Pakistan 2017-18 Demographic and Health Survey
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2017-18 Demographic and Health Survey Key Findings Pakistan The 2017-18 Pakistan Demographic and Health Survey (PDHS) was implemented by the National Institute of Population Studies (NIPS) under the aegis of Ministry of National Health Services, Regulations and Coordination. ICF provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide. Support for the survey was also provided by the Department for International Development (DFID) and the United Nations Population Fund (UNFPA). Additional information about the 2017-18 PDHS may be obtained from National Institute of Population Studies, Ministry of National Health Services, Regulations and Coordination, National Institute of Health (NIH), Park Road, Chak Shahzad, Islamabad, Pakistan; Telephone: +92-51-9255937; Fax: +92-51-9255932; Internet: www.nips.org.pk. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1-301-407-6500; fax: +1-301-407-6501; e-mail: [email protected]; Internet: www. DHSprogram.com. ISBN: 978-969-9732-04-1 Suggested citation: National Institute of Population Studies (NIPS) [Pakistan] and ICF. 2019. 2017-18 Pakistan Demographic and Health Survey Key Findings. Islamabad, Pakistan, and Rockville, Maryland, USA: NIPS and ICF. Cover: “Blue Hour at Pakistan Monument” © 2016 by Muhammad Ashar [CC BY-SA 4.0] from Wikimedia Commons ABOUT THE 2017-18 PDHS The 2017-18 Pakistan Demographic and Health Survey (PDHS) is designed to provide data for monitoring the population and health situation in Pakistan. The 2017-18 PDHS is the fourth Demographic and Health Survey conducted in Pakistan since 1990-91. The objective of the survey was to provide reliable estimates of fertility and family planning, breastfeeding practices, nutrition, maternal and child health, childhood mortality, women’s empowerment, domestic violence, HIV/AIDS, migration, disability, and other health-related issues that can be used by programme managers and policymakers to evaluate and improve existing programmes. The sample design for the 2017-18 PDHS provides Results of Household and Individual Interviews estimates at the national level; for urban and rural in the 2017-18 Pakistan DHS areas separately; for four provinces including Punjab, Households Pakistan AJK GB Sindh, Khyber Pakhtunkhwa, and Balochistan; for two Households selected 12,815 1,792 1,064 regions including Azad Jammu and Kashmir (AJK) Households occupied 12,338 1,728 985 and Gilgit Baltistan (GB); Islamabad Capital Territory Households interviewed 11,869 1,697 974 (ICT); and FATA. In total, there are 13 second-level Response rate 96% 98% 99% survey domains. The national total for indicators Ever-married women age 15-49 excludes AJK and GB. Eligible women 13,118 1,769 1,043 A nationally representative sample of 12,364 Women interviewed 12,364 1,720 984 ever-married women age 15-49 in 12,815 selected Response rate 94% 97% 94% households and 3,145 ever-married men age 15-49 in Ever-married men age 15-49 one-third of the selected households were interviewed. Eligible men 3,634 359 250 This represents a response rate of 94% of women and Men interviewed 3,145 336 210 87% of men. Results of the household and individual Response rate 87% 94% 84% interviews for Pakistan, AJK ,and GB are presented in the table to the right. 2017-18 Pakistan Demographic and Health Survey Page 1 CHARacTERISTICS OF HOUSEHOLDS AND RESPONDENTS Household Composition The average household size in Pakistan is 6.6 members. Thirteen percent of households are headed by women. More than one-third (38%) of the Pakistani population is under age 15. Water, Sanitation, and Electricity More than 9 in 10 households (95%) have access to an improved source of drinking water. Ninety- seven percent of urban households and 93% of rural households have access to an improved source of drinking water. Seven in ten households in Pakistan © USAID Pakistan use an improved toilet facility. Urban households are more likely than rural households to use improved Ownership of Goods toilet facilities (88% versus 58%). Three in ten Most Pakistani households have a mobile phone households use unimproved sanitation—11% use a (94%), 63% have a television, and 6% have a radio. shared facility, 7% use an unimproved facility, and Urban households are more likely than rural 13% have no toilet facility. About 9 in 10 households households to own a mobile telephone or television, (93%) have a place for handwashing, either fixed or and rural households are more likely to own a radio. mobile. The majority of Pakistani households have In contrast, rural households are more likely to electricity (93%). Nearly all urban households have own agricultural land or farm