MEASURE DHS assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. Funded by the U.S. Agency for International Development 

(USAID), MEASURE DHS is implemented by ORC Macro in Calverton, Maryland. The opinions 

expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for 

International Development. 

The main objectives of the MEASURE DHS project are: 

1) to provide decisionmakers in survey countries with information useful for informed policy choices, 

2) to expand the international population and health database, 

3) to advance survey methodology, and 

4) to develop in participating countries the skills and resources necessary to conduct high-quality demographic and health surveys. 

 

Information about the MEASURE DHS project or the status of MEASURE DHS surveys is available 

on the Internet at http://www.measuredhs.com or by contacting: 

ORC Macro 

11785 Beltsville Drive, 

Suite 300 

Calverton, MD 20705 USA 

Telephone: 301-572-0200 

Fax: 301-572-0999 

E-mail: reports@orcmacro.com 

DHS Comparative Reports No. 11 

The Context of Women’s Health: 

Results from the Demographic 

and Health Surveys, 1994-2001 

Altrena Mukuria 

 Casey Aboulafia 

Albert Themme 

ORC Macro 

Calverton, Maryland, USA 

December 2005 
This publication was made possible through support provided by the U.S. 

Agency for International Development under the terms of Contract No. 

HRN-C-00-97-00019-00. The opinions expressed herein are those of the 

authors and do not necessarily reflect the views of the U.S. Agency for 

International Development. 

Recommended citation: 

Mukuria, Altrena, Casey Aboulafia, and Albert Themme. 2005. The Context of Women’s Health: 

Results from the Demographic and Health Surveys, 1994-2001. Comparative Reports No. 11. 

Calverton, Maryland: ORC Macro. 
Contents iii

Contents 

Tables and Figures v 

Preface ix 

Acknowledgments xi 

Executive Summary xiii 

 

1 Introduction 1 

2 Background 3 

3 Methodology 5 

 3.1 Sample of Women 5 

 3.2 Indicators for Defining the Context of the Health 

 of Mothers 5 

 

4 Findings 9 

 4.1 Women’s Health 9 

 4.1.1 Maternal Mortality 9 

 4.1.2 Maternal Nutritional Status 10 

 4.1.3 Micronutrient Status, Supplementation, and 

 Fortification 14 

 4.1.4 Low Birth Weight 20 

 4.2 Context of Women’s Health 21 

 4.2.1 Social Context 22 

 4.2.2 Behavioral Context 34 

 4.2.3 Environmental Context 60 

5 Summary and Conclusions 67 

 5.1 Women’s Health 67 

 5.2 Context of Women’s Health 68 

 5.2.1 Social Context 68 

 5.2.2 Behavioral Context 69 

 5.2.3 Environmental Context 71 

 

References 73 

Appendix A Tables 77 

Tables and Figures v

Tables and Figures 

Table 1.1 Summary of DHS surveys included in this report, 1994-2001 2 

Table 3.1 List of indicators used in this analysis 7 

Table A.4.1 Maternal mortality ratio 77 

Table A.4.2 Nutritional status of mothers with children under three years 78 

Table A.4.3 Micronutrients: Anemia status and iron intake among mothers 79 

Table A.4.4 Micronutrients: Night blindness, vitamin A intake among 

 mothers, and iodized salt 80 

Table A.4.5 Low birth weight 81 

Table A.4.6 Education 82 

Table A.4.7 Literacy 83 

Table A.4.8 Exposure to mass media 84 

Table A.4.9 Employment status 85 

Table A.4.10 Current marital status 86 

Table A.4.11 Polygyny 87 

Table A.4.12 Female-headed households 88 

Table A.4.13 Median age at first sexual intercourse, first marriage, and 

first birth 89 

Table A.4.14 Fertility 90 

Table A.4.15 Duration of childbearing period 91 

Table A.4.16 Initial breastfeeding and median duration of breastfeeding 92 

Table A.4.17 Exclusive breastfeeding 93 

Table A.4.18 Postpartum amenorrhea, abstinence, and insusceptibility 94 

Table A.4.19 Current use of contraception 95 

Table A.4.20 Unmet need for family planning or child spacing 96 
vi Tables and Figures

Table A.4.21 Antenatal care 98 

Table A.4.22 Delivery care 99 

Table A.4.23 Knowledge of HIV/AIDS prevention methods 100 

Table A.4.24 Urban-rural residence 101 

Table A.4.25 Household amenities 102 

Figure 4.1 Maternal mortality ratio 10 

Figure 4.2 Short stature in women 11 

Figure 4.3 Chronic energy deficiency (CED) 12 

Figure 4.4 Overweight in women 13 

Figure 4.5 Anemia in women 15 

Figure 4.6 Iron supplementation during pregnancy 16 

Figure 4.7 Night blindness in pregnancy 17 

Figure 4.8 Vitamin A supplementation 18 

Figure 4.9 Iodized salt 19 

Figure 4.10 Low birth weight 21 

Figure 4.11 School attendance ratio 22 

Figure 4.12 Illiteracy 24 

Figure 4.13 Newspaper reading 25 

Figure 4.14 Television watching 26 

Figure 4.15 Radio listening 27 

Figure 4.16 Employment status 28 

Figure 4.17 Work in agriculture 29 

Figure 4.18 Marital status 31 

Figure 4.19 Polygyny 32 

Figure 4.20 Female-headed households 34 
Tables and Figures vii

Figure 4.21 Median age at first sexual intercourse 35 

Figure 4.22 Median age at first marriage 36 

Figure 4.23 Median age at first birth 37 

Figure 4.24 Fertility 39 

Figure 4.25 Duration of childbearing period 41 

Figure 4.26 Exclusive breastfeeding 43 

Figure 4.27 Median duration of breastfeeding 44 

Figure 4.28 Median duration of postpartum amenorrhea 45 

Figure 4.29 Median duration of postpartum abstinence 46 

Figure 4.30 Median duration of postpartum insusceptibility 47 

Figure 4.31 Current use of contraception 48 

Figure 4.32 Unmet need for family planning or child spacing 49 

Figure 4.33 Antenatal care by urban-rural residence 51 

Figure 4.34 Antenatal care visits by urban-rural residence 53 

Figure 4.35 Tetanus immunization during pregnancy 54 

Figure 4.36 Live births attended by a medical professional by urban- 

 rural residence 56 

Figure 4.37 Knowledge of abstinence to prevent HIV/AIDS 58 

Figure 4.38 Knowledge of being faithful to one partner to prevent 

HIV/AIDS 59 

Figure 4.39 Knowledge of using condoms as a way to prevent HIV/AIDS 60 

Figure 4.40 Rural residence 61 

Figure 4.41 Lack of electricity 62 

Figure 4.42 Household flooring 63 

Figure 4.43 Lack of piped water 64 

Figure 4.44 Lack of toilet facilities 65 

Preface ix

Preface 

One of the most significant contributions of the MEASURE DHS program is the creation of an internationally comparable body of data on the demographic and health characteristics of populations in developing countries. The DHS Comparative Reports series examines these data across countries in a comparative 

framework. The DHS Analytical Studies series focuses on specific topics. The principal objectives of both 

series are to provide information for policy formulation at the international level and to examine individual country results in an international context. Whereas Comparative Reports are primarily descriptive, 

Analytical Studies take a more analytical approach. 

The Comparative Reports series covers a variable number of countries, depending on the availability of 

data sets. Where possible, data from previous DHS surveys are used to evaluate trends over time. Each 

report provides detailed tables and graphs organized by region. Survey-related issues such as questionnaire 

comparability, survey procedures, data quality, and methodological approaches are addressed as needed. 

The topics covered in Comparative Reports are selected by MEASURE DHS staff in conjunction with 

the U.S. Agency for International Development. Some reports are updates of previously published reports. 

It is anticipated that the availability of comparable information for a large number of developing countries will enhance the understanding of important issues in the fields of international population and 

health by analysts and policymakers. 

Martin Vaessen 

Project Director

Acknowledgments xi

 Acknowledgments 

The authors would like to thank Adrienne Cox, Alfredo Fort, Kiersten Johnson, Sunita Kishor, Monica 

Kothari, Laurie Liskin, Reena Sethi, and Vinod Mishra for their work in data and/or report reviewing 

and editing. The authors also thank Kaye Mitchell for assistance with the document production. 

Executive Summary xiii

Executive Summary 

This report describes the context of women’s health in developing countries by reporting on key indicators found in the Demographic and Health Surveys (DHS) of 46 countries in 5 regions around the 

world. An analysis of the context of women’s health explores the status of maternal health (since most 

women age 15-49 years are mothers in developing countries, key measures of women’s health are based 

on mothers) along with the social, behavioral, and environmental contexts that encompass the lives of 

women. 

Women’s Health 

The status of women’s health as measured by the maternal mortality ratio (MMR), maternal nutritional status, and proportion of low birth weight babies born to women age 15-49 years is a reflection of 

the level of poverty under which women live. MMR is highest in sub-Saharan Africa averaging about 

500 deaths per 100,000 live births, but it reaches as high as 1,000 in 4 of the 25 sub-Saharan African 

countries. South/Southeast Asia follows, with ratios ranging between 172 and 540 deaths per 100,000 live 

births. Although these ratios are appalling, they do not tell the full story of maternal health. Many women 

die in childbirth, but many more women survive only to live in unhealthy conditions. 

This report calls for a renewed emphasis on women’s health, including monitoring national-level indicators of the context in which women live. Poor nutritional status, including chronic energy and micronutrient deficiencies, undermines women’s health as evidenced by the proportion of women delivering low 

birth weight babies. Maternal nutrition is poor worldwide. It is particularly evident in South/Southeast 

Asia and Latin America and the Caribbean, where three countries in each region have more than 10 percent of mothers being less than 145 cm tall. However poor rates of nutritional status, as measured by low 

body mass index—BMI less than 18.5—range from 10 to 19 percent in most countries. Serious undernutriton (over 20 percent) is evident in most countries in sub-Saharan Africa, South/Southeast Asia, and in 

Yemen in North Africa/West Asia/Europe. With the prevalence of undernutrition over 40 percent, the 

situation is considered critical in Eritrea and Bangladesh. Despite these levels of undernutrition, women 

in developing countries also suffer from over nutrition, particularly in North Africa/West Asia/Europe 

and Latin America and the Caribbean. 

High levels of anemia (25 percent or more) among women age 15-49 years are found in all of 11 countries for which data are available. The highest proportion is found in Uzbekistan (60 percent), with Cambodia, India, and Haiti having prevalences over 50 percent. Nevertheless, iron supplementation is not 

widely practiced; only half of 23 countries report 50 percent or more of women receiving some iron supplementation in pregnancy. Vitamin A supplementation is quite low; 6 of 12 countries report only 11 

percent of women receiving vitamin A postpartum. 

A high prevalence of low birth weight babies is indicative of poor health and nutritional status among 

women. In 27 of the 44 countries with available birth weight data, more than 10 percent of women give 

birth to low birth weight children. Three countries, Yemen, India, and Haiti have a prevalence greater 

than 20 percent. 

Social Context 

Social context indicators reflect the education, employment, marital status, and household headship 

experiences of women that influence women’s potential access to resources and information. Women’s 
xiv Executive Summary 

status indicators are likely to influence the health of women by the way they limit their socioeconomic 

opportunities, fertility choices, nutritional status, and access and utilization of health services, along with 

other factors. Low rates of girls’ school attendance between ages 6-10 years are evidence in all regions except Latin America and the Caribbean. Gender bias in favor of boys’ school attendance is noted in half of 

the countries in sub-Saharan Africa, Yemen in North Africa/West Asia/Europe and in Nepal in 

South/Southeast Asia. Widespread female illiteracy exists in these same three regions along with limited 

exposure of women to mass media. Female employment rates are high but women are mostly working in 

agriculture which is generally of low pay and status thereby associated with a greater risk of poor health. 

Marital status provides a mixed blessing for women. Although marriage offers social security, it increases 

a woman’s exposure to higher rates of fertility. Female-headed households pose an opportunity and a 

threat to women’s health; many decisions affecting women are made at the household level but if female 

household heads have low education, are employed in the agricultural sector, and have an excessive workload, this does not promote women’s health. About 20 percent of households are headed by women in 

most countries, and prevalences of over 40 percent are reported in Ghana, Namibia, and Haiti. 

Behavioral Context 

The behavioral context of women’s health is composed of the decisions and actions that influence overall fertility, such as a woman’s age at first intercourse and first marriage, fertility-limiting behaviors, use of 

antenatal and delivery services, and awareness of preventive HIV/AIDS practices. A key observation is 

that for 50 percent of women, first intercourse, marriage, and childbearing all occur during the adolescent 

period (under 20 years), thereby inhibiting women’s opportunities to pursue education and to secure skills 

for self-empowerment and improved work opportunities. The median age at first marriage is higher in 

Central Asia and Latin America and the Caribbean than in sub-Saharan Africa and South/Southeast 

Asia. 

To control natural fertility, the practice of child spacing and family planning is most effective. Although rates of contraceptive use are at an all-time high, countries in sub-Saharan Africa have the lowest 

rates of any region, with most of the countries falling below 30 percent—and traditional methods contribute significantly to current use. The highest rates of current contraceptive use are found in Latin 

America and the Caribbean. 

Maternal health is affected by access to and utilization of health services, i.e., antenatal and delivery 

care. Underutilization of antenatal care is associated with suboptimal pregnancy outcomes. In 38 out of 

46 countries, 50 percent or more women use antenatal care. The countries in Central Asia have the highest rates (over 90 percent) of women having seen a trained medical professional for at least one antenatal 

care visit. However in almost one-third of the 42 countries reporting on this indicator, 50 percent or 

fewer of women received at least one tetanus toxoid injection during their pregnancy for the most recent 

birth in the three years preceding the survey. A skilled attendant at delivery has a strong association with 

levels of maternal mortality. The lowest rates of use of a trained medical attendant at delivery are found in 

sub-Saharan Africa and South/Southeast Asia. In Central Asia, there is almost universal use of trained 

medical professionals for delivery. Yemen in North Africa/West Asia/Europe and Haiti in Latin America 

and the Caribbean have very low rates for their regions. 

Messages to prevent HIV/AIDS are not effectively reaching women in most developing countries. Although the HIV/AIDS pandemic is taking a heavy toll on women, for the most part, less than 40 percent 

of women world-wide are aware of the ABC approach to prevention. 
Executive Summary xv

Environmental Context 

The environmental context describes the external living conditions of women. Since the majority of 

women live in rural areas in much of the developing world, except for Latin America and the Caribbean, 

the potential impact of disparities in infrastructure between rural and urban areas and the extent of the 

lack of basic household amenities for women is great. Women bear most of the responsibility for child 

care, cooking, and household maintenance with few basic amenities to assist them. In most countries in 

sub-Saharan Africa (24 out of 25 countries) and South/Southeast Asia (3 out of 6 countries), the majority 

of women live in houses without electricity. Housing quality and lack of access to clean drinking water 

and toilet facilities have implications for women’s health. Poor housing makes residents vulnerable to 

communicable diseases and respiratory problems. The type of flooring is indicative of the quality of the 

housing. Earthen floors (dirt, dung, or sand) are most prevalent in houses in sub-Saharan Africa (60 percent or more) and in Bangladesh and Nepal in South/Southeast Asia. Piped water is considered the safest 

drinking water, and women spend less time collecting and carrying water if it is piped. However, most 

women live in households that do not have access to piped drinking water in most countries in subSaharan Africa and South/Southeast Asia, and in Turkey and Yemen. In Central Asia and Latin America and the Caribbean, more than 20 percent of women live in households that do not have access to 

piped water, with the exception of Colombia. In 10 of 25 countries in sub-Saharan Africa and 3 of 5 

countries in South/Southeast Asia, 50 percent or more of women lack access to toilet facilities. In Yemen, 

Bolivia and Haiti about 30 percent of women do not have access to any toilet facility. 

In summary, behavior change policies and programs focusing on the individual are important to improve the health of women, but efforts at the social and environmental levels are also needed to effect improvements in women’s health. Regions and countries within regions vary on individual indicators, but as 

a whole, sub-Saharan Africa, South/Southeast Asia, Yemen in North Africa/West Asia/Europe, and 

Haiti in Latin America and the Caribbean need priority attention. Central Asia exhibits acceptable results 

on most indicators except women’s nutrition and contraceptive use. This report provides evidence across 

countries and regions for renewed advocacy and commitment to women’s nutrition, education, and environmental living conditions, along with continued emphasis on improving maternal and reproductive 

health. 
Introduction 1

 1 Introduction 

his comparative report on the context of women’s health is designed to be a resource for researchers, 

policymakers, and program managers, providing data on key indicators that influence the health and 

nutrition of women in the developing world. The findings are based on the results from Demographic 

and Health Surveys (DHS) conducted in 46 countries in five regions around the world: sub-Saharan 

Africa, North Africa/West Asia/Europe, Central Asia, South/Southeast Asia, and Latin America and the 

Caribbean (Table 1.1). Over the past 20 years, DHS surveys have been conducted in more than 70 

countries around the world, and in some countries, two or more surveys have been conducted at intervals 

of three to six years. The United States Agency for International Development (USAID) has provided 

most of the funding for these surveys. Because of funding priorities, surveys are conducted in selected 

countries. Of the 46 countries included in this report, most are in sub-Saharan Africa (25), followed by 

Latin America and the Caribbean (8), South/Southeast Asia (6), North Africa/West Asia/Europe (4), 

and Central Asia. Since the data are not representative in all regions, this report can provide only limited 

comparisons within and across regions. The main purpose of this report is to provide a comparative 

update on key indicators that reflect the context of women’s health and nutrition in regions of the 

developing world. Policies and programs can benefit from the data to identify areas in need of 

intervention, to monitor progress, and to compare the status of indicators for countries in the same 

region. This report is also useful for advocacy, demonstrating the need for further investments to improve 

the context of women’s health. 

T 
2 Introduction 

Table 1.1 Summary of DHS surveys included in this report, 1994-2001 

Country Year Female respondents 

Number 

of women 

Household 

sample size 

Sub-Saharan Africa 

Benin 1996 All women 5,491 4,499 

Burkina Faso 1998-99 All women 6,445 4,812 

Cameroon 1998 All women 5,501 4,697 

Central African Republic 1994-95 All women 5,884 5,551 

Chad 1996-97 All women 7,454 6,840 

Comoros 1996 All women 3,050 2,252 

Côte d’Ivoire 1994 All women 8,099 5,935 

Eritrea 1995 All women 5,054 5,469 

Ethiopia 2000 All women 15,367 14,072 

Gabon 2000 All women 6,183 6,203 

Ghana 1998 All women 4,843 6,003 

Guinea 1999 All women 6,753 5,090 

Kenya 1998 All women 7,881 8,380 

Madagascar 1997 All women 7,060 7,171 

Malawi 2000 All women 13,220 14,213 

Mali 1995-96 All women 9,704 8,716 

Mozambique 1997 All women 8,779 9,282 

Namibia 2000 All women 6,755 6,392 

Niger 1998 All women 7,577 5,928 

Rwanda 2000 All women 10,421 9,696 

Tanzania 1996 All women 8,120 7,969 

Togo 1998 All women 8,569 7,517 

Uganda 2000-01 All women 7,246 7,885 

Zambia 1996 All women 8,021 7,286 

Zimbabwe 1999 All women 4,201 4,107 

North Africa/West Asia/ 

 Europe 

Egypt 2000 Ever-married women 15,573 16,957 

Jordan 1997 Ever-married women 5,548 7,335 

Turkey 1998 Ever-married women 8,576 8,059 

Yemen 1997 Ever-married women 10,414 10,701 

Central Asia 

Kazakhstan 1999 All women 4,800 5,844 

Kyrgyz Republic 1997 All women 3,848 3,672 

Uzbekistan 1996 All women 4,415 3,703 

South/Southeast Asia 

Bangladesh 1999-2000 Ever-married women 10,544 9,854 

Cambodia 2000 All women 15,351 12,236 

India 1998-99 Ever-married women 90,303 92,486 

Indonesia 1997 Ever-married women 28,810 34,255 

Nepal 1996 Ever-married women 8,429 8,082 

Philippines 1998 All women 13,983 12,407 

Latin America/Caribbean 

Bolivia 1998 All women 11,187 12,109 

Brazil 1996 All women 12,612 13,283 

Colombia 1995 All women 11,140 10,112 

Dominican Republic 1996 All women 8,422 8,831 

Guatemala 1995 All women 12,403 11,754 

Haiti 2000 All women 10,159 9,595 

Nicaragua 1998 All women 13,634 11,528 

Peru 2000 All women 27,843 28,900 

Note: The Indonesia and Jordan data are based on de jure populations. 
Background 3

 2

Background 

he circumstances of women’s lives are important to their health and well-being and should be 

included in any discussion of maternal health. Although men, women, and children in developing 

countries live under socioeconomic conditions that are associated with ill health—and improvements in 

these conditions are overdue—this report focuses on the social, behavioral, and environmental context of 

women’s health. In the developing world, most women of reproductive age are also mothers; therefore, 

the terms “women’s health” and “maternal health” are used interchangeably. Women’s health in 

developing countries typically implies reproductive health as well as a woman’s capacity to produce and 

take care of children. As a result, efforts primarily focus analytically and programmatically on indicators of 

reproductive health, child health, and, more recently, maternal health. However, in this report, a broader 

discussion of the context of maternal health is being made. 

 On the basis of DHS findings, three key indicators—maternal mortality, maternal nutritional status, 

and low birth weight—are used as outcome variables to describe the overall health status and condition of 

mothers in developing countries. Because of the limited range of indictors of women’s health, maternal 

mortality dominates as a key indicator. At the same time, however, more women survive childbirth but 

continue to live with morbidities that are not measured. It is for this reason that it is important to explore 

the context of women’s lives. 

 Many factors have been found to be determinants of women’s nutritional status and health. Some of 

these factors are dietary intake, illness, early and frequent childbearing, strenuous work or physical 

activity, and women’s status (Leslie, 1991; Tinker, 2000). 

 Area of residence, economic status of the household, antenatal care, and use of health services have 

also been associated with maternal nutritional status (Rutstein et al., 1999:65) as well as a woman’s 

education level and her work status (Rutstein, 1996) 

 Social, behavioral, and environmental factors are important in their potential to interact with or 

mediate direct determinants of maternal health. Using DHS data, it is possible to measure factors at all 

three levels (social, behavioral, and environmental), along with three key indicators of maternal health 

(maternal mortality, maternal nutritional status, and low birth weight. 

T 

Methodology 5

 3 Methodology 

n each country, information is collected at the level of the household and the individual. At the 

household level, information is collected on basic characteristics of household members, structure of 

the dwelling, anthropometric measurements of women age 15-49 years and children age 0-3 or 0-5 

years), anemia testing of women and children (in selected countries), testing of household salt for level of 

iodization, source of drinking water, and availability of sanitation facilities, among others. The Women’s 

Questionnaire collects information on fertility, nuptiality, fertility preferences, family planning, infant and 

child mortality, maternal mortality, maternal and child health, infant and young child feeding practices, 

and knowledge and attitudes about sexually transmitted diseases and HIV/AIDS. 

 This report is based upon data from 46 DHS surveys conducted from 1994 through 2001. Of these, 

43 included anthropometric measurements of women. Data were not always collected on all variables in 

every country. Nevertheless, this report provides descriptive data on most of the key indicators regarding 

the context of women’s health and nutrition. Since there is variation in the availability amd accessibility of 

health services, urban-rural differentials are included in the discussion of utilization of antenatal and 

delivery care services. 

3.1 Sample of Women 

The sample is composed of women age 15 to 49. It reflects all women in this age group, regardless of 

marital status, in sub-Saharan Africa, Central Asia, Latin America and the Caribbean, and Cambodia 

and the Philippines in South/Southeast Asia. An ever-married sample of women was surveyed in North 

Africa/West Asia/Europe and in Bangladesh, India, Indonesia, and Nepal in South/Southeast Asia. To 

maintain comparability of health and nutritional indicators, this report uses a sample of mothers with 

children under three years of age. Unless otherwise indicated, women age 15-49 are used for all other 

indicators. Sample sizes of women range from 3,050 in Comoros to 90,303 in India. The average sample 

size is about 9,500 women. 

3.2 Indicators for Defining the Context of the Health of Mothers 

In this report, maternal health refers to the health and nutritional status of women who had a child age 

0-3 years at the time of the survey; the context of women’s health includes all women. DHS collects data 

on three key indicators that are used to describe the status of women’s health, maternal mortality, 

maternal nutritional status, and low birth weight. Two of these indicators are measured directly: maternal 

mortality is measured using the sisterhood method and nutritional status is measured using anthropometry and anemia testing. The percentage of mothers with low birth weight infants is a proxy measure 

of maternal health. 

 Maternal mortality is an outcome measure not only of the health status of women who died as a result 

of the childbirth process but also of the ability of the health care system to reach women with complications and provide emergency obstetrical care. Low birth weight in infants is used as a proxy measure of 

women’s health in developing countries because it is influenced directly by the mother’s health and 

nutritional status (ACC/SCN, 2000). 

 Nutritional status is based on anthropometric and micronutrient indicators. Anthropometric measurements of height and weight are used to determine women’s height and body mass index (BMI). Women 

I 
6 Methodology 

are weighed on a digital scale, and their weight is recorded in kilograms, to the nearest 100 grams. Height 

is measured using an anthropometer with standard gradations, and is recorded to the nearest millimeter. 

The assessment of nutritional status in nonpregnant women is based on normative distributions. 

Commonly used anthropometric references for adult women are averages based on healthy populations 

(Krasovec and Anderson, 1991). 

 Micronutrient status is assessed for anemia (hemoglobin testing) and vitamin A deficiency (based on a 

woman’s reported experience of night blindness during the pregnancy), and programmatic coverage is 

assessed for iron supplementation and vitamin A supplementation, and cooking salt is tested for iodine 

fortification. 

 The context of maternal health is defined by social, behavioral, and environmental indicators that are 

collected by the Household Questionnaire and the Women’s Questionnaire. Social factors measured are 

education, media exposure, employment, marital status, and female-headed households. Behavioral 

factors measured are fertility practices, breastfeeding practices, child spacing and family planning 

practices, antenatal care practices, delivery care practices, and awareness of HIV/AIDS. Environmental 

factors measured arfe urban-rural residence and lack of household amenities: electricity, finished flooring, 

clean water, and adequate sanitation. 

 A detailed list of the indicators included in this report and their area of influence is given in Table 3.1. 
Methodology 7

Table 3.1 List of indicators used in this analysis 

Context of women’s health 

Indicators 

Women’s health 

and nutrition 

Social 

context 

Behavioral 

context 

Environmental 

context 

OUTCOME MEASURES OF WOMEN’S HEALTH 

Maternal mortality ratio * 

Anthropometry 

Short stature (< 145 cm) 

Chronic Energy Deficiency (BMI < 18.5) 

Overweight and obesity (BMI > 25) 

* 

* 

* 

Micronutrients 

Anemia prevalence 

Iron supplementation 

Night blindness in pregnancy 

Vitamin A supplementation 

Household use of iodized salt 

* 

* 

* 

* 

* 

Low birth weight * 

SOCIAL FACTORS 

Education 

School attendance 

Attendance ratio of girls to boys 

Female illiteracy

* 

* 

* 

Media exposure

Radio listening 

Newspaper reading 

TV viewing 

* 

* 

* 

Employment 

Working women 

Work in agriculture 

* 

* 

Marital status 

Currently married and cohabitating 

Not currently married 

Never married 

Polygynous marriage 

* 

* 

* 

* 

Female-headed household * 

BEHAVIORAL FACTORS 

Fertility practices 

Median age at first marriage 

Median age at first intercourse 

Median age at first birth 

Total fertility rate 

Wanted fertility rate 

Mean duration of childbearing period 

* 

* 

* 

* 

* 

* 

Breastfeeding behaviors 

Exclusive breastfeeding (< 6 months) 

Median duration of breastfeeding 

* 

* 

Child spacing and family planning 

Median duration of postpartum amenorrhea 

Median duration of postpartum abstinence 

Median duration of postpartum susceptibility 

Current use of contraception 

Unmet need for contraception 

* 

* 

* 

* 

* 

Utilization of health care services 

Antenatal care 

Use of health professional 

4+ visits 

Urban-rural differentials 

Tetanus toxoid 

* 

* 

* 

* 

Delivery care 

Urban-rural differentials in use of health 

professionals * 

HIV/AIDS awareness 

Knowledge of preventive measures * 

ENVIRONMENTAL FACTORS 

Residence 

Rural area residence * 

Household amenities 

Electricity 

Earthen floor 

Piped drinking water 

Sanitation facilities 

* 

* 

* 

* 

Findings 9

 4

 Findings 

4.1 Women’s Health 

4.1.1 Maternal Mortality 

he level of maternal mortality in a population is an indicator not only of the status of the population 

but also the level of national development. Maternal deaths in most developing countries account for 

a high proportion of all causes of death among women of reproductive age. However, few countries have 

comprehensive vital registration systems that are capable of accurately capturing and reporting maternal 

deaths. Underreporting may be significant, since many deaths occur outside of the health system. Therefore, national household surveys like DHS surveys are used to estimate the level of maternal mortality. 

Since maternal deaths are relatively rare events, large sample sizes are needed for precise estimates. 

 In DHS surveys, a maternal death is defined as any death that occurs during pregnancy, during childbirth, or during the two months following the birth or the termination of the pregnancy. In this report, 

the maternal mortality ratio (MMR) is used to report on the rates of maternal deaths for the seven-year 

period preceding the survey. The MMR is estimated from data on the survivorship of sisters of survey 

respondents collected in the sibling history (Rutenberg and Sullivan, 1991). The sibling history is a 

detailed account of survivorship of all live-born children of the respondent’s biological mother (i.e., 

maternal siblings). These data allow deaths and births to be placed in calendar time and therefore permit 

the calculation of sex- and age-specific death rates for defined reference periods. (An in-depth discussion 

of maternal mortality indicators and data quality can be found in Stanton, Abderrahim, and Hill (1997). 

 Maternal mortality data were not collected in 11 of the 46 countries included in this report. In two 

countries, Rwanda and India, MMR estimates are based on 4-year and 2-year reference periods, 

respectively. For all other countries, MMR estimates are based on a 7-year reference period. 

 The MMR varies widely among countries and between regions (Table A.4.1). The highest ratios are 

found in sub-Saharan Africa, where 16 of the 22 countries with reported data have ratios equal to or 

greater than 500 maternal deaths per 100,000 live births. In four countries in sub-Saharan Africa—

Central African Republic (CAR), Eritrea, Malawi, and Rwanda—the rate is over 1,000 (Figure 4.1). For 

North Africa/West Asia/Europe, MMR data are available for only two countries—Jordan and Yemen. 

Jordan has the lowest rate (37) of all the countries included in Table A.4.1. In South/Southeast Asia, the 

rate ranges from 172 in the Philippines to 540 in India. In Latin America and the Caribbean, Haiti has a 

much higher rate (523) than the other countries (155 to 185). 

T 
10 Findings 

4.1.2 Maternal Nutritional Status 

Malnutrition, either undernutrition or overnutrition, has implications for the health of women. Height is 

often used as an indicator of women’s nutritional status. It can also be used to assess past nutritional status 

and reflect the cumulative effects of social and economic influences on access to adequate nutrition and 

health care during childhood and adolescence. In addition, height can predict a woman’s risk of a difficult 

delivery. Short stature is correlated with higher risks of miscarriage, stillbirth, and delivery of low birth 

weight infants (Krasovec and Anderson, 1991). 

