED FOR EACH COLUMN 10 SENE 04 04 SENE
09 GEN 05 05 GEN
COL. 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE ** 1 08 MEI 06 06 MEI 1
B BIRTHS 9 07 MEG 07 07 MEG 9
P PREGNANCIES 9 06 YEK 08 08 YEK 9
T TERMINATIONS 7 05 TIRR 09 09 TIRR 7
E. 04 TAH 10 10 TAH E.
0 NO METHOD C. 03 HID 11 11 HID C.
1 FEMALE STERILIZATION 02 TIK 12 12 TIK
2 MALE STERILIZATION 01 MES 13 13 MES
3 PILL
4 IUD 13 PAG 14 14 PAG
5 INJECTABLES 12 NEH 15 15 NEH
6 IMPLANTS 11 HAM 16 16 HAM
7 CONDOM 10 SENE 17 17 SENE
8 DIAPHRAGM/FOAM/JELLY 09 GEN 18 18 GEN
9 STANDARD DAYS METHOD 1 08 MEI 19 19 MEI 1
J LACTATIONAL AMENORRHEA METHOD 9 07 MEG 20 20 MEG 9
K RHYTHM METHOD 9 06 YEK 21 21 YEK 9
L WITHDRAWAL 6 05 TIRR 22 22 TIRR 6
X OTHER E. 04 TAH 23 23 TAH E.
(SPECIFY) C. 03 HID 24 24 HID C.
02 TIK 25 25 TIK
COL. 2: SOURCE OF CONTRACEPTION 01 MES 26 26 MES
1 GOV'T HOSPITAL
2 GOV'T HEALTH CENTER 13 PAG 27 27 PAG
3 GOV'T HEALTH POST 12 NEH 28 28 NEH
4 GOV'T HEALTH STATION/CLINIC 11 HAM 29 29 HAM
5 CBD 10 SENE 30 30 SENE
6 OTHER PUBLIC 09 GEN 31 31 GEN
7 NON-GOV'T HEALTH FACILITY 1 08 MEI 32 32 MEI 1
8 NON-GOV'T CBD/CBRHA 9 07 MEG 33 33 MEG 9
9 OTHER NGO 9 06 YEK 34 34 YEK 9
A PVT. HOSPITAL/CLINIC/DOCTOR 5 05 TIRR 35 35 TIRR 5
B PHARMACY E. 04 TAH 36 36 TAH E.
C OTHER PRIVATE MEDICAL C. 03 HID 37 37 HID C.
D DRUG VENDOR 02 TIK 38 38 TIK
E SHOP 01 MES 39 39 MES
F FRIENDS/RELATIVES
X OTHER 13 PAG 40 40 PAG
(SPECIFY) 12 NEH 41 41 NEH
11 HAM 42 42 HAM
10 SENE 43 43 SENE
COL. 3: DISCONTINUATION OF CONTRACEPTIVE USE 09 GEN 44 44 GEN
0 INFREQUENT SEX/HUSBAND AWAY 1 08 MEI 45 45 MEI 1
1 BECAME PREGNANT WHILE USING 9 07 MEG 46 46 MEG 9
2 WANTED TO BECOME PREGNANT 9 06 YEK 47 47 YEK 9
3 HUSBAND/PARTNER DISAPPROVED 4 05 TIRR 48 48 TIRR 4
4 WANTED MORE EFFECTIVE METHOD E. 04 TAH 49 49 TAH E.
5 HEALTH CONCERNS C. 03 HID 50 50 HID C.
6 SIDE EFFECTS 02 TIK 51 51 TIK
7 LACK OF ACCESS/TOO FAR 01 MES 52 52 MES
8 COSTS TOO MUCH
9 INCONVENIENT TO USE 13 PAG 53 53 PAG
M METHOD NOT AVAILABLE 12 NEH 54 54 NEH
F FATALISTIC 11 HAM 55 55 HAM
A DIFFICULT TO GET PREGNANT/MENOPAUSAL 10 SENE 56 56 SENE
D MARITAL DISSOLUTION/SEPARATION 09 GEN 57 57 GEN
X OTHER 1 08 MEI 58 58 MEI 1
(SPECIFY) 9 07 MEG 59 59 MEG 9
Z DON'T KNOW 9 06 YEK 60 60 YEK 9
COL. 4: 3 05 TIRR 61 61 TIRR 3
MARRIAGE/UNION E. 04 TAH 62 62 TAH E.
X IN UNION (MARRIED OR LIVING TOGETHER) C. 03 HID 63 63 HID C.
0 NOT IN UNION 02 TIK 64 64 TIK
01 MES 65 65 MES

13 PAG 66 66 PAG
12 NEH 67 67 NEH
11 HAM 68 68 HAM
10 SENE 69 69 SENE
09 GEN 70 70 GEN
1 08 MEI 71 71 MEI 1
9 07 MEG 72 72 MEG 9
9 06 YEK 73 73 YEK 9
2 05 TIRR 74 74 TIRR 2
E. 04 TAH 75 75 TAH E.
C. 03 HID 76 76 HID C.
02 TIK 77 77 TIK
01 MES 78 78 MES

386 | Appendix E
14 APRIL 2005
2005 ETHIOPIA DEMOGRAPHIC AND HEALTH SURVEY
MAN'S QUESTIONNAIRE
IMPLEMENTING ORGANIZATION:
PHCCO

IDENTIFICATION

LOCALITY NAME

NAME OF HOUSEHOLD HEAD

CLUSTER NUMBER ................................................................

HOUSEHOLD NUMBER ..............................................................

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LARGE CITY/SMALL CITY/TOWN/RURAL


(LARGE CITY=1, SMALL CITY=2, TOWN=3, RURAL=4) ..................................

NAME AND LINE NUMBER OF MAN

INTERVIEWER VISITS

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR
INTERVIEWER'S
NAME INT. NUMBER

RESULT* RESULT

NEXT VISIT: DATE


TOTAL NUMBER
TIME OF VISITS

*RESULT CODES:
1 COMPLETED 4 REFUSED
2 NOT AT HOME 5 PARTLY COMPLETED 7 OTHER
3 POSTPONED 6 INCAPACITATED (SPECIFY)

LANGUAGE OF QUESTIONNAIRE: LANGUAGE OF INTERVIEW: LANGUAGE OF RESPONDENT

LANGUAGE CODES: AMARIGNA = 1, OROMIGNA = 2, TIGRIGNA = 3, OTHER = 6

TRANSLATOR USED:
(YES = 1, NO = 2)

SUPERVISOR FIELD EDITOR OFFICE KEYED BY


EDITOR
NAME NAME

DATE DATE

Appendix E | 387
SECTION 1. RESPONDENT'S BACKGROUND AND WORK STATUS

INTRODUCTION

Hello. My name is _______________________________________ and I am working with the Population and Housing Census
Commission Office (PHCCO). We are conducting a national survey about the health of women, men and children. We would very
much appreciate your participation in this survey. I would like to ask you about your health. This information will help the
government to plan health services. The survey usually takes about 30 minutes to complete.
Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

At this time, do you want to ask me anything about the survey?


