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Kazakhstan Demographic and Health Survey 1999 [FR111]

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Kazakhstan Demographic and Health Survey 1999 [FR111] World Summit for Children Indicators: Kazakhstan 1999 __________________________________________________________________________________________________ Value __________________________________________________________________________________________________ BASIC INDICATORS __________________________________________________________________________________________________ Childhood mortality Infant mortality rate 61.9 per 1,000 Under-five mortality rate 71.4 per 1,000 Maternal mortality Maternal mortality ratio 62.5 per 100,0001 Childhood undernutrition Percent stunted (of children under 5 years) 9.7 Percent wasted (of children under 5 years) 1.8 Percent underweight (of children under 5 years) 4.2 Clean water supply Percent of households within 15 minutes of a safe water supply2 83.6 Sanitary excreta disposal Percent of households with flush toilets 47.2 Basic education Percent of women 15-49 with completed primary education 99.3 Percent of men 15-49 with completed primary education 99.1 Percent of girls 6-12 attending school 81.4 Percent of boys 6-12 attending school 80.3 Percent of women 15-49 who are literate 99.8 Children in especially Percent of children who are orphans (both parents dead) 0.2 difficult situations Percent of children who do not live with their natural mother 6.2 Percent of children who live in single adult households 5.9 __________________________________________________________________________________________________ SUPPORTING INDICATORS __________________________________________________________________________________________________ Women's Health Birth spacing Percent of births within 24 months of a previous birth3 32.3 Safe motherhood Percent of births with medical prenatal care 94.4 Percent of births with prenatal care in first trimester 46.8 Percent of births with medical assistance at delivery 99.0 Percent of births in a medical facility 98.0 Percent of births at high risk 38.7 Family planning Contraceptive prevalence rate (any method, married women) 66.1 Percent of currently married women with an unmet demand for family planning 8.7 Percent of currently married women with an unmet need for family planning to avoid a high-risk birth 6.0 Nutrition Maternal nutrition Percent of mothers with low BMI 7.4 Low birth weight Percent of births at low birth weight (of those reporting numeric weight) 7.3 Breastfeeding Percent of children under 4 months who are exclusively breastfed 46.6 Child Health Measles vaccination Percent of children 12-23 months with measles vaccination 86.5 Fully vaccinated Percent of children 12-23 months fully vaccinated 80.5 Diarrhea control Percent of children with diarrhea in preceding 2 weeks who received oral rehydration therapy 32.0 Acute respiratory infection Percent of children with acute respiratory infection in preceding 2 weeks who were seen by medical personnel 48.0 __________________________________________________________________________________________________ 1 Data from the Agency on Health 2 Piped, well, and bottled water 3 First births are excluded. Kazakhstan Demographic and Health Survey 1999 Academy of Preventive Medicine Almaty, Kazakhstan Macro International Inc. Calverton, Maryland USA November 2000 Academy of Preventive Medicine Macro International Inc. The report summarizes the findings of the 1999 Kazakhstan Demographic and Health Survey (1999 KDHS), which was conducted by the Academy of Preventive Medicine of Kazakhstan. Macro International Inc. provided technical assistance. Funding was provided by the U.S. Agency for International Development (USAID). The KDHS is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect data on fertility, family planning, and maternal and child health. Additional information on the Kazakhstan survey may be obtained from the Academy of Preventive Medicine of Kazakhstan (telephone: 73272-427855 ; fax: 73272-429203; e-mail: [email protected]). Additional information about the DHS program may be obtained by writing to DHS, Macro International Inc., 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA (telephone 301-572- 0200; fax 301-572-0999; e-mail: [email protected]). Recommended citation: Academy of Preventive Medicine [Kazakhstan] and Macro International Inc. 1999. Kazakhstan Demographic and Health Survey 1999. Calverton, Maryland: Academy of Preventive Medicine and Macro International Inc. ii * Contents CONTENTS Page Tables and Figures ......................................................... ix Foreword ................................................................xvii Summary of Findings ...................................................... xix Map of Kazakhstan ....................................................... xxiv