 To be consistent with the other maternal health indicators, analysis of anthropometric measurements 

is restricted to women who had a live birth in the three years preceding the survey (Table A.4.2). A 

woman is considered to be short if her height is less than 145 centimeters. South/Southeast Asia and 

Latin America and the Caribbean each have three countries in which more than 10 percent of women are 

less than 145 cm. Guatemala has, by far, the largest percentage (35 percent) of women who are less than 

145 cm (Figure 4.2). 

Sub-Saharan Africa

Mozambique

Namibia

Togo

Burkina Faso

Madagascar

Benin

Cameroon

Gabon

Uganda

Guinea

Mali

Côte d'Ivoire

Tanzania

Zimbabwe

Zambia

Kenya

Chad

Ethiopia

Eritrea

Malawi

CAR

Rwanda

North Africa/West Asia/Europe

Jordan

Yemen

South/Southeast Asia

Philippines

Indonesia

Cambodia

Nepal

India

Latin America/Caribbean

Guatemala

Brazil

Peru

Haiti

0 200 400 600 800 1000 1200 1400 1600 1800

Deaths per 100,000

Figure 4.1 Maternal Mortality Ratio

Maternal Mortality Ratio (deaths per 100,000 births) calculated as the maternal mortality rate divided by the 

general fertility rate, for the seven-year period preceding the survey, based on survivorship of sisters of 

survey respondents

Note: Rwanda data are for the period 0-4 years preceding the survey;

India data are for the period 0-2 years preceding the survey.
Findings 11

 

 The body mass index (BMI) is a commonly used measure of women’s nutritional status. BMI, a 

woman’s weight in kilograms divided by the square of her height in meters (kg/m2

), incorporates both 

height and weight and provides a better measure of nutritional status than height or weight alone. Undernutrition in women is defined as a BMI of less than 18.5 and is classified as chronic energy deficiency 

(CED). The proportion of women who suffer from CED ranges from less than 1 percent in Egypt, 

Bolivia, and Peru to 47 percent in Bangladesh. South/Southeast Asia has the highest rates of CED, followed by sub-Saharan Africa. Yemen stands out in the North Africa/West Asia/Europe region, with 26 

percent of women having a BMI of less than 18.5 (Table A.4.2 and Figure 4.3). 

 Nestel and Rutstein (2001) reported on a World Health Organization (WHO) categorization of the 

public health significance of low BMI (<18.5). They report that in a healthy population, 3 to 5 percent of 

the population are expected to have a low BMI. Nutritional monitoring is required if 5 to 9 percent have a 

low BMI. The nutritional situation is considered poor if 10 to 19 percent of the population has a low 

BMI. The nutritional situation is serious at 20 to 39 percent of the population, and if over 40 percent of 

Figure 4.2 Short stature in women 

Percentage of women age 15-49 with a birth in the three years preceding the survey whose height is less than 145 centimeters

Sub-Saharan Africa

Burkina Faso

Chad

Mali

Niger

Ghana

Côte d'Ivoire

Kenya

Togo Cameroon

Guinea

Rwanda

Zambia

Benin

Gabon

Zimbabwe

Uganda

Ethiopia

Eritrea

CAR

Malawi

Tanzania

Comoros

Mozambique

Madagascar

North Africa/West Asia/Europe Egypt

Jordan

Turkey

Yemen

Central Asia

Kazakhstan

Kyrgyz Republic Uzbekistan

South/Southeast Asia

Cambodia

India

Nepal Bangladesh

Latin America/Caribbean

Haiti

Dominican Republic Brazil

Colombia

Nicaragua Bolivia

Peru

Guatemala

0 10 20 30 40

Percent
12 Findings 

the population has a low BMI, it is critical. Of the 43 countries in this study with anthropometric data on 

women, 13 countries require nutritional monitoring, 11 countries are in a poor nutritional situation, eight 

countries are in a serious nutritional situation, and two countries are in a critical nutritional situation. The 

remaining nine countries have less than 5 percent of mothers with a low BMI. 

 Regionally, of the 24 sub-Saharan countries, 10 have a poor nutritional situation, four countries have 

a serious nutritional situation, and one country (Eritrea) has a critical situation. North Africa/West 

Asia/Europe has only one country (Yemen) with a serious nutritional situation; the remaining three 

countries are within the normal range. Central Asia has one country (Uzbekistan) with a poor nutritional 

situation, and the remaining two just require monitoring. However, for the four South/Southeast Asia 

countries, the situation is either serious (Cambodia, India, and Nepal) or critical (Bangladesh). Five 

countries in Latin America and the Caribbean fall in the normal range, while three need only nutritional 

monitoring. 

Figure 4.3 Chronic energy deficiency (CED)

Percentage of women age 15-49 with a birth in the three years preceding the survey whose BMI is less than 18.5

Sub-Saharan Africa

Zimbabwe

Rwanda

Malawi

Gabon

Côte d'Ivoire

Cameroon

Tanzania

Zambia

Uganda

Comoros

Togo Mozambique Guinea

Ghana

Kenya Burkina Faso

Benin

CAR

Mali

Chad

Madagascar Niger Ethiopia

Eritrea

North Africa/West Asia/Europe Egypt

Jordan

Turkey

Yemen

Central Asia

Kyrgyz Republic Kazakhstan

Uzbekistan

South/Southeast Asia

Cambodia

Nepal

India

Bangladesh

Latin America/Caribbean

Peru

Bolivia

Nicaragua

Colombia

Guatemala

Brazil

Dominican Republic Haiti

0 10 20 30 40 50

Percent
Findings 13

 Overnutrition (BMI ≥25) also has implications for women’s health, predisposing women to cardiovascular and other diseases. Obesity is not as prevalent in developing countries as it is in the developed 

countries. However, it is becoming a growing concern. In 15 of 24 sub-Saharan countries, the percentage 

of women with a high BMI ≥25 is about the same or greater than the percentage of women with low 

BMI <18.5. The North Africa/West Asia/Europe region is an exception; in three out of four countries, 

more than 50 percent of women are overweight or obese. Egypt has the highest proportion of overweight 

or obese women (68 percent) among all the countries included in Table A.4.2. The prevalence of 

overweight and obesity is also substantial in the Latin America and the Caribbean region, where, on 

average, 36 percent of women are overweight or obese (Figure 4.4). 

Figure 4.4 Overweight in women 

Percentage of women age 15-49 with a birth in the three years preceding the survey whose BMI is greater than or equal to 25 

Sub-Saharan Africa

Ethiopia Madagascar Eritrea

Chad

Burkina Faso

CAR

Niger

Mali

Benin

Mozambique Malawi

Uganda

Guinea

Togo Zambia

Tanzania

Rwanda

Kenya Côte d'Ivoire

Ghana

Comoros

Cameroon

Zimbabwe

Gabon

North Africa/West Asia/Europe Yemen

Turkey

Jordan

Egypt

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Nepal Bangladesh

Cambodia

India

Latin America/Caribbean

Haiti

Guatemala

Brazil

Dominican Republic Nicaragua

Colombia

Bolivia

Peru

0 20 40 60 80

Percent
14 Findings 

4.1.3 Micronutrient Status, Supplementation, and Fortification 

Women in developing countries are undernourished not only because of low intake of protein and calories 

but also because of limited intake or bioavailability of micronutrients from animal products, fruits, 

vegetables, and fortified foods. Chronic energy deficiency (CED) and short stature in women result from 

early malnutrition during fetal development, infancy, and childhood, and these conditions continue 

because of poor intake in adulthood. Micronutrient deficiencies are a result of inadequate intake of foods 

rich in micronutrients and inadequate utilization of available micronutrients because of infections and 

parasitic infestations or other factors related to diet. Although stunting cannot be remedied in adulthood, 

reversal of micronutrient deficiencies is possible (Huffman et al., 1998). 

 The major micronutrient deficiencies of concern regarding women in developing countries are iron, 

vitamin A, and iodine. In DHS surveys, data are collected on micronutrient status (anemia), micronutrient supplementation (iron and vitamin A), and micronutrient fortification (iodized or iodated 

household cooking salt). 

4.1.3.1 Anemia 

Iron-deficiency anemia is the most common form of nutritional deficiency worldwide. This type of 

nutritional deficiency develops slowly and often does not manifest symptoms until anemia becomes 

severe. The cutoff points for anemia are 11.0 grams per deciliter (g/dl) of hemoglobin for pregnant 

women and 12.0 g/dl for nonpregnant women. Women with less than 7.0 g/dl of hemoglobin have severe 

anemia, women with 7.0 to 9.9 g/dl have moderate anemia, and pregnant women with 10.0 to 10.9 g/dl 

and nonpregnant women with 10.0 to 11.9 g/dl have mild anemia. 

 Diets that are heavily dependent on one grain or starch as the major staple often lack sufficient iron. 

Iron is found in meats, poultry, fish, grains, some cereals, and dark green leafy vegetables (such as 

spinach). Foods rich in vitamin C increase absorption of iron into the blood. Tea, coffee, and whole-grain 

cereals can inhibit iron absorption. Anemia in women is caused by several different health conditions; iron 

and folate deficiencies are some of the most prevalent conditions. Malaria and parasite infestation also 

cause anemia. Iron-deficiency anemia is related to decreased work and mental capacity and is associated 

with poor pregnancy outcomes including low birth weight, perinatal mortality, and maternal mortality 

(WHO/UNU/UNICEF, 2001). 

 Beginning in early adolescence, girls’ nutritional needs increase with the growth spurt in puberty and 

the onset of menstruation. Iron-deficiency anemia is a problem that begins in adolescence and continues 

through menopause (WHO/UNU/UNICEF, 2001). At the initial drafting of this report, anemia data 

were available for 11 countries (Table A.4.3). So that these data can be compared, the analysis is based on 

women who had a birth in the three years preceding the survey. The preliminary results of hemoglobin 

testing of women confirm a high prevalence of anemia in women age 15-49 (25 percent or more). The 

prevalence of any anemia ranges from a low of 27 percent in Bolivia and 28 percent in Egypt to 60 

percent in Uzbekistan. In Uzbekistan, Cambodia, Haiti, and India, more than 50 percent of women are 

anemic. The prevalence of moderate to severe anemia is also substantial in these countries. For example, 

in Haiti, 16 percent of women are moderately anemic and another 3 percent are severely anemic. When 

more than 2 percent of women have severe anemia, it is a major public health problem in need of longterm intervention (Stoltzfus and Dreyfuss, 1998) (Figure 4.5). 
Findings 15

 The high physiological demand for iron in pregnancy is hard to meet through dietary intake of ironrich foods alone. Therefore, it is recommended that pregnant women routinely receive iron supplements 

for at least three months during pregnancy. Iron supplementation in pregnancy has been shown to 

improve birth outcomes (low birth weight and perinatal mortality) and maternal morbidity and mortality. 

Iron supplementation data are available for 23 countries (Table A.4.3 and Figure 4.6). The data reflect 

mothers reporting that they received or purchased iron tablets or syrups during the pregnancy of their last 

birth in the three years preceding the survey. 

 The proportion of women who received iron supplementation during pregnancy ranges from a low of 

9 percent in Nepal to a high of 91 percent in the Dominican Republic. In five of the nine countries with 

data in sub-Saharan Africa, over 50 percent of women reported that they received iron supplementation. 

However, in the North Africa/West Asia/Europe region, only in Turkey did over 50 percent of women 

report having received iron supplementation. In Latin America and the Caribbean, all four countries have 

rates over 50 percent. In South/Southeast Asia, three of the six countries have iron supplementation rates 

over 50 percent. 

Figure 4.5 Anemia in women

Percentage of women age 15-49 with a birth in the three years preceding the survey who have anemia

Uganda

Madagascar

Egypt

Kazakhstan

Kyrgyz Republic 

Uzbekistan 

India

Cambodia

Bolivia

Peru

Haiti

0 20 40 60 80 100

Mild

Moderate

Severe

Percent

Note: Anemia levels in Uganda are based on women with a birth in the three years 

preceding the survey; anemia levels in India are based on ever-married women.
16 Findings 

4.1.3.2 Vitamin A 

Vitamin A is an essential micronutrient for the immune system and plays an important role in 

maintaining the body’s epithelial tissue. Severe vitamin A deficiency (VAD) can cause eye damage 

(xerophthalmia) leading to blindness. Severe VAD can also increase the severity of infections and slow 

recovery from illness. 

 Night blindness is an indicator of severe VAD, and pregnant women are especially prone to this 

condition. In DHS surveys, women are asked whether they had difficulty with their vision during daylight 

and whether they also suffered from night blindness during their last pregnancy. In areas where there are 

local terms for night blindness, the local term is used. Table A.4.4 shows the rate of night blindness and 

the adjusted night blindness rate (less those with day vision problems) for 12 countries. (The Nepal survey 

did not ask about day vision problems and is excluded from Figure 4.7). Of the data available, Ethiopia 

has the highest adjusted rate of reported night blindness (slightly less than 5 percent). Proportions of 5 

percent or greater are considered a significant public health concern (Christian, 2002). 

Figure 4.6 Iron supplementation during pregnancy

Percentage of women age 15-49 with a birth in the three years preceding the survey who received any iron 

supplementation during their most recent pregnancy

Sub-Saharan Africa

Niger 

Rwanda

Eritrea 

Tanzania 

Uganda 

Zimbabwe 

Malawi 

Gabon 

Ghana 

North Africa/West Asia/Europe

Yemen 

Egypt 

Turkey 

Central Asia

Kazakhstan

South/Southeast Asia

Nepal 

Cambodia 

Bangladesh 

India 

Indonesia 

Philippines 

Latin America/Caribbean

Peru 

Haiti 

Colombia 1995

Dominican Republic 

0 20 40 60 80 100

Percent
Findings 17

 VAD can be prevented in women through the provision of a high-dose (200,000 IU) vitamin A 

capsule in the first six to eight weeks after delivery (when women are considered not at risk of pregnancy). 

High doses of vitamin A cannot be given to pregnant women because of the possible adverse effects (birth 

defects). 

 Data on vitamin A supplementation during the two months following the most recent birth are 

available for 12 countries in Table A.4.4. Although the Gabon survey had information on night blindness, it did not include questions about vitamin A supplementation. On the other hand, Ghana did not 

include information on night blindness, but it has information on vitamin A supplementation. Figure 4.8 

shows that of the countries reporting, no more than 42 percent of women received vitamin A in any 

country. In 6 of the 12 countries, only about 11 percent of women received postpartum vitamin A supplementation. 

Figure 4.7 Night blindness in pregnancy 

Percentage of women age 15-49 with a birth in the three years preceding the survey who experienced night blindness

during their most recent pregnancy (adjusted rates)

Sub-Saharan Africa

Uganda

Zimbabwe 

Malawi

Gabon

Madagascar

Rwanda

Ethiopia

South/Southeast Asia

Cambodia

India

Latin America/Caribbean

Haiti

Peru

0246

Percent
18 Findings 

4.1.3.3 Iodine 

Dietary deficiency of iodine is a major public health concern. The lack of sufficient iodine is known to 

cause goiter, cretinism (a severe form of neurological defect), spontaneous abortion, premature birth, 

infertility, stillbirth, and increased child mortality. Iodine-deficiency disorder (IDD) is the single most 

common cause of preventable mental retardation and brain damage. 

 The human body requires only about a teaspoon of iodine over a lifetime. However, because iodine 

cannot be stored for long periods by the body, tiny amounts are needed regularly for good health. Where 

soil and therefore crops and grazing animals do not provide sufficient dietary iodine to the population, 

food fortification and supplementation have proven to be highly successful and sustainable interventions. 

The fortification of salt with iodine is the most common means of preventing IDD. Fortified salt that 

contains 15 parts per million (ppm) of iodine is considered adequate for the prevention of IDD. 

Figure 4.8 Vitamin A supplementation

Percentage of women age 15-49 with a birth in the three years preceding the survey who received a vitamin A dose in the

 two months following of their most recent birth

Sub-Saharan Africa

Tanzania 

Uganda 

Ethiopia 

Rwanda

Ghana 

Namibia 

Malawi 

North Africa/West Asia/Europe

Egypt 

South/Southeast Asia

Cambodia 

Bangladesh 

Latin America/Caribbean

Peru 

Haiti 

0 10 20 30 40 50

Percent
Findings 19

 In DHS surveys, the iodine content of household salt is tested using a rapid test kit provided by 

UNICEF (World Health Organization et al., 2001). Because of the early nonstandardization of cutoff 

points for adequately iodized salt, the data on testing of household salt are comparable only at the level of 

any positive reading for iodine. This could be 15 ppm or more. More recent DHS surveys use 15 ppm as 

the accepted cutoff point. 

 The results of testing household cooking salt are available for 27 of the 46 countries (Table A.4.4). In 

nine countries, salt packets were read for iodine content. The international cutoff for adequate national 

coverage requires that 90 percent of households use adequately iodized salt. In 10 of the 27 countries 

where salt was tested, less than one-third of the women lived in households using salt with some level of 

iodization. Of the 15 countries in sub-Saharan Africa where salt was tested, only four had over 90 

percent of women living in households with iodized salt. In another five countries in sub-Saharan Africa, 

between 75 and 90 percent of women live in households using iodized salt. In the two countries in the 

North Africa/West Asia/Europe region with household salt tested, the rates were low. Although in 

Jordan, where salt packets were read, the proportion was 96 percent. In contrast, Central Asia has low 

coverage for iodized salt. In the South/Southeast Asia region, only Nepal has over 90 percent coverage. 

Three of the five countries in Latin America and the Caribbean with household salt tested have over 90 

percent coverage (Figure 4.9). 

Figure 4.9 Iodized salt

Percentage of women age 15-49 who live in households with iodized salt

Sub-Saharan Africa

Gabon

Ghana

Central African Republic

Ethiopia

Chad

Niger

Benin

Madagascar

Namibia

Malawi

Cameroon

Zambia

Rwanda

Uganda

North Africa/West Asia/Europe

Yemen

Egypt

Central Asia

Kazakhstan

South/Southeast Asia

Cambodia

Philippines

India

Nepal

Latin America/Caribbean

Dominican Republicublic

Haiti

Guatemala

Nicaragua

Peru

0 20 40 60 80 100

Percent Note: Results are shown for household cooking salt only. 

Countries where salt packets were read are not shown.
20 Findings 

4.1.4 Low Birth Weight 

Low birth weight in infants is a significant public health problem in developing countries. Low birth 

weight is primarily caused by inadequate maternal health and nutrition. Poor nutritional status prior to 

conception (short stature), as a result of chronic undernutrition and illnesses in childhood, and poor nutrition and illness during pregnancy are significant influences. Other influences on birth weight include 

malaria, anemia, and acute and chronic infections (ACC/SCN, 2000). Low birth weight influences the 

future nutritional status of children; therefore, women’s health begins in the womb. In many developing 

countries, girls born with low birth weight tend to experience poor growth during childhood and 

adolescence, and this results in their giving birth to low birth weight infants (Ramakrishnan, 2004; 

Ramakrishnan et al., 1999). Improving preconceptual nutritional status of women is important for improving birth outcomes. 

 To obtain birth weight data, the DHS surveys asked mothers whether their baby was weighed at birth 

and, if so, how much the baby weighed. Babies weighing 2.5 kg or more are considered to have a normal 

birth weight, and babies weighing less than 2.5 kg are regarded as small or as having low birth weight. In 

many developing countries, large proportions of births do not occur in health facilities and therefore 

babies are not weighed. Mothers were also asked whether the baby was very large, larger than average, 

average, smaller than average, or very small at birth. 

 Table A.4.5 shows the percentage of women who have a recorded birth weight of less than 2.5 kg for 

their most recent live birth in the three years preceding the survey. For those children without a recorded 

birth weight, the proportion with low birth weight is assumed to be the same as the proportion among 

children who have a recorded low birth weight, in each of the categories of mother’s perceived birth size 

(i.e., very large, larger than average, average, smaller than average or very small at birth). For example, if 

2 percent of babies whose mothers perceived them to be larger than average at birth had a recorded birth 

weight of <2.5 kg, then 2 percent of babies without a recorded birth weight, whose mothers perceived 

them to be larger than average at birth, are included in the low birth weight category. 

 The proportion of women with low birth weight children ranges from a low of 3 percent in 

Uzbekistan to a high of 34 percent in Yemen. Overall, 27 of the 44 countries with available birth weight 

data have more than 10 percent of mothers delivering low birth weight babies (Figure 4.10). These rates 

are higher than the 1990 World Summit for Children goal of less than 10 percent. Central Asian 

countries are all below 10 percent. On the high side, there are three countries with rates higher than 

20 percent (India, Haiti, and Yemen). Improvements in low birth weight can be expected when 

improvements are made in food security, maternal nutritional status, and increased access to antenatal 

care (Ramakrishnan, 2004). 
Findings 21

4.2 Context of Women’s Health 

For a discussion of women’s health, this analysis explores three key contexts: social, behavioral, and 

environmental. The social context is represented by five indicators: education, exposure to media, 

employment, marital status, and female-headed households. These indicators provide insights into the 

social status of women, their potential access to productive resources, and influences on their overall wellbeing. The behavioral context includes the important fertility-related behaviors that can have a profound 

impact on maternal health. These include fertility practices (median age at first intercourse, median age at 

first marriage, median age at first birth, total fertility rate and wanted fertility rate, and duration of the 

childbearing period); breastfeeding practices (exclusive breastfeeding and median duration of breastfeeding); child spacing and family planning (median duration of postpartum amenorrhea, median duration of postpartum abstinence, median duration of postpartum insusceptibility, use of contraception, and 

unmet need for contraception); and utilization of health care services, including antenatal care (use of 

health professionals, four or more antenatal care visits, and receipt of tetanus toxoid), delivery care (use of 

a health professional for delivery), and HIV/AIDS prevention awareness. The environmental context 

includes those indicators related to the physical circumstances in which women live. Included in this 

group are rural residence and lack of household amenities (electricity, earthen floor, piped drinking water, 

and sanitary facilities). 

Figure 4.10 Low birth weight

Percentage of live births in the three years preceding the survey that weighed less than 2.5 kg or were estimated to 

be low birth weight based on projected proportions from mothers’ perceptions of birth size

Sub-Saharan Africa

Rwanda

Ghana

Cameroon

Kenya Zimbabwe

Uganda

Guinea

Zambia

Tanzania

Mozambique Ethiopia

Gabon

CAR

Togo

Malawi

Benin

Côte d'Ivoire

Namibia

Madagascar Niger

Mali

Chad

Burkina Faso

Comoros

Eritrea

North Africa/West Asia/Europe Jordan

Egypt

Turkey

Yemen

Central Asia

Uzbekistan

Kazakhstan

Kyrgyz Republic

South/Southeast Asia

Indonesia

Cambodia

Philippines India

Latin America/Caribbean

Colombia

Bolivia

Brazil

Peru

Guatemala

Dominican Republic Nicaragua Haiti

0 10 20 30 40

Percent
22 Findings 

4.2.1 Social Context 

Women’s health is usually viewed from a biomedical perspective; however, a woman’s own understanding 

of her health is often rooted in the social conditions of her life (Avorti and Walters, 1999). Indicators of 

the social context of women’s health are education, exposure to media, employment, marital status, and 

female-headed households. These social factors are important to a woman’s social status and ability to 

access productive resources to enhance her personal health as well as that of her family. 

4.2.1.1 Education 

Education is an important indicator of the context of women’s health. Generally, women with more 

education have better health, have improved life opportunities, live in healthier environments, and have 

healthier children than women with little or no education. Education impacts women’s health through 

delayed marriage (even primary education has been found to be associated with postponement of marriage). A higher age at marriage is associated with higher women’s status. The higher status increases a 

woman’s voice in decisions affecting her health, including fertility, which in turn affects her risk of poor 

health. Education also increases a woman’s knowledge of modern health and nutrition practices that lead 

to better hygiene and utilization of health services (Jejeebhoy, 1995; Celik and Hotchkiss, 2000; 

Matsumura and Gubhaju, 2001). 

 Because of the varying types of educational systems, rates of school attendance and illiteracy rates are 

used for comparability in DHS survey countries. Two indicators function as measures of education: the 

ratio of girls’ school attendance to boys’ attendance and the rate of female illiteracy. The ratio of girls’ 

primary school attendance to boys’ attendance provides an indication of the degree to which girls’ 

education is valued. Illiteracy in DHS surveys is determined by a respondent’s inability to read all or part 

of a simple sentence in any of the major language groups of the country. 

School attendance ratio 

The level of girls’ education is determined from the proportion of children age 6-10 attending school, 

disaggregated by sex. Table A.4.6 shows the percentage of the de facto household population age 6-10 

who are currently attending school, by sex. School attendance rates are generally lower in sub-Saharan 

Africa than in other regions. In sub-Saharan Africa, the proportion of females age 6-10 currently 

attending school ranges from a low of 17 percent in Niger to a high of 93 percent in Gabon. In 15 of 25 

sub-Saharan countries, less than 50 percent of females age 6-10 years are attending school. In only one 

country (Yemen) in North Africa/West Asia/Europe are less than 50 percent of females currently attending school. For all countries in the other regions, the rate is greater than 50 percent. Countries in Latin 

America and the Caribbean have a much higher rate of school attendance of girls than the other regions. 

In five out of eight countries in Latin America and the Caribbean, the rate of girls’ school attendance is 

over 90 percent. 

 The ratio of girls’ to boys’ attendance rates is based on the percentage of girls age 6-10 who are currently attending school divided by the percentage of boys currently attending school (Figure 4.11). A ratio 

of less than 1 indicates that a smaller proportion of girls than boys attend school. This ratio ranges from 

an average of 0.88 in North Africa/West Asia/Europe to a high of 1.00 in Central Asia. Gender bias in 

education is evident in a number of countries. Ten out of 25 countries in sub-Saharan Africa have female/ 

male attendance ratios that are low (less than 0.90), indicating female disadvantage in education. Yemen, 

in North Africa/West Asia/Europe, has a very low ratio of 0.61, and Nepal in South/Southeast has a ratio 

of 0.77. Nevertheless, 18 of the 46 countries have a ratio greater than 1.00, indicating a female advantage 

in education in these countries. Central Asia and Latin America and the Caribbean regions have the 

highest ratios (greater than 0.90) of female/male attendance. 
Findings 23

Female Illiteracy 

The ability to read is an important personal asset allowing women increased opportunities in life. In DHS 

surveys, literacy is established by the demonstration of a respondent’s ability to read all or part of a simple 

sentence in any of the major language groups of the country. Table A.4.7 shows the percent distribution 

of women age 15-49 years who read easily, read with difficulty, and cannot read. Figure 4.12 shows the 

rates of illiteracy across regions. Sub-Saharan Africa has the highest rates of female illiteracy (53 percent 

on average), followed by South/Southeast Asia (41 percent) and North Africa/West Asia/Europe 

(39 percent). The Central Asian region has the lowest rates of illiteracy (less than 1 percent), followed by 

Latin America and the Caribbean (16 percent). In 17 of the 45 countries in Table A.4.7, the prevalence 

of illiteracy is 50 percent or higher. Schooling is universal in Kazakhstan, and since the majority of 

respondents attained secondary schooling or higher, the literacy question was not asked. 

Figure 4.11 School attendance ratio

Ratio of girls to boys attending school at age 6-10 years

Sub-Saharan Africa

Chad

Benin

Niger

Burkina Faso

CAR

Guinea

Mali

Côte d'Ivoire

Togo

Mozambique 

Eritrea

Ethiopia

Comoros

Cameroon

Gabon

Kenya

Namibia

Ghana

Zimbabwe

Zambia

Rwanda

Uganda

Madagascar 

Malawi

Tanzania

North Africa/West Asia/Europe

Yemen 

Turkey

Egypt

Jordan 

Central Asia

Kyrgyz Republic 

Kazakhstan

Uzbekistan

South/Southeast Asia

Nepal

India

Cambodia

Indonesia 

Bangladesh

Philippines

Latin America/Caribbean

Guatemala

Haiti

Peru

Bolivia

Brazil

Colombia

Dominican Republic

Nicaragua

0 0.2 0.4 0.6 0.8 1 1.2 1.4

Ratio
24 Findings 

4.2.1.2 Exposure to media 

Despite high levels of illiteracy, exposure to mass media enables women to be more informed about their 

community, to have access to information on healthy behaviors and practices, and to broaden their 

perspectives on life beyond the household and community. In DHS surveys, exposure to media is assessed 

by asking women how often they read a newspaper, watch television, and listen to radio. 

 Table A.4.8 shows the percentage of women exposed to the different types of mass media. Figure 

4.13 shows that newspaper reading is more widely practiced in countries with low levels of female 

illiteracy. In all of the sub-Saharan countries, less than 40 percent of women reported reading a 

newspaper at least once a week. In 9 out of 25 countries in sub-Saharan Africa, less than 10 percent of 

women reported reading a newspaper at least once a week. Central Asia is the only region where all 

countries have a prevalence of weekly newspaper reading that exceeds 50 percent. Yemen has the lowest 

Figure 4.12 Illiteracy

Percentage of women age 15-49 years who cannot read

Sub-Saharan Africa

Zimbabwe

Namibia

Gabon

Kenya Madagascar Zambia

Rwanda

Tanzania

Cameroon

Uganda

Malawi

Ghana

Comoros

Togo

Eritrea

Côte d'Ivoire

Mozambique CAR

Ethiopia Benin

Chad

Guinea

Mali

Niger Burkina Faso

North Africa/West Asia/Europe Jordan 

Turkey

Egypt Yemen 

Central Asia

Uzbekistan

Kyrgyz Republic 

South/Southeast Asia

Philippines

Indonesia 

Cambodia

Bangladesh India

Nepal

Latin America/Caribbean

Colombia

Brazil

Peru

Dominican Republic Bolivia

Nicaragua

Guatemala

Haiti

0 20 40 60 80 100

Percent
Findings 25

rate (10 percent) in North Africa/West Asia/Europe. In South/Southeast Asia, less than 10 percent of 

women in Nepal and Bangladesh report having read a newspaper in the past week. In Latin America and 

the Caribbean, the prevalence of newspaper reading is over 50 percent in half of the countries. Peru and 

Haiti have the lowest rates of newspaper reading in this region (26 percent each). 

 Figure 4.14 shows the percentage of women who watch television at least once a week. Again, subSaharan Africa has the lowest rates. Central Asia consistently has the highest prevalence of television 

watching (about 90 percent). Viewership in North Africa/West Asia/Europe, except for Yemen and 

Turkey, exceeds 85 percent. In South/Southeast Asia, television viewing varies from a low of 12 percent 

in Nepal to a high of 80 percent in the Philippines. Countries in Latin America and the Caribbean have 

television viewing rates ranging from 31 percent in Haiti to 89 percent in Brazil. In all but one of the 

Latin America and Caribbean countries, more than 50 percent of women reported watching television 

weekly. 