May I begin the interview now?

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

101 RECORD THE TIME.


MORNING/EVENING ........
MORNING = 1
EVENING = 2 HOUR . . . . . . . . . . . . . . . . . . . . .

MINUTES . . . . . . . . . . . . . . . . . .

102 How long have you been living continuously in (NAME OF


CURRENT PLACE OF RESIDENCE)? YEARS ...................

IF LESS THAN ONE YEAR, RECORD '00' YEARS. ALWAYS . . . . . . . . . . . . . . . . . . . . . . . 95


VISITOR . . . . . . . . . . . . . . . . . . . . . . . 96 104

103 Just before you moved here, did you live in a city, in a town, or in CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the countryside? TOWN . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
COUNTRYSIDE . . . . . . . . . . . . . . . . . . . 3

104 In what month and year were you born?


MONTH ...................

DON'T KNOW MONTH . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . .

DON'T KNOW YEAR . . . . . . . . . . . . 9998

105 How old were you at your last birthday?


AGE IN COMPLETED YEARS
COMPARE AND CORRECT 104 AND/OR 105 IF INCONSISTENT.

106 Have you ever attended school? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 110

108 What is the highest grade you completed?


GRADE ...................

TECH./VOC. CERTIFICATE . . . . . . . . . . 13
UNIVERSITY/COLLEGE DIPLOMA . . . 14
UNIVERSITY/COLLEGE DEGREE OR
HIGHER . . . . . . . . . . . . . . . . . . . . . . . 15

388 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

109 CHECK 108:

GRADE 00-06 GRADE 07


AND ABOVE 113

110 Now I would like you to read this sentence to me. CANNOT READ AT ALL . . . . . . . . . . . . 1
ABLE TO READ ONLY PARTS OF
SHOW CARD TO RESPONDENT. SENTENCE . . . . . . . . . . . . . . . . . . . . . 2
ABLE TO READ WHOLE SENTENCE . 3
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: NO CARD WITH REQUIRED
Can you read any part of the sentence to me? LANGUAGE 4
(SPECIFY LANGUAGE)
BLIND/VISUALLY IMPAIRED . . . . . . . 5

111 Have you ever participated in a Basic Education Program or any


other program that involves learning to read or write (not including YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
primary school)? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

112 CHECK 110:

CODE '2', '3' CODE '1' OR '5'


OR '4' CIRCLED 114
CIRCLED

113 Do you read a newspaper or magazine almost every day, at least ALMOST EVERY DAY . . . . . . . . . . . . . . 1
once a week, less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

114 Do you listen to the radio almost every day, at least once a week, ALMOST EVERY DAY . . . . . . . . . . . . . . 1
less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

115 Do you watch television almost every day, at least once a week, ALMOST EVERY DAY . . . . . . . . . . . . . . 1
less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2
LESS THAN ONCE A WEEK ........ 3
NOT AT ALL ..................... 4

116 In the last 12 months, on how many separate occasions have you
traveled away from your home community and slept away? NUMBER OF TRIPS ........

NONE . . . . . . . . . . . . . . . . . . . . . . . . . 00 118

117 In the last 12 months, have you been away from your home YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
community for more than one month at a time? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

118 What is your religion? ORTHODOX . . . . . . . . . . . . . . . . . . . . . 1


CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . 2
PROTESTANT ................... 3
MOSLEM ....................... 4
TRADITIONAL ................... 5
OTHER _________________________ 6
(SPECIFY)

119 What is your ethnicity?


RECORD THE MAJOR ETHNIC GROUP. _________________________

120 Are you currently working? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 123


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

121 Have you done any work in the last 12 months? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 123
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Appendix E | 389
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

122 What have you been doing for most of the time over the last GOING TO SCHOOL/STUDYING . . . . . . 01
12 months? LOOKING FOR WORK ............ 02
RETIRED . . . . . . . . . . . . . . . . . . . . . . . . . 03
TOO ILL TO WORK .............. 04 201
HANDICAPPED, CANNOT WORK ... 05
HOUSEWORK/CHILD CARE . . . . . . . . 06

OTHER _________________________ 96
(SPECIFY)

123 What is your occupation, that is, what kind of work do you
mainly do?

124 CHECK 123:

WORKS IN DOES NOT WORK


AGRICULTURE IN AGRICULTURE 126

125 Do you work mainly on your own land or on family land, or do you OWN LAND . . . . . . . . . . . . . . . . . . . . . . . 1
work on land that you rent from someone else, or do you work on FAMILY LAND . . . . . . . . . . . . . . . . . . . . . 2
someone else's land? RENTED LAND . . . . . . . . . . . . . . . . . . . 3
SOMEONE ELSE'S LAND .......... 4
DOESN'T WORK ON LAND . . . . . . . . . . 5

126 Are you paid in cash or kind for this work or are you not paid at all? CASH ONLY . . . . . . . . . . . . . . . . . . . . . 1
CASH AND KIND . . . . . . . . . . . . . . . . . . . 2
IN KIND ONLY . . . . . . . . . . . . . . . . . . . . . 3
NOT PAID . . . . . . . . . . . . . . . . . . . . . . . 4

390 | Appendix E
SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

201 Now I would like to ask about any children you have had. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
I am interested only in the children that are biologically yours. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Have you ever fathered any children with any woman? DON'T KNOW ................... 8 206

202 Do you have any sons or daughters that you have fathered YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
who are now living with you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 204

203 How many sons live with you? SONS AT HOME . . . . . . . . . . . .

And how many daughters live with you? DAUGHTERS AT HOME ......

IF NONE, RECORD '00'.

204 Do you have any sons or daughters you have fathered YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
who are alive but do not live with you? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 206

205 How many sons are alive but do not live with you? SONS ELSEWHERE ........

And how many daughters are alive but do not live with you? DAUGHTERS ELSEWHERE . . .

IF NONE, RECORD '00'.