CHAPTER 1 KAZAKHSTAN: BACKGROUND INFORMATION, OBJECTIVES, AND ORGANIZATION OF THE SURVEY ................1 Toregeldy Sharmanov 1.1 Geography and Population .........................................1 1.2 History of Kazakhstan ............................................1 1.3 Economy ......................................................3 1.4 Health Care System and Epidemiological Profile of Kazakhstan ............4 1.5 Family Planning Policies and Programs ...............................5 1.6 Demographic and Health Data Collection System in Kazakhstan ............6 1.7 Objectives and Organization of the Survey .............................7 1.7.1 Sample Design and Implementation ............................7 1.7.2 Questionnaires ............................................8 1.7.3 Training and Fieldwork ......................................9 1.7.4 Data Processing ..........................................10 1.7.5 Response Rates ...........................................10 CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS .........11 Adyl Katarbayev and Kristi Fair 2.1 Demographic Characteristics of Households ...........................11 2.2 Household Composition ..........................................13 2.3 Educational Level of Household Members ............................14 2.3.1 Educational Attainment of Household Members ..................15 2.3.2 School Attendance Ratios ...................................15 2.3.3 Grade Repetition and Dropout Rates ...........................17 2.4 Housing Characteristics ..........................................18 2.4.1 Household Durable Goods ..................................20 CHAPTER 3 CHARACTERISTICS OF SURVEY RESPONDENTS AND WOMEN’S STATUS ......................................23 Raikhan Sissekenova, Sunita Kishor, and Elnar Kurmangaliyeva 3.1 Characteristics of Survey Respondents ...............................23 3.1.1 Background Characteristics ..................................23 3.1.2 Educational Level of the Respondents ..........................23 3.1.3 Occupation ..............................................27 3.1.4 Access to Mass Media ......................................28 Contents * 3 Page 3.2 Women’s Status ................................................29 3.2.1 Employment and Cash Earnings ..............................30 3.2.2 Decision-making Regarding Use of Cash Earnings .................33 3.2.3 Household Decision-making .................................35 3.2.4 Women’s Agreement with Reasons for Wife Beating ...............37 3.2.5 Women’s Agreement with Reasons for Refusing Sexual Relations .....41 CHAPTER 4 FERTILITY ..................................................43 Toregeldy Sharmanov and Kia I. Weinstein 4.1 Current Fertility ................................................43 4.2 Fertility Trends .................................................47 4.3 Children Ever Born and Living .....................................49 4.4 Birth Intervals .................................................50 4.5 Age at First Birth ...............................................50 4.6 Pregnancy and Motherhood Among Teenage Women ....................53 CHAPTER 5 CONTRACEPTION ...........................................55 Holly Seyhan and Akkumis Salkhanova 5.1 Knowledge of Contraceptive Methods ...............................55 5.2 Ever Use of Contraception ........................................57 5.3 Current Use of Contraception ......................................57 5.4 Current Use by Background Characteristics ...........................60 5.5 Current Use by Women’s Status ....................................64 5.6 Use of the Pill ..................................................66 5.7 Number of Children at First Use of Contraception ......................67 5.8 Source of Family Planning Methods .................................68 5.9 Informed Choice ................................................69 5.10 Discontinuation within 12 Months of Use .............................69 5.11 Intention to Use Family Planning among Nonusers .....................72 5.12 Reasons for Nonuse of Contraception ................................73 5.13 Contact of Nonusers of Family Planning with Family Planning Providers .....73 5.14 Exposure to Family Planning Messages in the Electronic Media ............74 5.15 Exposure to Family Planning Messages in the Print Media ................76 5.16 Red Apple Social Marketing Logo ...................................76 5.17 Attitudes of Couples toward Family Planning ..........................78 CHAPTER 6 INDUCED ABORTION ........................................79 Akkumis Salkhanova and Holly Seyhan 6.1 Pregnancy Outcomes ............................................79 6.2 Lifetime Experience with Induced Abortion ...........................80 6.3
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