Figure 4.13 Newspaper reading

Percentage of women age 15-49 who usually read a newspaper at least once a week

Sub-Saharan Africa

Ethiopia Burkina Faso

Chad

Niger Rwanda

Guinea

Mali

Benin

Malawi 

Mozambique Tanzania

Cameroon

Togo

CAR

Uganda 

Comoros

Côte d'Ivoire

Ghana

Eritrea

Zambia

Madagascar

Zimbabwe 

Gabon

Kenya Namibia

North Africa/West Asia/Europe Yemen

Egypt 

Turkey

Jordan

Central Asia

Uzbekistan

Kazakhstan

Kyrgyz Republic

South/Southeast Asia

Nepal Bangladesh

Cambodia 

India

Indonesia

Philippines

Latin America/Caribbean

Peru 

Haiti 

Dominican Republic Guatemala

Nicaragua Bolivia

Brazil

Colombia

0 20 40 60 80

Percent
26 Findings 

 

 In most countries in sub-Saharan Africa, the proportion of women who listen to the radio daily is 

greater than the proportion who read a newspaper or watch television weekly (Table A.4.8 and Figure 

4.15). Overall, women in Latin America and the Caribbean are much more likely to listen to the radio 

daily than women in other regions. For all countries in North Africa/West Asia/Europe, Central Asia, 

and South/Southeast Asia, except Nepal, the proportion of women who listen to radio daily is lower than 

the proportion who watch television weekly. Information on radio listening is available only on a weekly 

basis in CAR, Côte d’Ivoire, Eritrea, Mali, Yemen, and India (Table A.4.8). 

Figure 4.14 Television watching

Percentage of women age 15-49 who watch television at least once a week

Sub-Saharan Africa

Malawi 

Ethiopia Chad

Rwanda

Tanzania

Uganda Mozambique

Burkina Faso

Madagascar CAR

Eritrea

Guinea

Comoros

Niger

Kenya

Zambia

Mali

Zimbabwe 

Cameroon

Namibia

Togo Côte d'Ivoire

Ghana

Gabon

North Africa/West Asia/Europe Yemen

Jordan

Egypt 

Central Asia

Kyrgyz Republic Kazakhstan

Uzbekistan

South/Southeast Asia

Nepal Bangladesh India

Cambodia 

Indonesia

Philippines

Latin America/Caribbean

Haiti 

Guatemala

Peru 

Nicaragua Bolivia

Colombia

Dominican Republic Brazil

0 20 40 60 80 100

Percent
Findings 27

4.2.1.3 Employment 

The role of work in women’s lives should be included in any discussion of women’s health. Women are 

increasingly entering the labor force, and mothers are required to fit their child-care and domestic 

responsibilities around their hours of work, often leaving little time for themselves. On the other hand, 

income from wage work may offer health benefits to women by allowing them to purchase basic 

necessities such as housing and food. Women’s work has been found to improve dietary intake (Bisgrove 

and Popkins, 1996) and to influence fertility (Derose, 2002). Women’s autonomy and well-being are 

enhanced by income earned from work outside the home, thereby reducing their social dependence on a 

male partner. However, economic pressures on women living in poverty draw them into agricultural work, 

and women’s nutritional status and health may be diminished by the long hours and heavy work required 

(Doyal, 1995). 

 In DHS surveys, women are asked a series of questions about the role of work in their lives, two of 

which are reported on in this analysis: 

Figure 4.15 Radio listening

Percentage of women age 15-49who listen to the radio at least once a day

Sub-Saharan Africa

Ethiopia 

Togo

Burkina Faso

Chad

Cameroon

Rwanda

Guinea

Mozambique

Tanzania

Zambia

Uganda 

Madagascar

Malawi 

Zimbabwe 

Gabon

Niger

Comoros

Namibia

Kenya

Ghana

North Africa/West Asia/Europe

Jordan

Egypt 

Central Asia

Kazakhstan

Kyrgyz Republic

Uzbekistan

South/Southeast Asia

Bangladesh

Cambodia 

Nepal

Indonesia

Latin America/Caribbean

Haiti 

Peru 

Dominican Republic

Brazil

Guatemala

Bolivia

Nicaragua

Colombia

0 20 40 60 80 100

Percent
28 Findings 

1) Have you done any work [aside from housework] in the past 12 months? 

2) What is your occupation, that is, what kind of work do you mainly do? 

 The two indicators of women’s work drawn from the questions are the percentage of women age 

15-49 who are currently working (worked in the 12 months preceding the survey) and, of the women who 

worked in the past 12 months, the percentage working in agriculture. 

 Overall, women in sub-Saharan Africa are more likely to work than women in other regions. In 18 of 

the 25 countries in this region, more than 50 percent of women reported that they were currently 

working; in 6 of the countries, this proportion is over 75 percent (Table A.4.9 and Figure 4.16). In 

countries in North Africa/West Asia/Europe and in Central Asia, women were not as economically 

active. None of the countries in these regions reported a rate as high as 50 percent (Figure 4.16). 

However, more women were working in Central Asia than in North Africa/West Asia/Europe. In 

South/Southeast Asia, a small percentage of women reported that they were working, except in 

Cambodia and Nepal, where more than 70 percent of women reported working in the past year (Table 

A.4.9). In Latin America and the Caribbean, the proportion working ranges from 32 percent in 

Guatemala to 57 percent in Peru (Table A.4.9). 

Figure 4.16 Employment status

Percentage of women 15-49 who worked in the past 12 months

Sub-Saharan Desert

Eritrea

Namibia

Gabon

Comoros

Chad

Zambia

Zimbabwe

Kenya

Niger

Mali

Tanzania

Malawi

Ethiopia Mozambique

Burkina Faso

Cameroon

Côte d'Ivoire

Uganda

Ghana

CAR

Madagascar Togo Guinea

Rwanda

Benin

North Africa/West Asia/Europe Jordan

Egypt

Yemen

Turkey

Central Asia

Kazakhstan

Kyrgyzstan

Uzbekistan

South/Southeast Asia

Bangladesh Indonesia

India

Philippines

Cambodia

Nepal

Latin America/Caribbean

Guatemala

Nicaragua

Dominican

Haiti

Colombia

Brazil

Bolivia

Peru

0 20 40 60 80 100

Percent
Findings 29

 In much of the developing world, women are producers of food and livestock as well as primary meal 

makers. The majority of women in sub-Saharan Africa and a large percentage of those in 

South/Southeast Asia reported that they were currently working; many in agriculture (Table A.4.9). In 

Latin America and the Caribbean and in Central Asia, few women worked in agriculture. In North 

Africa/West Asia/Europe, the proportion working in agriculture ranges from a low of 6 percent in Jordan 

to a high of 83 percent in Yemen (Figure 4.17). Agricultural work is often considered low-level work, 

providing little if any income, and thereby not contributing to women’s status or empowerment. 

Figure 4.17 Work in agriculture

Percentage of women who work in agriculture among women age 15-49 who worked in the past 12 months

Sub-Saharan Africa

Namibia

Gabon

Benin

Ghana

Chad

Togo Comoros

Zambia

Mali

Zimbabwe

Niger Burkina Faso

Côte d'Ivoire

Kenya

Eritrea

Ethiopia

Guinea

Cameroon

Malawi

Madagascar CAR

Tanzania

Uganda Mozambique Rwanda

North Africa/West Asia/Europe Jordan

Egypt

Turkey

Yemen

Central Asia

Kazakhstan

Kyrgyzstan

Uzbekistan

South/Southeast Asia

Philippines

Bangladesh India

Cambodia

Nepal Indonesia

Latin America/Caribbean

Dominican

Nicaragua

Colombia

Brazil

Guatemala

Haiti

Bolivia

Peru

0 20 40 60 80 100

Percent
30 Findings 

4.2.1.4 Marital status 

It has been posited that marriage provides a sense of security and social support for women, which may be 

associated with better health. However, increased exposure to the risk of pregnancy can jeopardize 

women’s health. On the other hand, married women are less at risk of pregnancy problems than women 

who conceive outside of marriage. Also, married women in monogamous unions are likely to be healthier 

than those in polygynous unions. However, women in polygynous unions may have long periods of 

postpartum insusceptibility and hence longer birth intervals, which benefit their health (Defo, 1997). 

 Table A.4.10 shows the percent distribution of women by current marital status. In 8 of the 46 

countries, more than three-fourths of women are married or living with a partner. In all but two subSaharan countries (Namibia and Rwanda), most women are married or living with a partner. Namibia 

stands out for having only 39 percent of women currently married or living with a partner. Countries in 

Latin America and the Caribbean generally have lower proportions of women currently married or living 

with a partner than countries in other regions. 

 Few women are single in the developing world. Sub-Saharan Africa has both the lowest and the 

highest rates of never-married women. The lowest rates are reported in Niger (11 percent), Mali 

(13 percent), and Chad and Guinea (14 percent each). The highest rate is reported in Namibia, at 

54 percent. In other regions, the proportion never married ranges from 17 to 45 percent (Table A.4.10). 

In all but three countries (Rwanda, the Dominican Republic, and Nicaragua), less than 15 percent of 

women age 15-49 are widowed/divorced/separated (Figure 4.18). 

Traditional marriage practices, particularly polygyny, are still practiced throughout sub-Saharan Africa 

and in parts of North Africa/West Asia/Europe, South/Southeast Asia, and Latin America and the 

Caribbean. The extent of polygyny is measured by asking married women respondents, “Does your 

husband/partner have any other wives besides yourself?” Polygyny has implications for the frequency of 

exposure to sexual activity, the risk of sexually transmitted diseases, and fertility. 

 The percentage of currently married women living in a polygynous union varies from 3 percent in 

Madagascar to 53 percent in Guinea and 55 percent in Burkina Faso in sub-Saharan Africa (Table 

A.4.11). In the three countries of North Africa/West Asia/Europe and South/Southeast Asia, the rates 

are 6 to 7 percent. In Latin America and the Caribbean, Haiti has a rate of almost 20 percent (Figure 

4.19). It has been reported elsewhere that polygyny is on the decline in most countries, and it is more 

common in rural areas and among less educated women (Westoff, 2003). 
Findings 31

Figure 4.18 Marital status

Percent distribution of women age 15-49 by marital status

Sub-Saharan Africa

Namibia

Rwanda

Comoros

Gabon

Zambia

Zimbabwe

Kenya

Madagascar

Ethiopia

Ghana

Côte d'Ivoire

Tanzania

Eritrea

Cameroon

Uganda

Togo

CAR

Malawi

Mozambique

Benin

Chad

Burkina Faso

Guinea

Niger

Mali

North Africa/West Asia/Europe

Jordan

Egypt

Yemen

Turkey

Central Asia

Kazakhstan

Kyrgyz Republic

Uzbekistan

South/Southeast Asia

Cambodia

Philippines

Bangladesh

Indonesia

India

Nepal

Latin America/Caribbean

Colombia

Peru

Haiti

Nicaragua

Dominican Republic

Bolivia

Brazil

Guatemala

0 20 40 60 80 100

Never Married Married/Living Together Widowed/Divorced/Separated

Percent
32 Findings 

4.2.1.5 Female-Headed Households 

The circumstances creating female-headed households are not homogeneous. Female headship is composed of widowed/separated/divorced women, never-married women, abandoned women, and women 

whose husbands have migrated away in search of employment (Joshi, 2004). In some countries, there are 

larger percentages of female-headed households in urban areas; in others, rural areas have more femaleheaded households. Each is influenced by different socioeconomic dynamics and the changing social 

structure of families. 

 Poor women have to efficiently manage their limited resources, and women who are heads of households and have control over resources tend to cope more efficiently with fewer resources. If female heads 

of households have more control over resources than women who are not heads of households, it would 

be expected that they might put these resources to use in safeguarding their health and nutrition and that 

of their children (Chant, 2003). However, a multivariate analysis of DHS data in three sub-Saharan 

countries shows no clear relationship between female-headed households and the nutritional status of 

Figure 4.19 Polygyny

Percentage of currently married women age 15-49 who are in polygynous unions

Sub-Saharan Africa

Madagascar

Eritrea

Rwanda

Namibia

Ethiopia

Zimbabwe

Kenya

Zambia

Malawi

Gabon

Ghana

Comoros

Mozambique

Tanzania

CAR

Uganda

Cameroon

Côte d'Ivoire

Niger

Chad

Togo

Mali

Benin

Guinea

Burkina Faso

North Africa/West Asia/Europe

Jordan

Yemen

South/Southeast Asia

Nepal

Latin America/Caribbean

Haiti

0 10 20 30 40 50 60

Percent
Findings 33

children. In Mozambique, children living in female-headed households are worse off than children living 

in male-headed households (Espeut et al., 2001). 

 In Eritrea, female-headed households put children at a nutritional advantage (Rutstein et al., 1999). 

Whereas, in Madagascar, it is found to have no effect on children’s nutritional status (Haggerty et al., 

1999). This variation is consistent with the international literature (Onyango et al., 1994; Johnson and 

Rogers, 1993). Moreover, there is little in the literature about the effects of female headship on women’s 

health and nutrition. 

 As part of the DHS interview, household members are asked to state who is the head of the household. Although men are frequently determined to be household heads, there are significant numbers of 

households reported to be headed by women. A de jure sample of women (women who are usual legal 

residents of the household) was used to define the female-headed households for this analysis. Table 

A.4.12 shows that the percentage of de jure women who live in female-headed households ranges from a 

low of 6 percent in Mali and Burkina Faso to a high of 47 percent in Haiti and Namibia. 

 In 17 of 25 sub-Saharan countries, more than 20 percent of households are headed by females. 

Countries in North Africa/West Asia/Europe and South/Southeast Asia generally have lower proportions 

of women living in female-headed households than countries in Central Asia and Latin America and the 

Caribbean. In South/Southeast Asia, Cambodia stands out with 25 percent of women living in femaleheaded households. Central Asia has rates ranging from 20 percent in Uzbekistan to 28 percent in 

Kazakhstan. Countries in Latin America and the Caribbean have rates that vary from about 18 percent in 

Peru to a high of 47 percent in Haiti (Figure 4.20). 

 Female-headed households, especially those with young children, are often overrepresented among 

poor households (Buvinic, 1998). Women who are heads of households are less likely to be educated and, 

if educated, they have less education than women who are not heads of households (Kishor and Neitzel, 

1996). Women heads of households are often older (40 or more years), are widowed, have higher parity, 

and are currently employed (Kishor and Neitzel, 1996). Female-headed households may or may not be 

poorer than male-headed households in terms of material poverty, but women tend to be worse off in 

terms of deprivation due to excessive workload, social subordination, and reduced life chances (Cagatay, 

1998). 
34 Findings 

4.2.2 Behavioral Context 

Behavioral practices related to fertility are important to the context of women’s health. A young age at 

first intercourse and marriage may lead to a life of high fertility and a long childbearing period that can 

leave women living lives of exhaustion and nutritional depletion as they tend to their family’s needs rather 

than to their own health. 

4.2.2.1 Fertility practices 

Age of first intercourse, first marriage, and first birth provide a picture of initial influences on fertility that 

is suggestive of fertility-related outcomes. In most countries, marriage is a primary indication of the 

exposure of a woman to the risk of pregnancy and therefore is important in understanding fertility. 

Populations in which the age at first marriage is low tend to have early childbearing and high fertility; 

therefore, it is important to examine trends in age at first marriage. Data on age at first sexual intercourse 

are a more direct measure of the beginning of exposure to pregnancy. Related to this indicator is the 

Figure 4.20 Female-headed households

Percentage of women age 15-49 living in households headed by women

Sub-Saharan Africa

Burkina Faso

Mali

Guinea

Niger Côte d'Ivoire

Benin

CAR

Madagascar Tanzania

Chad

Cameroon

Zambia

Ethiopia Togo

Gabon

Malawi

Mozambique Uganda

Eritrea

Kenya Comoros

Zimbabwe

Rwanda

Ghana

Namibia

North Africa/west Asia/Europe Yemen

Jordan

Turkey

Egypt

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Bangladesh India

Indonesia

Nepal Philippines

Cambodia

Latin America/Caribbean

Bolivia

Peru

Guatemala

Brazil

Colombia

Dominican Republic Nicaragua Haiti

0 10 20 30 40 50

Percent
Findings 35

median age at first birth. The age at which childbearing begins is associated with the number of children 

a woman bears during her reproductive period in the absence of any active fertility control. 

 The median ages at first sexual intercourse, first marriage, and first birth for women age 25-49 are 

shown in Table A.4.13. A key observation that can be drawn from these data is that for 50 percent of 

women, first marriage, first intercourse, and first birth all occurred during the adolescent period (under 20 

years), thereby inhibiting women’s opportunities for pursuing education and for securing skills for selfempowerment and improved work opportunities. 

 Median age at first sexual intercourse ranges from a low of about 16 years in 10 countries of subSaharan Africa to 22 years in the Philippines in South/Southeast Asia (Figure 4.21). 

Figure 4.21 Median age at first sexual intercourse 

Women age 25-49

Sub-Saharan Africa

Chad

Cameroon

Côte d'Ivoire

Mali

CAR

Mozambique

Ethiopia

Guinea

Gabon

Zambia

Kenya

Uganda

Niger

Tanzania

Eritrea

Malawi

Madagascar

Benin

Togo

Burkina Faso

Ghana

Comoros

Zimbabwe

Namibia

Rwanda

Central Asia

Uzbekistan

Kyrgyz Republic

Kazakhstan

South/Southeast Asia

Nepal

Indonesia

Cambodia

Philippines

Latin America/Caribbean

Guatemala

Haiti

Nicaragua

Dominican Republic

Bolivia

Peru

Brazil

Colombia

0 5 10 15 20 25

Years of Age
36 Findings 

 In sub-Saharan Africa, the median age at first sexual intercourse is lower than the median age at first 

marriage by a difference of one to three years. Niger and Eritrea are the only countries where the median 

age at first marriage is lower than the median age at first sexual intercourse; in Ethiopia, the median age 

at both first marriage and first sex are the same. No data were collected on age at first sexual intercourse 

in countries in North Africa/West Asia/Europe. In Central Asia and South/Southeast Asia, the median 

ages at first sexual intercourse and first marriage are about the same. Median ages at first sexual intercourse and first marriage are higher in Latin America and the Caribbean than they are in sub-Saharan 

Africa, but show a similar one- to two-year difference, with first sexual intercourse occurring before first 

marriage. 

 Overall, the median age at first marriage is higher in Central Asia and in Latin America and the 

Caribbean than it is in sub-Saharan Africa and South/Southeast Asia (Figure 4.22). In all three countries 

in Central Asia and in five of the eight countries in Latin America and the Caribbean, the median age at 

first marriage is over 20 years. Median age at marriage is most variable in South/Southeast Asia, ranging 

from a low of just under 15 years in Bangladesh to a high of just over 22 years in the Philippines. 

Figure 4.22 Median age at first marriage

Women age 25-49

Sub-Saharan Africa

Niger

Chad

Mali

Ethiopia

Guinea

Eritrea

Mozambique CAR

Cameroon

Burkina Faso

Zambia

Uganda

Malawi

Côte d'Ivoire

Tanzania

Benin

Madagascar Comoros

Togo

Ghana

Kenya Zimbabwe

Gabon

Rwanda

North Africa/West Asia/Europe Yemen

Egypt

Turkey

Jordan

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Bangladesh Nepal

India

Indonesia

Cambodia

Philippines

Latin America/Caribbean

Nicaragua

Guatemala

Dominican Republic Haiti

Bolivia

Brazil

Peru

Colombia

0 5 10 15 20 25

Years of Age
Findings 37

 Figure 4.23 shows patterns of median age at first birth among women age 25-49. The median age at 

first birth is about 20 years or higher in most regions. In sub-Saharan Africa, only 6 of 25 countries have a 

median age at first birth of 20 years or more. In nearly all countries in North Africa/West Asia/Europe, 

Central Asia, and Latin America and the Caribbean, the median age at first birth is 20 years or more. In 

South/Southeast Asia, 3 of 6 countries have a median age at first birth of 20 years or more. At 17.8 years, 

Niger in sub-Saharan Africa and Bangladesh in South/Southeast Asia have the lowest median age at first 

birth of all the countries. Jordan, in North Africa/West Asia/Europe, and the Philippines, in South/ 

Southeast Asia, have the highest median age at first birth (23.2 and 23.3 years, respectively). 

Figure 4.23 Median age at first birth

Women age 25-49 

Sub-Saharan Africa

Niger

Chad

Gabon

Zambia

Mali

Guinea

Uganda Côte d'Ivoire

Ethiopia Cameroon

Malawi

Tanzania

Mozambique

Burkina Faso

CAR

Kenya Madagascar Benin

Zimbabwe

Togo

Ghana

Comoros

Namibia

Eritrea

Rwanda

North Africa/West Asia/Europe Yemen

Turkey

Egypt

Jordan

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Bangladesh India

Nepal Indonesia

Cambodia

Philippines

Latin America/Caribbean

Nicaragua

Guatemala

Dominican Republic Bolivia

Haiti

Peru

Colombia

Brazil

0 5 10 15 20 25

Years of Age
38 Findings 

 The differences between median age at first intercourse and median age at first birth and between 

median age at first marriage and median age at first birth are very small, if there are any differences. It 

appears that women have sexual intercourse, get married, and have children in fairly close succession. In 

21 of 25 countries in sub-Saharan Africa, the difference between median age at first marriage and median 

age at first birth is usually between 1 and 3 years, and the difference between median age at first sex and 

median age at first birth is between 2 and 3.5 years. In Eritrea, the difference between median age at first 

birth and first intercourse is comparatively large at 4.6 years, and the difference is virtually the same 

between median age at first birth and first marriage. 

 In North Africa/West Asia/Europe, there is no information on age at first intercourse, but the difference between median age at first marriage and first birth is between 1 and 2 years for three of the four 

countries. In Yemen. the difference between median age at first marriage and first birth is almost 4 years. 

 In Central Asia and South/Southeast Asia, the difference between the median age at first intercourse 

and median age at first birth is about 1.5 years, which is the same as the difference between median age at 

first marriage and median age at first birth. In the countries of Latin America and the Caribbean, the 

difference between the median age at first intercourse and median age at first birth is from 1.5 to 3 years, 

and a little less between the median age at first marriage and median age at first birth (less than 1.5 years). 

The differences between age at first marriage and age at first birth as well as age at first intercourse and 

age at first birth range from 1 to 2 years in Central Asia and one to three years in South/Southeast Asia 

for four of six countries for which there are data on all three indicators. 

 

Total Fertility Rate and Wanted Fertility 

Total fertility rate (TFR) is a useful measure for examining the overall level of fertility of women. It is 

interpreted as the average number of children a woman would bear in her lifetime if she experienced the 

currently observed age-specific fertility rates throughout her reproductive years. Undernutrition and, in 

turn, poor health in women are linked to fertility as well as food availability. Many women in developing 

countries have depleted their nutritional stores because of improperly spaced births (Labbok, 1991; 

Merchant and Martorell, 1988). In countries where the TFR is high, there is usually a correlation with 

poor health in women. 

 Table A.4.14 presents the TFR and wanted TFR for the 46 countries surveyed. The wanted total 

fertility rate is calculated in the same manner as the standard TFR by adding up the age-specific fertility 

rates, except that unwanted births are omitted from the numerator. Observing the two rates comparatively 

suggests the potential effect of the elimination of unwanted births. 

 In sub-Saharan Africa, the TFR ranges from 4.0 in Zimbabwe to 7.2 in Niger, with an overall 

average across the region of 5.5. North Africa/West Africa/Europe follows with an overall average of 4.5, 

ranging from 2.6 in Turkey to 6.5 in Yemen. South/Southeast Asia and Latin America and the Caribbean have similar averages of 3.5 and 3.6, respectively. Kazakhstan in Central Asia has the lowest TFR 

(2.0) among the countries surveyed. 

 As expected, the actual TFR is higher than the wanted TFR (Figure 4.24). The smallest differences 

between the TFR and the wanted TFR are found in Central Asia, with an average difference of 0.2, 

meaning that women are having the number of children they desire. The largest differences are seen in 

North Africa/West Asia/Europe, with an average difference of 1.4. Latin America and the Caribbean and 

South/Southeast Asia have an average of about 1.0 unwanted children per woman. Although sub-Saharan 

Africa has the highest regional TFR, the average difference between the TFR and the wanted TFR in 

that region is less than 1 (0.8), suggesting that the women both want large families and are having large 

families. 
Findings 39

Figure 4.24 Fertility

Total fertility rate and total wanted fertility rate for the

three years preceding the survey

Sub-Saharan Africa

Zimbabwe

Namibia

Gabon

Ghana

Comoros

Kenya

Cameroon

CAR

Togo

Mozambique

Côte d'Ivoire

Ethiopia

Guinea

Rwanda

Tanzania

Benin

Madagascar

Zambia

Eritrea

Malawi

Burkina Faso

Chad

Mali

Uganda

Niger

North Africa/West Asia/Europe

Turkey

Egypt

Jordan

Yemen

Central Asia

Kazakhstan

Uzbekistan

Kyrgyz Republic

South/Southeast Asia

India

Indonesia

Bangladesh

Philippines

Cambodia

Nepal

Latin America/Caribbean

Brazil

Peru

Colombia

Dominican Republic

Nicaragua

Bolivia

Haiti

Guatemala

02468

Wanted TFR TFR

Rate
40 Findings 

Duration of Childbearing Period 

The length of the childbearing period (Table A.4.15), which is defined here as the average number of 

years between the first and last birth for ever-married women age 40-49 with two or more births, gives an 

indication of approximately how much of a woman’s life is spent being pregnant, breastfeeding, and 

caring for young infants. Compared with a previous analyses, these results indicate that the length of the 

childbearing period seems to have decreased by one to three years in the past ten years (Carr and Way, 

1994). 

 The childbearing period is longest in sub-Saharan Africa, ranging from 14.5 years in Namibia to 18.3 

years in Niger. If the median age at first birth is about 19 years of age, a typical woman in this region 

might have her first birth at 19 and her last birth around 35 years of age. Previous survey results indicate 

that women age 40-49 had their first birth around age 19 and continued childbearing through age 38 or 

39 (Carr and Way, 1994). 

 In North Africa/West Asia/Europe, the length of the childbearing period ranges from 10 years in 

Turkey to 17 years in Yemen. An average woman in this region has her first birth around 21 years of age 

and her last birth around 33 years of age. In Central Asia, the childbearing period is the shortest, ranging 

from 8 years in Kazakhstan to 11 years in the Kyrgyz Republic and Uzbekistan. Women in this region 

have their first birth around 22 years of age and their last birth around age 32. In South/Southeast Asia, 

women have their first birth at around 20 years of age and continue childbearing for around 13 years to 

about 33 years of age. In Latin America and the Caribbean, a woman typically has her first birth at 

around 21 years of age and continues having children for about 12 years to about 33 years of age (Figure 

4.25). 
Findings 41

4.2.2.2 Breastfeeding Practices 

Optimal breastfeeding practices are important not only for child health but also for maternal health by 

supporting child spacing and women’s nutrition. Optimal breastfeeding practices include (but are not 

limited to) putting the infant to the breast within 30 minutes after delivery, exclusively breastfeeding for 

about six months, and continuing to breastfeed for at least two years. 

 In the context of women’s health, breastfeeding shortly after delivery helps the uterus retract and 

hence reduce postpartum blood loss to the mother. Fertility is influenced by breastfeeding through 

lactational amenorrhea that is supported by exclusive breastfeeding, thereby prolonging protection against 

a subsequent pregnancy. In addition, lactational amenorrhea enables a woman to recover her iron stores 

lost in pregnancy and reduces the chances of developing anemia (Stoltzfus, 1994). A mother’s ability to 

adequately breastfeed is affected by her nutritional status, but at the same time, the mother’s nutritional 

status is affected by breastfeeding. Breastfeeding can add to maternal nutritional stress, requiring 

Figure 4.25 Duration of childbearing period

Average number of years between first and last birth among ever-married women age 40-49 with 2+ births 

Sub-Saharan Africa

Namibia

Eritrea

CAR

Comoros

Kenya Zimbabwe

Ghana

Mozambique Gabon

Rwanda

Cameroon

Chad

Togo Madagascar

Côte d'Ivoire

Malawi

Guinea

Benin

Uganda Mali

Tanzania

Zambia

Burkina Faso

Ethiopia Niger

North Africa/West Asia/Europe Turkey

Egypt

Jordan

Yemen

Central Asia

Kazakhstan

Kyrgyz Republic Uzbekistan

South/Southeast Asia

India

Philippines

Indonesia

Cambodia

Nepal Bangladesh

Lattin America/Caribbean

Brazil

Dominican Republic Colombia

Peru

Bolivia

Nicaragua

Guatemala

Haiti

0 5 10 15 20

Years
42 Findings 

additional energy and micronutrients, which can put demands on a mother’s fat stores and micronutrient 

reserves (Baker et al., 1996). However, increases in caloric intake and micronutrient supplementation can 

offset maternal nutritional demands. The benefits of breastfeeding for both mother and child outweigh 

the possible maternal nutritional stress of lactation (Huffman, 1991). 

 In all but two countries surveyed, over 90 percent of children born in the three years preceding the 

survey were breastfed. The lowest rates for children ever breastfed are in Gabon (86 percent) and the 

Philippines (89 percent) (Table A.4.16). 

Exclusive breastfeeding 

Figures for exclusive breastfeeding (defined here as a child being given breast milk only in the past day or 

night) in the first six months of life are shown in Table A.4.17. Exclusive breastfeeding has a positive 

hormonal effect on the mother, suppressing fertility and influencing the length of the birth interval (Gray 

et al., 1987; Short, 1984). Examining exclusive breastfeeding practices over time, it can be seen that this 

indicator is driven by the higher rates of exclusive breastfeeding in the early months after birth, particularly the first two months (Mukuria, 2003). Nevertheless, exclusive breastfeeding for a full six-month 

period is not widely practiced. In 29 of 43 countries, less than 40 percent of children under six months are 

exclusively breastfed. 

 In sub-Saharan Africa, the proportion of children less than six months of age who are exclusively 

breastfed ranges from less than 1 percent in Niger to a high of 84 percent in Rwanda. In 15 of the 25 

countries in this region, less than 20 percent of children under age six months are exclusively breastfed. In 

North Africa/West Asia/Europe, the prevalence of exclusive breastfeeding ranges from 7 percent in 

Turkey to 57 percent in Egypt. In Central Asia, data are only available for one country, Kazakhstan (36 

percent). In South/Southeast Asia, the rate ranges from a low of 11 percent in Cambodia to a high of 75 

percent in Nepal. Exclusive breastfeeding varies widely in the Latin America and the Caribbean region, 

from a low of 12 percent in Colombia to a high of 67 percent in Peru (Figure 4.26). 
Findings 43

Median duration of breastfeeding (living children under age 3) 

It is internationally recommended that breastfeeding continue through the second year of life. The 

duration of breastfeeding in DHS surveys is calculated from current breastfeeding status data. For each 

month of age, the percentage of children breastfeeding is derived by dividing the number of children 

breastfeeding by the total number of children born the same number of months ago. The median is 

derived (usually by interpolation) by identifying the age at which 50 percent of the sample children under 

age three are no longer breastfeeding (Table A.4.16). This method is preferred over mothers’ reports of 

breastfeeding duration among fully weaned children because of biases in recall (Haggerty and Rutstein, 

1999). 