206 Have you ever fathered a boy or girl who was born alive
but later died?
YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
IF NO, PROBE: Any baby who cried or showed signs of life but NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 208
did not survive?

207 How many boys have died? BOYS DEAD ..............

And how many girls have died? GIRLS DEAD ..............

IF NONE, RECORD '00'.

208 (In addition to the children that you have just told me about), do you have any other living sons or daughters
or sons or daughters who died who are biologically your children but who are not legally yours
or do not have your name?
PROBE AND
NO YES CORRECT
201-207 AS
NECESSARY.

209 SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'. TOTAL . . . . . . . . . . . . . . . . . . . . .

210 CHECK 209:


HAS HAD ONLY ONE CHILD 213
HAS HAD
MORE THAN
ONE CHILD HAS NOT HAD ANY CHILDREN 214

211 Do the children you have fathered all have the same YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 213
biological mother? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Appendix E | 391
212 In all how many women have you fathered children with?
NUMBER OF WOMEN ......

213 How old were you when your (first) child was born?
AGE IN YEARS ...... ......

214 Are you the primary care giver for any children? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 301

215 Are any of these children for whom you are the primary YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
caregiver under the age of 18? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 301

216 Now I would like to ask you about the children who are under YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the age of 18 and for whom you are the primary caregiver. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . 8
Have you made arrangements for someone to care for these
children in the event that you fall sick or are unable to care
for them?

392 | Appendix E
SECTION 3. CONTRACEPTION

301 Now I would like to talk about family planning - the various ways or methods that a couple
can use to delay or avoid a pregnancy.

Which ways or methods have you heard about?


FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.


THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF
EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD 302 Have you ever used
IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD (METHOD)?
WITH CODE 1 CIRCLED IN 301, ASK 302.

01 FEMALE STERILIZATION Women can have an operation to avoid YES . . . . . . . . . . . . . . 1


having any more children. NO . . . . . . . . . . . . . . 2

02 MALE STERILIZATION Men can have an operation to avoid having YES . . . . . . . . . . . . . . 1 Have you ever had an operation
any more children. NO . . . . . . . . . . . . . . 2 to avoid having any more children?

YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . 2

03 PILL Women can take a pill every day to avoid becoming pregnant. YES . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . 2

04 IUD Women can have a loop or coil placed inside them by a doctor or YES . . . . . . . . . . . . . . 1
a nurse. NO . . . . . . . . . . . . . . 2

05 INJECTABLES Women can have an injection by a health provider YES . . . . . . . . . . . . . . 1


that stops them from becoming pregnant for one or more months. NO . . . . . . . . . . . . . . 2

06 IMPLANTS (or NORPLANTS) Women can have several small rods YES . . . . . . . . . . . . . . 1
placed in their upper arm by a doctor or nurse which can prevent NO . . . . . . . . . . . . . . 2
pregnancy for five or more years.

07 CONDOM Men can put a rubber sheath on their penis before sexual YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
intercourse. NO . . . . . . . . . . . . . . 2
NO ................... 2

08 DIAPHRAGM/FOAM/JELLY Women can place a sheath and/or a YES . . . . . . . . . . . . . . 1


suppository/tablet/jelly/cream in their vagina before intercourse. NO . . . . . . . . . . . . . . 2

09 STANDARD DAYS METHOD Women can use a cycle of beads to YES . . . . . . . . . . . . . . 1


count the days they are most likely to get pregnant and avoid sexual NO . . . . . . . . . . . . . . 2
intercourse during those days.

10 LACTATIONAL AMENORRHEA METHOD (LAM) YES . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . 2

11 RHYTHM METHOD Every month that a woman is sexually active YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
she can avoid pregnancy by not having sexual intercourse NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . 2
on the days of the month she is most likely to get pregnant.

12 WITHDRAWAL Men can be careful and pull out before climax. YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . 2
NO ................... 2

13 Have you heard of any other ways or methods that women or men YES . . . . . . . . . . . . . . 1
can use to avoid pregnancy?

(SPECIFY)

(SPECIFY)
NO .............. 2

Appendix E | 393
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

303 In the last few months, have you discussed the practice of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
family planning with a health worker or health professional? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

304 Now I would like to ask you about when a woman is most YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
likely to get pregnant. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
From one menstrual period to the next, are there certain days DON'T KNOW ................... 8 306
when a woman is more likely to become pregnant if she has
sexual relations?

305 Is this time just before her period begins, during her period, right JUST BEFORE HER PERIOD
after her period has ended, or halfway between two periods? BEGINS . . . . . . . . . . . . . . . . . . . . . . . 1
DURING HER PERIOD ............ 2
RIGHT AFTER HER
PERIOD HAS ENDED . . . . . . . . . . . . 3
HALFWAY BETWEEN
TWO PERIODS . . . . . . . . . . . . . . . . 4

OTHER _______________________ 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

306 Do you think that a woman who is breastfeeding her baby YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
can get pregnant? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DEPENDS . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW ................... 8

307 I willl now read you some statements about contraception.


Please tell me if you agree or disagree with each one.
AGREE DISAGREE DK
Contraception is women's business and a man should
not have to worry about it 1 2 8
Women who use contraception may become promiscuous. 1 2 8
A woman is the one who gets pregnant so she should be
the one to get sterilized. 1 2 8

394 | Appendix E
SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

401 Are you currently married or living together with a woman as if YES, CURRENTLY MARRIED . . . . . . . . 1
married? YES, LIVING WITH A WOMAN ..... 2 404
NO, NOT IN UNION . . . . . . . . . . . . . . . . 3 407

402 Do you currently have one wife or more than one wife?

IF ONLY ONE WIFE, ENTER '01'. NUMBER OF WIVES ........

IF MORE THAN ONE, ASK: How many wives do you currently


have?

403 In addition to your wife (wives), are you currently living with YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
any other women as if married? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 405

404 Are you living with one woman or more than one
woman as if married?
NUMBER OF LIVE-IN
IF ONE LIVE-IN PARTNER, ENTER '01'. PARTNERS . . . . . . . . . . . . . . . .

IF MORE THAN ONE, ASK: How many women are you living
with as if you were married?

405 CHECK Q.402 AND Q.404

SUM OF Q.402 AND SUM OF Q.402 AND


Q.404 = 01 Q.404 > 01

Please tell me the name of your wife/partner. Please tell me the name of each wife/partner that
you live with as if married, starting with the one
you lived with first.

