Nepal Demographic And Health Survey 2006 Population Division Ministry of Health and Population Government of Nepal Kathmandu, Nepal New ERA Kathmandu, Nepal Macro International Inc. Calverton, Maryland, U.S.A. May 2007 New ERA Ministry of Health and Population The 2006 Nepal Demographic and Health Survey (2006 NDHS) is part of the worldwide MEASURE DHS project, which is funded by the United States Agency for International Development (USAID) under contract GPO-C-00- 03-00002-00. The views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. Additional information about the 2006 NDHS may be obtained from Population Division, Ministry of Health and Population, Government of Nepal, Ramshahpath, Kathmandu, Nepal; Telephone: (977-1) 4262987; New ERA, P.O. Box 722, Kathmandu, Nepal; Telephone: (977-1) 4423176/4413603; Fax: (977-1) 4419562; E-mail: [email protected]. Additional information about the DHS project may be obtained from Macro International Inc., 11785 Beltsville Drive, Calverton, MD 20705 USA; Telephone: 301-572-0200, Fax: 301-572- 0999, E-mail: [email protected], Internet: http://www.measuredhs.com. Recommended citation: Ministry of Health and Population (MOHP) [Nepal], New ERA, and Macro International Inc. 2007. Nepal Demographic and Health Survey 2006. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. CONTENTS TABLES AND FIGURES ........................................................................................................... ix FOREWORD ........................................................................................................................... xv ACKNOWLEDGMENTS ........................................................................................................xvii 2006 NDHS TECHNICAL ADVISORY COMMITTEE....................................................xix CONTRIBUTORS TO THE REPORT............................................................................xxi SUMMARY OF FINDINGS ..................................................................................................xxiii MILLENNIUM DEVELOPMENT GOALS ............................................................................xxix MAP OF NEPAL .....................................................................................................................xxx CHAPTER 1 INTRODUCTION 1.1 History, Geography, and Economy...................................................................1 1.2 Population.......................................................................................................3 1.3 Population and Reproductive Health Policies and Programs.............................3 1.4 Objectives of the Survey ..................................................................................5 1.5 Organization of the Survey...............................................................................6 1.6 Sample Design .................................................................................................6 1.7 Questionnaires.................................................................................................7 1.8 Hemoglobin Testing.........................................................................................8 1.9 Listing, Pretest, Training and Fieldwork ............................................................8 1.9.1 Listing................................................................................................8 1.9.2 Pretest...............................................................................................8 1.9.3 Training.............................................................................................8 1.9.4 Fieldwork...........................................................................................9 1.10 Data Processing................................................................................................9 1.11 Response Rates ..............................................................................................10 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2.1 Household Population by Age and Sex...........................................................11 2.2 Household Composition ................................................................................14 2.3 Household Characteristics..............................................................................16 2.4 Household Possessions...................................................................................20 2.5 Socioeconomic Status Index...........................................................................21 2.6 Possession of Mosquito Nets ..........................................................................22 2.7 Education of Household Population ...............................................................23 2.7.1 Educational Attainment of Household Population ............................23 2.7.2 School Attendance Ratios.................................................................27 2.8 Birth Registration............................................................................................32 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS 3.1 Characteristics of Survey Respondents............................................................35 3.2 Educational Attainment and Literacy ..............................................................37 Contents | iii 3.3 Access to Mass Media ....................................................................................43 3.3.1 Access to Specific Radio and Television Programs ............................45 3.4 Employment..................................................................................................48 3.4.1 Employment Status ..........................................................................48 3.4.2 Occupation......................................................................................51 3.4.3 Earnings, Employers, and Continuity of Employment........................54 3.5 Knowledge and Attitudes Concerning Tuberculosis ........................................55 3.6 Use of Tobacco..............................................................................................58 3.7 Hand Washing Practices ................................................................................61 CHAPTER 4 FERTILITY 4.1 Current Fertility..............................................................................................63 4.2 Fertility Differentials .......................................................................................64 4.3 Fertility Trends ...............................................................................................66 4.4 Pregnancy Outcomes .....................................................................................68 4.5 Children Ever Born and Surviving...................................................................69 4.6 Birth Intervals.................................................................................................70 4.7 Age at First Birth.............................................................................................72 4.8 Adolescent Pregnancy and Motherhood.........................................................73 CHAPTER 5 FAMILY PLANNING 5.1 Knowledge of Contraceptive Methods...........................................................75 5.2 Ever Use of Contraception ............................................................................76 5.3 Current Use of Contraception ........................................................................78 5.4 Current Use of Contraception by Background Characteristics .........................79 5.5 Trends in Current Use of Family Planning.......................................................81 5.6 Number of Children at First Use of Contraception..........................................82 5.7 Knowledge of Fertile Period ...........................................................................83 5.8 Sterilization....................................................................................................83 5.9 Source of Contraception ................................................................................86 5.10 Payment of Fees for Modern Contraceptive Methods .....................................87 5.11 Informed Choice............................................................................................88 5.12 Contraceptive Discontinuation.......................................................................89 5.13 Future Use of Contraception ..........................................................................89 5.14 Reasons for Nonuse of Contraception ............................................................90 5.15 Preferred Method of Contraception for Future Use ......................................90 5.16 Exposure to Family Planning Messages ...........................................................91 5.17 Contact of Nonusers with Family Planning Providers ......................................93 5.18 Men’s Attitudes toward Contraception ...........................................................94 5.19 Husband’s Knowledge of Wife’s Use of Contraception...................................97 5.20 Discussion of Family Planning Between Spouses ............................................97 CHAPTER 6 PROXIMATE DETERMINANTS OF FERTILITY 6.1 Current Marital Status ....................................................................................99