Figure 4.26 Exclusive breastfeeding

Percentage of youngest children under six months living with their mother who were exclusively breastfed

Sub-Saharan Africa

Niger

Chad

CAR

Côte d'Ivoire

Comoros

Gabon

Burkina Faso

Mali

Benin

Togo Guinea

Cameroon

Kenya

Namibia

Zambia

Tanzania

Mozambique Ghana

Zimbabwe

Malawi

Madagascar Ethiopia

Eritrea

Uganda

Rwanda

North Africa/West Asia/Europe Turkey

Jordan

Egypt

Central Asia

Kazakhstan

South/Southeast Asia

Cambodia

Philippines

Indonesia

Bangladesh India

Nepal

Latin America/Caribbean

Colombia

Dominican Republic Nicaragua Haiti

Brazil

Guatemala

Bolivia

Peru

0 20 40 60 80 100

Percent
44 Findings 

 In sub-Saharan Africa, the median duration of any breastfeeding ranges from 12 months in Gabon 

to 26 months in Burkina Faso. In North Africa/West Asia/Europe, it ranges from 12 to 18 months. 

Central Asia has a median duration of about 16 months. South/Southeast Asia has a much longer median 

duration of breastfeeding (over 20 months), except in the Philippines, where the median duration is about 

13 months. Bangladesh and Nepal stand out as having a median duration of breastfeeding of over 30 

months. Countries in Latin America and the Caribbean have much shorter median durations of 

breastfeeding, ranging from 7 months in Brazil to 21 months in Peru (Table A.4.15 and Figure 4.27). 

4.2.2.3 Child Spacing and Family Planning 

Duration of postpartum amenorrhea, abstinence, and insusceptibility 

Postpartum amenorrhea refers to the interval between childbirth and the return of menstruation. This is 

the period during which a woman becomes temporarily infecund following childbirth. There is a direct 

relationship between the length and intensity of breastfeeding and the duration of postpartum amenorFigure 4.27 Median duration of breastfeeding

Median duration (months) of any breastfeeding among children born in the three years preceding the survey 

who were ever breastfed

Sub-Saharan Africa

Gabon

Cameroon

Namibia

Zimbabwe

Uganda

Zambia

Comoros

Côte d'Ivoire

CAR

Niger Madagascar Kenya

Chad

Ghana

Tanzania

Mali

Mozambique Eritrea

Rwanda

Guinea

Benin

Malawi

Togo Ethiopia Burkina Faso

North africa/West Asia/Europe Jordan

Turkey

Yemen

Egypt

Central Asia

Kazakhstan

Kyrgyz Republic Uzbekistan

South/Southeast Asia

Philippines

Cambodia

Indonesia

India

Bangladesh Nepal

Latin America/Caribbean

Brazil

Dominican Republic Colombia

Nicaragua Haiti

Bolivia

Guatemala

Peru

0 5 10 15 20 25 30 35

Months
Findings 45

rhea. Postpartum abstinence refers to the period of voluntary sexual inactivity after childbirth. Women are 

considered insusceptible if they are not exposed to the risk of pregnancy, either because they are amenorrheic or are abstaining from sexual intercourse following a birth. Women who gave birth during the three 

years preceding the survey were asked about the duration of amenorrhea and the duration of sexual 

abstinence following childbirth. 

 Table A.4.18 shows the median duration of postpartum amenorrhea, abstinence, and insusceptibility. 

Sub-Saharan countries have the longest median durations of postpartum amenorrhea (ranging from 

7 months in Comoros to 19 months in Ethiopia) and insusceptibility (ranging from 8 months in 

Comoros to 23 months in Burkina Faso). North Africa/West Asia/Europe has the shortest period of 

insusceptibility of all of the regions (from 4 months in Jordan, Egypt, and Turkey to 6 months in 

Yemen). Postpartum abstinence is more widely practiced in sub-Saharan Africa (from less than 1 month 

in Rwanda to 22 months in Guinea) than in other regions (from 2 to 3 months) (Figures 4.28 through 

4.30). 

Figure 4.28 Median duration of postpartum amenorrhea

Median number of months of postpartum amenorrhea following births

in the three years preceding the survey

Sub-Saharan Africa

Comoros

Gabon

Kenya Namibia

Cameroon

Ghana

Madagascar Uganda

Zambia

Guinea

Tanzania

Côte d'Ivoire

Zimbabwe

Malawi

Benin

Mali

Mozambique Togo

CAR

Eritrea

Rwanda

Chad

Niger Burkina Faso

Ethiopia

North Africa/West Asia/Europe Turkey

Jordan

Egypt

Yemen

Central Asia

Uzbekistan

Kazakhstan

Kyrgyz Republic

South/Southeast Asia

Philippines

Indonesia

Bangladesh India

Cambodia

Nepal

Latin America/Caribbean

Brazil

Dominican Republic Colombia

Nicaragua Haiti

Peru

Bolivia

Guatemala

0 5 10 15 20

Months
46 Findings 

Figure 4.29 Median duration of postpartum abstinence 

Median number of months of postpartum abstinence following births in the 

three years preceding the survey

Sub-Saharan Africa

Rwanda

Uganda

Niger

Comoros

Ethiopia

Eritrea

Mali

Kenya

Zimbabwe

Madagascar

Chad

Zambia

Tanzania

Malawi

Namibia

Ghana

Gabon

CAR

Mozambique

Côte d'Ivoire

Cameroon

Togo

Benin

Burkina Faso

Guinea

North Africa/West Asia/Europe

Jordan

Egypt

Yemen

Turkey

Central Asia

Kyrgyz Republic

Uzbekistan

Kazakhstan

South/Southeast Asia

Bangladesh

Philippines

Indonesia

India

Cambodia

Nepal

Latin America/Caribbean

Brazil

Colombia

Dominican Republic

Guatemala

Nicaragua

Peru

Bolivia

Haiti

0 5 10 15 20 25

Months
Findings 47

Current Use of Contraception 

DHS surveys collect data on the level of contraceptive use, which is defined as the percentage of currently 

married women age 15-49 who are using any contraceptive method. Table A.4.19 shows the percentage 

of currently married women who are currently using either a modern or a traditional method of family 

planning. 

 Although rates of contraceptive use are at an all time high, countries in sub-Saharan Africa have the 

lowest rates, with most being below 30 percent. In some countries such as Rwanda and Togo, contraceptive prevalence rates decreased from previous levels (Carr and Way, 1994). Traditional methods of 

family planning continue to be important in most countries in sub-Saharan Africa. For most countries in 

the other regions, 50 percent or more of currently married women use family planning. However, in each 

region, there are exceptions where rates of 30 percent or less are found in one or two countries. In North 

Africa/West Asia/Europe, use of traditional methods continues to be important except in Egypt, where 

traditional methods account for only 2 percent of current use. In Central Asia, traditional methods are 

not as important as in other regions. In South/Southeast Asia, traditional methods are of greatest 

importance in the Philippines, where they contribute to 41 percent of contraceptive use. Bolivia and Peru 

are the only countries in the Latin America and Caribbean region where traditional methods contribute 

substantially to current use of family planning (Figure 4.31). 

Figure 4.30 Median duration of postpartum insusceptibility

Median number of months of postpartum insusceptibility following births in

the three years preceding the survey

Sub-Saharan Africa

Comoros

Kenya

Gabon

Madagascar Uganda

Ghana

Zambia

Mali

Malawi

Rwanda

Cameroon

Zimbabwe

Tanzania

Niger

CAR

Mozambique

Côte d'Ivoire

Eritrea

Chad

Togo Namibia

Benin

Ethiopia

Guinea

Burkina Faso

North Africa/West Asia/Europe Jordan

Egypt

Turkey

Yemen

Central Asia

Uzbekistan

Kazakhstan

Kyrgyz Republic

South/Southeast Asia

Philippines

Indonesia

Bangladesh India

Cambodia

Nepal

Latin America/Caribbean

Brazil

Dominican Republic Colombia

Nicaragua Haiti

Peru

Bolivia

Guatemala

0 5 10 15 20 25

Months
48 Findings 

Unmet Need for Contraception 

Women are said to have an unmet need for contraception if they stated that they would like to stop 

having children or wanted to wait at least two years before their next birth and were not using 

contraception (Table A.4.20). Haiti, at 40 percent, has the highest rate of unmet need, followed by 

Yemen (39 percent). Overall, sub-Saharan Africa has the highest level of unmet need: in 15 of the 25 

countries, more than 25 percent of currently married women have an unmet need for family planning 

(Figure 4.32). 

 Levels of unmet need are low where contraceptive use is widespread—for example, in Central Asia, 

and in Brazil and Colombia in Latin America and the Caribbean. On the other hand, some countries 

such as Chad have both a low level of unmet need (10 percent) and a low rate of contraceptive use 

(4 percent), indicating little desire to limit fertility (Figure 4.32). 

Figure 4.31 Current use of contraception

Percentage of currently married women age 15-49 currently using a contraceptive method (modern or traditional method)

Sub-Saharan Africa

Chad

Mozambique Guinea

Mali

Eritrea

Ethiopia Niger Côte d'Ivoire

Burkina Faso

Rwanda

CAR

Benin

Tanzania

Cameroon

Madagascar Comoros

Ghana

Uganda Togo Zambia

Malawi

Gabon

Kenya Namibia

Zimbabwe

North Africa/West Asia/Europe Yemen

Jordan

Egypt

Turkey

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Cambodia

Nepal Philippines India

Bangladesh Indonesia

Latin America/Caribbean

Haiti

Guatemala

Bolivia

Nicaragua Dominican Republic Peru

Colombia

Brazil

0 20 40 60 80 100

Modern method

Traditional method

Percent
Findings 49

4.2.2.4 Utilization of Health Care Services 

Utilization of health care services provides an opportunity for women to obtain critical health and nutrition information and services. Access to emergency maternity care means the difference between life and 

death in complicated deliveries. Measures of access to and utilization of health services include the use of 

antenatal care services, receipt of tetanus toxoid and iron supplementation (discussed previously), and the 

use of delivery care services. Exposure to HIV/AIDS prevention information takes place primarily 

through the health sector in developing countries. Demonstrated knowledge and awareness of HIV/ 

AIDS prevention is a measure of women’s access to and utilization of health education. 

Antenatal Care 

Underutilization of antenatal care is associated with suboptimal pregnancy outcomes. The most common 

of these in developing countries is low birth weight. Antenatal care should be part of a multipronged 

approach to improve pregnancy outcomes. Such an approach includes family planning services, increasing 

women’s access to health care, and improving the socioeconomic status of women (AbouZahr and 

Wardlaw, 2003). Improving women’s nutrition is also an important contribution to antenatal care (Villar 

et al., 2003). 

Figure 4.32 Unmet need for family planning or child spacing

Percentage of currently married women age 15-49 who had a live birth in the three years

preceding the survey and who have an unmet need for family planning or child spacing

Sub-Saharan Africa

Chad

Zimbabwe

CAR

Niger Cameroon

Namibia

Mozambique Kenya Tanzania

Guinea

Madagascar Benin

Mali

Burkina Faso

Zambia

Côte d'Ivoire

Eritrea

Gabon

Malawi

Togo

Ghana

Comoros

Uganda

Ethiopia

Rwanda

North Africa/West Asia/Europe Turkey

Egypt

Jordan

Yemen

Central Asia

Kazakhstan

Kyrgyz Republic Uzbekistan

South/Southeast Asia

Indonesia

Bangladesh India

Philippines

Cambodia

Nepal

Latin America/Caribbean

Brazil

Colombia

Peru

Dominican Republic Nicaragua

Guatemala

Bolivia

Haiti

0 10 20 30 40

Percent
50 Findings 

 In surveys conducted before 1998-99, women were asked about antenatal care for all pregnancies 

associated with live births in the five years preceding the survey. From about 1999 on, information was 

collected only for the last live birth. For comparative purposes in this report, the results are based on the 

respondent’s last live birth in the three years preceding the survey. The results are presented by urbanrural residences for women who had at least one antenatal care visit with a trained health professional and 

those who had four or more antenatal care visits. There are large inter- and intracountry differences in the 

use of antenatal care services. 

 In Table A.4.21, the percentage of women in sub-Saharan Africa who had at least one antenatal visit 

with a trained health professional ranges from 26 percent in Ethiopia to 95 percent in Zambia. In North 

Africa/West Asia/Europe, the range is also quite broad, from 36 percent in Yemen to 96 percent in 

Jordan. Central Asia has the highest coverage of antenatal care: over 90 percent in all of the countries 

surveyed. South/Southeast Asia has levels of antenatal care use similar to sub-Saharan Africa and North 

Africa/West Asia/Europe, ranging from 38 percent in Bangladesh to 91 percent in Indonesia. Latin 

America and the Caribbean has a narrower spread, from 71 percent in Bolivia to 99 percent in the 

Dominican Republic. 

 Figure 4.33 shows the percentage of women who reported having at least one antenatal visit with a 

trained medical professional by urban-rural residence. In 11 of the 46 countries, there is at least a 30 

percentage point difference between urban and rural women in reporting at least one antenatal visit with a 

trained medical professional (Table A.4.21). Kazakhstan stands out as the only country having higher 

coverage in rural areas than in urban areas. In countries with more accessible preventive health services, 

the urban-rural differential in access to antenatal care is less pronounced (Rwanda, Zimbabwe, Gyrgyz 

Republic, Uzbekistan, and the Dominican Republic). 
Findings 51

Sub-Saharan Africa

Ethiopia 

Chad 

Niger 

Mali 

Eritrea 

CAR

Burkina Faso 

Mozambique 

Guinea 

Cameroon 

Madagascar 

Côte d'Ivoire 

Benin 

Togo 

Comoros 

Gabon 

Ghana 

Namibia 

Tanzania 

Zimbabwe 

Kenya 

Malawi 

Uganda 

Rwanda 

Zambia 

North Africa/West Asia/Europe

Yemen 

Egypt 

Turkey 

Jordan 

Central Asia

Kazakhstan 

Uzbekistan

Kyrgyz Republic 

South/Southeast Asia

Bangladesh 

Cambodia

Nepal 

India 

Philippines 

Indonesia 

Latin America/Caribbean

Guatemala 

Peru 

Bolivia 

Colombia 

Brazil 

Haiti 

Nicaragua 

Dominican Republic 

0 20 40 60 80 100

Urban Rural

Percent

Figure 4.33 Antenatal care by area of residence

Percentage of women age 15-49 who had a live birth in the three years preceding the survey 

and who received at least one antenatal care visit with a trained medical professional 

(doctor, nurse, midwife) during pregnancy for the most recent birth, by urban-rural residence
52 Findings 

 WHO recommends a minimum of four antenatal care visits for normal pregnancies. In Table A.4.21, 

the proportion of mothers in sub-Saharan Africa who have had at least four antenatal visits ranges from 

9.6 percent in Ethiopia to 73 percent in Namibia. In 12 of 25 countries in this region, at least 50 percent 

of women report having received four or more antenatal care visits. Central Asia has the highest coverage 

of WHO-compliant antenatal care visits, from 79 percent in Kazakhstan to almost 90 percent in the 

Kyrgyz Republic. South/Southeast Asia and North Africa/West Asia/Europe have variable rates of 

coverage across countries. Only two countries in South/Southeast Asia (Indonesia and the Philippines) 

and only one country in North Africa/West Asia/Europe (Jordan) have rates over 50 percent. The 

proportion having four or more antenatal care visits in the Latin America and Caribbean countries ranges 

from 42 percent in Haiti to 88 percent in the Dominican Republic (Table A.4.21). 

 In much of the developing world, at least 50 percent of women are having four or more antenatal care 

visits but many more need to be reached with services. Those in rural areas and those with less education 

or who live in poorer households have been found to utilize antenatal care less than other women 

(AbouZahr and Wardlaw, 2003). Urban-rural differences are 30 percent or greater in 12 of 46 countries 

(Figure 4.34). Although antenatal care has not been proven to be effective in reducing maternal mortality 

or serious morbidities in developing country settings, there are components that are effective in detecting, 

treating, or preventing conditions in pregnant women that may give rise to serious morbidity or death. 

These components that improve maternal health include prevention and treatment of anemia through 

iron supplementation and malaria prophylaxis, as well as infection prevention and treatment through 

tetanus immunization and management of sexually transmitted infections (Carroli et al., 2001). Iron 

supplementation during pregnancy was previously reported in the micronutrient section. Tetanus 

immunization is discussed below. 
Findings 53

Figure 4.34 Antenatal care visits by urban-rural residence

Percentage of women age 15-49 who had a live birth in the three years preceding the survey 

and who had at least four antenatal care visits during pregnancy for the most recent birth, by urban-rural residence 

Percent

Sub-Saharan Africa

Ethiopia 

Niger 

Chad 

Rwanda 

Eritrea 

Mali 

Burkina Faso 

Côte d'Ivoire 

CAR

Mozambique 

Madagascar 

Uganda 

Guinea 

Togo 

Gabon 

Cameroon 

Comoros 

Benin 

Malawi 

Ghana 

Kenya 

Zambia 

Tanzania 

Namibia 

Zimbabwe 

North Africa/West Asia/Europe

Yemen 

Turkey 

Egypt 

Jordan 

Central Asia

Kazakhstan 

Uzbekistan 

Kyrgyz Republic 

South/Southeast Asia

Cambodia

Bangladesh 

Nepal 

India 

Philippines 

Indonesia 

Latin America/Caribbean

Bolivia 

Peru 

Haiti 

Guatemala 

Nicaragua 

Colombia 

Brazil 

Dominican Republic 

0 20 40 60 80 100

Urban Rural
54 Findings 

Receipt of Tetanus Toxoid 

One of the most successful interventions in pregnancy is the introduction of maternal vaccination to 

prevent maternal and neonatal tetanus from occurring as a result of infection at delivery. A woman is 

expected to receive two doses of tetanus toxoid during pregnancy for full protection. However, if a woman 

has been fully vaccinated during a previous pregnancy, she may require only one dose for the current 

pregnancy. Five doses are considered adequate to provide lifetime coverage. To estimate the extent of 

tetanus toxoid coverage during pregnancy, DHS surveys collect data on the number of tetanus injections 

women received during pregnancy for the most recent birth in the three years preceding the survey. These 

results are presented in Table A.4.21 and Figure 4.35. The data may underestimate the actual extent of 

protection against tetanus because women who received prior vaccinations may not have been given 

additional injections, as they were considered adequately covered. 

 

Figure 4.35 Tetanus immunization during pregnancy

Percentage of women age 15-49 who had at least one tetanus toxoid injection during the pregnancy for the 

most recent birth in the three years preceding the survey

Sub-Saharan Africa

Ethiopia 

Chad 

Mozambique 

Niger 

Eritrea 

Madagascar 

Mali 

Burkina Faso 

Comoros 

Togo 

Rwanda 

CAR

Uganda 

Cameroon 

Benin 

Guinea 

Côte d'Ivoire 

Gabon 

Malawi 

Zimbabwe 

Ghana 

Zambia 

Kenya 

Tanzania 

North Africa/West Asia/Europe

Yemen 

Jordan 

Turkey 

Egypt 

South/Southeast Asia

Cambodia

Nepal 

Philippines 

Indonesia 

India 

Bangladesh 

Latin America/Caribbean

Bolivia 

Guatemala 

Brazil 

Haiti 

Peru 

Colombia 

Nicaragua 

Dominican Republic 

0 20 40 60 80 100

Percent
Findings 55

 In sub-Saharan Africa, the proportion who received at least one tetanus toxoid vaccination during 

their last pregnancy ranges from 26 percent in Ethiopia to 93 percent in Tanzania. One-third of the 

countries in sub-Saharan Africa have rates between 60 and 80 percent. Another 38 percent have rates less 

than 60 percent. There are seven countries where more than 80 percent of mothers reported having 

received at least one tetanus toxoid injection during their last pregnancy. No data were available for 

Namibia. 

 In North Africa/West Asia/Europe, tetanus toxoid vaccination varies by country, from 17 percent in 

Yemen to 73 percent in Egypt. There are no data for the Central Asian countries. In South/Southeast 

Asia, coverage ranges from 46 percent in Cambodia to 81 percent in Bangladesh. In Latin America and 

the Caribbean, coverage ranges from 49 percent in Bolivia to 96 percent in the Dominican Republic. 

Delivery Care 

The main causes of maternal mortality include hemorrhage, obstructed labor, and puerperal infection. All 

of these conditions are responsive to improvements in the quality of coverage, utilization of services, and 

emergency access to delivery care. The type of assistance a woman receives during childbirth has 

important consequences for both the mother and the child. The presence of a skilled attendant at delivery 

is associated with lower levels of maternal mortality (De Browere et al., 1998). Women interviewed in 

DHS surveys were asked who assisted with the delivery of their last child born in three years preceding 

the survey. Table A.4.22 and Figure 4.36 show the percentage of women who received assistance from a 

trained medical professional (doctor, nurse, midwife) for their last live birth by urban-rural residence. 

 The percentage of women who received assistance from a trained medical professional for their last 

live birth ranges from 6 percent in Ethiopia to 99 percent in Kazakhstan. In two-thirds of the countries in 

sub-Saharan Africa and South/Southeast Asia, less than 50 percent of women reported using a trained 

medical professional for delivery. In the sub-Saharan region, 20 percent or fewer women had a medically 

trained professional assist with delivery in Ethiopia, Chad, and Niger. Nepal and Bangladesh, in 

South/Southeast Asia, also have fewer than 20 percent of women reporting that they were attended by a 

trained medical professional at delivery. In North Africa/West Asia/Europe, Yemen stands out with 23 

percent, followed by Egypt with 63 percent. Women in Central Asia are most likely to have a trained 

medical professional at delivery, with coverage reaching over 97 percent in all countries. Use of a trained 

medical professional at delivery in Latin America and Caribbean countries varies from 27 percent of 

women in Haiti to 96 percent in the Dominican Republic. 

 Compared with antenatal care, urban-rural disparities are even greater in the use of a trained health 

professional to assist with the delivery of the last birth. Sub-Saharan Africa has the greatest disparities 

between women in urban and rural areas, and Central Asia has the least. In all but 4 countries, over 50 

percent of urban women reported having the assistance of a medical professional at delivery; in contrast, 

at least 50 percent of rural women received medical assistance at delivery. In Central Asia, coverage for 

professional medical assistance at delivery is almost universal in both urban and rural areas (Figure 4.36). 
56 Findings 

Figure 4.36 Live births attended by a medical professional by 

urban-rural residence

Percentage of women age 15-49 who had a live birth in the three years preceding 

the survey and who received professional medical assistance for their 

most recent birth, by urban-rural residence

Sub-Saharan Africa

Ethiopia

Chad

Niger

Eritrea

Rwanda

Guinea

CAR

Burkina Faso

Mali

Zambia

Côte d'Ivoire

Mozambique

Uganda

Ghana

Kenya

Tanzania

Togo

Madagascar

Comoros

Cameroon

Malawi

Benin

Zimbabwe

Namibia

Gabon

North Africa/West Asia/Europe

Yemen

Egypt

Turkey

Jordan

Central Asia

Uzbekistan

Kyrgyz Republic

Kazakhstan

South/Southeast Asia

Nepal

Bangladesh

Cambodia

India

Indonesia

Philippines

Latin America/Caribbean

Haiti

Peru

Guatemala

Bolivia

Nicaragua

Colombia

Brazil

Dominican Republic

0 20 40 60 80 100

Rural Urban

Percent
Findings 57

4.2.2.5 HIV/AIDS Prevention Awareness 

The HIV/AIDS pandemic has taken a heavy toll on women. Over half of those currently infected are 

women, and almost six out of ten new HIV/AIDS cases are women. Nevertheless, it has been thought 

that women may be poorly informed about the prevention of HIV/AIDS because of gender-related sociocultural barriers that deny or discourage their access to information about HIV/AIDS and because of 

their willingness to discuss such information (WHO, 2003). Information campaigns may not reach 

women because of low literacy (Figure 4.12 and Table A.4.7) or limited access to mass media (Figures 

4.13 through 4.15 and Table A.4.8). In addition, condoms are often seen as a male contraceptive or are 

associated with illicit sexual activity. Some providers may not be willing to talk to women about condom 

use as a preventive measure for HIV. 

 In an effort to reduce the sexual transmission of HIV/AIDS, prevention programs focus their 

messages on three key aspects of sexual behavior: the use of condoms, limiting the number of sexual 

partners or staying faithful to one partner, and abstinence. Women age 15-49 were asked whether they 

had heard of AIDS, and women who said that they had heard of AIDS were asked, “Is there anything a 

person can do to avoid getting AIDS, or the virus that causes AIDS? What can a person do?” All ways 

mentioned were recorded. 

 Table A.4.23 shows the percentage of women who reported that they had heard of AIDS, and among 

these, the percentage who reported that abstaining from sex, being faithful to one sex partner, and using 

condoms would prevent the spread of HIV/AIDS. In all of the regions except South/Southeast Asia, over 

50 percent of women had heard of AIDS, and in 23 of the 41 countries with data, 90 percent or more of 

women had heard of AIDS. In South/Southeast Asia, there are countries where 40 percent or fewer 

women had heard of AIDS. Nepal has the lowest proportion (27 percent) of women who had heard of 

AIDS. 

 In 5 of the 41 countries where data were collected on HIV/AIDS prevention awareness, at least onethird of women who had heard of AIDS reported that abstaining from sex was a way of preventing 

HIV/AIDS; however, in 15 of the 41 countries, less than 10 percent of women reported abstinence as a 

means of preventing HIV/AIDS. This is, perhaps, because most of the women age 15-49 are married and 

hence abstinence is not a choice or a possible alternative. Nevertheless, in Rwanda, Malawi, and the 

Dominican Republic, 60 percent or more of the women reported abstinence as a way to avoid AIDS 

(Figure 4.37). 
58 Findings 

 In most countries, a much larger percentage of women reported being faithful to one partner as a 

means of avoiding HIV/AIDS (Figure 4.38). Nevertheless, in a large majority of the countries, less than 

50 percent of women with knowledge of HIV/AIDS reported being faithful to one partner as a means to 

avoid HIV/AIDS. 

Figure 4.37 Knowledge of abstinence to prevent HIV/AIDS

Percentage of women age 15-49 who had heard about AIDS and said that people can reduce the risk of 

getting the AIDS virus by abstaining from sex

Sub-Saharan Africa

Mozambique Comoros

Madagascar

Côte d'Ivoire

Benin

Burkina Faso

Ghana

Togo

Mali

Cameroon

Ethiopia Niger Tanzania

CAR

Chad

Zimbabwe

Gabon

Eritrea

Kenya

Guinea

Zambia

Namibia

Uganda

Malawi

Rwanda

North Africa/West Asia/Europe Turkey

Jordan

Central Asia

Kazakhstan

South/Southeast Asia

Indonesia

India

Bangladesh Nepal Cambodia

Latin America/Caribbean

Brazil

Colombia

Nicaragua Haiti

Peru

Bolivia

Guatemala

Dominican Republic

0 20 40 60 80 100

Percent
Findings 59

 Table A.4.23 and Figure 4.39 show the proportion of women who reported using condoms as a way 

to avoid HIV/AIDS. In Brazil, the Dominican Republic, and Namibia, 80 percent or more of women 

who had heard of AIDS mentioned condom use as a way to avoid HIV/AIDS. The proportion reporting 

condom use is higher in Latin America and the Caribbean than in other regions, ranging from 30 percent 

in Guatemala to 81 percent in the Brazil and the Dominican Republic. In South/Southeast Asia, it ranges 

from a low of 4 percent in Indonesia to a high of 70 percent in Cambodia; and in sub-Saharan Africa, it 

ranges from 11 percent in Chad to 83 percent in Namibia. In 31 of 41 countries that collected these data, 

less then 50 percent of women were aware that condoms were a protective measure for HIV/AIDS. 

 Messages on how to prevent HIV/AIDS are not reaching many women in developing countries. 

Figure 4.38 Knowledge of being faithful to one partner to prevent HIV/AIDS

Percentage of women age 15-49 who heard about AIDS and said that people can reduce the risk of getting the AIDS virus by having

sex with just one partner who has no other partners

Sub-Saharan Africa

Rwanda

Niger

Mali

Malawi

Tanzania

Gabon

Mozambique Namibia

Kenya Comoros

Madagascar Togo Cameroon

Benin

Chad

Eritrea

Burkina Faso

Zambia

Uganda CAR

Zimbabwe

Ethiopia Côte d'Ivoire

Ghana

Guinea

North Africa/West Asia/Europe Turkey

Jordan

Central Asia

Kazakhstan

South/Southeast Asia

Bangladesh Indonesia

Cambodia

India

Nepal

Latin America/Caribbean

Brazil

Guatemala

Nicaragua Peru

Haiti

Colombia

Bolivia

Dominican Republic

0 20 40 60 80 100

Percent
60 Findings 

4.2.3 Environmental Context 

The environmental context describes the external living conditions of women, illustrating the potential 

impact of disparities in infrastructure between urban and rural areas and the extent to which women lack 

basic household amenities. 

4.2.3.1 Residence 

Infrastructure and essential resources vary between urban and rural areas in most countries; therefore, the 

potential impact of these disparities is seen in the distribution of women by residence. The living 

standards of women who reside in rural areas are much lower than those of women living in urban areas. 

Rural areas continue to be left behind in the benefits of economic and social progress that are experienced 

in urban areas (Sahn and Stifel, 2003). For example, the nutritional status of women usually varies by 

urban-rural residence. Low body mass index (BMI) and chronic energy deficiency (CED) occur more frequently among women living in rural areas, and overweight and obesity are more common among urban 

women (Martorell et al., 2000). 

Figure 4.39 Knowledge of using condoms as a way to prevent HIV/AIDS

Percentage of women age 15-49 who had heard about AIDS and said that people can reduce the risk of 

getting the AIDS virus by using condoms

Sub-Saharan Africa

Chad

Mozambique

Ethiopia Niger

Ghana

Guinea

Burkina Faso

Mali

Benin

Madagascar CAR

Côte d'Ivoire

Togo

Eritrea

Comoros

Rwanda

Kenya

Zambia

Tanzania

Cameroon

Uganda

Malawi

Zimbabwe

Gabon

Namibia

North Africa/West Asia/Europe Jordan

Turkey

Central Asia

Kazakhstan

South/Southeast Asia

Indonesia

Bangladesh India

Nepal Cambodia

Latin America/Caribbean

Guatemala

Peru

Haiti

Bolivia

Nicaragua

Colombia

Brazil

Dominican Republic

0 20 40 60 80 100

Percent
Findings 61

 Most women in developing countries live in rural areas, except for Latin America and the Caribbean (Table A.4.24). In sub-Saharan Africa, more than 50 percent of women age 15-49 reside in rural 

areas, except for Gabon, where only 20 percent of women live in rural areas. In 5 of the 25 sub-Saharan 

countries, more than 80 percent of women live in rural areas (Figure 4.40). 

 

 In North Africa/West Asia/Europe, women in Turkey and Jordan are more likely to live in urban 

areas (67 and 83 percent of women, respectively). However, in Egypt and Yemen, over 50 percent of 

women live in rural areas. In Central Asia, 50 percent or more of women reside in rural areas. In South/ 

Southeast Asia, the proportion of women living in rural areas ranges from 43 percent in the Philippines to 

91 percent in Nepal. Latin America and the Caribbean is the most urbanized region: only Haiti and 

Guatemala have levels of rural residence over 50 percent; 82 percent of Brazilian women live in urban 

areas (Figure 4.40). 