RECORD THE WIFE'S/PARTNER'S NAME AND LINE RECORD EACH WIFE'S/PARTNER'S NAME AND LINE
NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF SHE IS NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE
NOT LISTED IN THE HOUSEHOLD, RECORD '00'. SEPARATELY. IF A WIFE/PARTNER IS NOT LISTED IN
THE HOUSEHOLD, RECORD '00'. CIRCLE THE
APPROPRIATE CODE FOR WIFE OR PARTNER.

Q.405A
How old was your
WIFE/PARTNER NAME LINE NUMBER STATUS wife/partner on her
IN HHOLD WIFE=1 last birthday?
QUEST. PARTNER=2
AGE

1 _____________________________ 1 2

2 _____________________________ 1 2

3 _____________________________ 1 2

4 _____________________________ 1 2

5 _____________________________ 1 2

6 _____________________________ 1 2

7 _____________________________ 1 2

Appendix E | 395
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

406 CHECK 405:


YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 409
ONLY ONE MORE THAN ONE NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 410
WIFE/PARTNER WIFE/PARTNER

Have you ever been married Have you ever been married
to or lived together as if to or lived together as if
married with any other woman married with any other woman
than your current wife/ in addition to those you
partner? have just mentioned?

407 Have you ever been married or lived together with a woman YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
as if married? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 412

408 What is your marital status now: are you widowed, WIDOWED . . . . . . . . . . . . . . . . . . . . . . 1
divorced, or separated? DIVORCED . . . . . . . . . . . . . . . . . . . . . . 2
SEPARATED . . . . . . . . . . . . . . . . . . . . 3

409 In total, how many women have you been married to or lived
together with as if married in your whole life? NUMBER . . . . . . . . . . . . . . . . . .

409A CHECK 405 AND 409:


ONLY ONE WIFE/PARTNER MORE THAN ONE WIFE/PARTNER
TOTAL IN 405 AND 409 IN 405 AND/OR 409 410A

410 In what month and year did you start living with your wife/partner? MONTH ................

DON'T KNOW MONTH . . . . . . . . . . . . 98


410A Now I would like to ask about when you started living with your
first wife/partner.
In what month and year was that? YEAR . . . . . . . . . . . . 412

DON'T KNOW YEAR . . . . . . . . . . . . 9998

411 How old were you when you first started living with her?
AGE ....................

412 Now I need to ask you some questions about sexual activity in NEVER . . . . . . . . . . . . . . . . . . . . . . . . 00
order to gain a better understanding of some family life issues.

How old were you when you had sexual intercourse for the AGE IN YEARS ............ 414
very first time (if ever)?
FIRST TIME WHEN STARTED
LIVING WITH (FIRST)
WIFE/PARTNER . . . . . . . . . . . . 95 414

413 Do you intend to wait until you get married to have sexual YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
intercourse for the first time? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 443
DON'T KNOW/UNSURE . . . . . . . . . . . . 8
.

414 CHECK 105: 15-24 25-59


YEARS OLD YEARS OLD 419

415 The first time you had sexual intercourse, was a condom YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
used? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/DON'T REMEMBER . . . 8

419 When was the last time you had sexual intercourse?
DAYS AGO . . . . . . . . . . . . 1
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE
WAS ONE OR MORE YEARS AGO. WEEKS AGO . . . . . . . . . . 2

IF 12 MONTHS OR MORE, ANSWER MUST BE MONTHS AGO ........ 3


RECORDED IN YEARS.
YEARS AGO .......... 4 428

396 | Appendix E
LAST SECOND-TO-LAST
SEXUAL PARTNER SEXUAL PARTNER
420 The last time you had sexual YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
intercourse with this (second) NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
person, was a condom used? (SKIP TO 422) (SKIP TO 422)

421 Did you use a condom every time YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


you had sexual intercourse with this NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
person in the last 12 months?

422 What was your relationship to SPOUSE . . . . . . . . . . . 01 SPOUSE . . . . . . . . . . . 01


this person with whom you had (SKIP TO 424) (SKIP TO 424)
sexual intercourse? LIVE-IN PARTNER . . . . 02 LIVE-IN PARTNER . . . . 02
BOYFRIEND/GIRLFRIEND BOYFRIEND/GIRLFRIEND
IF BOYFRIEND/GIRLFRIEND: NOT LIVING WITH NOT LIVING WITH
Were you living together as if RESPONDENT . . . . 03 RESPONDENT . . . . 03
married? CASUAL CASUAL
IF YES, CIRCLE '02' ACQUAINTANCE . . . . 04 ACQUAINTANCE . . . . 04
IF NO, CIRCLE '03' COMMERCIAL COMMERCIAL
SEX WORKER . . . . 05 SEX WORKER . . . . 05
OTHER ______________96 OTHER ______________96
(SPECIFY) (SPECIFY)

423 For how long (have you had/did you


have) a sexual relationship with DAYS . . . 1 DAYS . . . 1
this person?
IF ONLY HAD SEXUAL MONTHS . 2 MONTHS . 2
RELATIONS WITH THIS PERSON
ONCE, RECORD '01' DAYS. YEARS . . . 3 YEARS . . . 3

424 The last time you had sexual YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1


intercourse with this (second) NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
person, did you or this person (SKIP TO 426) (SKIP TO 426)
drink alcohol?

425 Were you or your partner drunk RESPONDENT ONLY 1 RESPONDENT ONLY 1
at that time? PARTNER ONLY . . . 2 PARTNER ONLY . . . 2
RESPONDENT AND RESPONDENT AND
IF YES: Who was drunk? PARTNER BOTH . 3 PARTNER BOTH . 3
NEITHER . . . . . . . . . 4 NEITHER . . . . . . . . . 4
426 Apart from [this person/these two YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1
people], have you had sexual (GO BACK TO 420 (GO TO 427
intercourse with any other IN NEXT COLUMN) IN NEXT PAGE)
person in the last 12 months? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2
(SKIP TO 428) (SKIP TO 428)

Appendix E | 397
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

427 In total, with how many different people have you had sexual NUMBER OF PARTNERS
intercourse in the last 12 months? LAST 12 MONTHS . . . . . . . .

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

IF NUMBER OF PARTNERS IS GREATER THAN 95,


WRITE '95.'

428 In total, with how many different people have you had sexual NUMBER OF PARTNERS
intercourse in your lifetime? IN LIFETIME . . . . . . . . . . . . . .

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. DON'T KNOW . . . . . . . . . . . . . . . . . . . 98

IF NUMBER OF PARTNERS IS GREATER THAN 95,


WRITE '95.'

