Pakistan 2017-18 Pakistan - Demographic and Health Surveys

1 PakistanDemographic and Health Survey2017-18 Pakistan 2017-18 Demographic and Health survey Pakistan Demographic AND Health survey 2017-18 National Institute of Population studies Islamabad, Pakistan The DHS Program ICF Rockville, Maryland, USA January 2019 The 2017- 18 Pakistan Demographic and Health survey (2017- 18 P DHS) was implemented by the National Institute of Population studies (NIPS) under the aegis of the Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan . ICF provided technical assistance through The DHS Program, a project funded by the United States Agency for International Development (USAID) that provides support and technical assistance in the implementation of population and Health Surveys in countries worldwide.

2 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 the 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: 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; email: internet: Cover photo: Blue Hour at Pakistan Monument 2016 by Muhammad Ashar [CC BY-SA ], from Wikimedia Commons ISBN: 978-969- 9732-04-1 Suggested citation: National Institute of Population studies (NIPS) [ Pakistan ] and ICF.

3 2019. Pakistan Demographic and Health survey 2017-18 . Islamabad, Pakistan , and Rockville, Maryland, USA: NIPS and ICF. Contents iii CONTENTS TABLES AND FIGURES .. ix FOREWORD .. xvii ACKNOWLEDGEMENTS .. xix 2017-18 Pakistan Demographic AND Health survey TECHNICAL ADVISORY COMMITTEE .. xxi CONTRIBUTORS TO THE REPORT .. xxiii ACRONYMS AND ABBREVIATIONS .. xxv READING AND UNDERSTANDING TABLES FROM THE 2017-18 Pakistan Demographic AND Health survey (PDHS) .. xxix SUSTAINABLE DEVELOPMENT GOALS INDICATORS .. xxxvii MAP OF Pakistan .. xxxviii 1 INTRODUCTION AND survey METHODOLOGY .. 1 survey Objectives .. 1 Sample Design .. 2 Questionnaires .. 3 Anthropometry .. 4 Pretest .. 4 Training of Field Staff .. 4 Fieldwork .. 5 Data Processing .. 6 Response Rates.

4 6 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION .. 9 Drinking Water Sources and Treatment .. 9 Sanitation .. 10 Exposure to Smoke inside the Home .. 11 Other Housing Characteristics .. 11 Household Wealth .. 11 Household Durable Goods .. 11 Hand washing .. 12 Household Population and Composition .. 12 Children s Living Arrangements and Parental Survival .. 13 Birth Registration .. 14 Registration with NADRA .. 15 Education .. 15 Educational Attainment .. 15 School Attendance .. 16 3 CHARACTERISTICS OF RESPONDENTS .. 33 Basic Characteristics of survey Respondents .. 33 Education and Literacy .. 34 Mass Media Exposure .. 35 Employment .. 36 Occupation .. 36 Health Insurance Coverage and Safety Net .. 37 Tobacco Use .. 38 Knowledge Concerning Tuberculosis.

5 38 Knowledge Concerning Hepatitis .. 38 iv Contents 4 MARRIAGE AND SEXUAL ACTIVITY .. 67 Marital Status .. 67 Polygyny .. 68 Age at First Marriage .. 69 Consanguinity .. 69 Age at First Sexual Intercourse .. 70 Recent Sexual Activity .. 71 5 FERTILITY .. 83 Current Fertility .. 84 Children Ever Born and Living .. 85 Birth Intervals .. 86 Insusceptibility to Pregnancy .. 86 Age at First Birth .. 88 Teenage Childbearing .. 88 6 FERTILITY PREFERENCES .. 101 Desire for Another Child .. 101 Ideal Family Size .. 103 Fertility Planning Status .. 104 Wanted Fertility Rates .. 104 7 FAMILY PLANNING .. 113 Contraceptive Knowledge and Use .. 114 Source of Modern Contraceptive Methods .. 116 Informed Choice .. 117 Discontinuation of Contraceptives.