Figure 4.40 Rural residence

Proportion of women age 15-49 years living in rural areas

Sub-Saharan Africa

Gabon

Zambia

CAR

Côte d'Ivoire

Namibia

Benin

Zimbabwe

Togo

Ghana

Cameroon

Eritrea

Guinea

Mali

Comoros

Madagascar 

Mozambique Tanzania

Kenya

Chad

Niger Ethiopia

Rwanda

Burkina Faso

Uganda

Malawi

North Africa/West Asia/Europe Jordan 

Turkey

Egypt Yemen 

Central Asia

Kazakhstan

Uzbekistan

Kyrgyz Republic 

South/Southeast Asia

Philippines

Indonesia 

India

Bangladesh

Cambodia

Nepal

Latin America/Caribbean

Brazil

Colombia

Bolivia

Peru

Dominican Republic Nicaragua Haiti

Guatemala

0 20 40 60 80 100

Percent
62 Findings 

4.2.3.2 Household Amenities 

Women bear most of the responsibility for child care, cooking, and household maintenance. However, in 

developing countries they have few amenities to assist them. Table A.4.25 shows the percentages of 

women age 15-49 living in households without electricity, with dirt floors, without access to piped water, 

and without access to a toilet facility. In all countries in sub-Saharan Africa, except Gabon, the majority 

of women live in households without electricity. In 15 of the 25 countries, about 80 percent of women live 

in houses without electricity. In all countries in North Africa/West Asia/Europe, except Yemen, and in 

all of the countries in Central Asia, almost all women live in houses with electricity. In 4 of the 6 

countries in South/Southeast Asia, at least 40 percent of women live in households without electricity. In 

Cambodia and Nepal, more than 79 percent of women live in homes without electricity. In Latin 

America and the Caribbean, Brazil, Colombia, and the Dominican Republic have less than 7 percent of 

women living in houses without electricity. In the remaining 5 countries in this region, the proportion 

without electricity ranges from 21 percent in Bolivia to a high of 57 percent in Haiti (Figure 4.41). 

Figure 4.41 Lack of electricity

Percentage of women age 15-49 living in houses without electricity

Sub-Saharan Africa

Gabon

Cameroon

Ghana

Côte d'Ivoire

Zimbabwe

Namibia

Comoros

Eritrea

Zambia

Guinea

Togo

Benin

Kenya

Ethiopia Madagascar Tanzania

Mozambique Uganda Mali

Niger Rwanda

Burkina Faso

Malawi

CAR

Chad

North Africa/West Asia/Europe Turkey

Jordan

Egypt

Yemen

Central Asia

Kyrgyz Republic Uzbekistan

Kazakhstan

South/Southeast Asia

Indonesia

Philippines India

Bangladesh

Cambodia

Nepal

Latin America/Caribbean

Dominican Republic Brazil

Colombia

Bolivia

Peru

Nicaragua

Guatemala

Haiti

0 20 40 60 80 100

Percent
Findings 63

Housing quality has implications for women’s health. Poor housing increases the vulnerability of 

household members to communicable diseases. Damp housing provides environments that encourage the 

growth of mites, mold, and other conditions that lead to respiratory problems (WHO, 1997). The type of 

flooring is indicative of the quality of the housing (Table A.4.25). Earthen floors (dirt, dung, or sand) are 

most prevalent (60 percent or more) in houses in sub-Saharan Africa and in Bangladesh and Nepal in 

South/Southeast Asia. In about half of the countries in sub-Saharan Africa, more than 70 percent of 

women live in households with dirt floors. In half of the countries in Latin America and the Caribbean, 

about 40 percent or more of women live in households with earthen floors, as do women in Yemen in 

North Africa/West Asia/Europe (Figure 4.42). (India was not included because the flooring data are not 

comparable.) 

 

Figure 4.42 Household flooring

Percentage of women age 15-49 living in houses with dirt floors

Sub-Saharan Africa

Madagascar Ghana

Gabon

Côte d'Ivoire

Togo Zimbabwe

Benin

Comoros

Guinea

Cameroon

Zambia

Namibia

Kenya Burkina Faso

Mozambique Mali

Eritrea

Tanzania

Uganda

Malawi

CAR

Rwanda

Niger Ethiopia Chad

North Africa/West Asia/Europe Jordan

Turkey

Egypt

Yemen

Central Asia

Kazakhstan

Kyrgyz Republic Uzbekistan

South/Southeast Asia

Philippines

Cambodia

Indonesia

Bangladesh Nepal

Latin America/Caribbean

Brazil

Dominican Republic Colombia

Bolivia

Peru

Haiti

Nicaragua

Guatemala

0 20 40 60 80 100

Percent
64 Findings 

Clean drinking water is essential for health. Piped water is considered the safest, compared with well 

water or water fetched from rivers or lakes. Moreover, women spend less time collecting and carrying 

water if it is piped (Table A.4.25). With ease of access to safe water, food is less likely to become 

contaminated, and more water is likely to be available for cleaning and personal hygiene. The majority of 

women live in households that do not have access to piped drinking water. This includes most countries 

in sub-Saharan Africa (over 60 percent of women in 17 of 25 countries) and South/Southeast Asia (over 

60 percent of women in 5 of 6 countries). Turkey and Yemen also have large percentages of women living 

in households that do not have access to safe water. Even in Central Asia and Latin America and the 

Caribbean, more than 20 percent of women live in households that do not have access to piped water, 

with the exception of Colombia (Figure 4.43). 

 

Figure 4.43 Lack of piped water

Percentage of women age 15-49 living in houses without piped water

Sub-Saharan Africa

Gabon

Namibia

Comoros

Côte d'Ivoire

Zimbabwe

Ghana

Zambia

Togo Cameroon

Tanzania

Rwanda

Kenya

Benin

Eritrea

Mozambique Malawi

Guinea

CAR

Madagascar Mali

Niger Ethiopia Burkina Faso

Uganda Chad

North Africa/West Asia/Europe Jordan

Egypt

Turkey

Yemen

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

Soouth/Southeast Asia

Philippines India

Nepal Indonesia

Cambodia

Bangladesh

Latin America/Caribbean

Colombia

Bolivia

Peru

Brazil

Nicaragua

Guatemala

Haiti

Dominican Republic

0 20 40 60 80 100

Percent
Findings 65

The lack of sanitation facilities poses a serious public health problem. As part of the survey, the type 

of toilet facility used by the household was assessed, that is, whether the facility is a traditional latrine (pit 

or other) or modern flush toilet, or there is no facility (Table A.4.25). In two-thirds of the countries in 

sub-Saharan Africa, 20 percent or more of women live in households without access to any toilet facility; 

in 10 of the 25 countries, 50 percent or more of women are without access to a toilet facility. In 3 of the 5 

countries in South/Southeast Asia, more than 64 percent of women live in households without access to 

any toilet facility. Women living in countries in Central Asia and North Africa/West Asia/Europe 

generally have access to facilities, except in Yemen, where 30 percent of women live in households 

without any toilet facility. Lack of access to toilet facilities in the Latin America and Caribbean region is 

low except in Bolivia (29 percent) and Haiti (34 percent) (Figure 4.44). 

Figure 4.44 Lack of toilet facilities

Percentage of women age 15-49 living in households without access to sanitation facilities

Sub-Saharan Africa

Comoros

Gabon

Rwanda

Cameroon

Tanzania

Uganda

Kenya

Malawi

Ghana

Zimbabwe

Zambia

Mali

CAR

Côte d'Ivoire

Guinea

Namibia

Madagascar Togo Mozambique Benin

Chad

Burkina Faso

Eritrea

Niger Ethiopia

North Africa/West Asia/Europe Jordan

Turkey

Egypt

Yemen

Central Asia

Uzbekistan

Kyrgyz Republic Kazakhstan

South/Southeast Asia

Philippines

Bangladesh India

Cambodia

Nepal

Latin America/Caribbean

Dominican Republic Brazil

Colombia

Nicaragua

Guatemala

Peru

Bolivia

Haiti

0 20 40 60 80 100

Percent

Summary and Conclusions 67

 5 Summary and Conclusions 

his report describes the context of women’s health in developing countries based on key indicators 

reported in the DHS surveys carried out in 46 countries in five world regions. An analysis of the 

context of women’s health explores not only the status of maternal health, but also the social, behavioral, 

and environmental contexts that influence the lives and health of women. 

5.1 Women’s Health 

Women’s health, as measured by the maternal mortality ratio (MMR), levels of maternal nutritional 

status, and the rate of low birth weight babies among women age 15-49 is a reflection of the poverty and 

poor conditions under which many women live. Maternal mortality is highest in sub-Saharan Africa, 

averaging about 500 deaths per 100,000 live births, but the MMR reaches 1,000 in 4 of the 25 countries. 

South/Southeast Asia follows, with MMR ranging from 172 to 540 deaths per 100,000 live births. 

Although these rates are alarming, they do not tell the full story of maternal health. Many women die in 

childbirth, but many more survive and live in conditions that are detrimental to their health and that of 

their families. 

 Maternal nutrition is an important indicator of the health of women during a key period in their life. 

Short stature (less than 145 cm in height) is correlated with a higher risk of difficult delivery, stillbirth, 

and low birth weight infants. South/Southeast Asia and Latin America and the Caribbean have the most 

countries with more than 10 percent of mothers being less than 145 cm tall. Low body mass index (BMI 

<18.5) is an indicator of undernutrition or chronic energy deficiency (CED) in women. In a healthy 

population, 3 to 5 percent of women are expected to have a low BMI. However, South/Southeast Asia 

has the highest rates of undernutrition among women, followed by sub-Saharan Africa. With a 

prevalence of low BMI over 20 percent in most countries in South/Southeast Asia, the nutrition situation 

is serious, and in Bangladesh, it is critical (over 40 percent have a low BMI). In four countries in subSaharan Africa, the situation is also serious, and in Eritrea, the situation is considered critical. Yemen, in 

North Africa/West Asia/Europe, has a serious rate of undernutrition (26 percent). The other regions 

require nutrition monitoring or, at most, have low levels of nutritional status with undernutrition in 

women falling between 10 and 19 percent. Despite these levels of undernutrition, women in developing 

countries also experience overnutrition, particularly in North Africa/West Asia/Europe and Latin 

America and the Caribbean. In Central Asia and a few countries in sub-Saharan Africa, overweight in 

women reaches almost 20 percent. 

 Women suffer from undernutrition not only as a result of low or poor food intake, but also because of 

limited intake or bioavailability of micronutrients in food or inadequate utilization of available micronutrients because of infections and parasitic infestations. The major micronutrient deficiencies of concern 

are iron, vitamin A, and iodine. Iron-deficiency anemia is the most common form of nutritional 

deficiency. Hemoglobin testing had been carried out in 11 countries at the time this report was prepared. 

Anemia prevalence was 25 percent or more among women age 15-49. The highest proportion was found 

in Uzbekistan (60 percent), with Cambodia, India, and Haiti having rates over 50 percent. The high 

demand for iron in pregnancy is hard to meet through dietary intake of iron-rich foods alone; hence, it is 

recommended that pregnant women routinely receive iron supplements for at least three months during 

pregnancy. In half of the 23 countries with data on iron supplementation, 50 percent or more of women 

reported receiving iron supplementation during pregnancy. 

T 
68 Summary and Conclusions 

 Vitamin A is an essential micronutrient for the immune system. Night blindness is an indicator of 

severe vitamin A deficiency (VAD), and women are especially prone to it during pregnancy. Adjusted 

rates of night blindness range from 1 to almost 5 percent in the 12 countries that had data. A rate of 5 

percent is considered a public health concern. VAD can be prevented by taking a high-dose vitamin A 

capsule in the first six to eight weeks after delivery. Vitamin A supplementation information was available 

for 12 countries. In 6 of the 12 countries, only about 11 percent of women received postpartum vitamin A 

supplementation. 

 Iodine-deficiency disorder is the single most common cause of preventable mental retardation and 

brain damage. A deficiency of iodine is known to cause goiter, infertility, and poor pregnancy outcomes. 

Data on the results of testing of household cooking salt were available for 27 of the 46 countries. In 10 of 

these 27 countries, less than one-third of women lived in households using salt with some level of 

iodization. A nation is considered to have adequate coverage of iodine fortification when at least 90 

percent of households are found to be using iodized salt; only 8 of the 27 countries met this standard. 

 Maternal undernutrition is a major determinant of low birth weight (less than 2.5 kg) in infants, 

which is also influenced by illnesses (i.e., malaria, anemia, acute and chronic infections). High rates of low 

birth weight babies are considered an indicator of poor health and nutritional status in women. The 1990 

World Summit for Children goal was for countries to have a prevalence of low birth weight babies of less 

than 10 percent. The goal is a long way from being met, with 27 of the 44 countries with available birth 

weight data having more than 10 percent of women giving birth to low birth weight children. Three 

countries—Yemen, India, and Haiti—have a prevalence greater than 20 percent. 

5.2 Context of Women’s Health 

Three aspects of the context of women’s health include the social, behavioral, and environmental 

conditions that make up women’s lives. The social context of women’s health includes measures of 

women’s status and ability to access resources. The behavioral context is composed of the decisions and 

actions that influence fertility, and the environmental context illustrates the external living conditions of 

women: urban-rural residence, and the lack of household amenities. 

5.2.1 Social Context 

Social context indicators reflect the education, employment, marital status, and household headship 

experiences of women that influence their access to resources and information. Women’s status indicators 

are likely to influence the health of women by the way they limit socioeconomic opportunities, fertility 

choices, nutritional status, and access and utilization of health services, along with other factors that may 

affect women’s health (Defo, 1997:1029). 

 The current status of girls’ education is used to explore the context of education for women. Girls’ 

school attendance rates are lowest in sub-Saharan Africa, with 15 of 25 countries having less than 50 

percent of girls age 6-10 currently attending school. A gender bias in girls’ school attendance is evidenced 

by a girls-to-boys attendance ratio of less than 0.90 in 10 of 25 sub-Saharan countries, in Yemen (0.61) in 

North Africa/West Asia/Europe, and in Nepal (0.77) in South/Southeast Asia. Central Asia and Latin 

America and the Caribbean have the highest ratio of girls’ attendance. However, only 70 to 76 percent of 

girls age 6-10 are attending school in Central Asia. By contrast, in 5 out of 8 countries in Latin America 

and the Caribbean, the rate of girls’ school attendance is over 90 percent. 

 Female illiteracy is highest in sub-Saharan Africa, averaging over 50 percent, followed by South/ 

Southeast Asia and North Africa/West Asia/Europe. Again, Yemen stands out in the North Africa/West 

Asia/Europe region, with a female illiteracy rate of 81 percent. With such high levels of illiteracy, 

exposure to mass media becomes an opportunity for women to become more informed, thereby 

enhancing their decisionmaking ability. As expected, regular newspaper reading is more widely practiced 

in regions where illiteracy is low. Hence, Central Asia has the highest level of newspaper reading, 
Summary and Conclusions 69

followed by Latin America and the Caribbean. Television viewing is similar to newspaper reading, with 

the highest prevalences found in Central Asia. Countries in North Africa/West Asia/Europe have high 

levels of television viewing, except for Yemen. Countries in Latin America and the Caribbean have high 

levels (over 50 percent) of viewership, except for Haiti (31 percent). Weekly radio listening is widely 

practiced in Latin America and the Caribbean (greater than 60 percent), followed by sub-Saharan Africa, 

where weekly radio listening is over 50 percent in 9 of 25 countries. On the other hand, 50 percent of 

women in much of sub-Saharan Africa are not exposed to mass media at all. Overall, television viewing is 

the only mass media that has a prevalence of over 75 percent, and that is in only 10 of the 46 countries. 

 Employment can provide a means of empowerment by increasing a woman’s status and autonomy. 

Large percentages of women in sub-Saharan Africa and in Cambodia and Nepal in South/Southeast Asia 

report that they are working. However, most of these women are working in agriculture. Working in the 

agricultural sector does not necessarily improve women’s status, especially given its low level of pay, if any. 

In addition, the heavy workload associated with agriculture puts women at a greater risk of poor health. 

Since women who work have the double burden of both employment and domestic work, they have less 

time to take care of themselves or to seek health care when needed. 

 Marital status provides a mixed blessing for women. In developing countries, marriage may provide a 

sense of security and social support for women. At the same time, without deliberate efforts to control 

fertility, marriage increases a woman’s exposure to pregnancy and the possible adverse outcomes. Nevertheless, married women are less at risk of adverse outcomes than women who conceive outside of 

marriage. Most women age 15-49 are married. Among unmarried women, a small percentage are 

widowed/divorced/separated, but the larger percentage were never married. Jordan and Namibia have the 

highest rates of women age 15-49 who have never been married. This is because women in these 

countries marry at a later age (21.5 and 26.2 years, respectively). 

 Polygyny is practiced in much of sub-Saharan Africa and to a small extent in a few countries in North 

Africa/West Asia/Europe, Nepal in Southeast Asia, and Haiti in Latin America and the Caribbean. 

Polygyny is thought to be an indicator of lower status for women because of reduced access to resources. 

Most polygynous families have limited resources, and these must be allocated among a larger group of 

adults and children. On the other hand, polygyny can work to enhance a woman’s health because women 

in polygynous unions are more likely to practice longer periods of postpartum abstinence and hence have 

long birth intervals. 

 Female-headed households pose both an opportunity and a threat to women’s health. In developing 

countries, many decisions affecting women’s health are made at the household level. If female heads of 

households are more autonomous and have control over resources, they are better able to care for their 

children and invest in their own health. However, if female heads of households are less educated, have 

limited access to resources, and have an excessive workload, they may not be able to promote their health 

or seek health care services. With growing numbers of female-headed households in sub-Saharan Africa 

and Latin America and the Caribbean, it is recommended that there be further study of this population to 

determine how women’s health is affected. Countries of interest include Ghana, Namibia, and Haiti, 

where more than 40 percent of women age 15-49 live in female-headed households. 

5.2.2 Behavioral Context 

A woman’s increased exposure to childbirth is related to her risk of maternal morbidity and mortality. 

The behavioral context of women’s health is composed of the decisions and actions that influence overall 

fertility, such as a woman’s age at first intercourse, first marriage and first birth, fertility-limiting 

behaviors, use of antenatal and delivery services, and awareness of HIV/AIDS preventive practices. 

 A key observation is that for 50 percent of women, first intercourse, first marriage, and first birth all 

occur during the adolescent period (under 20 years), thereby inhibiting women’s opportunities for 

pursuing education and for securing skills for self-empowerment and improved work opportunities. The 
70 Summary and Conclusions 

median age at first marriage is higher in Central Asia and Latin America and the Caribbean than it is in 

sub-Saharan Africa and South/Southeast Asia. Childbirth follows marriage within one to three years, 

depending on the region. It is about the same length of time between childbirth and first sexual 

intercourse. Hence, first intercourse, first marriage, and first birth follow in close succession and at a 

young age, allowing for high fertility and a long childbearing period if fertility-limiting actions are not 

taken. 

 The overall regional average total fertility rate is highest in sub-Saharan Africa (5.5), followed by 

North Africa/West Asia/Europe (4.5), Latin America and the Caribbean (3.6), and South/Southeast Asia 

(3.5); Central Asia has the lowest rate (2.0). Women spend more than 10 years being pregnant, 

breastfeeding, and caring for young infants in most of the developing countries. The longest childbearing 

periods (more than 15 years) are in sub-Saharan Africa and in Yemen in North Africa/West 

Asia/Europe. 

 Breastfeeding promotes women’s health by reducing postpartum blood loss, suppressing fertility, 

influencing the length of the birth interval, and reducing the iron demands of women as a result of 

postpartum amenorrhea. Breastfeeding is widely practiced, with over 90 percent of children being 

breastfed for some period of time in almost all countries (except Gabon and the Philippines). Exclusive 

breastfeeding for the internationally recommended six months is not common. In 29 of 43 countries, less 

than 40 percent of children under six months are being exclusively breastfed. It is more widely practiced 

in South/Southeast Asia and in a few countries in Latin America and the Caribbean, as well as in Egypt 

in North Africa/West Asia/Europe. While exclusive breastfeeding is 40 percent or higher in only onefourth of sub-Saharan countries, the median duration of breastfeeding is more than 20 months in all subSaharan countries as well as the countries of South/Southeast Asia. 

 Fertility is also influenced by the duration of postpartum amenorrhea, abstinence, and insusceptibility. 

Sub-Saharan countries have the longest median durations of postpartum amenorrhea, abstinence, and 

insusceptibility. North Africa/West Asia/Europe has the shortest durations of postpartum amenorrhea 

and insusceptibility. However, countries in all of the regions, except for most of sub-Saharan Africa, have 

short median durations (less than 3 months) of postpartum abstinence. 

 To control natural fertility, the practice of child spacing and family planning is most effective. 

Although rates of contraceptive use are at an all-time high, countries in sub-Saharan Africa have the 

lowest rates of any region, with most of the countries falling below 30 percent—and traditional methods 

contribute substantially to levels of current use. The highest rates of contraceptive use are found in Latin 

America and the Caribbean. The rates of unmet need for family planning are highest in sub-Saharan 

Africa (over 25 percent) and lowest in Central Asia and parts of Latin America and the Caribbean. 

Yemen in North Africa/West Asia/Europe and Haiti in Latin America and the Caribbean have low rates 

of contraceptive use and high (almost 40 percent) rates of unmet need. 

 Maternal health is affected by access to and utilization of health services for antenatal care and 

delivery care. Underutilization of antenatal care is associated with suboptimal pregnancy outcomes. There 

are large differences in the use of a trained health professional for antenatal care. The highest levels are in 

Central Asia, where more than 90 percent of women saw a trained medical professional for at least one 

antenatal care visit. In the other regions, the country rates range from 30 percent to over 90 percent. In 38 

of 46 countries, the levels are 50 percent or higher. 

 Urban-rural differences are largest in the countries of sub-Saharan Africa, North Africa/West 

Asia/Europe, and South/Southeast Asia. In a little less than half of the countries, 50 percent or more of 

women in rural areas reported that they had at least 4 antenatal visits; in urban areas in three-fourths of 

the countries, 50 percent or more of women reported that they had at least 4 antenatal care visits with a 

trained medical professional. Central Asia has the highest rates (more than 80 percent) in both urban and 

rural areas. The lowest rates are found in South/Southeast Asia, Yemen in North Africa/West 

Asia/Europe, and sub-Saharan Africa. 
Summary and Conclusions 71

 Maternal immunization for tetanus toxoid is an important part of antenatal care services, preventing 

maternal and neonatal infection at delivery. The rates for women receiving at least one tetanus toxoid 

injection for their last birth in the three years preceding the survey range from 18 percent in Yemen to 97 

percent in the Dominican Republic. One-third of the 42 countries reporting on this indicator have 50 

percent or fewer of women reporting that they received at least one tetanus toxoid injection during 

pregnancy for the last birth. 

 Having a skilled attendant at delivery is strongly associated with low levels of maternal morbidity and 

mortality. In Central Asia there is almost universal use of trained medical professionals for delivery. 

Yemen in North Africa/West Asia/Europe and Haiti in Latin America and the Caribbean have low rates 

for their regions but he lowest rates of use of a trained medical attendant at delivery are found in subSaharan Africa and South/Southeast Asia. 

 Messages to prevent HIV/AIDS are not effectively reaching women in most developing countries. 

Although the HIV/AIDS pandemic is taking a heavy toll on women, less than 40 percent are aware that 

abstaining from sex, being faithful to one sex partner, and using condoms are ways to prevent the spread 

of HIV/AIDS (the ABC approach to HIV/AIDS prevention). 

5.2.3 Environmental Context 

The environmental context describes the external living conditions of women, illustrating the potential 

impact of disparities in infrastructure between rural and urban areas and the extent that women lack basic 

household amenities. In much of the developing world, except for Latin America and the Caribbean., the 

majority of women live in rural areas. Over 60 percent of women in most countries in sub-Saharan Africa 

and South/Southeast Asia live in rural areas with limited infrastructure and access to essential resources. 

Over 50 percent of women in Egypt and Yemen in North Africa/West Asia/Europe live in rural areas, as 

do half of women in Central Asia. 

 Women in developing countries bear most of the responsibility for child care, cooking, and household 

maintenance with few basic amenities to assist them. In most countries in sub-Saharan Africa (24 of 25 

countries) and South/Southeast Asia (3 of 6 countries) the majority of women live in houses without 

electricity. In Central Asia, most of North Africa/West Asia/Europe (except for Yemen), and Latin 

America and the Caribbean (except for Haiti), the majority of women live in households with electricity. 

Housing quality has implications for women’s health. Poor housing makes residents vulnerable to 

communicable diseases and respiratory problems. The type of flooring is indicative of the quality of the 

housing. Earthen floors (dirt, dung, or sand) are most prevalent in houses in sub-Saharan Africa (60 

percent or more) and in Bangladesh and Nepal in South/Southeast Asia. 

 Clean drinking water is essential for health. Piped water is considered the safest, compared with well 

water or water fetched from rivers or lakes. Moreover, women spend less time collecting and carrying 

water if it is piped. With ease of access to safe water, food is less likely to become contaminated, and more 

water is likely to be available for cleaning and personal hygiene. Most women in sub-Saharan Africa and 

South/Southeast Asia women live in households that do not have access to piped drinking water. A large 

percentage of women living in Turkey and Yemen also do not have access to safe water. In Central Asia 

and Latin America and the Caribbean, more than 20 percent of women live in households that do not 

have access to piped water, with the exception of Colombia. 

 Lack of sanitation facilities is a serious public health problem. In 10 of the 25 sub-Saharan countries, 

50 percent or more of women are without access to a toilet facility. In 3 of the 5 countries in 

South/Southeast Asia, more than 64 percent of women live in households without access to toilet 

facilities. Women living in countries in Central Asia and North Africa/West Asia/Europe generally have 

access to toilet facilities, except in Yemen, where 30 percent of women live in households without any 

toilet facility. Lack of access to toilet facilities in Latin America and the Caribbean is low, except in 

Bolivia (29 percent) and Haiti (34 percent). 
72 Summary and Conclusions 

5.3 Conclusions 

Behavior change policies and programs that focus on the individual are important for improving the 

health of women, but efforts at the social and environmental levels are also needed. Reviewing the context 

of women’s health is important, along with renewed emphasis on women’s health, including monitoring 

national-level indicators of the context in which women live. Poor nutritional status, including chronic 

energy deficiency and micronutrient deficiencies, undermine women’s health. High fertility, low 

contraceptive use, and limited access and use of antenatal and delivery services continue to challenge 

reproductive and maternal health policies and program interventions. To improve the conditions under 

which women live, environmental health programs need to target and reach women with basic amenities 

including piped water and sanitation facilities. However, despite major inputs and financial investments in 

public health, intersectoral approaches to women’s health are required. Poor housing conditions produce 

environments that encourage the transmission of infections and viruses. Illiterate women who have 

limited exposure to health information and education cannot be expected to adopt health-sustaining 

behaviors. Improving infrastructures in rural areas would meet the needs of the majority of women in 

developing countries. 

 Regions and countries vary on specific indicators but, overall, sub-Saharan Africa, South/Southeast 

Asia, and Yemen in North Africa/West Asia/Europe need priority attention. Central Asia demonstrates 

acceptable results on most indicators except women’s nutrition and contraceptive use. All regions need to 

focus attention on women’s nutrition, education, and environmental factors, along with continued 

emphasis on maternal and reproductive health. 

 
References 73

 References 

AbouZahr, C., and T. Wardlaw. 2003. Antenatal care in developing countries: Promises, achievements, and 

missed opportunities. An analysis of trends, levels and differentials, 1990-2001. Geneva: World Health 

Organization and United Nations Children’s Fund. 

Administrative Committee on Coordination/Sub-Committee on Nutrition (ACC/SCN), United 

Nations. 2000. Low Birthweight: Report of a Meeting in Dhaka, Bangladesh on 14-17 June 1999. J. Pojda 

and L. Kelley (eds.). Nutrition Policy Paper Number 18. Geneva: ACC/SCN, in collaboration with 

International Centre for Diarrhoeal Disease Research, Bangladesh. 

Analytical and Information Center, Ministry of Health of the Republic of Uzbekistan, State Department 

of Statistics, Ministry of Macroeconomics and Statistics, and ORC Macro. 2004. Uzbekistan Health 

Examination Survey 2002. Calverton, Maryland, USA: Analytical and Information Center, State 

Department of Statistics, and ORC Macro. 

Avorti, J.Y., and V. Walters. 1999. You look at our work and see if you have any freedom on earth: 

Ghanaian women’s accounts of their work and their health. Social Science and Medicine 48: 1123-1133. 

Baker, J., L. Martin, and E. Piwoz. 1996. The time to act: Women’s nutrition and its consequences for child 

survival and reproductive health in Africa. Washington, D.C.: SARA Project, Academy for Educational 

Development. 

Bisgrove, E.Z. and B. Popkin. 1996. Does women’s work improve their nutrition: Evidence from the 

urban Philippines. Social Science and Medicine 43(10): 1475-1488. 

Buvinic, M. 1998. Women in poverty: A new global underclass. Reprinted article no. WID101. Washington, 

D.C.: Inter-American Development Bank.

Cagatay, N. 1998. Gender and poverty. Working Paper Series (WP5), Social Development and Poverty 

Elimination Division. New York: United Nations Development Programme. 

Carr, D., and A. Way. 1994. Women’s lives and experiences: A decade of research findings from the 

Demographic and Health Surveys Program. Calverton, Maryland, USA: Macro International Inc. 

Carroli, G., C. Rooney, and J. Villar. 2001. How effective is antenatal care in preventing maternal 

mortality and serious morbidity? An overview of the evidence. Paediatric and Perinatal Epidemiology 15 

(suppl. 1): 1-42. 

Celik, Y., and D.R. Hotchkiss. 2000. The socio-economic determinants of maternal health care 

utilization in Turkey. Social Science and Medicine 50(12): 1797-1806. 

Chant, S. 2003. Female household headship and the feminisation of poverty: Facts, fictions and forward 

strategies. New working paper series. Gender Institute. London School of Economics. 
74 References 

Christian, P. 2002. Recommendations for indicators: Night blindness during pregnancy—A simple tool 

to assess vitamin A deficiency in a population. Proceedings of XX International Vitamin A Consultative 

Group Meeting. Journal of Nutrition 132: 2884S-2888S. 

De Browere, V., R. Tonglet, and W. Van Lerberghe. 1998. Strategies for reducing maternal mortality in 

developing countries: What can we learn from the history of the industrialized West? Tropical Medicine 

and International Health 3(10): 771-782. 

Defo, K. 1997. Effects of socioeconomic disadvantage and women’s status on women’s health in 

Cameroon. Social Science and Medicine 44(7): 1023-1042. 

Derose, L.F. 2002. Continuity of women’s work, breastfeeding and fertility in Ghana in the 1980s. 

Population Studies 56(2): 167-169. 

Doyal, L. 1995. What makes women sick: Gender and the political economy of health. New Brunswick, New 

Jersey: Rutgers University Press. 

Espeut, D., M. Fidalgo, C. Ismail, R. Johnson, and A. Mukuria, A. 2001. Africa nutrition, nutrition and 

health status of young children and their mothers in Mozambique. Calverton, Maryland, USA: Macro 

International Inc. 

Gray, R., O. Campbell, H. Zacur, M. Labbok, and S. MacRae. 1987. Postpartum return of ovarian 

activity in nonbreastfeeding women monitored by urinary assays. Journal of Clinical Endocrinology and 

Metabolism 64(4): 645-650. 

 

Haggerty, P., E.G. Barclay, A. Dustagheer, H.A. Randrianiriana, S. Rakotoniriana, and B. Razafiarisoa. 