429 CHECK 422 ALL COLUMNS:


AT LEAST ONE 431
NO PARTNERS PARTNER A
ARE COMMERCIAL COMMERCIAL Q. 422 NOT ASKED 443
SEX WORKERS SEX WORKER

430 In the last 12 months, did you pay anyone in exchange YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
for sex? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 433

431 The last time you paid someone in exchange for sex, was YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
a condom used? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 433

432 Was a condom used every time you paid someone in YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
exchange for sex in the last 12 months? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

433 CHECK 420 COLUMN 1 (CONDOM USE WITH LAST SEXUAL PARTNER)

YES NO/NOT 439


ASKED

434 The last time you had intercourse you told me you used a MAN HIMSELF ................ 1
condom. Did you or your partner obtain the condom? PARTNER . . . . . . . . . . . . . . . . . . . . . . . 2
SOMEONE ELSE ................ 3

435 What brand did you use?


BRAND NAME
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

436 How much did you (your partner) pay when getting the
condom? COST . . . . . . .
FREE . . . . . . . . . . . . . . . . . . . . . . . . . 995
DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

437 How many condoms did you (your partner) get the last time?
NUMBER . . . . . . . . . . . . . . . . . . .

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98

398 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

438 From where did you (your partner) obtain the condom the PUBLIC SECTOR
last time? GOVT. HOSPITAL . . . . . . . . . . . . A
GOVT. HEALTH CENTER ...... B
GOVT. HEALTH POST ........ C
GOVT. HEALTH STATION/CLINIC D
IF SOURCE IS HOSPITAL, HEALTH CENTER OR CLINIC, CBD ....................... E
WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE OTHER PUBLIC ________________ F
TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. (SPECIFY)
NON GOVT (NGO)
NGO HEALTH FACILITY . . . . . . . . G
CBD/CBRHA . . . . . . . . . . . . . . . . H
OTHER NGO ________________ I
(SPECIFY)
(NAME OF PLACE(S))
PRIVATE MEDICAL SECTOR
Any other place? PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . . . J
PHARMACY ................ K
RECORD ALL SOURCES MENTIONED. OTHER PRIVATE
MEDICAL L
(SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . M
SHOP ..................... N
FRIEND/RELATIVE . . . . . . . . . . . . O
OTHER _______________________ X
(SPECIFY)

439 CHECK 302 (02) USING MALE STERILIZATION

NO YES 442

440 The last time you had sex did you (or your partner) use any YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
method (other than the condom) to avoid or prevent a NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
pregnancy? DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 442

441 What method did you (your partner) use? FEMALE STERILIZATION . . . . . . . . . . . . A
MALE STERILIZATION ............ B
PROBE: PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
Did you use any other method to prevent pregnancy? IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
INJECTABLES . . . . . . . . . . . . . . . . . . . . . E
IMPLANTS . . . . . . . . . . . . . . . . . . . . . . . F
CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . G
DIAPHRAGM/FOAM/JELLY . . . . . . . . . . H
STANDARD DAYS METHOD . . . . . . . . I
LACTATIONAL AMEN. METHOD . . . . . . J
RHYTHM METHOD . . . . . . . . . . . . . . . . K
WITHDRAWAL ................... L

OTHER _______________________ X
(SPECIFY)

442 CHECK 420 COLUMN 1 (CONDOM USE WITH LAST SEXUAL PARTNER)

NO/NOT YES
447
ASKED

443 CHECK 301 (07) KNOWS MALE CONDOM

YES NO
447

444 Do you know of a place where a person can get condoms? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 447

Appendix E | 399
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

445 Where is that? PUBLIC SECTOR


GOVT. HOSPITAL . . . . . . . . . . . . A
GOVT. HEALTH CENTER ...... B
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, GOVT. HEALTH POST ........ C
WRITE THE NAME OF THE PLACE. GOVT. HEALTH STATION/CLINIC D
PROBE TO IDENTIFY THE TYPE OF SOURCE CBD ....................... E
AND CIRCLE THE APPROPRIATE CODE. OTHER PUBLIC ________________ F
(SPECIFY)
NON GOVT (NGO)
NGO HEALTH FACILITY . . . . . . . . G
CBD/CBRHA . . . . . . . . . . . . . . . . H
OTHER NGO ________________ I
(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/
DOCTOR . . . . . . . . . . . . . . . . . . . . . J
Any other place? PHARMACY ................ K
OTHER PRIVATE
MEDICAL L
RECORD ALL SOURCES MENTIONED. (SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . M
SHOP ..................... N
FRIEND/RELATIVE . . . . . . . . . . . . O
OTHER _______________________ X
(SPECIFY)

446 If you wanted to, could you yourself get a condom? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/UNSURE . . . . . . . . . . . . 8

447 I will now read you some statements about the male condom.
Please tell me if you agree or disagree with each statement. YES NO DK

Condoms diminish a man's sexual pleasure. DIMINISH MAN'S PLEASUE . 1 2 8


Condoms diminish a woman's pleasure. DIMINISH WOMAN'S
PLEASURE . . . . . . . . . . . . 1 2 8
A condom is very inconvenient to use. INCONVENIENT . . . . . . . . . . 1 2 8
A condom can be reused. REUSED . . . . . . . . . . . . . . . . 1 2 8
Buying condoms is embarrasing. EMBARRASING TO BUY . . . 1 2 8

448 Some men are circumcised. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


Are you circumcised? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

400 | Appendix E
SECTION 5. FERTILITY PREFERENCES

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

501 CHECK 401 and 405:

IN Q. 405 MARRIED IN Q. 405 MARRIED TO 502A


TO OR LIVING WITH AND/OR LIVING WITH Q. 401: NOT
ONE WOMAN MORE THAN ONE WOMAN IN UNION 505

502 Is your wife/partner currently pregnant? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
502A IF MORE THAN ONE WIFE/PARTNER, ASK: UNSURE . ..................... 8
Are any of your wives/partners currently pregnant?

503 CHECK 502:

WIFE NOT PREGNANT WIFE


OR UNSURE PREGNANT

Now I have some questions Now I have some questions HAVE (A/ANOTHER) CHILD ........ 1
about the future. about the future. NO MORE/NONE ................. 2
Would you like to have After the child you are SAYS WIFE/WIVES CAN'T GET 505
(a/another) child, or would you expecting now, would you like PREGNANT ................... 3
prefer not to have any (more) to have another child, or would UNDECIDED/DON'T KNOW ........ 8
children? you prefer not to have any
more children?