animals than urban electricity, compared to 89% of rural households. households. Education Water, Sanitation, and Electricity by Residence Half of ever-married women age 15-49 and one- Percent of households with: quarter of ever-married men have no education. Total Urban Rural About 1 in 5 women (17%) and men (20%) have 99 attended primary school (classes 1-5), while 9% of 95 97 93 93 88 89 women and 15% of men have attended middle school 70 (classes 6-8). Only 12% of women and 20% of men 58 have secondary education (classes 9-10), while 13% of women and 19% of men have higher education (class 11 and above). Half of ever-married women and 30% of ever-married men are illiterate, meaning they Improved Improved Electricity cannot read. source of toilet facility Education among Women and Men drinking water Percent distribution of ever-married women and men NOTE: Excludes Azad Jammu and Kashmir and Gilgit Baltistan age 15-49 by highest level of education attended 13 19 Higher 12 9 20 Secondary 17 15 Middle 20 49 Primary 25 No education Women Men NOTE: Excludes Azad Jammu and Kashmir and Gilgit Baltistan. Figure <100% due to rounding. Page 2 2017-18 Pakistan Demographic and Health Survey FERTILITY AND ITS DETERMINANTS Total Fertility Rate Trends in Total Fertility Rate Births per woman for the three-year Currently, women in Pakistan have an average of 3.6 period before the survey children. Since 1990-91, fertility has decreased from 4.9 children per woman to the current level, a decline of 1.3 children. Fertility varies by residence and region. Women in 4.9 rural areas have an average of 3.9 children, compared 4.1 3.8 3.6 to 2.9 children among women in urban areas. Regionally, fertility ranges from a low of 3.0 children per woman in ICT Islamabad to 4.8 children per 1990-91 2006-07 2012-13 2017-18 woman in FATA. PDHS PDHS PDHS PDHS NOTE: Excludes Azad Jammu and Kashmir and Gilgit Baltistan Fertility also varies with education and household wealth. Women with no education have 1.6 more children than women with higher education (4.2 Total Fertility Rate by Household Wealth versus 2.6). Fertility decreases as the wealth of the Births per woman for the three-year respondent’s household* increases. Women living period before the survey in the poorest households have an average of 4.9 children, compared to 2.8 children among women living in the wealthiest households. 4.9 3.6 3.8 3.0 2.8 Total Fertility Rate by Region Births per woman for the three-year period before the survey Lowest Second Middle Fourth Highest Khyber Gilgit Poorest Wealthiest Pakhtunkhwa Baltistan Azad Jammu 4.0 4.7 NOTE: Excludes Azad Jammu and Kashmir and Gilgit Baltistan & Kashmir Jammu and 3.5 FATA 4.8 Kashmir (Disputed) ICT Punjab Islamabad 3.4 3.0 Balochistan 4.0 <3.5 3.5 - 4.0 Sindh 3.6 >4.0 * Wealth of families is calculated through household assets collected from DHS surveys—i.e., type of flooring; source of water; availability of electricity; possession of durable consumer goods. These are combined into a single wealth index. They are then divided into five groups of equal size, or quintiles, based on their relative standing on the household wealth index. 2017-18 Pakistan Demographic and Health Survey Page 3 Age at First Marriage, Sexual Intercourse, and Birth Pakistani women marry much earlier than men. The median age at first marriage for women age 25-49 years is 20.4 years, compared to 25.9 years for men age 30-49. Women with no education marry more than six years earlier than women with higher education (18.7 years versus 24.9 years). Three in ten Pakistani women are married by age 18. The median age at first sexual intercourse for women age 25-49 is 20.7 years, compared to 26.1 years among men age 30-49. Women from the wealthiest © 2017 Afshan Najafi, Courtesy of Photoshare households begin sexual activity nearly five years later than women from the poorest households (23.2 years versus 18.5 years). Six percent of women begin Teenage Fertility sexual activity before age 15, while 27% begin sexual activity before age 18. In Pakistan, 8% of adolescent women age 15-19 are already mothers or pregnant with their first child. Women have their first birth more than two years Teenage childbearing has remained unchanged after marriage. The median age at first birth for since 2012-13. Five percent of adolescent women in women is 22.8 years. Thirteen percent of women give the wealthiest households have begun childbearing, birth by age 18. compared to 10% of adolescent women in the two lowest wealth quintiles. Polygyny Median Age at First Marriage, Sex, and Birth Four percent of Pakistani women age 15-49 are in a Among women age 25-49 and men age 30-49 polygynous union, that is they have at least one co- Women Men wife.