1999. Africa nutrition, nutrition and health status of young children and their mothers in Madagascar. Calverton, Maryland, USA: Macro International Inc. 

Haggerty, P.A., and S.O. Rutstein. 1999. Breastfeeding and complementary infant feeding, and the 

postpartum effects of breastfeeding, DHS Comparative Studies No. 3. Calverton, Maryland, USA: Macro 

International Inc. 

Huffman, S.L. 1991. Maternal malnutrition and breastfeeding: Is there really a choice for policy makers? 

Journal of Tropical Pediatrics 37(suppl. 1): 19-22. 

Huffman, S.L., J. Baker, J. Shumann, E.R. Zehner. 1998. The case for promoting multiple vitamin/mineral 

supplements for women of reproductive age in developing countries. Washington, D.C. Linkages Project. 

Academy for Educational Development. 

Jejeebhoy, S.J. 1995. Women’s education, autonomy and reproductive behavior: Experience from developing 

countries. New York: Clarendon Press. 

Johnson, F.C., and B.L. Rogers. 1993. Children’s nutritional status in female-headed households in the 

Dominican Republic. Social Science and Medicine 37(11): 1293-1301. 
References 75

Joshi, S. 2004. Female household-headship in rural Bangladesh: Incidence, determinants and impact on 

children’s schooling. Economic Growth Center Discussion Paper No. 894. New Haven, Connecticut: Yale 

University. 

Kishor, S., and K. Neitzel. 1996. The status of women: Indicators for 25 countries. DHS Comparative 

Studies No. 21. Calverton, Maryland, USA: Macro International Inc. 

Krasovec, K., and M. Anderson. 1991. Maternal nutrition and pregnancy outcomes: Anthropometric 

assessment. PAHO Scientific Publications No. 259. Washington, D.C.: Pan American Health 

Organization. 

Labbok, M. 1991. Breastfeeding and borderline malnutrition in women. Journal of Tropical Pediatrics 37: 

(suppl.): 23-24. 

Leslie, J. 1991. Women’s nutrition: The key to improving family health in developing countries? Health 

Policy and Planning 6(1): 1-19. 

Martorell, R., L. Khan, M. Hughes, and L. Grummer-Strawn. 2000. Obesity in women from developing 

countries European Journal of Clinical Nutrition 54(3): 247-252. 

Matsumura, M., and B. Gubhaju. 2001. Women’s status, household structure and the utilization of 

maternal health services in Nepal. Asia-Pacific Population Journal 16(1): 23-44. 

Merchant, K., and R. Martorell. 1988. Frequent reproductive cycling: Does it lead to nutritional 

depletion of mothers? Progress in Food and Nutrition Science 12: 339-369. 

Ministry of Health and Social Services (MOHSS) [Namibia]. 2003. Namibia Demographic and Health 

Survey 2000. Windhoek, Namibia: MOHSS. 

Mukuria, A. 2003. Changes in infant feeding practices: A decade of findings from the DHS. Paper presented at 

the UNICEF Expert Meeting on Breastfeeding, New York, April 8, 2003. 

Nestel, P. and S. Rutstein. 2001. Defining nutritional status of women in developing countries. Public 

Health Nutrition 5(1): 17-27. 

Onyango, A., K. Tucker, and T. Eisemon. 1994. Household headship and child nutrition: A case study 

in western Kenya. Social Science and Medicine 39(12): 1633-1639. 

Ramakrishnan, U. 2004. Nutrition and low birth weight: From research to practice. American Journal of 

Clinical Nutrition 79: 17-21. 

Ramakrishnan, U., R. Martorell, D.G. Schroeder, and R. Flores. 1999. Intergenerational effects on linear 

growth. Journal of Nutrition 129: 544-549. 

Rutenberg, N., and J. Sullivan. 1991. Direct and indirect estimates of maternal mortality from the sisterhood 

method. In Proceedings of the Demographic and Health Surveys World Conference, Washington, D.C. 1991.

Vol. 3. Columbia, Maryland, USA: IRD/Macro International Inc., pp. 1669-1696. 
76 References 

Rutstein, S. 1996. Factors influencing the nutritional status of mothers and children in sub-Saharan Africa: An 

analytical report based on the Demographic and Health Surveys. Calverton, Maryland, USA: Macro 

International Inc. 

Rutstein, S., A. Tesfazion, S. Alemu, and N. Hill. 1999. Africa nutrition, nutrition and health status of 

young children and their mothers in Eritrea. Calverton, Maryland, USA: Macro International Inc. 

 

Sahn, D., and D. Stifel. 2003. Urban-rural inequality in living standards in Africa. Journal of African 

Economies 12(4): 564-597. 

Short, R. 1984. Breastfeeding. Scientific American 250(4): 23-29. 

Stanton, C., N. Abderrahim, and K. Hill. 1997. DHS maternal mortality indicators: An assessment of data 

quality and implications for data use. DHS. Analytical Report No. 4. Calverton, Maryland, USA: ORC 

Macro. 

Stoltzfus, R. 1994. Iron deficiency and strategies for its control. A report prepared for the Office of 

Nutrition, Agency for International Development. Baltimore, Maryland: Johns Hopkins University. 

Stoltzfus, R., and M. Dreyfuss. 1998. Guidelines for the use of iron supplements to prevent and treat iron 

deficiency anemia. International Nutrition Anemia Consultative Group (INACG), World Health 

Organization (WHO), and United Nations Children’s Fund (UNICEF). Washington, D.C.: INACG. 

Tinker, A. 2000. Women’s health: The unfinished agenda. International Journal of Gynecology and 

Obstetrics 70: 149-158. 

Villar, J., M. Merialdi, A. Metin Gülmezoglu, E. Abalos, G. Carroli, R. Kulier, and M. de Onis. 2003. 

Nutritional interventions during pregnancy for the prevention or treatment of maternal morbidity and 

preterm delivery: An overview of randomized controlled trials. Journal of Nutrition 133: 1606S-1625S. 

Westoff, C.F. 2003. Trends in marriage and early childbearing in developing countries. DHS Comparative 

Report No. 5. Calverton, Maryland, USA: ORC Macro. 

World Health Organization (WHO). 1997. Health and environment in sustainable development: Five years 

after the Earth Summit. Geneva: WHO. 

World Health Organization (WHO). 2003. Integrating gender into HIV/AIDS programmes, a review paper. 

Department of Gender and Women’s Health, Family and Community Health. Geneva: WHO. 

World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and International 

Council for the Control of Iodine Deficiency Disorders (ICCIDD). 2001. Assessment of iodine deficiency 

disorders and monitoring their elimination: A guide for programme managers. 2nd Edition. Geneva: WHO. 

World Health Organization (WHO) United Nations University (UNU), and United Nations Children’s 

Fund (UNICEF). 2001. Iron deficiency anemia: Assessment, prevention and control. A guide for programme 

managers. Geneva: WHO. 
Appendix A 77

Appendix A 

Table A.4.1 Maternal mortality ratio

Maternal mortality ratio (per 100,000 births) for the 

seven-year period preceding the survey, based on 

survivorship of sisters of survey respondents, Demographic and Health Surveys 1994-2001 

Country 

Maternal 

deaths per 

100,000 live 

births 

Sub-Saharan Africa 

Benin 1996 498 

Burkina Faso 1998-99 440 

Cameroon 1998 511 

Central African Republic 1994-95 1,380 

Chad 1996-97 827 

Côte d’Ivoire 1994 597 

Eritrea 1995 1,018 

Ethiopia 2000 871 

Gabon 2000 519 

Guinea 1999 528 

Kenya 1998 743 

Madagascar 1997 488 

Malawi 2000 1,123 

Mali 1995-96 541 

Mozambique 1997 289 

Namibia 2000 330 

Rwanda 2000 1,558 

Tanzania 1996 612 

Togo 1998 417 

Uganda 2000-01 524 

Zambia 1996 649 

Zimbabwe 1999 647 

North Africa/West Asia/Europe

Jordan 1997 37 

Yemen 1997 357 

South/Southeast Asia

Cambodia 2000 437 

India 1998-99 540 

Indonesia 1997 312 

Nepal 1996 499 

Philippines 1998 172 

Latin America/Caribbean

Brazil 1996 184 

Guatemala 1995 155 

Haiti 2000 523 

Peru 2000 185 

Note: The Rwanda data are for the period 0-4 years 

preceding the survey; the India data are for the period 0-

2 years preceding the survey. Maternal mortality ratio = 

maternal mortality rate/general fertility rate 
78 Appendix A 

Table A.4.2 Nutritional status of mothers with children under three years

Among women age 15-49 years with children under three years, percentage whose height is less than 145 centimeters 

(cm) and percentage with a body mass index (BMI) <18.5, 18.5-24.9, and ≥25, Demographic and Health Surveys 

1994-2001 

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 

 Height BMI (kg/m2) 

 ––––––––––––––––––– –––––––––––––––––––––––––––– 

 Number Percentage Number 

 Percentage of Percentage 18.5- Percentage of 

Country <145 cm women <18.5 24.9 ≥25 children

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 

Sub-Saharan Africa 

Benin 1996 1.3 2,544 15.0 75.6 9.4 2,135 

Burkina Faso 1998-99 0.3 3,215 13.0 81.9 5.1 2,725 

Cameroon 1998 1.1 2,004 7.9 71.5 20.7 1,655 

Central African Republic 1994-95 2.4 2,388 15.2 78.1 6.7 1,917 

Chad 1996-97 0.3 3,783 20.4 75.0 4.6 3,018 

Comoros 1996 3.8 891 10.3 70.6 19.1 729 

Côte d’Ivoire 1994 0.8 3,510 7.9 78.4 13.7 2,941 

Eritrea 1995 2.3 2,189 40.4 55.4 4.2 1,773 

Ethiopia 2000 2.0 6,309 24.9 73.1 2.0 5,228 

Gabon 2000 1.5 2,005 6.9 66.0 27.1 1,706 

Ghana 1998 0.7 1,704 12.3 72.5 15.2 1,486 

Guinea 1999 1.2 2,948 11.0 78.3 10.7 2,492 

Kenya 1998 1.0 2,934 12.3 74.6 13.1 2,464 

Madagascar 1997 8.3 3,201 20.6 75.7 3.7 2,600 

Malawi 2000 2.5 6,682 6.6 83.3 10.1 5,477 

Mali 1995-96 0.4 5,040 16.2 75.2 8.6 4,023 

Mozambique 1997 4.8 3,743 10.9 79.6 9.5 3,088 

Niger 1998 0.4 4,180 20.7 71.8 7.5 3,324 

Rwanda 2000 1.2 4,025 5.6 81.6 12.7 3,248 

Tanzania 1996 2.7 3,590 9.0 79.2 11.8 3,031 

Togo 1998 1.0 3,548 10.9 77.8 11.3 3,029 

Uganda 2000-01 1.9 3,615 9.3 80.2 10.5 2,827 

Zambia 1996 1.2 3,751 9.2 79.3 11.5 3,066 

Zimbabwe 1999 1.6 1,916 4.9 72.9 22.2 1,661 

 

North Africa/West Asia/Europe 

Egypt 2000 1.2 5,942 0.7 31.1 68.2 5,068 

Jordan 1997 1.2 2,932 2.8 38.5 58.7 2,317 

Turkey 1998 2.1 1,795 3.0 45.4 51.7 1,536 

Yemen 1997 8.7 5,933 25.8 60.4 13.7 4,479 

 

Central Asia 

Kazakhstan 1999 0.2 354 8.9 70.5 20.6 327 

Kyrgyz Republic 1997 0.5 1,014 7.2 74.3 18.6 876 

Uzbekistan 1996 1.1 1,204 11.6 73.1 15.3 1,055 

South/Southeast Asia 

Bangladesh 1999-2000 16.2 3,745 46.8 49.6 3.6 3,252 

Cambodia 2000 4.4 2,012 22.0 73.3 4.7 1,672 

India 1998-99 12.2 26,901 38.6 56.4 5.0 22,561 

Nepal 1996 14.8 3,746 28.4 70.0 1.6 3,193 

 

Latin America/Caribbean 

Bolivia 1998 12.6 3,359 0.9 55.5 43.6 2,871 

Brazil 1996 3.8 2,309 6.7 60.9 32.4 2,016 

Colombia 1995 5.6 2,548 4.2 57.6 38.2 2,237 

Dominican Republic 1996 2.6 2,125 7.0 57.5 35.5 1,776 

Guatemala 1995 34.6 4,424 4.3 64.1 31.6 3,496 

Haiti 2000 2.1 3,364 9.4 67.3 23.3 2,835 

Nicaragua 1998 6.3 3,872 4.1 59.7 36.3 3,390 

Peru 2000 15.3 6,154 0.8 54.9 44.3 5,489 
Appendix A 79

Table A.4.3 Micronutrients: Anemia status and iron intake among mothers

Among women age 15-49 with a birth in the three years preceding the survey, percentage with specific anemia levels, and percentage who took 

iron tablets or syrup during pregnancy, Demographic and Health Surveys 1994-2001 

Anemia status of mothers 

Iron supplementation 

during last pregnancy 

Country Mild Moderate Severe Total 

Not 

anemic Number No Yes 

Don't 

know Missing Number 

Sub-Saharan Africa u u u u u u u u u u u 

Benin 1996 u u u u u u u u u u u 

Burkina Faso 1998-99 u u u u u u u u u u u 

Cameroon 1998 u u u u u u u u u u u 

Central African Republic 

 1994-95 u u u u u u u u u u u 

Chad 1996-97 u u u u u u u u u u u 

Côte d’Ivoire 1994 u u u u u u u u u u u 

Eritrea 1995 u u u u u u 69.8 30.2 0.0 0.1 2,202 

Ethiopia 2000 u u u u u u u u u u u 

Gabon 2000 u u u u u u 30.8 67.9 0.8 0.5 2,766 

Ghana 1998 u u u u u u 20.7 78.4 0.9 0.0 2,311 

Guinea 1999 u u u u u u u u u u u 

Kenya 1998 u u u u u u u u u u u 

Madagascar 1997 30.1 11.1 0.9 42.1 57.9 3,299 u u u u u 

Malawi 2000 u u u u u u 32.5 67.3 0.0 0.2 8,057 

Mali 1995-96 u u u u u u u u u u u 

Mozambique 1997 u u u u u u u u u u u 

Namibia 2000 u u u u u u u u u u u 

Niger 1998 u u u u u u 88.7 11.1 0.0 0.2 4,242 

Rwanda 2000 u u u u u u 78.3 20.6 1.0 0 5,141 

Tanzania 1996 u u u u u u 53.3 44.4 2.2 0.0 2,183 

Togo 1998 u u u u u u u u u u u 

Uganda 2000-01 25.8 10.0 0.9 36.7 63.3 6,548 48.2 51.4 0.3 0.1 4,489 

Zambia 1996 u u u u u u u u u u u 

Zimbabwe 1999 u u u u u u 39.1 59.9 0.8 0.2 2,770 

North Africa/West Asia/ 

 Europe 

Egypt 2000 22.7 4.6 0.3 27.6 72.3 7,575 70.5 26.5 2.9 0.1 7,953 

Jordan 1997 u u u u u u u u u u u 

Turkey 1998 u u u u u u 45.7 54.0 0.0 0.3 2,617 

Yemen 1997 u u u u u i 77.7 22.1 0.0 0.2 7.343 

Central Asia 

Kazakhstan 1999 26.6 7.7 1.2 35.5 64.5 2,269 51.1 48.1 0.5 0.3 1,129 

Kyrgyz Republic 1997 27.7 9.0 1.5 38.2 61.9 3,767 u u u u u 

Uzbekistan 1996 45.3 14.2 0.9 60.4 39.6 4,333 u u u u u 

South/Southeast Asia 

Bangladesh 1999-2000 u u u u u u 63.1 36.4 0.2 0.4 5,263 

Cambodia 2000 44.8 12.7 1.3 58.8 41.2 3,634 78.6 20.7 0.3 0.3 5,714 

India 1998-99 34.9 14.6 1.7 51.2 48.8 80,693 41.9 57.9 0.0 0.2 28,446 

Indonesia 1997 u u u u u u 26.4 67.1 6.5 0.1 13,393 

Nepal 1996 u u u u u u 90.9 8.9 0.2 0.0 3,813 

Philippines 1998 u u u u u u 24.0 75.6 0.3 0.1 4,968 

Latin America/Caribbean 

Bolivia 1998 20.7 5.6 0.9 27.2 72.9 3,531 u u u u u 

Brazil 1996 u u u u u u u u u u u 

Colombia 1995 u u u u u u 27.5 72.0 0.4 0.1 3,547 

Dominican Republic 1996 u u u u u u 9.1 90.9 0.0 0.0 3,067 

Guatemala 1995 u u u u u u u u u u u 

Haiti 2000 36.9 15.7 2.8 55.4 44.6 3,138 40.9 57.1 2.0 0.0 4,254 

Nicaragua 1998 u u u u u u u u u u u 

Peru 2000 25.4 5.9 0.3 31.6 68.4 6,184 47.4 52.0 0.5 0.1 9,535 

Note: The India anemia levels are based on ever-married women. 

u = Unknown (question not asked) 
80 Appendix A 

Table A.4.4 Micronutrients: Night blindness, vitamin A intake among mothers, and iodized salt

Among women age 15-49 with a birth in the three years preceding the survey, percentage who had night blindness during pregnancy, percentage 

who received a vitamin A dose in the first two months after delivery, and percentage of all women age 15-49 who live in households with salt 

that received a positive reading for the presence of iodine, Demogoraphic and Health Surveys 1994-2001 

Night blindness during last pregnancy Iodized salt 

Vitamin A supplements given 

within two months after last 

pregnancy 

Country 

Night 

blindness 

Day vision 

problems 

Both 

night 

blind and 

day vision 

problems

Adjusted 

rate (night 

blind but 

no day 

vision 

problems) Number No Yes Number 

Percentage 

of women 

15-49 in 

households 

with iodized 

salt 

Number of 

women 

living in 

households 

with salt 

tested 

Sub-Saharan Africa 

Benin 1996 u u u u u u u u 78.8 5,294 

Burkina Faso 1998-99 u u u u u u u u 2.7a 6,424 

Cameroon 1998 u u u u u u u u 94.5 5,065 

Central African Republic 

 1994-95 

u u u u u u u u 28.2 5,211 

Chad 1996-97 u u u u u u u u 64.5 7,099 

Côte d’Ivoire 1994 u u u u u u u u u u 

Eritrea 1995 u u u u u u u u 0.2a 5,047 

Ethiopia 2000 17.0 20.6 12.5 4.5 6,354 88.0 11.8 7,978 29.8 15,254 

Gabon 2000 9.9 14.6 7.7 2.1 2,137 u u u 18.3 5,765 

Ghana 1998 u u u u u 71.3 28.3 2,311 27.8 4,803 

Guinea 1999 u u u u u u u u 13.9 6,092 

Kenya 1998 u u u u u u u u 

Madagascar 1997 9.6 6.5 6.5 3.1 722 81.8 6,551 

Malawi 2000 4.3 7.9 2.8 1.5 6,753 58.1 41.7 8,057 83.6 12,145 

Mali 1995-96 u u u u u u u u 1.7a 9,655 

Mozambique 1997 u u u u u u u u 1.8a 8,707 

Namibia 2000 u u u u u 63.9 33.4 3,002 83.0 6,247 

Niger 1998 u u u u u u u u 76.8 6,977 

Rwanda 2000 7.4 7.1 3.2 4.2 4,071 85.8 13.9 5,141 98.0 9,564 

Tanzania 1996 u u u u u 89.0 10.9 2,183 u u 

Togo 1998 u u u u u u u u 78.8a 8,207 

Uganda 2000-01 8.7 22.6 7.6 1.1 3,848 88.5 11.3 4,489 98.6 6,638 

Zambia 1996 u u u u u u u u 96.1 7,170 

Zimbabwe 1999 4.4 6.3 3.3 1.1 2,018 u u u u u 

North Africa/West Asia/ 

 Europe 

Egypt 2000 u u u u u 86.4 11.9 7,953 55.3 15,553 

Jordan 1997 u u u u u u u u 95.7a 5,539 

Turkey 1998 u u u u u u u u u u 

Yemen 1997 u u u u u u u u 40.3 10,285 

Central Asia 

Kazakhstan 1999 u u u u u u u u 31.0 4,654 

Kyrgyz Republic 1997 u u u u u u u u 26.1a 3,617 

Uzbekistan 1996 u u u u u u u u 16.6a 4,409 

South/Southeast Asia 

Bangladesh 1999-2000 u u u u u 84.1 15.8 5,263 u u 

Cambodia 2000 8.8 25.4 6.9 1.9 4,105 88.9 10.7 5,714 15.7 15,216 

India 1998-99 12.4 22.4 9.0 3.4 28,779 u u u 71.9 89,830 

Indonesia 1997 u u u u u u u u u u 

Nepal 1996 18.7 na na na 3,813 u u u 93.3 8,417 

Philippines 1998 u u u u u u u u 28.7 13,916 

Latin America/Caribbean 

Bolivia 1998 u u u u u u u u u u 

Brazil 1996 u u u u u u u u 97.3a 12,444 

Colombia 1995 u u u u u u u u u u 

Dominican Republic 1996 u u u u u u u u 15.6 7,969 

Guatemala 1995 u u u u u u u u 91.3 12,114 

Haiti 2000 10.0 15.1 9.0 1.0 3,392 75.5 24.5 4,254 23.4 9,633 

Nicaragua 1998 u u u u u u u u 91.8 12,940 

Peru 2000 8.3 14.2 6.5 1.8 6,377 88.3 11.6 9,535 97.9 27,463 

Note: In Nepal, night blindness was not adjusted for daylight problems because the question was not asked. In Madagascar, only currently 

pregnant women were asked about night blindness. 

u = Unknown (question not asked) 

a

 No actual iodine test, information from salt package only 

 
Appendix A 81

Table A.4.5 Low birth weight

Percentage of women whose most recent live birth in the three years 

preceding the survey was a low-birth-weight baby, Demographic and 

Health Surveys 1994-2000 

Country 

Percentage of 

mothers with 

low-birthweight babies Number 

Sub-Saharan Africa 

Benin 1996 13.3 2,597 

Burkina Faso 1998-99 17.1 3,302 

Cameroon 1998 8.8 2,148 

Central African Republic 1994-95 12.2 2,446 

Chad 1996-97 16.7 3,847 

Comoros 1996 18.1 934 

Côte d’Ivoire 1994 13.4 3,556 

Eritrea 1995 19.5 2,202 

Ethiopia 2000 12.0 6,354 

Gabon 2000 12.1 2,137 

Ghana 1998 8.8 1,744 

Guinea 1999 10.1 3,089 

Kenya 1998 9.0 3,007 

Madagascar 1997 14.5 3,305 

Malawi 2000 12.4 6,753 

Mali 1995-96 15.8 5,175 

Mozambique 1997 11.7 3,822 

Namibia 2000 13.6 2,235 

Niger 1998 15.1 4,242 

Rwanda 2000 7.2 4,071 

Tanzania 1996 10.8 3,755 

Togo 1998 12.3 3,592 

Uganda 2000-01 9.4 3,848 

Zambia 1996 10.3 3,790 

Zimbabwe 1999 9.3 2,018 

North Africa/West Asia/Europe 

Egypt 2000 9.5 6,017 

Jordan 1997 9.2 2,956 

Turkey 1998 13.7 1,869 

Yemen 1997 34.1 6,130 

Central Asia 

Kazakhstan 1999 5.6 730 

Kyrgyz Republic 1997 6.4 1,025 

Uzbekistan 1996 3.4 1,213 

South/Southeast Asia 

Bangladesh 1999-2000 u 3,824 

Cambodia 2000 8.9 4,105 

India 1998-99 25.1 28,779 

Indonesia 1997 7.5 9,034 

Nepal 1996 u 3,813 

Philippines 1998 16.8 3,747 

Latin America/Caribbean 

Bolivia 1998 7.7 3,500 

Brazil 1996 8.7 2,515 

Colombia 1995 7.4 2,689 

Dominican Republic 1996 12.7 2,241 

Guatemala 1995 12.6 4,613 

Haiti 2000 23.8 3,392 

Nicaragua 1998 13.0 3,992 

Peru 2000 8.8 6,377 

Note: Low-birth-weight babies are those whose birth weight was less 

than 2.5 kg or who were estimated to be low birth weight based on 

projected proportions from mother’s perceptions of birth size. 

u = Unknown (question not asked) 
82 Appendix A 

Table A.4.6 Education

Percentage of de facto household population of males and females age 6-10 who are currently attending school, and among 

those attending school, ratio of females to males, Demographic and Health Surveys 1994-2001 

Percentage of 

the household 

population 

attending school 

Country Male Female Total 

Ratio of

females

to males 

Number 

of 

males 

Number 

of 

females 

Total 

population

age 6-10 

Sub-Saharan Africa 

Benin 1996 49.7 33.8 41.8 0.68 2,336 2,278 4,615 

Burkina Faso 1998-99 28.9 20.7 25.0 0.72 2,860 2,676 5,536 

Cameroon 1998 70.6 69.7 70.1 0.99 2,074 2,019 4,093 

Central African Republic 1994-95 61.7 47.6 54.8 0.77 2,320 2,226 4,546 

Chad 1996-97 34.2 22.9 28.4 0.67 3,196 3,330 6,525 

Comoros 1996 44.9 41.7 43.2 0.93 1,110 1,156 2,266 

Côte d’Ivoire 1994 52.8 42.3 47.5 0.80 3,005 3,096 6,101 

Eritrea 1995 38.4 34.8 36.6 0.91 1,918 2,006 3,924 

Ethiopia 2000 21.8 19.8 20.8 0.91 5,383 5,085 10,468 

Gabon 2000 93.4 92.9 93.2 0.99 2,036 2,145 4,180 

Ghana 1998 74.0 75.3 74.6 1.02 1,704 1,585 3,289 

Guinea 1999 24.3 18.9 21.6 0.78 3,082 3,032 6,114 

Kenya 1998 82.0 82.5 82.3 1.01 2,989 2,834 5,823 

Madagascar 1997 57.6 59.7 58.6 1.04 2,659 2,576 5,235 

Malawi 2000 70.5 73.9 72.2 1.05 4,812 4,929 9,741 

Mali 1995-96 28.0 22.0 25.0 0.79 4,121 4,185 8,307 

Mozambique 1997 53.3 47.0 50.1 0.88 3,163 3,237 6,401 

Namibia 2000 81.0 81.5 81.3 1.01 2,375 2,548 4,924 

Niger 1998 24.0 16.8 20.5 0.70 3,018 2,845 5,863 

Rwanda 2000 36.3 37.1 36.7 1.02 3,437 3,603 7,040 

Tanzania 1996 25.1 29.5 27.3 1.18 3,093 3,027 6,121 

Togo 1998 72.4 63.6 68.2 0.88 3,665 3,415 7,080 

Uganda 2000-01 78.0 80.0 79.1 1.03 3,190 3,299 6,489 

Zambia 1996 48.3 49.3 48.8 1.02 2,971 2,975 5,946 

Zimbabwe 1999 82.1 83.6 82.8 1.02 1,918 1,880 3,799 

North Africa/West Asia/Europe 

Egypt 2000 87.6 83.9 85.8 0.96 5,325 5,114 10,439 

Jordan 1997 87.6 88.1 87.8 1.01 3,031 2,777 5,809 

Turkey 1998 74.4 70.4 72.4 0.95 1,855 1,764 3,619 

Yemen 1997 67.1 41.2 54.5 0.61 6,730 6,414 13,144 

Central Asia 

Kazakhstan 1999 73.1 72.7 72.9 0.99 1,167 1,101 2,268 

Kyrgyz Republic 1997 78.3 75.7 77.1 0.97 1,147 1,068 2,214 

Uzbekistan 1996 67.8 70.4 69.1 1.04 1,278 1,232 2,510 

South/Southeast Asia 

Bangladesh 1999-2000 78.4 80.3 79.3 1.02 3,401 3,389 6,790 

Cambodia 2000 63.1 62.9 63.0 1.00 5,497 5,449 10,946 

India 1998-99 85.2 78.3 81.9 0.92 33,121 30,486 63,607 

Indonesia 1997 85.7 87.2 86.5 1.02 8,634 8,262 16,896 

Nepal 1996 73.7 56.7 65.3 0.77 3,144 3,081 6,224 

Philippines 1998 81.0 84.7 82.8 1.05 4,034 3,883 7,917 

Latin America/Caribbean 

Bolivia 1998 94.7 94.5 94.6 1.00 3,774 3,654 7,428 

Brazil 1996 93.4 93.7 93.5 1.00 3,020 3,006 6,026 

Colombia 1995 89.5 91.4 90.5 1.02 2,527 2,525 5,052 

Dominican Republic 1996 91.1 93.1 92.0 1.02 2,426 2,236 4,662 

Guatemala 1995 60.9 55.2 58.1 0.91 4,431 4,328 8,758 

Haiti 2000 60.4 58.9 59.6 0.98 3,122 3,133 6,256 

Nicaragua 1998 69.2 73.7 71.5 1.07 4,508 4,511 9,019 

Peru 2000 94.8 94.2 94.5 0.99 7,997 7,685 15,683 
Appendix A 83

Table A.4.7 Literacy

Percent distribution of women age 15-49 who reported that they can read easily, read with difficulty, or 

cannot read, Demographic and Health Surveys 1994-2001 

Country 

Reads 

easily 

Reads 

with 

difficulty 

Cannot 

read Total Number 

Sub-Saharan Africa 

Benin 1996 13.9 7.9 78.2 100.0 5,488 

Burkina Faso 1998-99 7.6 3.3 89.1 100.0 6,439 

Cameroon 1998 45.2 18.3 36.6 100.0 5,481 

Central African Republic 1994-95 17.6 12.7 69.7 100.0 5,883 

Chad 1996-97 6.8 7.8 85.4 100.0 7,449 

Comoros 1996 29.0 18.8 52.2 100.0 3,047 

Côte d’Ivoire 1994 24.3 10.4 65.4 100.0 8,099 

Eritrea 1995 28.6 6.3 65.1 100.0 5,051 

Ethiopia 2000 18.6 5.9 75.5 100.0 15,310 

Gabon 2000 78.3 8.1 13.6 100.0 6,109 

Ghana 1998 53.3 3.1 43.6 100.0 4,842 

Guinea 1999 10.3 3.4 86.3 100.0 6,710 

Kenya 1998 62.5 20.5 17.1 100.0 7,855 

Madagascar 1997 56.3 14.3 29.5 100.0 7,044 

Malawi 2000 48.7 7.9 43.4 100.0 13,202 

Mali 1995-96 8.7 4.0 87.3 100.0 9,684 

Mozambique 1997 17.6 15.2 67.2 100.0 8,763 

Namibia 2000 80.6 8.4 11.0 100.0 6,579 

Niger 1998 7.7 3.6 88.8 100.0 7,571 

Rwanda 2000 57.9 8.3 33.8 100.0 10,407 

Tanzania 1996 54.3 11.2 34.4 100.0 8,102 

Togo 1998 22.0 18.3 59.7 100.0 8,541 

Uganda 2000-01 48.7 10.6 40.7 100.0 7,065 

Zambia 1996 46.8 19.7 33.4 100.0 8,010 

Zimbabwe 1999 75.0 14.8 10.3 100.0 5,891 

North Africa/West Asia/Europe 

Egypt 2000 42.2 8.0 49.8 100.0 15,569 

Jordan 1997 82.1 6.9 11.0 100.0 5,547 

Turkey 1998 75.8 8.8 15.4 100.0 8,569 

Yemen 1997 14.7 4.7 80.6 100.0 10,409 

Central Asia 

Kyrgyz Rep 1997 96.1 3.6 0.4 100.0 3,848 

Uzbekistan 1996 94.6 5.2 0.2 100.0 4,415 

South/Southeast Asia 

Bangladesh 1999-2000 33.6 12.2 54.2 100.0 10,530 

Cambodia 2000 42.9 24.5 32.6 100.0 15,258 

India 1998-99 41.9 0.0 58.1 100.0 90,279 

Indonesia 1997 72.9 9.1 18.0 100.0 28,809 

Nepal 1996 16.5 4.4 79.1 100.0 8,429 

Philippines 1998 85.8 11.6 2.6 100.0 13,936 

Latin America/Caribbean 

Bolivia 1998 71.5 17.7 10.8 100.0 11,132 

Brazil 1996 80.6 11.6 7.8 100.0 12,557 

Colombia 1995 86.9 8.4 4.7 100.0 11,121 

Dominican Republic 1996 80.7 9.9 9.5 100.0 8,389 

Guatemala 1995 49.2 19.4 31.4 100.0 12,344 

Haiti 2000 46.1 12.6 41.4 100.0 10,145 

Nicaragua 1998 73.9 12.4 13.7 100.0 13,607 

Peru 2000 86.7 4.6 8.6 100.0 27,749 

Note: In Zimbabwe and Cambodia, if the respondent had higher than primary education, the question 

on literacy was not asked; literacy was assumed. In India, literacy was based on the respondent's selfassessment; reading ability was not observed. 
84 Appendix A 