504 CHECK 502:


MONTHS . . . . . . . . . . . . . . 1
WIFE NOT PREGNANT WIFE
OR UNSURE PREGNANT YEARS .............. 2

How long would you like to wait After the birth of the child you SOON/NOW . . . . . . . . . . . . . . . . . . . 993
from now before the birth of are expecting now, how long AFTER MARRIAGE . . . . . . . . . . . . . . 995
(a/another) child? would you like to wait before
the birth of another child? OTHER _______________________ 996
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . 998

505 CHECK 202 AND 204:

HAS LIVING CHILDREN NO LIVING CHILDREN


NONE . . . . . . . . . . . . . . . . . . . . . . . . . 00 507
If you could go back to the time If you could choose exactly the
you did not have any children number of children to have in NUMBER . . . . . . . . . . . . . . . . . . .
and could choose exactly the your whole life, how many
number of children to have in would that be?
your whole life, how many OTHER _______________________ 96 507
would that be? (SPECIFY)
PROBE FOR A NUMERIC RESPONSE.

506 How many of these children would you like to be boys, how many BOYS GIRLS EITHER
would you like to be girls and for how many would the sex not
matter? NUMBER

OTHER _______________________ 96
(SPECIFY)

507 In the last few months have you heard about family planning: YES NO

On the radio? RADIO . . . . . . . . . . . . . . . . . . . . . . . 1 2


On the television? TELEVISION . . . . . . . . . . . . . . . . . 1 2
In a newspaper or magazine? NEWSPAPER OR MAGAZINE . . . 1 2
In a pamphlet/poster/leaflets/booklets? PAMPHLET, ETC. . . . . . . . . . . . . 1 2
At a community event? COMMUNITY EVENT . . . . . . . . . . 1 2

Appendix E | 401
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

508 CHECK 401 and 405:

IN Q. 405 MARRIED IN Q. 405 MARRIED TO 509A


TO OR LIVING WITH AND/OR LIVING WITH Q. 401: NOT
ONE WOMAN MORE THAN ONE WOMAN IN UNION 514

509 Is your wife/partner currently using a method of family planning? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
509A IF MORE THAN ONE WIFE/PARTNER, ASK: DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8 511
Are any of your wives/partners currently using a method of
family planning?

510 Would you say that using contraception is mainly your MAINLY RESPONDENT .......... 1
decision, mainly your wife's/partner's decision, or did MAINLY WIFE/PARTNER ...... 2
you both decide together? JOINT DECISION ................. 3
OTHER 6
(SPECIFY)

511 Do you think your wife/partner wants the same number of SAME NUMBER . . . . . . . . . . . . . . . . . . . 1
children that you want, or does she want more or fewer than you MORE CHILDREN . . . . . . . . . . . . . . . . . 2
want? FEWER CHILDREN . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

512 Who decides how the money you earn will be used: RESPONDENT ................... 1
mainly you, mainly your wife/partner, or you and your WIFE/PARTNER .............. 2
wife/partner jointly? RESPONDENT AND
WIFE/PARTNER JOINTLY . . . . . . . . 3
RESPONDENT DOESN'T
BRING IN ANY MONEY . . . . . . . . . . 4
OTHER . . . . . . . . . . . . . . . . . . . . . . . . . 6

513 Would you say that the money that you bring into the household MORE THAN HER . . . . . . . . . . . . . . . . . 1
is more than what your wife/partner brings in, less than LESS THAN HER ................. 2
what she brings in, or about the same? ABOUT THE SAME . . . . . . . . . . . . . . . . . 3
WIFE/PARTNER DOESN'T
BRING IN ANY MONEY . . . . . . . . . . 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

514 Now I would like to ask you a few questions regarding


relationships between men and women.

In a couple, who do you think should have the greater say in BOTH DON'T
each of the following decisions: the husband, the wife or both HUS- EQUAL- KNOW,
equally: BAND WIFE LY DEPENDS

making large household purchases? 1 2 3 8

making small daily household purchases? 1 2 3 8

deciding when to visit family, friends or relatives? 1 2 3 8

deciding what to do with the money she earns for her


work? 1 2 3 8
deciding how many children to have and when to have
them? 1 2 3 8

515 Sometimes a husband is annoyed or angered by things that his


wife does. In your opinion, is a husband justified in hitting or
beating his wife in the following situations: YES NO DK

If she goes out without telling him? GOES OUT . . . . . . . . . . 1 2 8


If she neglects the children? NEGL. CHILDREN . . . 1 2 8
If she argues with him? ARGUES . . . . . . . . . . . . 1 2 8
If she refuses to have sex with him? REFUSES SEX . . . . . . 1 2 8
If she burns the food? BURNS FOOD ...... 1 2 8

402 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

516 Husbands and wives do not always agree on everything. Please


tell me if you think a wife is justified in refusing to have sex with
her husband when:
YES NO DK
She knows her husband has a sexually transmitted disease? HAS STD .............. 1 2 8
She knows her husband has sex with other women? OTHER WOMEN ........ 1 2 8
She is tired or not in the mood? TIRED/NOT IN MOOD ... 1 2 8

517 Do you think that if a woman refuses to have sex with her DON'T
husband when he wants her to, he has the right to... KNOW,
YES NO DEPENDS

Get angry and reprimand her? 1 2 8


Refuse to give her money or other means of financial
support? 1 2 8
Use force and have sex with her even if she doesn’t want
to? 1 2 8
Go and have sex with another woman? 1 2 8

518 When a wife knows her husband has a disease that can YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
be transmitted through sexual contact, is she justified in NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
asking that they use a condom when they have sex? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

519 Now I would like to ask you some questions about any injections
you have had in the last 12 months. Have you had an injection
for any reason in the last 12 months? NUMBER OF INJECTIONS ...

IF YES: How many injections have you had?