6 117 Demand for Family Planning .. 118 Decision Making about Family Planning .. 120 Future Use of Contraception .. 120 Exposure to Family Planning Messages in the Media .. 120 Contact of Nonusers with Family Planning Providers .. 121 Postpartum Counselling on Family Planning .. 122 Men s Attitude towards Contraceptive Use .. 122 8 INFANT AND CHILD MORTALITY .. 145 Infant and Child Mortality .. 146 Biodemographic and Sociodemographic Risk Factors .. 146 Perinatal Mortality .. 148 High-Risk Fertility Behaviour .. 149 9 MATERNAL Health CARE .. 155 Antenatal Care Coverage and Content .. 156 Skilled Providers .. 156 Timing and Number of ANC Visits .. 157 Components of ANC Visits .. 157 Protection against Neonatal Tetanus .. 158 Delivery Services.

7 158 Institutional Deliveries .. 158 Skilled Assistance during Delivery .. 160 Delivery by Caesarean Section .. 161 Postnatal Care .. 162 Postnatal Health Check for Mothers .. 162 Postnatal Health Check for Newborns .. 163 Contents v Newborn Care Practices .. 163 Pregnancy Outcomes .. 164 Problems in Accessing Health Care .. 164 10 CHILD Health .. 183 Birth Weight .. 184 Vaccination of Children .. 184 Symptoms of Acute Respiratory Infection .. 187 Fever .. 188 Diarrhoeal Disease .. 189 Prevalence of Diarrhoea and Treatment-seeking Behaviour .. 189 Feeding Practices .. 190 Treatment of Diarrhoea .. 190 Knowledge of ORS Packets .. 192 Treatment of Childhood Illness .. 192 Disposal of Children s Stools .. 192 11 NUTRITION OF CHILDREN AND WOMEN.

8 209 Nutritional Status of Children .. 209 Measurement of Nutritional Status among Young Children .. 210 Data Collection .. 211 Malnutrition Prevalence in Children .. 211 Infant and Young Child Feeding Practices .. 212 Initiation of Breastfeeding .. 213 Exclusive Breastfeeding .. 213 Reasons for Not Breastfeeding or Stopping Breastfeeding .. 215 Median Duration of Breastfeeding .. 215 Complementary Feeding .. 215 Minimum Acceptable Diet .. 216 Micronutrient Intake and Supplementation among Children .. 217 Nutritional Status of Women .. 218 Micronutrient Supplementation And Deworming During Pregnancy .. 219 12 MALARIA .. 233 Ownership of Insecticide-treated Nets .. 234 Household Access to and Use of ITNs .. 235 Use of ITNs by Children and Pregnant Women.

9 236 Use of Antimalarial Drugs .. 236 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR .. 245 HIV/AIDS Knowledge, Transmission, and Prevention Methods .. 246 Knowledge about Mother-to-Child Transmission .. 247 Discriminatory Attitudes towards People Living with HIV .. 248 Coverage of HIV Testing Services .. 248 Awareness of HIV Testing Services and Experience with HIV Testing .. 249 Self-reporting of Sexually Transmitted Infections .. 249 HIV/AIDS-related Knowledge and Behaviour among Young People .. 249 Knowledge .. 249 First Sex .. 250 Coverage of HIV Testing Services .. 250 Knowledge of Treatment of HIV .. 250 vi Contents 14 DISABILITY .. 263 Disability by Domain and Age .. 263 Disability among Adults by Other Background Characteristics.

10 264 15 WOMEN S EMPOWERMENT .. 269 Married Women s and Men s Employment .. 270 Control over Women s Earnings .. 270 Control over Men s Earnings .. 271 Women s Control over Their Own Earnings and Those of Their Husbands .. 272 Women s and Men s Ownership of Assets .. 272 Ownership of Title or Deed for House and Land .. 273 Ownership and Use of Bank Accounts and Mobile Phones .. 273 Women s Participation in Decision Making .. 274 Attitudes toward Wife Beating .. 275 Attitude towards Negotiating Safer Sexual Relations with Husband .. 276 Ability to Negotiate Sexual Relations with Husband .. 277 Women s Empowerment Indicators .. 278 Current Use of Contraception by Women s Empowerment .. 278 Ideal Number of Children and Unmet Need for Family Planning by Women s Empowerment.