Cambodia 2014 Cambodia - The DHS Program

1 CambodiaDemographic and Health Survey2014 Cambodia 2014 Demographic and Health Survey Cambodia Demographic and Health Survey 2014 National Institute of Statistics Ministry of Planning Phnom Penh, Cambodia Directorate General for Health Ministry of Health Phnom Penh, Cambodia The DHS Program ICF International Rockville, Maryland, USA September 2015 The analysis of the Cambodia Demographic and Health Survey 2014 was achieved through the joint efforts of: Sok Kosal, NIS/MoP Chhay Satia, NIS/MoP They Kheam, NIS/MoP Phan Chinda, NIS/MoP Loun Mondol, DGH/MoH Lam Phirun, DGH/MoH Rathavuth Hong, ICF International Bernard Barr re, ICF International Anne Cross, ICF International Sunita Kishor, ICF International See Appendix D for a list of contributors to the implementation of the CDHS. The 2014 Cambodia Demographic and Health Survey (2014 CDHS) is part of The DHS Program , a worldwide project which assists countries in the collection of data to monitor and evaluate population, health, and nutrition programs.

2 Funding was provided by the Royal Government of Cambodia (RGC), the United States Agency for International Development (USAID), the Australian Department of Foreign Affairs and Trade (Australia-DFAT), the United Nations Population Fund (UNFPA), the United Nations Children s Fund (UNICEF), the Japan International Cooperation Agency (JICA), the Korean International Cooperation Agency (KOICA), and the Health Sector Support Program Second Phase (HSSP-2). Additional information about the survey can be obtained from the National Institute of Statistics; 386 Monivong Boulevard, Sangkat Beong Keng Kang 1, Chamkar Mon, Phnom Penh, Cambodia ; Telephone: (855) 23-213650; E-mail: Internet: and the Directorate General for Health, Ministry of Health 80 Samdech Penn Nouth Boulevard (289), Sangkat Boeungkak 2, Tuol Kork, Phnom Penh, Cambodia ; Telephone: (855) 23-885970/23-884909; E-mail: Internet: Additional information about The DHS Program can be obtained from ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850 USA; Telephone: 301-572-0200, Fax: 301-572-0999, E-mail: Internet: Suggested citation: National Institute of Statistics, Directorate General for Health, and ICF International, 2015.

3 Cambodia Demographic and Health Survey 2014. Phnom Penh, Cambodia , and Rockville, Maryland, USA: National Institute of Statistics, Directorate General for Health, and ICF International. Cover photo of Angkor Wat temple 2014 Tan. Contents iii CONTENTS TABLES AND FIGURES .. ix FOREWORD .. xvii ACKNOWLEDGMENTS .. xix MAP OF Cambodia .. xx 1 INTRODUCTION .. 1 Geodemography, History, and Economy .. 1 Geodemography .. 1 History .. 2 Economy .. 2 Health Status and Policy .. 2 Objective and Survey Organization .. 4 Sample Design .. 4 Questionnaires .. 5 Training and Fieldwork .. 7 Biomarker Testing .. 7 Anthropometric Measurement .. 7 Hemoglobin 8 Micronutrient Testing .. 8 Data Processing .. 8 Sample Coverage .. 8 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS.

4 11 Characteristics of the Household Population .. 11 Age and Sex Composition .. 11 Household Composition .. 13 Education of the Household Population .. 14 Housing Characteristics .. 17 Water Supply .. 18 Sanitation Facilities .. 20 Hand Washing .. 21 Flooring Material and Cooking Arrangements .. 22 Household Possessions .. 23 Household Wealth .. 23 Birth Registration .. 24 Children s Living Arrangements, Orphanhood, and School Attendance by Survivorship of Parents .. 25 Children s Living Arrangements and Orphanhood .. 25 School Attendance by Survivorship of Parents .. 27 3 UTILIZATION OF HEALTH SERVICES FOR ACCIDENT, ILLNESS, OR INJURY .. 29 Accidental Death or Injury .. 29 Frequency of Accidental Death or Injury .. 29 Type of Accident .. 30 Prevalence and Severity of Illness or Injury .. 32 Treatment Sought for Illness or Injury.

5 33 Utilization of Health Care Facilities .. 34 iv Contents Cost for Health Care .. 36 Distribution of Cost for Health Care .. 36 Expenditures for Health Care .. 36 Sources of Money for Health Care Expenditures .. 38 4 DISABILITY .. 41 Disability among the General Household Population .. 41 Disability among Ill or Injured Household Members .. 43 Disability and Employment .. 44 5 RESPONDENT CHARACTERISTICS .. 47 Characteristics of Survey Respondents .. 47 Educational Attainment and Literacy .. 49 Access to Mass Media .. 52 Employment .. 55 Employment Status .. 55 Occupation .. 57 Earnings, Employers, and Continuity of Employment .. 59 Health Insurance .. 60 Use of Tobacco .. 62 6 FERTILITY .. 67 Current Fertility Levels and Differentials .. 67 Fertility Trends.