IF NUMBER OF INJECTIONS IS GREATER THAN 90, NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 523
OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

520 Among these injections, how many were administered by a


doctor, a nurse, a pharmacist, a dentist, or any other NUMBER OF INJECTIONS ...
health worker?
IF NUMBER OF INJECTIONS IS GREATER THAN 90,
OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 523
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

521 The last time you had an injection given to you by a health worker, PUBLIC SECTOR
where did you go to get the injection? GOVERNMENT HOSPITAL/CLINIC . 11
GOVT. HEALTH CENTER ........ 12
GOVT. HEALTH POST ........ 13
COMM. HEALTH AGENT ........ 14

OTHER PUBLIC 16
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY 21

PRIVATE MEDICAL SECTOR


PRIVATE HOSPITAL/CLINIC/
DOCTOR ................... 31
DENTAL CLINIC/OFFICE ........ 32
PHARMACY ................... 33
OFFICE OR HOME OF NURSE/
HEALTH WORKER . . . . . . . . . . . . 34
OTHER PRIVATE
MEDICAL 36
(SPECIFY)
OTHER PLACE
AT HOME . . . . . . . . . . . . . . . . . . . . . 41

OTHER 96
(SPECIFY)

Appendix E | 403
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

522 Did the person who gave you that injection take the syringe and YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
needle from a new, unopened package? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

523 Do you currently smoke cigarettes? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 525

524 In the last 24 hours, how many cigarettes did you smoke?
CIGARETTES . . . . . . . . . . . . . .

525 Do you currently smoke or use any other type of tobacco YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
like gaya, shisha or suret? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 527

526 What (other) type of tobacco do you currently smoke or use? PIPE . . . . . . . . . . . . . . . . . . . . . . . . . . . A
CHEWING TOBACCO . . . . . . . . . . . . . . B
SNUFF/SURET . . . . . . . . . . . . . . . . . . . C
RECORD ALL MENTIONED SHISHA . . . . . . . . . . . . . . . . . . . . . . . . . D
GAYA ......................... E
OTHER X
(SPECIFY)

527 Have you ever heard of an illness called tuberculosis or TB? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 601

528 How does tuberculosis spread from one person to another? THROUGH THE AIR WHEN
COUGHING OR SNEEZING . . . . . . . . A
PROBE: Any other ways? THROUGH SHARING UTENSILS . . . . . . B
THROUGH TOUCHING A PERSON
RECORD ALL MENTIONED. WITH TB . . . . . . . . . . . . . . . . . . . . . . . C
THROUGH FOOD . . . . . . . . . . . . . . . . . D
THROUGH SEXUAL CONTACT . . . . . . E
THROUGH MOSQUITO BITES . . . . . . . . F

OTHER X
(SPECIFY)
DON’T' KNOW . . . . . . . . . . . . . . . . . . . . . Z

529 Can tuberculosis be cured? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 8

530 If a member of your family got tuberculosis, would you want it to YES, REMAIN A SECRET .......... 1
remain a secret or not? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/NOT SURE/
DEPENDS . . . . . . . . . . . . . . . . . . . . . . . 8

404 | Appendix E
SECTION 6. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

601 Now I would like to talk about something else. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


Have you ever heard of an illness called AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 634

602 Can people reduce their chances of getting the AIDS virus YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
by having just one sex partner who is not infected and who has NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
no other partners? DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

603 Can people get the AIDS virus from mosquito bites? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

604 Can people reduce their chances of getting the AIDS virus by YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
using a condom every time they have sex? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

605 Can people get the AIDS virus by sharing food with a person who YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
has AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

606 Can people reduce their chance of getting the AIDS virus by YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
abstaining from sexual intercourse? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

607 Can people get the AIDS virus because of the curse of God YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
or other supernatural means? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

608 Is there anything else a person can do to avoid or reduce the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
chances of getting the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8 610

609 What can a person do? ABSTAIN FROM SEX . . . . . . . . . . . . . . A


USE CONDOMS . . . . . . . . . . . . . . . . . . B
LIMIT SEX TO ONE PARTNER/STAY
FAITHFUL TO ONE PARTNER . . . . . C
LIMIT NUMBER OF SEXUAL
Anything else? PARTNERS . . . . . . . . . . . . . . . . . . . . D
AVOID SEX WITH PROSTITUTES . . . E
AVOID SEX WITH PERSONS WHO
HAVE MANY PARTNERS . . . . . . . F
AVOID SEX WITH HOMOSEXUALS . . . G
RECORD ALL WAYS MENTIONED. AVOID SEX WITH PERSONS WHO
INJECT DRUGS . . . . . . . . . . . . . . . . H
AVOID BLOOD TRANSFUSIONS . . . . . I
AVOID INJECTIONS . . . . . . . . . . . . . . J
AVOID SHARING RAZORS/BLADES . K
AVOID KISSING . . . . . . . . . . . . . . . . . . L
AVOID MOSQUITO BITES . . . . . . . . . M
SEEK PROTECTION FROM
TRADITIONAL PRACTITIONER . . . N

OTHER _______________________ W
(SPECIFY)
OTHER _______________________ X
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . Z

610 Is it possible for a healthy-looking person to have the AIDS virus? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

Appendix E | 405
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

611 Can the virus that causes AIDS be transmitted from a mother to
her baby: YES NO DK
During pregnancy? DURING PREG. . . . . . 1 2 8
During delivery? DURING DELIVERY . . . 1 2 8
By breastfeeding? BREASTFEEDING . . . 1 2 8

CHECK 611:
612 AT LEAST OTHER
ONE 'YES' 614

613 Are there any special medications that a doctor or a nurse can YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
give to a woman infected with the AIDS virus to reduce the risk NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
of transmission to the baby? DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

614 Is there any special medication that people infected with the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
AIDS virus can get from a doctor or a nurse? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

615 I don't want to know the results, but have you ever been tested YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
to see if you have the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 620

616 When was the last time you were tested? LESS THAN 12 MONTHS AGO . . . . . 1
12 - 23 MONTHS AGO . . . . . . . . . . . . . . 2
2 OR MORE YEARS AGO . . . . . . . . . 3

617 The last time you had the test, did you yourself ask for the test, ASKED FOR THE TEST . . . . . . . . . . . . 1
was it offered to you and you accepted, or was it required? OFFERED AND ACCEPTED . . . . . . . 2
REQUIRED . . . . . . . . . . . . . . . . . . . . . . 3

618 I don't want to know the results, but did you get the results of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the test? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

619 Where was the test done? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC 11
GOVT. HEALTH CENTER . . . . . . 12
VCT CENTER . . . . . . . . . . . . . . . . 13
GOVT. HEALTH POST . . . . . . . . 14
FAMILY PLANNING CLINIC . . . . . . 15
STAND ALONE VCT CENTER 16
OTHER PUBLIC 17
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY 21 622


STAND ALONE VCT CENTER . . . . . . . 22

PRIVATE MEDICAL SECTOR


IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, PRIVATE HOSPITAL/CLINIC/
WRITE THE NAME OF THE PLACE. DOCTOR .................. 31
PROBE TO IDENTIFY THE TYPE OF SOURCE AND STAND ALONE VCT CENTER . . . . . 32
CIRCLE THE APPROPRIATE CODE. OTHER PRIVATE
MEDICAL 36
(SPECIFY)
(NAME OF PLACE) OTHER 96
(SPECIFY)