Table A.4.8 Exposure to mass media

Percentage of women age 15-49 who usually read a newspaper at least once a week, watch television at least 

once a week, and listen to the radio at least once a day, Demographic and Health Surveys 1994-2001 

Country 

Reads 

newspaper 

weekly 

Watches 

television 

weekly 

Listens to 

radio 

weekly 

Listens to 

radio 

daily Number 

Sub-Saharan Africa 

Benin 1996 8.4 u u u 5491 

Burkina Faso 1998-99 3.3 12.6 u 17.5 6,445 

Cameroon 1998 13.4 32.9 u 24.2 5,501 

Central African Republic 1994-95a 14.6 13.9 65.4 u 5,884 

Chad 1996-97 4.7 4.8 u 22.9 7,454 

Comoros 1996 18.0 25.2 u 54.4 3,050 

Côte d’Ivoire 1994a 18.0 48.2 39.6 u 8,099 

Eritrea 1995a 20.2 17.5 52.6 u 5,054 

Ethiopia 2000 1.7 4.4 11.2 8.6 15,367 

Gabon 2000 36.2 64.0 71.9 50.1 6,183 

Ghana 1998 19.1 49.0 u 58.5 4,843 

Guinea 1999 5.7 22.6 u 25.8 6,753 

Kenya 1998 36.9 25.7 u 58.2 7,881 

Madagascar 1997 26.5 13.8 u 39.6 7,060 

Malawi 2000 9.8 3.8 52.3 43.3 13,220 

Mali 1995-96a 6.5 29.8 59.8 u 9,704 

Mozambique 1997 10.9 10.4 u 27.1 8,779 

Namibia 2000 37.5 35.9 72.7 58.1 6,755 

Niger 1998 5.3 25.4 u 53.5 7,577 

Rwanda 2000 5.4 6.3 39.0 25.0 10,421 

Tanzania 1996 13.1 8.8 43.5 32.6 8,120 

Togo 1998 13.8 41.1 u 11.1 8,569 

Uganda 2000-01 14.7 9.7 52.6 36.8 7,246 

Zambia 1996 24.6 28.8 56.9 36.3 8,021 

Zimbabwe 1999 27.2 31.8 53 43.3 5,907 

North Africa/West Asia/Europe 

Egypt 2000 25.3 92.6 71.7 49.9 15,573 

Jordan 1997 42.5 88.6 58.0 44.2 5,548 

Turkey 1998 32.4 u u u 8,576 

Yemen 1997a 10.2 33.6 31.2 u 10,414 

Central Asia 

Kazakhstan 1999 61.9 90.1 35.4 28.3 4,800 

Kyrgyz Republic 1997 68.7 89.7 u 51.9 3,848 

Uzbekistan 1996 57.2 94.4 u 56.1 4,415 

South/Southeast Asia 

Bangladesh 1999-2000 8.8 35.2 28.8 16.7 10,544 

Cambodia 2000 12.2 56.3 46.1 30.7 15,351 

India 1998-99a 20.8 45.7 36.5 u 90,303 

Indonesia 1997 25.1 77.9 u 49.5 28,810 

Nepal 1996 5.3 12.3 u 36.4 8,429 

Philippines 1998 63.0 79.8 u u 13,983 

Latin America/Caribbean 

Bolivia 1998 55.1 72.8 u 75.5 11,187 

Brazil 1996 56.6 88.7 u 70.9 12,612 

Colombia 1995 68.1 82.6 u 81.2 11,140 

Dominican Republic 1996 37.7 84.1 83.3 67.0 8,422 

Guatemala 1995 44.7 56.4 u 72.3 12,403 

Haiti 2000 26.2 31.3 61.9 43.8 10,159 

Nicaragua 1998 52.1 68.4 u 76.2 13,634 

Peru 2000 26.0 63.2 65.3 62.2 27,843 

u = Unknown (question not asked) 

a

 Listens to radio weekly 
Appendix A 85

Table A.4.9 Employment status

Percentage of women age 15-49 who were employed in the 12 months preceding the 

survey, and among those, the percentage who worked in agriculture, Demographic and 

Health Surveys 1994-2001 

Of those who worked, 

percentage who 

worked: 

Country 

Percentage 

who 

worked 

in past 

12 months 

Number

of 

women 

In 

agriculture Number 

Sub-Saharan Africa 

Benin 1996 85.7 5,486 28.4 4,703 

Burkina Faso 1998-99 66.4 6,440 41.9 4,273 

Cameroon 1998 68.7 5,494 60.7 3,774 

Central African Republic 1994-95 77.1 5,881 73.3 4,532 

Chad 1996-97 43.9 7,451 32.7 3,271 

Comoros 1996 40.1 3,042 35.3 1,221 

Côte d’Ivoire 1994 71.0 8,099 45.3 5,753 

Eritrea 1995 25.1 5,050 55.4 1,265 

Ethiopia 2000 56.5 15,362 58.9 8,682 

Gabon 2000 38.7 6,173 21.7 2,389 

Ghana 1998 73.7 4,839 32.5 3,564 

Guinea 1999 78.9 6,753 60.5 5,329 

Kenya 1998 51.9 7,874 47.9 4,086 

Madagascar 1997 77.8 7,056 70.7 5,488 

Malawi 2000 56.4 13,217 66.5 7,455 

Mali 1995-96 53.4 9,698 37.3 5,180 

Mozambique 1997 62.4 8,749 84.3 5,462 

Namibia 2000 32.7 6,748 11.1 2,207 

Niger 1998 53.0 7,575 40.7 4,011 

Rwanda 2000 79.0 10,409 88.1 8,221 

Tanzania 1996 54.1 8,117 76.2 4,387 

Togo 1998 77.9 8,561 33.4 6,669 

Uganda 2000-01 73.5 7,233 77.3 5,316 

Zambia 1996 45.6 8,016 36.1 3,655 

Zimbabwe 1999 49.4 5,907 38.6 2,916 

North Africa/West Asia/Europe 

Egypt 2000 16.8 15,573 17.3 2,611 

Jordan 1997 12.5 5,548 5.8 695 

Turkey 1998 35.3 8,562 49.5 3,019 

Yemen 1997 28.5 10,413 82.5 2,972 

Central Asia 

Kazakhstan 1999 41.3 4,792 3.7 1,979 

Kyrgyz Republic 1997 43.4 3,848 26.4 1,668 

Uzbekistan 1996 44.3 4,415 27.8 1,955 

South/Southeast Asia 

Bangladesh 1999-2000 22.5 10,541 32.5 2,377 

Cambodia 2000 73.5 15,351 66.6 11,276 

India 1998-99 37.4 90,281 65.7 33,742 

Indonesia 1997 23.8 28,810 90.6 6,853 

Nepal 1996 77.4 8,418 90.0 6,513 

Philippines 1998 46.2 13,966 11.0 6,448 

Latin America/Caribbean 

Bolivia 1998 53.1 11,171 19.5 5,936 

Brazil 1996 51.1 12,592 9.2 6,437 

Colombia 1995 49.8 11,132 8.5 5,548 

Dominican Republic 1996 41.8 8,416 3.0 3,521 

Guatemala 1995 31.9 12,342 9.9 3,937 

Haiti 2000 44.8 10,159 10.4 4,552 

Nicaragua 1998 38.6 13,612 6.9 5,259 

Peru 2000 56.5 27,814 25.7 15,726 
86 Appendix A 

Table A.4.10 Current marital status

Distribution of women age 15-49 by current marital status, Demographic and Health 

Surveys 1994-2001 

Country 

Married/

living 

together 

Widowed/

divorced

separated 

Never 

married Number 

Sub-Saharan Africa 

Benin 1996 76.5 4.5 19.0 5,491 

Burkina Faso 1998-99 80.4 2.7 16.9 6,445 

Cameroon 1998 66.8 9.7 23.4 5,501 

Central African Republic 1994-95 69.4 11.1 19.5 5,884 

Chad 1996-97 78.2 8.1 13.7 7,454 

Comoros 1996 53.6 7.5 39.0 3,050 

Côte d’Ivoire 1994 65.1 8.6 26.4 8,099 

Eritrea 1995 66.7 13.3 20.0 5,054 

Ethiopia 2000 63.7 12.3 24.0 15,367 

Gabon 2000 54.1 13.2 32.6 6,183 

Ghana 1998 64.7 11.7 23.7 4,843 

Guinea 1999 82.4 3.6 13.9 6,753 

Kenya 1998 61.3 8.6 30.1 7,881 

Madagascar 1997 62.8 13.8 23.4 7,060 

Malawi 2000 71.5 11.5 17.0 13,220 

Mali 1995-96 84.7 2.4 12.8 9,704 

Mozambique 1997 74.4 10.5 15.1 8,779 

Namibia 2000 38.6 7.1 54.3 6,755 

Niger 1998 84.2 4.5 11.2 7,577 

Rwanda 2000 48.5 17.5 34.1 10,421 

Tanzania 1996 66.6 10.1 23.2 8,120 

Togo 1998 67.9 7.1 24.9 8,569 

Uganda 2000-01 67.4 12.6 20.1 7,246 

Zambia 1996 61.1 13.5 25.3 8,021 

Zimbabwe 1999 61.1 11.2 27.7 5,907 

North Africa/West Asia/Europe 

Egypt 2000 62.8 5.2 31.9 22,884 

Jordan 1997 52.5 2.1 45.4 10,165 

Turkey 1998 69.0 3.2 27.7 8,576 

Yemen 1997 67.4 4.3 28.3 14,521 

Central Asia 

Kazakhstan 1999 62.9 11.8 25.3 4,800 

Kyrgyz Republic 1997 69.5 9.0 21.5 3,848 

Uzbekistan 1996 70.3 4.8 24.9 4,415 

South/Southeast Asia 

Bangladesh 1999-2000 64.5 5.5 30.0 15,063 

Cambodia 2000 59.1 9.1 31.8 15,351 

India 1998-99 75.1 5.0 19.9 12,709 

Indonesia 1997 69.7 5.0 25.3 38,590 

Nepal 1996 79.0 4.4 16.6 10,101 

Philippines 1998 59.6 4.0 36.4 13,983 

Latin America/Caribbean 

Bolivia 1998 59.4 7.1 33.4 11,187 

Brazil 1996 60.1 9.3 30.6 12,612 

Colombia 1995 54.7 13.0 32.2 11,140 

Dominican Republic 1996 59.2 15.3 25.6 8,422 

Guatemala 1995 64.4 7.6 28.0 12,403 

Haiti 2000 58.6 10.0 31.4 10,159 

Nicaragua 1998 59.0 17.4 23.6 13,634 

Peru 2000 56.1 8.0 35.8 27,843 
Appendix A 87

Table A.4.11 Polygyny

Percentage of currently married women age 15-49 who are 

in a polygynous union, Demographic and Health Surveys 

1994-2001 

Country Percent Number 

Sub-Saharan Africa 

Benin 1996 49.5 4,198 

Burkina Faso 1998-99 54.6 5,181 

Cameroon 1998 32.7 3,676 

Central African Republic 1994-95 28.4 4,083 

Chad 1996-97 39.1 5,832 

Comoros 1996 25.0 1,634 

Côte d’Ivoire 1994 36.4 5,271 

Eritrea 1995 6.9 3,371 

Ethiopia 2000 13.5 9,789 

Gabon 2000 21.1 3,348 

Ghana 1998 22.6 3,131 

Guinea 1999 53.3 5,561 

Kenya 1998 16.0 4,834 

Madagascar 1997 3.3 4,435 

Malawi 2000 17.0 9,452 

Mali 1995-96 44.2 8,222 

Mozambique 1997 27.3 6,530 

Namibia 2000 12.4 2,610 

Niger 1998 37.6 6,382 

Rwanda 2000 12.1 5,052 

Tanzania 1996 28.1 5,411 

Togo 1998 42.8 5,819 

Uganda 2000-01 28.9 4,881 

Zambia 1996 16.6 4,902 

Zimbabwe 1999 15.3 3,609 

North Africa/West Asia/Europe 

Jordan 1997 6.5 5,337 

Yemen 1997 6.9 9,786 

South/Southeast Asia 

Nepal 1996 5.7 7,982 

Latin America/Caribbean 

Haiti 2000 19.6 5,958 
88 Appendix A 

Table A.4.12 Female-headed households

Percentage of women age 15-49 living in a female-headed 

household, Demographic and Health Surveys 1994-2001 

Country 

Percentage 

of women 

living in a 

femaleheaded 

household Number 

Sub-Saharan Africa 

Benin 1996 14.9 5,733 

Burkina Faso 1998-99 5.9 6,987 

Cameroon 1998 21.6 5,651 

Central African Republic 1994-95 18.8 6,028 

Chad 1996-97 17.1 7,827 

Comoros 1996 31.8 3,198 

Côte d’Ivoire 1994 15.9 8,070 

Eritrea 1995 28.2 5,060 

Ethiopia 2000 21.7 15,472 

Gabon 2000 31.2 7,017 

Ghana 1998 40.7 5,081 

Guinea 1999 11.3 7,132 

Kenya 1998 33.9 7,965 

Madagascar 1997 20.4 7,695 

Malawi 2000 25.5 13,376 

Mali 1995-96 5.8 10,303 

Mozambique 1997 23.6 9,880 

Namibia 2000 47.1 7,569 

Niger 1998 9.6 7,692 

Rwanda 2000 37.3 10,307 

Tanzania 1996 21.1 8,549 

Togo 1998 23.0 8,543 

Uganda 2000-01 27.1 7,810 

Zambia 1996 22.9 8,713 

Zimbabwe 1999 39.0 6,123 

North Africa/West Asia/Europe 

Egypt 2000 9.5 22,459 

Jordan 1997 8.4 10,435 

Turkey 1998 8.2 9,272 

Yemen 1997 8.0 15,446 

Central Asia 

Kazakhstan 1999 28.0 5,399 

Kyrgyz Republic 1997 23.5 4,081 

Uzbekistan 1996 19.6 4,728 

South/Southeast Asia 

Bangladesh 1999-2000 7.7 12,876 

Cambodia 2000 24.6 16,079 

India 1998-99 9.1 122,721 

Indonesia 1997 9.7 39,121 

Nepal 1996 10.9 10,508 

Philippines 1998 13.9 15,478 

Latin America/Caribbean 

Bolivia 1998 18.5 12,401 

Brazil 1996 19.4 14,368 

Colombia 1995 24.3 12,047 

Dominican Republic 1996 27.9 9,419 

Guatemala 1995 19.7 13,632 

Haiti 2000 46.5 10,342 

Nicaragua 1998 33.0 15,274 

Peru 2000 18.3 31,453 

Note: Based on the de jure household population of women age 

15-49 
Appendix A 89

Table A.4.13 Median age at first sexual intercourse, first marriage, and first birth

Median age at first sexual intercourse, first marriage, and first birth among women age 

25-49 years, Demographic and Health Surveys 1994-2001 

Country 

Median age 

at first 

sexual 

intercourse 

Median age 

at first 

marriage 

Median age 

at first birth Number 

Sub-Saharan Africa 

Benin 1996 17.3 18.4 19.6 3,396 

Burkina Faso 1998-99 17.5 17.6 19.3 3,843 

Cameroon 1998 15.8 17.4 19.0 3,092 

Central African Republic 1994-95 15.9 17.3 19.4 3,471 

Chad 1996-97 15.5 15.8 18.3 4,370 

Comoros 1996 18.3 18.5 21.0 1,630 

Côte d’Ivoire 1994 15.8 18.1 18.8 4,566 

Eritrea 1995 16.8 16.7 21.4 3,102 

Ethiopia 2000 16.0 16.0 19.0 8,797 

Gabon 2000 16.1 19.7 18.5 3,336 

Ghana 1998 17.7 19.1 20.3 3,033 

Guinea 1999 16.0 16.4 18.8 4,346 

Kenya 1998 16.5 19.2 19.4 4,482 

Madagascar 1997 16.9 18.5 19.5 4,182 

Malawi 2000 16.8 17.8 19.1 7,396 

Mali 1995-96 15.8 16.0 18.8 6,227 

Mozambique 1997 15.9 17.1 19.2 5,280 

Namibia 2000 19.2 a 21.1 3,917 

Niger 1998 16.7 15.1 17.8 4,499 

Rwanda 2000 20.1 20.7 22.0 5,897 

Tanzania 1996 16.7 18.2 19.1 4,712 

Togo 1998 17.3 18.8 20.1 5,316 

Uganda 2000-01 16.6 17.8 18.8 4,127 

Zambia 1996 16.4 17.7 18.6 4,187 

Zimbabwe 1999 18.7 19.3 19.9 3,166 

North Africa/West Asia/Europe 

Egypt 2000 u 19.5 21.6 13,597 

Jordan 1997 u 21.5 23.2 5,592 

Turkey 1998 u 19.5 21.3 5,299 

Yemen 1997 u 16.0 19.5 7,646 

Central Asia 

Kazakhstan 1999 20.8 21.2 22.4 3,343 

Kyrgyz Republic 1997 20.4 20.4 21.7 2,456 

Uzbekistan 1996 20.1 20.1 21.6 2,628 

South/Southeast Asia 

Bangladesh 1999-2000 u 14.7 17.8 7,000 

Cambodia 2000 19.9 20.0 21.9 9,751 

India 1998-99 u 17.1 19.4 67,433 

Indonesia 1997 18.6 18.6 20.8 24,940 

Nepal 1996 16.6 16.2 19.8 5,963 

Philippines 1998 22.0 22.1 23.3 8,760 

Latin America/Caribbean 

Bolivia 1998 18.9 20.9 21.5 6,733 

Brazil 1996 19.5 21.1 22.4 8,256 

Colombia 1995 19.5 21.4 22.1 7,036 

Dominican Republic 1996 18.7 19.3 21.1 5,036 

Guatemala 1995 18.2 19.0 20.1 7,186 

Haiti 2000 18.2 20.5 21.9 5,899 

Nicaragua 1998 18.2 18.3 19.7 7,904 

Peru 2000 19.0 21.4 21.9 17,459 

a = Omitted because less than 50% of respondents married before reaching the lower boundary 

of the age group 

u = Unknown (question not asked) 
90 Appendix A 

Table A.4.14 Fertility

Total wanted fertility rate and total fertility rate for the 

three years preceding the survey, Demographic and 

Health Surveys 1994-2001 

Country 

Wanted

total 

fertility 

rate 

Total 

fertility 

rate 

Sub-Saharan Africa 

Benin 1996 5.0 6.0 

Burkina Faso 1998-99 5.7 6.4 

Cameroon 1998 4.3 4.8 

Central African Republic 1994-95 4.7 5.1 

Chad 1996-97 6.1 6.4 

Comoros 1996 3.7 4.6 

Côte d’Ivoire 1994 4.4 5.3 

Eritrea 1995 5.7 6.1 

Ethiopia 2000 4.7 5.5 

Gabon 2000 3.5 4.2 

Ghana 1998 3.6 4.4 

Guinea 1999 5.0 5.5 

Kenya 1998 3.5 4.7 

Madagascar 1997 5.2 6.0 

Malawi 2000 5.2 6.3 

Mali 1995-96 6.0 6.7 

Mozambique 1997 4.7 5.2 

Namibia 2000 3.4 4.2 

Niger 1998 7.0 7.2 

Rwanda 2000 4.7 5.8 

Tanzania 1996 5.1 5.8 

Togo 1998 4.2 5.2 

Uganda 2000-01 5.3 6.9 

Zambia 1996 5.2 6.1 

Zimbabwe 1999 3.4 4.0 

Noth Africa/West Asia/Europe 

Egypt 2000 2.9 3.5 

Jordan 1997 2.9 4.4 

Turkey 1998 1.9 2.6 

Yemen 1997 4.6 6.5 

Central Asia 

Kazakhstan 1999 1.9 2.0 

Kyrgyz Republic 1997 3.1 3.4 

Uzbekistan 1996 3.1 3.3 

South/Southeast Asia 

Bangladesh 1999-2000 2.2 3.3 

Cambodia 2000 3.0 3.8 

India 1998-99 2.1 2.8 

Indonesia 1997 2.4 2.8 

Nepal 1996 2.9 4.6 

Philippines 1998 2.7 3.7 

Latin America/Caribbean 

Bolivia 1998 2.5 4.2 

Brazil 1996 1.8 2.5 

Colombia 1995 2.2 3.0 

Dominican Republic 1996 2.5 3.2 

Guatemala 1995 4.0 5.1 

Haiti 2000 2.8 4.7 

Nicaragua 1998 2.5 3.6 

Peru 2000 1.8 2.8 
Appendix A 91

Table A.4.15 Duration of childbearing period

Average number of years between first and last birth among evermarried women age 40-49 with two or more births, Demographic 

and Health Surveys 1994-2001 

Country 

Average 

number of 

years 

between 

first and 

last births Number 

Sub-Saharan Africa 

Benin 1996 17.5 934 

Burkina Faso 1998-99 17.9 1,075 

Cameroon 1998 16.1 730 

Central African Republic 1994-95 15.4 743 

Chad 1996-97 16.4 1,086 

Comoros 1996 15.4 385 

Côte d’Ivoire 1994 17.0 1,014 

Eritrea 1995 15.2 1,037 

Ethiopia 2000 17.9 2,521 

Gabon 2000 15.8 725 

Ghana 1998 15.7 835 

Guinea 1999 17.3 1,124 

Kenya 1998 15.6 1,064 

Madagascar 1997 16.6 1,003 

Malawi 2000 17.0 1,903 

Mali 1995-96 17.6 1,566 

Mozambique 1997 15.7 1,267 

Namibia 2000 14.5 830 

Niger 1998 18.3 1,128 

Rwanda 2000 16.0 1,754 

Tanzania 1996 17.8 1,190 

Togo 1998 16.5 1,293 

Uganda 2000-01 17.5 914 

Zambia 1996 17.8 1,015 

Zimbabwe 1999 15.6 775 

North Africa/West Asia/Europe 

Egypt 2000 12.3 4,187 

Jordan 1997 15.1 1,233 

Turkey 1998 10.2 1,476 

Yemen 1997 17.1 1,861 

Central Asia 

Kazakhstan 1999 8.4 992 

Kyrgyz Republic 1997 10.9 659 

Uzbekistan 1996 11.2 673 

South/Southeast Asia 

Bangladesh 1999-2000 14.4 1,884 

Cambodia 2000 14.1 2,873 

India 1998-99 10.1 17,579 

Indonesia 1997 12.1 6,654 

Nepal 1996 14.2 1,656 

Philippines 1998 11.7 2,226 

Latin America/Caribbean 

Bolivia 1998 13.2 1,850 

Brazil 1996 9.6 2,212 

Colombia 1995 10.6 1,821 

Dominican Republic 1996 10.2 1,247 

Guatemala 1995 14.0 2,050 

Haiti 2000 14.0 1,620 

Nicaragua 1998 13.5 2,029 

Peru 2000 12.2 4,897 
92 Appendix A 

Table A.4.16 Initial breastfeeding and median duration of breastfeeding

Percentage of children born in the three years preceding the survey who were ever 

breastfed, and among those, median duration of any breastfeeding, Demographic 

and Health Surveys 1994-2001 

Births in the three years before survey 

Country 

Proportion 

of children

ever 

breastfed 

Median 

duration of 

breastfeeding

(months) Number 

Sub-Saharan Africa 

Benin 1996 97.2 22.8 2,939 

Burkina Faso 1998-99 98.3 25.8 3,622 

Cameroon 1998 97.3 18.1 2,469 

Central African Republic 1994-95 97.9 20.6 2,836 

Chad 1996-97 98.3 21.4 4,450 

Comoros 1996 97.2 20.1 1,145 

Côte d’Ivoire 1994 97.7 20.3 3,989 

Eritrea 1995 98.7 22.0 2,580 

Ethiopia 2000 96.4 25.5 7,167 

Gabon 2000 86.3 12.1 2,482 

Ghana 1998 97.4 21.5 1,927 

Guinea 1999 95.4 22.4 3,427 

Kenya 1998 97.6 20.9 3,464 

Madagascar 1997 97.2 20.7 3,893 

Malawi 2000 98.1 23.3 7,758 

Mali 1995-96 97.5 21.6 6,019 

Mozambique 1997 98.1 22.0 4,207 

Namibia 2000 95.4 18.6 2,459 

Niger 1998 97.9 20.6 5,007 

Rwanda 2000 97.3 22.1 4,822 

Tanzania 1996 97.4 21.5 4,286 

Togo 1998 97.4 24.4 3,978 

Uganda 2000-01 98.3 19.9 4,681 

Zambia 1996 98.3 20.0 4,449 

Zimbabwe 1999 97.8 19.6 2,191 

North Africa/West Asia/Europe 

Egypt 2000 95.5 18.4 7,026 

Jordan 1997 95.0 11.9 3,817 

Turkey 1998 95.2 12.0 2,108 

Yemen 1997 96.8 17.8 7,706 

Central Asia 

Kazakhstan 1999 95.4 14.7 827 

Kyrgyz Republic 1997 95.5 16.9 1,172 

Uzbekistan 1996 96.3 17.3 1,392 

South/Southeast Asia 

Bangladesh 1999-2000 97.3 30.5 4,214 

Cambodia 2000 96.1 21.2 4,657 

India 1998-99 96.5 25.4 32,765 

Indonesia 1997 96.4 23.9 9,768 

Nepal 1996 97.7 31.0 4,375 

Philippines 1998 88.6 12.8 4,566 

Latin America/Caribbean 

Bolivia 1998 96.9 17.5 4,106 

Brazil 1996 93.4 7.0 2,865 

Colombia 1995 95.5 11.3 3,077 

Dominican Republic 1996 92.9 7.6 2,654 

Guatemala 1995 95.9 19.8 5,648 

Haiti 2000 97.8 17.3 3,985 

Nicaragua 1998 93.0 12.2 4,637 

Peru 2000 98.2 20.6 7,013 
Appendix A 93

Table A.4.17 Exclusive breastfeeding

Percentage of youngest children under six months of age living with 

the mother who are exclusively breastfed, Demographic and Health 

Surveys 1994-2001 

Country 

Percentage 

of children 

exclusively 

breastfed Number 

Sub-Saharan Africa 

Benin 1996 10.1 505 

Burkina Faso 1998-99 5.5 639 

Cameroon 1998 12.2 422 

Central African Republic 1994-95 3.0 456 

Chad 1996-97 1.9 808 

Comoros 1996 3.2 186 

Côte d’Ivoire 1994 3.0 663 

Eritrea 1995 58.9 448 

Ethiopia 2000 54.5 1,067 

Gabon 2000 5.2 400 

Ghana 1998 31.5 291 

Guinea 1999 11.2 661 

Kenya 1998 12.6 517 

Madagascar 1997 47.9 662 

Malawi 2000 44.0 1,256 

Mali 1995-96 8.4 1,039 

Mozambique 1997 30.3 757 

Namibia 2000 18.7 408 

Niger 1998 0.8 856 

Rwanda 2000 83.5 773 

Tanzania 1996 29.1 663 

Togo 1998 10.5 657 

Uganda 2000-01 63.4 704 

Zambia 1996 18.8 654 

Zimbabwe 1999 31.9 342 

North Africa/West Asia/Europe 

Egypt 2000 56.6 1,191 

Jordan 1997 11.0 490 

Turkey 1998 7.1 357 

Central Asia 

Kazakhstan 1999 35.8 113 

South/Southeast Asia 

Bangladesh 1999-2000 46.4 763 

Cambodia 2000 11.4 800 

India 1998-99 46.7 5,550 

Indonesia 1997 43.0 1,540 

Nepal 1996 74.9 677 

Philippines 1998 37.5 722 

Latin America/Caribbean 

Bolivia 1998 50.6 600 

Brazil 1996 29.4 433 

Colombia 1995 11.5 435 

Dominican Republic 1996 18.0 384 

Guatemala 1995 46.4 902 

Haiti 2000 23.6 531 

Nicaragua 1998 21.9 716 

Peru 2000 67.2 1,025 
94 Appendix A 

Table A.4.18 Postpartum amenorrhea, abstinence, and insusceptibility

Median number of months of postpartum amenorrhea, postpartum abstinence, and postpartum 

insusceptibility following births in the three years preceding the survey, Demographic and 