6 70 Comparison of Current and Cumulative Fertility Levels .. 70 Retrospective Data .. 70 Comparison with Previous CDHS .. 71 Children Ever Born and Living .. 72 Birth Intervals .. 73 Age at First Birth .. 75 Teenage Pregnancy and Motherhood .. 76 7 PRACTICE OF ABORTION .. 79 Number of Lifetime Induced Abortions .. 79 Practice of Abortion in the Past Five Years .. 81 Pregnancy Duration at the Time of Abortion .. 81 Place of Abortion .. 82 Persons Who Helped with the Abortion .. 83 Method Used for the Abortion .. 83 8 FAMILY PLANNING .. 85 Knowledge of Contraceptive Methods .. 85 Current Use of Contraceptive Methods .. 86 Use of Social Marketing Brands .. 89 Knowledge of Fertile Period .. 90 Timing of 91 Source of Family Planning Methods.

7 91 Informed Choice .. 92 Future Use of Contraception .. 93 Exposure to Family Planning Messages .. 94 Contact of Nonusers with Family Planning Providers .. 95 Contents v 9 OTHER PROXIMATE DETERMINANTS OF FERTILITY .. 97 Marital Status .. 97 Polygamy .. 98 Age at First Union .. 99 Age at First Sexual Intercourse .. 102 Recent Sexual Activity .. 105 Postpartum Amenorrhea, Abstinence, and Insusceptibility .. 108 Termination of Exposure to Pregnancy .. 109 10 FERTILITY PREFERENCES .. 111 Desire for More Children .. 111 Need and Demand for Family Planning Services .. 114 Ideal Family Size .. 116 Fertility Planning .. 118 11 ADULT AND MATERNAL MORTALITY .. 121 Data Quality Issues .. 121 Adult Mortality .. 123 Maternal Mortality .. 123 12 INFANT AND CHILD MORTALITY.

8 127 Assessment of Data Quality .. 128 Levels and Trends in Childhood Mortality .. 128 Socioeconomic Differentials in Childhood Mortality .. 129 Demographic Differentials in Mortality .. 131 Perinatal Mortality .. 132 High-Risk Fertility Behavior .. 133 13 MATERNAL HEALTH .. 137 Antenatal Care .. 137 Source of Antenatal Care .. 137 Components of Antenatal Care .. 139 Tetanus Toxoid Vaccinations .. 141 Childbirth and Delivery .. 141 Place of 142 Assistance at Delivery .. 143 Postnatal Care and Practices .. 144 Perceived Problems in Accessing Women s Health Care .. 149 14 CHILD HEALTH .. 151 Child s Size at Birth .. 151 Immunization of Children .. 152 Acute Respiratory Infection .. 155 Fever .. 157 Diarrhea .. 158 Feeding Practices.

9 161 Knowledge of ORS Packets .. 163 Stool Disposal .. 163 15 EARLY CHILDHOOD EDUCATION AND DEVELOPMENT .. 165 Early Childhood Education and Learning .. 165 Adequate Care for Young Children .. 169 Early Childhood Development .. 170 vi Contents 16 NUTRITION OF CHILDREN AND WOMEN .. 173 Nutritional Status of Children .. 174 Measurement of Nutritional Status among Young Children .. 174 Measures of Child Nutritional Status .. 175 Trends in Children s Nutritional Status .. 177 Initiation of Breastfeeding .. 178 Breastfeeding Status by Age .. 180 Duration of Breastfeeding .. 181 Types of Complementary Foods .. 183 Infant and Young Child Feeding (IYCF) Practices .. 184 Prevalence of Anemia in Children .. 187 Micronutrient Intake among Children .. 189 Use of Iodized Salt .. 191 Nutritional Status of Women .. 192 Prevalence of Anemia in Women.

10 194 Micronutrient Intake among Mothers .. 196 17 MICRONUTRIENTS .. 199 Coverage of Micronutrient Testing .. 200 Iron, Hemoglobin, and Parasitic Infections .. 200 Anemia and Iron Status in Mothers .. 201 Anemia and Iron Status in Children .. 201 Intestinal Parasite Infection .. 203 Vitamin and Calcium Deficiency .. 203 Vitamin and Calcium Deficiency among Mothers .. 203 Vitamin and Calcium Deficiency among Children .. 203 Urine Iodine Concentration .. 205 18 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR .. 207 Knowledge of HIV/AIDS and of Transmission and Prevention 207 Awareness of AIDS .. 207 HIV Prevention Methods .. 208 Knowledge about Transmission .. 210 Knowledge of Mother-to-Child Transmission .. 213 Stigma Associated with AIDS and Attitudes Related to HIV/AIDS .. 215 Attitudes towards Negotiating Safer Sex .. 217 Multiple Sexual Partnerships.