620 Do you know of a place where people can go to get tested for YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the virus that causes AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 622

406 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

621 Where is that? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC A
GOVT. HEALTH CENTER . . . . . . . B
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, VCT CENTER . . . . . . . . . . . . . . . . . . C
WRITE THE NAME OF THE PLACE. GOVT. HEALTH POST . . . . . . . . . D
PROBE TO IDENTIFY THE TYPE OF SOURCE FAMILY PLANNING CLINIC . . . . . . . E
AND CIRCLE THE APPROPRIATE CODE. STAND ALONE VCT CENTER . . . . . F
OTHER PUBLIC G
(SPECIFY)

NON-GOVT. (NGO) HEALTH FACILITY H


STAND ALONE VCT CENTER . . . . . . . I

PRIVATE MEDICAL SECTOR


PRIVATE HOSPITAL/CLINIC/
DOCTOR .................. J
STAND ALONE VCT CENTER . . . . . K
(NAME OF PLACE) OTHER PRIVATE
MEDICAL L
Any other place? (SPECIFY)
OTHER M
RECORD ALL SOURCES MENTIONED. (SPECIFY)

622 Would you buy fresh vegetables from a shopkeeper or vendor YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
if you knew that this person had the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

623 If a member of your family got infected with the AIDS virus, YES, REMAIN A SECRET . . . . . . . . . 1
would you want it to remain a secret or not? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . 8

624 If a relative of yours became sick with the virus that causes AIDS, YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
would you be willing to care for her or him in your own household? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . 8

625 In your opinion, if a female teacher has the AIDS virus but SHOULD BE ALLOWED . . . . . . . . . . . . 1
is not sick, should she be allowed to continue teaching SHOULD NOT BE ALLOWED . . . . . . . 2
in the school? DK/NOT SURE/DEPENDS . . . . . . . . . 8

626 Do you personally know someone who is suspected YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


to have the AIDS virus or who has the AIDS virus? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 630

627 Do you personally know someone who has been denied YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
health services in the last 12 months because he or she NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
is suspected to have the AIDS virus or has the AIDS virus?

628 Do you personally know someone who has been denied YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
involvement in social events, religious services, or community NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
events in the last 12 months because he or she is
suspected to have the AIDS virus or has the AIDS virus?

629 Do you personally know someone who has been verbally YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
abused or teased in the last 12 months because he or she NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
is suspected to have the AIDS virus or has the AIDS virus?

Appendix E | 407
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

630 Do you agree or disagree with the following statement: AGREE . . . . . . . . . . . . . . . . . . . . . . . . 1


People with the AIDS virus should be ashamed of themselves. DISAGREE . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW/NO OPINION . . . . . . . 8

631 Do you agree or disagree with the following statement: AGREE . . . . . . . . . . . . . . . . . . . . . . . . 1


People with the AIDS virus should be blamed for bringing the DISAGREE . . . . . . . . . . . . . . . . . . . . . . 2
disease into the community. DON'T KNOW/NO OPINION . . . . . . . 8

632 Should children age 12-14 be taught about using a condom YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
to avoid AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . 8

633 Should children age 12-14 be taught to wait until they get YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
married to have sexual intercourse in order to avoid AIDS? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DK/NOT SURE/DEPENDS . . . . . . . . . 8

634 CHECK 601:


HEARD ABOUT NOT HEARD
AIDS ABOUT AIDS
Apart from AIDS, have you Have you heard about infections YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
heard about other infections that can be transmitted through
that can be transmitted sexual contact? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
through sexual contact?

635 CHECK 412:


HAS HAD SEXUAL HAS NOT HAD SEXUAL
INTERCOURSE INTERCOURSE 643

636 CHECK 634:


HEARD ABOUT INFECTION HAS NOT HEARD ABOUT
TRANSMITTED THROUGH INFECTION TRANSMITTED 638
SEXUAL CONTACT THROUGH SEXUAL CONTACT

637 Now I would like to ask you some questions about your health in YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
the last 12 months. During the last 12 months, have you had a NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
disease which you got through sexual contact? DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

638 Sometimes men experience a bad smelling abnormal genital YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


discharge. NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
During the last 12 months, have you had a bad smelling abnormal DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8
genital discharge?

639 Sometimes men have a genital sore or ulcer. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1


During the last 12 months, have you had a genital sore or ulcer? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . 8

640 CHECK 637, 638, AND 639:


HAS HAD AN HAS NOT HAD AN
INFECTION INFECTION OR 643
(ANY 'YES') DOES NOT KNOW

641 The last time you had (PROBLEM FROM 637/638/639), YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
did you seek any kind of advice or treatment? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 643

408 | Appendix E
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

642 Where did you go? PUBLIC SECTOR


GOVERNMENT HOSPITAL/CLINIC . A
GOVT. HEALTH CENTER . . . . . . . B
Any other place? VCT CENTER . . . . . . . . . . . . . . . . . . C
GOVT. HEALTH POST . . . . . . . . . D
RECORD ALL SOURCES MENTIONED. FAMILY PLANNING CLINIC . . . . . . . E
STAND ALONE VCT CENTER . . . . . F
OTHER PUBLIC G
(SPECIFY)
NON-GOVT. (NGO) HEALTH FACILITY H
STAND ALONE VCT CENTER . . . . . . . I

PRIVATE MEDICAL SECTOR


PRIVATE HOSPITAL/CLINIC/
DOCTOR .................. J
STAND ALONE VCT CENTER . . . . K
PHARMACY . . . . . . . . . . . . . . . . . . L
OTHER PRIVATE
MEDICAL M
(SPECIFY)
OTHER SOURCE
DRUG VENDOR . . . . . . . . . . . . . . . . N
SHOP . . . . . . . . . . . . . . . . . . . . . . . . O
TRADITIONAL HEALER . . . . . . . . . P
OTHER X
(SPECIFY)

643 RECORD THE TIME.


MORNING/EVENING . . . . . . .
MORNING = 1
EVENING = 2 HOUR . . . . . . . . . . . . . . . . . . . .

MINUTES . . . . . . . . . . . . . . . . .

Appendix E | 409
INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

NAME OF THE SUPERVISOR: DATE:

EDITOR'S OBSERVATIONS

NAME OF EDITOR: DATE:

410 | Appendix E

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