Health Surveys 1994-2001 

Country 

Postpartum

amenorrhea 

Postpartum

abstinence 

Postpartum 

insusceptibility 

Number 

of births 

Sub-Saharan Africa 

Benin 1996 13.4 15.8 18.9 2,845 

Burkina Faso 1998-99 15.9 19.2 22.6 3,561 

Cameroon 1998 10.7 11.9 15.5 2,416 

Central African Republic 1994-95 14.1 10.4 16.4 2,807 

Chad 1996-97 15.5 3.7 16.6 4,377 

Comoros 1996 6.5 2.4 8.2 1,116 

Côte d’Ivoire 1994 12.3 11.8 16.6 3,921 

Eritrea 1995 14.2 2.7 16.6 2,556 

Ethiopia 2000 19.0 2.4 19.6 7,091 

Gabon 2000 7.8 9.5 11.7 2,432 

Ghana 1998 10.9 8.5 14.0 1,888 

Guinea 1999 11.6 22.1 22.3 3,355 

Kenya 1998 8.9 3.1 11.1 3,414 

Madagascar 1997 10.9 3.5 12.0 3,856 

Malawi 2000 12.7 5.8 14.5 7,590 

Mali 1995-96 13.6 2.8 14.4 5,931 

Mozambique 1997 13.7 11.6 16.5 4,156 

Namibia 2000 9.7 7.9 18.3 2,426 

Niger 1998 15.8 2.2 16.2 4,923 

Rwanda 2000 14.3 0.6 15.3 4,762 

Tanzania 1996 12.1 5.6 15.7 4,214 

Togo 1998 14.0 13.4 17.8 3,880 

Uganda 2000-01 11.5 2.1 12.2 4,611 

Zambia 1996 11.5 4.7 14.1 4,362 

Zimbabwe 1999 12.4 3.2 15.6 2,159 

North Africa/West Asia/Europe 

Egypt 2000 3.8 1.7 4.0 6,896 

Jordan 1997 3.6 1.7 3.8 3,766 

Turkey 1998 3.3 1.9 4.1 2,078 

Yemen 1997 6.1 1.7 6.4 7,653 

Central Asia 

Kazakhstan 1999 6.2 1.9 6.9 822 

Kyrgyz Republic 1997 6.7 1.7 7.1 1,159 

Uzbekistan 1996 5.3 1.8 5.4 1,379 

South/Southeast Asia 

Bangladesh 1999-2000 7.9 2.0 8.4 4,180 

Cambodia 2000 9.0 3.0 9.6 4,599 

India 1998-99 8.1 3.0 9.5 32,655 

Indonesia 1997 5.7 2.4 7.4 9,685 

Nepal 1996 10.3 3.0 11.3 4,343 

Philippines 1998 4.9 2.3 6.2 4,530 

Latin America/Caribbean 

Bolivia 1998 9.6 2.7 11.0 4,080 

Brazil 1996 3.0 2.2 4.3 2,847 

Colombia 1995 4.3 2.2 5.6 3,059 

Dominican Republic 1996 3.5 2.3 4.3 2,621 

Guatemala 1995 10.5 2.4 11.6 5,609 

Haiti 2000 6.2 2.9 9.4 3,927 

Nicaragua 1998 5.0 2.5 6.4 4,610 

Peru 2000 9.0 2.5 9.9 6,967 
Appendix A 95

Table A.4.19 Current use of contraception

Percentage of currently married women age 15-49 using a contraceptive method (modern, 

traditional, and any method), Demographic and Health Surveys 1994-2001 

Contraceptive use 

Country 

Modern

method 

Traditional

method 

Any 

method Number 

Sub-Saharan Africa 

Benin 1996 3.4 13.0 16.4 4,198 

Burkina Faso 1998-99 4.8 7.0 11.9 5,181 

Cameroon 1998 7.1 12.3 19.3 3,676 

Central African Republic 1994-95 3.2 11.5 14.8 4,083 

Chad 1996-97 1.2 3.0 4.1 5,832 

Comoros 1996 11.4 9.6 21.0 1,634 

Côte d’Ivoire 1994 4.3 7.1 11.4 5,271 

Eritrea 1995 4.0 4.0 8.0 3,371 

Ethiopia 2000 6.3 1.7 8.1 9,789 

Gabon 2000 13.4 19.4 32.7 3,348 

Ghana 1998 13.3 8.7 22.0 3,131 

Guinea 1999 4.2 2.0 6.2 5,561 

Kenya 1998 31.5 7.5 39.0 4,834 

Madagascar 1997 9.7 9.7 19.4 4,435 

Malawi 2000 26.1 4.5 30.6 9,452 

Mali 1995-96 4.5 2.2 6.7 8,222 

Mozambique 1997 5.1 0.5 5.6 6,530 

Namibia 2000 42.6 1.1 43.7 2,610 

Niger 1998 4.6 3.6 8.2 6,382 

Rwanda 2000 5.7 7.6 13.2 5,052 

Tanzania 1996 13.3 5.1 18.4 5,411 

Togo 1998 7.0 16.5 23.5 5,819 

Uganda 2000-01 18.2 4.6 22.8 4,881 

Zambia 1996 14.4 11.5 25.9 4,902 

Zimbabwe 1999 50.4 3.2 53.5 3,609 

North Africa/West Asia/Europe 

Egypt 2000 53.9 2.2 56.1 14,382 

Jordan 1997 37.7 14.9 52.6 5,337 

Turkey 1998 37.7 26.1 63.9 5,921 

Yemen 1997 9.8 11.0 20.8 9,786 

Central Asia 

Kazakhstan 1999 52.8 13.3 66.1 3,018 

Kyrgyz Republic 1997 48.9 10.7 59.5 2,675 

Uzbekistan 1996 51.3 4.3 55.6 3,102 

South/Southeast Asia 

Bangladesh 1999-2000 43.4 10.3 53.8 9,720 

Cambodia 2000 18.8 5.0 23.8 9,071 

India 1998-99 42.8 5.4 48.2 84,682 

Indonesia 1997 54.7 2.7 57.4 26,886 

Nepal 1996 26.0 2.5 28.5 7,982 

Philippines 1998 28.2 19.6 47.8 8,336 

Latin America 

Bolivia 1998 25.2 23.1 48.3 6,649 

Brazil 1996 70.3 6.5 76.7 7,584 

Colombia 1995 59.3 12.9 72.2 6,097 

Dominican Republic 1996 59.2 4.4 63.7 4,983 

Guatemala 1995 26.9 4.5 31.4 7,984 

Haiti 2000 22.8 5.2 28.1 5,958 

Nicaragua 1998 57.4 3.0 60.3 8,045 

Peru 2000 50.4 18.5 68.9 15,628 

Note: Modern method = female sterilization, pill, IUD, injectables, implants, male 

condom, female condom, diaphragm (where used), foam/jelly, and/or lactational 

amenorrhea method (LAM). Traditional method = periodic abstinence, withdrawal, and/or 

folk methods. 
96 Appendix A 

Table A.4.20 Unmet need for family planning or child spacing

Percentage of currently married women age 15-49 with unmet 

need for family planning or child spacing, Demographic and Health 

Surveys 1994-2001 

Country 

Unmet 

need Number 

Sub-Saharan Africa 

Benin 1996 25.7 4,198 

Burkina Faso 1998-99 25.8 5,181 

Cameroon 1998 19.7 3,676 

Central African Republic 1994-95 16.2 4,083 

Chad 1996-97 9.7 5,832 

Comoros 1996 34.6 1,634 

Côte d’Ivoire 1994 27.1 5,271 

Eritrea 1995 27.5 3,371 

Ethiopia 2000 35.2 9,789 

Gabon 2000 28.0 3,348 

Ghana 1998 33.5 3,131 

Guinea 1999 24.2 5,561 

Kenya 1998 23.9 4,834 

Madagascar 1997 25.6 4,435 

Malawi 2000 29.7 9,452 

Mali 1995-96 25.7 8,222 

Mozambique 1997 22.5 6,530 

Namibia 2000 22.1 2,610 

Niger 1998 16.6 6,382 

Rwanda 2000 35.6 5,052 

Tanzania 1996 23.9 5,411 

Togo 1998 32.3 5,819 

Uganda 2000-01 34.6 4,881 

Zambia 1996 26.5 4,902 

Zimbabwe 1999 12.9 3,609 

North Africa/West Asia/Europe 

Egypt 2000 10.7 14,382 

Jordan 1997 14.2 5,337 

Turkey 1998 10.1 5,921 

Yemen 1997 38.6 9,786 

Central Asia 

Kazakhstan 1999 8.7 3,018 

Kyrgyz Republic 1997 11.6 2,675 

Uzbekistan 1996 13.7 3,102 

South/Southeast Asia 

Bangladesh 1999-2000 15.3 9,720 

Cambodia 2000 29.7 9,071 

India 1998-99 15.8 84,682 

Indonesia 1997 9.2 26,886 

Nepal 1996 31.4 7,982 

Philippines 1998 18.8 8,336 

Continued... 
Appendix A 97

Table A.4.20—Continued

Percentage of currently married women age 15-49 with unmet 

need for family planning or child spacing, Demographic and Health 

Surveys 1994-2001 

Country 

Unmet 

need Number 

Latin America/Caribbean 

Bolivia 1998 26.1 6,649 

Brazil 1996 7.3 7,584 

Colombia 1995 7.7 6,097 

Dominican Republic 1996 12.5 4,983 

Guatemala 1995 24.3 7,984 

Haiti 2000 39.6 5,958 

Nicaragua 1998 14.7 8,045 

Peru 2000 10.2 15,628 

Note: Unmet need for child spacing includes pregnant women 

whose pregnancy was mistimed, amenorrheic women who are not 

using family planning and whose last birth was mistimed, and 

fecund women who are neither pregnant nor amenorrheic and 

who are not using any method of family planning and say that they 

want to wait two or more years for their next birth. Unmet need 

for child spacing also refers to fecund women who are not using 

any method of family planning and say that they are unsure 

whether they want another child or who want another child but are 

unsure when to have the birth, unless they say it would not be a 

problem if they discovered they were pregnant in the next few 

weeks. Unmet need also includes those who are limiting the 

number of children and thereby refers to pregnant women whose 

pregnancy was unwanted, amenorrheic women whose last child 

was unwanted, and fecund women who are neither pregnant nor 

amenorrheic and who are not using any method of family planning 

and who want no more children. Excluded from the unmet need 

category are pregnant and amenorrheic women who became 

pregnant while using a method (these women are in need of a 

better method of contraception). 
98 Appendix A 

Table A.4.21 Antenatal care

Among women age 15-49 who had a live birth in the three years preceding the survey, percentage who had at least one antenatal care visit 

with a trained medical professional (doctor, nurse/midwife) for the most recent birth and percentage who had at least four antenatal care visits 

with a trained medical professional for the most recent birth, by urban-rural residence, and percentage of women who received at least one 

tetanus toxoid (TT) injection for the most recent birth, Demographic and Health Surveys 1994-2001 

Percentage of 

women who 

received at least 

one tetanus toxoid 

injection for their 

most recent birth 

Percentage of women who had 

at least one antenatal visit with a 

trained medical professional for 

most recent birth 

Percentage of women who had at 

least four antenatal visits with a 

trained medical professional for 

most recent birth 

Country Urban Rural All Number Urban Rural All Number 

TT 

injection Number 

Sub-Saharan Africa 

Benin 1996 88.2 76.8 80.5 2,564 63.2 49.5 53.9 2,564 72.5 2,572 

Burkina Faso 1998-99 95.6 58.7 62.5 3,265 33.8 21.9 23.1 3,265 54.4 3,272 

Cameroon 1998 92.5 74.3 79.1 2,101 68.6 48.1 53.5 2,101 71.1 2,119 

Central African Republic 1994-95 89.7 50.1 66.1 2,381 52.8 24.2 35.8 2,381 68.6 2,442 

Chad 1996-97 67.9 22.9 32.6 3,828 36.3 7.5 13.7 3,828 31.8 3,831 

Comoros 1996 91.4 81.2 83.7 906 63.8 48.9 52.5 906 56.9 927 

Côte d’Ivoire 1994 96.3 76.5 83.3 3,531 40.9 22.3 28.6 3,531 75.0 3,543 

Eritrea 1995 87.2 40.5 50.3 2,193 67.6 16.3 27.1 2,193 34.8 2,178 

Ethiopia 2000 63.2 21.8 26.0 6,318 41.1 6.0 9.6 6,318 26.1 6,296 

Gabon 2000 98.1 86.2 94.9 2,103 70.5 43.6 63.3 2,103 80.5 2,102 

Ghana 1998 94.0 87.3 89.0 1,714 79.5 56.5 62.2 1,714 81.7 1,726 

Guinea 1999 95.2 67.5 74.6 2,989 73.5 41.3 49.6 2,989 72.9 3,061 

Kenya 1998 95.9 91.5 92.3 2,945 70.0 58.4 60.6 2,945 90.4 2,991 

Madagascar 1997 84.4 75.6 77.4 3,247 49.8 34.8 37.8 3,247 49.7 3,276 

Malawi 2000 98.2 91.5 92.4 6,680 68.5 52.3 54.4 6,680 80.8 6,721 

Mali 1995-96 80.2 34.5 46.2 5,021 54.8 16.5 26.2 5,021 51.8 5,140 

Mozambique 1997 95.2 63.5 69.8 3,522 70.3 33.3 40.7 3,522 34.5 3,751 

Namibia 2000 96.8 87.4 90.6 2,053 81.9 67.7 72.6 2,053 u u 

Niger 1998 90.2 30.3 39.9 4,226 35.3 7.0 11.5 4,226 34.7 4,224 

Rwanda 2000 94.5 92.1 92.5 4,058 19.0 8.4 10.0 4,058 64.7 4,048 

Tanzania 1996 97.1 88.7 90.2 3,605 78.4 64.4 66.9 3,605 92.9 3,723 

Togo 1998 95.7 78.7 82.7 3,537 65.5 41.7 47.3 3,537 62.0 3,547 

Uganda 2000-01 96.7 91.7 92.3 3,774 66.8 37.2 40.5 3,774 68.8 3,883 

Zambia 1996 99.1 92.7 95.1 3725 80.7 64.2 70.5 3,725 83.6 3,771 

Zimbabwe 1999 93.3 91.5 92.1 1,768 73.3 71.4 72.0 1,768 81.6 1,958 

North Africa/West Asia/Europe 

Egypt 2000 71.8 46.3 56.1 5,784 61.6 30.8 42.5 5,784 73.1 5,976 

Jordan 1997 97.0 93.3 96.3 2,954 88.3 79.0 86.6 2,954 37.6 2,932 

Turkey 1998 80.5 56.9 72.0 1,843 54.9 30.6 46.1 1,843 45.5 1,828 

Yemen 1997 63.0 28.1 36.0 6,065 32.1 6.1 11.9 6,065 17.4 6,079 

Central 

Kazakhstan 1999 91.3 92.5 91.9 640 80.8 78.4 79.4 640 u u 

Kyrgyz Republic 1997 98.3 96.9 97.2 928 95.8 88.1 89.8 928 u u 

Uzbekistan 1996 96.1 93.5 94.3 1,133 88.3 81.8 83.8 1,133 u u 

South/Southeast Asia 

Bangladesh 1999-2000 59.7 29.5 34.5 3,813 29.6 6.2 10.1 3,813 81.0 3,822 

Cambodia 2000 59.2 34.5 37.8 4,048 23.5 6.2 8.5 4,048 46.2 4,061 

India 1998-99 86.9 60.1 66.0 28,605 55.8 22.7 30.0 28,605 76.0 28,578 

Indonesia 1997 97.4 88.5 90.9 8,984 87.8 64.9 71.2 8,984 74.3 8,914 

Nepal 1996 68.5 36.9 39.0 3,706 37.0 7.0 9.0 3,706 46.5 3,801 

Philippines 1998 94.0 81.8 87.5 3,727 74.8 48.1 60.7 3,727 66.0 3,706 

Latin America/Caribbean 

Bolivia 1998 82.5 54.1 70.6 3,485 64.9 29.4 50.1 3,485 49.2 3,432 

Brazil 1996 93.8 73.2 89.1 2,462 87.2 58.3 80.6 2,462 61.6 2,427 

Colombia 1995 91.1 72.6 84.9 2,679 82.1 53.5 72.5 2,679 81.1 2,673 

Dominican Republic 1996 99.3 97.4 98.5 2,233 90.6 83.9 87.9 2,233 96.3 2,230 

Guatemala 1995 73.8 44.4 54.1 4,607 63.0 33.7 43.3 4,607 53.8 4,576 

Haiti 2000 89.3 73.8 79.0 3,353 59.7 33.4 42.2 3,353 69.3 3,363 

Nicaragua 1998 92.3 76.9 85.2 3,953 74.8 51.6 64.1 3,935 87.1 3,929 

Peru 2000 53.6 45.0 49.9 6,350 47.8 31.1 40.4 6,350 74.5 6,294 

u = Unknown (question not asked) 
Appendix A 99

Table A.4.22 Delivery care

Among women age 15-49 who had a live birth in the three years preceding the survey, 

percentge who received assistance during delivery from a trained medical professional for 

the most recent birth, by urban-rural residence, Demographic and Health Surveys 1994-

2001 

Percentage of women who 

received assistance during 

delivery from a trained 

medical professional 

Country Urban Rural Total Number 

Sub-Saharan Africa 

Benin 1996 79.4 56.2 63.7 2,597 

Burkina Faso 1998-99 90.7 24.8 32.3 4,099 

Cameroon 1998 84.6 49.3 58.8 2,148 

Central African Republic 1994-95 77.6 22.8 45.0 2,446 

Chad 1996-97 45.2 6.3 14.8 4,608 

Comoros 1996 78.5 43.8 52.2 934 

Côte d’Ivoire 1994 76.4 29.6 45.6 3,556 

Eritrea 1995 63.5 9.6 20.9 2,202 

Ethiopia 2000 36.8 2.2 6.2 7,978 

Gabon 2000 93.4 69.1 87.5 2,766 

Ghana 1998 77.9 34.9 46.1 2,311 

Guinea 1999 76.2 22.0 36.3 4,043 

Kenya 1998 71.8 38.0 44.2 3,007 

Madagascar 1997 69.0 42.0 47.5 3,305 

Malawi 2000 82.2 52.2 56.2 8,057 

Mali 1995-96 78.9 24.9 38.9 5,175 

Mozambique 1997 81.7 34.1 44.1 3,822 

Namibia 2000 93.9 68.2 77.7 3,002 

Niger 1998 69.1 8.1 17.9 4,242 

Rwanda 2000 65.0 19.0 25.7 5,141 

Tanzania 1996 82.2 39.3 47.9 4,577 

Togo 1998 87.1 40.3 51.4 3,592 

Uganda 2000-01 81.8 34.7 40.6 4,489 

Zambia 1996 77.1 26.4 47.2 4,564 

Zimbabwe 1999 90.3 66.1 74.5 2,770 

North Africa/West Asia/Europe 

Egypt 2000 82.9 49.7 63.1 7,953 

Jordan 1997 98.1 92.9 97.2 3,672 

Turkey 1998 90.0 73.5 84.2 2,617 

Yemen 1997 49.0 15.0 23.1 7,343 

Central Asia 

Kazakhstan 1999 98.2 99.6 99.0 1,129 

Kyrgyz Republic 1997 99.2 97.7 98.0 1,025 

Uzbekistan 1996 100.0 96.0 97.3 1,213 

South/Southeast Asia 

Bangladesh 1999-2000 34.6 8.5 13.0 5,263 

Cambodia 2000 62.0 30.1 34.4 5,714 

India 1998-99 74.2 33.7 42.6 28,779 

Indonesia 1997 80.0 38.9 50.1 13,170 

Nepal 1996 48.1 6.8 9.5 3,813 

Philippines 1998 80.2 40.1 59.3 4,968 

Latin America/Caribbean 

Bolivia 1998 80.5 35.2 62.8 4,616 

Brazil 1996 94.0 79.1 90.6 3,635 

Colombia 1995 94.2 73.3 87.4 3,771 

Dominican Republic 1996 98.3 92.9 96.2 3,067 

Guatemala 1995 68.6 24.8 40.1 5,679 

Haiti 2000 54.0 12.5 27.1 4,254 

Nicaragua 1998 86.9 49.1 70.1 5,593 

Peru 2000 71.8 23.3 51.6 9,535 
100 Appendix A 

Table A.4.23 Knowledge of HIV/AIDS prevention methods

Percentage of women age 15-49 who have heard about HIV/AIDS, and of those, percentage who know that people 

can reduce the risk of getting the AIDS virus by abstaining from sex, by having sex with just one partner who has no 

other partners, and by using condoms, Demographic and Health Surveys 1994-2001 

Women’s knowledge 

of HIV/AIDS 

Of those who have heard about HIV/AIDS, 

percentage who know specific 

preventive measures 

Country 

Percentage

who have 

heard 

about 

HIV/AIDS Number 

Abstain 

from sex 

Limit sex to 

one 

uninfected 

sex partner 

Use 

condoms Number 

Sub-Saharan Africa 

Benin 1996 81.7 5,491 6.1 43.8 26.9 4,488 

Burkina Faso 1998-99 87.2 6,444 6.7 48.7 23.9 5,619 

Cameroon 1998 89.7 5,501 12.5 38.6 40.6 4,936 

Central African Republic 1994-95 92.9 5,884 15.7 49.3 31.4 5,466 

Chad 1996-97 60.0 7,454 15.8 45.2 11.1 4,470 

Comoros 1996 97.9 3,050 1.2 35.9 35.6 2,985 

Côte d’Ivoire 1994 93.2 8,099 4.8 62.5 32.8 7,549 

Eritrea 1995 72.2 5,053 22.4 47.3 34.6 3,649 

Ethiopia 2000 84.7 15,363 12.7 62.1 20.2 13,010 

Gabon 2000 97.7 6,182 19.2 27.1 71.2 6,040 

Ghana 1998 96.7 4,843 6.9 63.3 22.1 4,683 

Guinea 1999 94.9 6,751 28.3 68.0 23.2 6,409 

Kenya 1998 99.0 7,880 27.9 33.2 37.5 7,804 

Madagascar 1997 69.1 7,046 4.0 38.0 27.2 4,867 

Malawi 2000 98.9 13,220 67.9 24.2 55.2 13,076 

Mali 1995-96 76.7 9,704 12.4 23.8 24.3 7,443 

Mozambique 1997 82.3 8,772 1.1 27.5 15.4 7,220 

Namibia 2000 98.1 6,752 35.4 31.6 82.5 6,626 

Niger 1998 54.6 7,575 12.8 22.8 21.4 4,136 

Rwanda 2000 99.7 10,419 76.5 21.2 37.1 10,384 

Tanzania 1996 97.0 8,118 15.0 24.6 39.3 7,876 

Togo 1998 95.6 8,566 7.8 38.2 34.4 8,186 

Uganda 2000-01 99.8 7,244 49.8 49.1 54.6 7,227 

Zambia 1996 99.6 8,021 28.6 48.7 38.4 7,986 

Zimbabwe 1999 96.5 5,907 17.4 59.9 68.1 5,698 

North Africa/West Asia/Europe 

Jordan 1997 97.9 5,548 13.3 30.5 0.3 5,430 

Turkey 1998 84.3 8,573 5.9 16.9 15.2 7,226 

Central Asia 

Kazakhstan 1999 97.7 4,800 14.4 49.4 36.9 4,688 

South/Southeast Asia 

Bangladesh 1999-2000 30.8 10,543 7.5 6.1 15.5 3,245 

Cambodia 2000 94.9 15,348 24.2 37.4 69.9 14,559 

India 1998-99 40.3 89,197 6.7 40.0 19.8 36,417 

Indonesia 1997 51.5 28,810 0.6 29.1 3.9 14,835 

Nepal 1996 26.9 8,420 13.4 52.6 30.9 2,263 

Latin America/Caribbean 

Bolivia 1998 78.8 11,185 12.7 55.9 45.7 8,809 

Brazil 1996 99.6 12,611 3.1 8.7 80.8 12,558 

Colombia 1995 98.8 11,140 5.3 50.4 71.7 11,010 

Dominican Republic 1996 99.7 8,422 77.8 88.9 81.0 8,394 

Guatemala 1995 71.1 12,394 14.1 23.8 29.9 8,811 

Haiti 2000 98.0 5,125 11.5 32.7 40.3 5,021 

Nicaragua 1998 95.6 13,631 8.8 24.8 56.2 13,033 

Peru 2000 87.3 27,843 12.6 31.5 38.1 24,308 
Appendix A 101

Table A.4.24 Urban-rural residence

Percentage of women age 15-49 living in urban and rural areas, 

Demographic and Health Surveys 1994-2001 

Country Urban Rural Number 

Sub-Saharan Africa 

Benin 1996 39.7 60.3 5,685 

Burkina Faso 1998-99 16.9 83.1 6,763 

Cameroon 1998 35.3 64.7 5,617 

Central African Republic 1994-95 42.6 57.4 6,077 

Chad 1996-97 23.1 76.9 7,742 

Comoros 1996 29.6 70.4 3,163 

Côte d’Ivoire 1994 42.1 57.9 8,250 

Eritrea 1995 32.6 67.4 5,019 

Ethiopia 2000 18.2 81.8 15,542 

Gabon 2000 80.2 19.8 7,091 

Ghana 1998 35.9 64.1 4,865 

Guinea 1999 32.2 67.8 7,042 

Kenya 1998 23.2 76.8 8,136 

Madagascar 1997 28.1 71.9 7,400 

Malawi 2000 16.1 83.9 13,397 

Mali 1995-96 31.7 68.3 9,923 

Mozambique 1997 23.7 76.3 9,387 

Namibia 2000 41.2 58.8 7,592 

Niger 1998 20.4 79.6 7,580 

Rwanda 2000 17.1 82.9 10,279 

Tanzania 1996 23.3 76.7 8,514 

Togo 1998 37.5 62.5 8,509 

Uganda 2000-01 16.7 83.3 7,572 

Zambia 1996 44.9 55.1 8,568 

Zimbabwe 1999 38.6 61.4 6,082 

North Africa/West Asia/Eruope 

Egypt 2000 45.9 54.1 22,827 

Jordan 1997 83.2 16.8 10,507 

Turkey 1998 66.5 33.5 9,262 

Yemen 1997 27.9 72.1 15,446 

Central Asia 

Kazakhstan 1999 49.0 51.0 5,192 

Kyrgyz Republic 1997 33.5 66.5 4,042 

Uzbekistan 1996 41.4 58.6 4,519 

South/Southeast Asia 

Bangladesh 1999-2000 21.0 79.0 12,905 

Cambodia 2000 17.6 82.4 15,736 

India 1998-99 28.4 71.6 122,217 

Indonesia 1997 32.5 67.5 39,121 

Nepal 1996 9.2 90.8 10,328 

Philippines 1998 56.7 43.3 14,847 

Latin America/Caribbean 

Bolivia 1998 71.4 28.6 12,124 

Brazil 1996 82.3 17.7 14,345 

Colombia 1995 74.6 25.4 12,072 

Dominican Republic 1996 67.1 32.9 9,401 

Guatemala 1995 43.9 56.1 13,668 

Haiti 2000 45.9 54.1 10,362 

Nicaragua 1998 65.0 35.0 15,117 

Peru 2000 70.0 30.0 31,099 

Note: The Indonesia and Jordan data are based on de jure household 

populations. 
102 Appendix A 

Table A.4.25 Household amenities

Percentage of women age 15-49 living in houses without electricity, percentage living in houses with dirt floors, 

percentage living in houses without piped water, percentage living without access to toilet facilities, 

Demographic and Health Surveys 1994-2001 

Country 

Percentage

of women 

without 

electricity 

Percentage

of women 

with dirt 

floors 

Percentage

of women 

without 

access to 

piped 

water 

Percentage 

of women 

without 

access to 

toilet 

facilities Number 

Sub-Saharan Africa 

Benin 1996 83.1 44.1 69.4 71.0 5,491 

Burkina Faso 1998-99 91.8 70.5 85.7 74.8 6,445 

Cameroon 1998 54.5 51.9 61.0 8.7 5,501 

Central African Republic 1994-95 95.0 82.0 78.4 26.4 5,884 

Chad 1996-97 97.3 95.6 91.6 72.0 7,454 

Comoros 1996 66.0 45.3 50.9 0.2 3,050 

Côte d’Ivoire 1994 57.6 21.8 51.4 38.5 8,099 

Eritrea 1995 70.5 75.0 73.3 77.2 5,054 

Ethiopia 2000 85.1 90.7 80.8 79.0 15,367 

Gabon 2000 19.4 17.1 21.0 1.7 6,183 

Ghana 1998 55.9 13.8 58.2 21.6 4,843 

Guinea 1999 79.3 51.3 76.6 41.7 6,753 

Kenya 1998 84.4 62.7 67.2 14.6 7,881 

Madagascar 1997 85.9 7.4 79.6 56.8 7,060 

Malawi 2000 93.3 78.4 74.7 16.0 13,220 

Mali 1995-96 89.9 74.2 80.1 25.9 9,704 

Mozambique 1997 88.8 71.9 74.4 59.2 8,779 

Namibia 2000 62.6 52.6 35.0 50.2 6,755 

Niger 1998 90.9 82.6 80.7 78.0 7,577 

Rwanda 2000 91.2 82.3 63.1 3.1 10,421 

Tanzania 1996 88.0 75.4 61.3 12.4 8,120 

Togo 1998 79.9 23.7 58.8 57.6 8,569 

Uganda 2000-01 89.0 77.0 87.7 14.2 7,246 

Zambia 1996 75.7 52.5 58.4 24.6 8,021 

Zimbabwe 1999 60.0 27.5 53.2 24.3 5,907 

North Africa/West Asia/Europe 

Egypt 2000 2.0 21.4 14.2 2.4 15,573 

Jordan 1997 0.7 0.3 5.1 0.4 5,548 

Turkey 1998 0.0 6.9 43.9 1.9 8,576 

Yemen 1997 54.4 41.6 59.9 29.7 10,414 

Central Asia 

Kazakhstan 1999 3.1 1.2 35.6 0.5 4,800 

Kyrgyz Republic 1997 0.2 5.1 27.3 0.1 3,848 

Uzbekistan 1996 0.4 15.4 24.2 0.0 4,415 

South/Southeast Asia 

Bangladesh 1999-2000 66.0 82.9 93.5 18.1 10,544 

Cambodia 2000 79.2 8.2 91.9 75.2 15,351 

India 1998-99 39.5 u 63.2 64.3 90,303 

Indonesia 1997 19.7 21.0 82.0 u 28,810 

Nepal 1996 82.7 91.6 70.2 84.4 8,429 

Philippines 1998 22.4 7.2 47.0 10.2 13,983 

Latin America/Caribbean 

Bolivia 1998 21.3 25.7 20.3 28.8 11,187 

Brazil 1996 5.2 5.0 25.7 9.2 12,612 

Colombia 1995 6.5 9.5 11.9 11.5 11,140 

Dominican Republic 1996 0.0 6.4 48.2 7.5 8,422 

Guatemala 1995 36.0 47.6 34.9 14.6 12,403 

Haiti 2000 56.6 40.6 41.3 34.0 10,159 

Nicaragua 1998 24.7 41.1 29.7 11.7 13,634 

Peru 2000 24.5 37.8 23.7 17.5 27,843 

u = Unknown (question not asked) 
DHS Comparative Reports Series 

1. Westoff, Charles F. 2001. Unmet Need at the End of the Century. 

2. Westoff, Charles F. and Akinrinola Bankole. 2002. Reproductive Preferences in Developing 

Countries at the Turn of the Century. 

3. Rutstein, Shea O. 2002. Fertility Levels, Trends, and Differentials 1995-1999. 

4. Mahy, Mary. 2003. Childhood Mortality in the Developing World: A Review of Evidence from 

the Demographic and Health Surveys. 

5. Westoff, Charles F. 2003. Trends in Marriage and Early Childbearing in Developing Countries. 

6. Rutstein, Shea O. and Kiersten Johnson. 2004. The DHS Wealth Index. 

7. Yoder, P. Stanley, Noureddine Abderrahim, and Arlinda Zhuzhuni. 2004. Female Genital Cutting 

in the Demographic and Health Surveys: A Critical and Comparative Analysis. 

8. Stallings, Rebecca. 2004. Child Morbidity and Treatment Patterns. 

9. Rutstein, Shea O. and Iqbal H. Shah. 2004. Infecundity, Infertility, and Childlessness in 

Developing Countries. 

10. Mukuria, Altrena, Jeanne Cushing, and Jasbir Sangha. 2005. Nutritional Status of Children: Results 

from the Demographic and Health Surveys, 1994–2001. 

11. Mukuria, Altrena, Casey Aboulafia, and Albert Themme. 2005. The Context of Women’s Health: 

Results from the Demographic and Health Surveys, 1994-2001.