Philippines National Demographic and Health Survey 2017 PDF

Philippines National Demographic and Health Survey 2017  Philippines National Demographic and Health Survey 2017 Philippine Statistics Authority Quezon City, Philippines The DHS Program ICF Rockville, Maryland, USA...

Philippines National Demographic and Health Survey 2017  Philippines National Demographic and Health Survey 2017 Philippine Statistics Authority Quezon City, Philippines The DHS Program ICF Rockville, Maryland, USA October 2018 The 2017 Philippines National Demographic and Health Survey (NDHS 2017) was carried out by the Philippine Statistics Authority (PSA). Funding for the NDHS 2017 was provided by the Government of the Philippines. The United States Agency for International Development (USAID) provided technical assistance and equipment through ICF under The DHS Program, which assists countries in the collection of data to monitor and evaluate population, health, and nutrition programs. Since 1993, an NDHS has been implemented in the country approximately every five years under The DHS Program. Additional information about the NDHS 2017 may be obtained from the Philippine Statistics Authority, PSA Complex, East Ave., Diliman, Quezon City; telephone: +63 (02)-462-6600; email: [email protected]; Internet: psa.gov.ph. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1-301-407-6500; fax: +1-301-407-6501; email: [email protected]; Internet: www.DHSprogram.com. Cover photo is provided courtesy of Karen Lakey Isenhower. Recommended citation: Philippine Statistics Authority (PSA) and ICF. 2018. Philippines National Demographic and Health Survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF. CONTENTS TABLES AND FIGURES..........................................................................................................................vii PREFACE................................................................................................................................................... xv ABBREVIATIONS...................................................................................................................................xvii READING AND UNDERSTANDING TABLES FROM THE NDHS 2017........................................ xix SUSTAINABLE DEVELOPMENT GOAL INDICATORS...............................................................xxvii MAP OF THE PHILIPPINES............................................................................................................. xxviii 1 INTRODUCTION AND SURVEY METHODOLOGY.............................................................. 1 1.1 Survey Objectives................................................................................................................ 1 1.2 Sample Design..................................................................................................................... 1 1.3 Questionnaires..................................................................................................................... 2 1.4 Pretest.................................................................................................................................. 3 1.5 Training of Field Staff......................................................................................................... 3 1.6 Fieldwork............................................................................................................................. 3 1.7 Data Processing................................................................................................................... 4 1.8 Response Rates.................................................................................................................... 4 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION................................ 5 2.1 Drinking Water Sources and Treatment.............................................................................. 5 2.2 Sanitation............................................................................................................................. 6 2.3 Exposure to Smoke inside the Home................................................................................... 7 2.4 Household Wealth............................................................................................................... 8 2.5 Handwashing....................................................................................................................... 9 2.6 Household Population and Composition............................................................................. 9 2.7 Birth Registration.............................................................................................................. 10 2.8 Education........................................................................................................................... 10 2.8.1 Educational Attainment....................................................................................... 10 2.8.2 School Attendance............................................................................................... 11 3 CHARACTERISTICS OF RESPONDENTS............................................................................. 27 3.1 Basic Characteristics of Survey Respondents.................................................................... 27 3.2 Education........................................................................................................................... 28 3.3 Mass Media Exposure and Internet Usage........................................................................ 29 3.4 Employment...................................................................................................................... 30 3.5 Occupation......................................................................................................................... 31 3.6 Health Insurance Coverage................................................................................................ 32 3.7 Tobacco Use and Alcohol Consumption........................................................................... 33 3.7.1 Tobacco Use........................................................................................................ 33 3.7.2 Alcohol Consumption.......................................................................................... 33 4 MARRIAGE AND EXPOSURE TO THE RISK OF PREGNANCY...................................... 47 4.1 Marital Status..................................................................................................................... 47 4.2 Age at First Marriage......................................................................................................... 48 4.3 Age at First Menstruation (Menarche).............................................................................. 49 4.4 Age at First Sexual Intercourse......................................................................................... 49 4.5 Recent Sexual Activity...................................................................................................... 50 4.6 Spouses Living Separately................................................................................................. 50 Contents iii  5 FERTILITY................................................................................................................................... 57 5.1 Current Fertility................................................................................................................. 57 5.2 Children Ever Born and Living......................................................................................... 58 5.3 Birth Intervals.................................................................................................................... 59 5.4 Insusceptibility to Pregnancy............................................................................................. 59 5.5 Age at First Birth............................................................................................................... 60 5.6 Childbearing among Teenagers and Youth....................................................................... 61 6 FERTILITY PREFERENCES..................................................................................................... 71 6.1 Desire for Another Child................................................................................................... 71 6.2 Ideal Family Size............................................................................................................... 72 6.3 Fertility Planning Status.................................................................................................... 73 6.4 Wanted Fertility Rates....................................................................................................... 74 6.5 Couples’ Consensus on Family Size.................................................................................. 74 7 FAMILY PLANNING.................................................................................................................. 81 7.1 Contraceptive Knowledge and Use................................................................................... 82 7.2 Source of Modern Contraceptive Methods........................................................................ 83 7.3 Cost of Contraceptive Methods......................................................................................... 84 7.4 Informed Choice................................................................................................................ 84 7.5 Demand for Family Planning............................................................................................ 85 7.6 Contact of Nonusers with Family Planning Providers....................................................... 87 7.7 Attitudes toward Minors’ Use of Contraception................................................................ 87 8 INFANT AND CHILD MORTALITY...................................................................................... 103 8.1 Infant and Child Mortality............................................................................................... 104 8.2 Biodemographic Risk Factors......................................................................................... 104 8.3 Perinatal Mortality........................................................................................................... 106 8.4 High-risk Fertility Behavior............................................................................................ 106 9 MATERNAL HEALTH CARE................................................................................................. 111 9.1 Antenatal Care Coverage................................................................................................. 112 9.1.1 Skilled Providers................................................................................................ 112 9.1.2 Timing and Number of ANC Visits................................................................... 112 9.2 Components of ANC Visits............................................................................................. 113 9.3 Protection against Neonatal Tetanus............................................................................... 113 9.4 Problems Experienced during Pregnancy and Delivery.................................................. 114 9.5 Delivery Services............................................................................................................. 114 9.5.1 Institutional Deliveries....................................................................................... 114 9.5.2 Skilled Assistance during Delivery.................................................................... 115 9.5.3 Delivery by Caesarean....................................................................................... 116 9.6 Postnatal Care.................................................................................................................. 117 9.6.1 Postnatal Health Check for Mothers.................................................................. 117 9.6.2 Postnatal Health Check for Newborns............................................................... 117 9.7 Problems in Accessing Health Care................................................................................ 118 10 CHILD HEALTH........................................................................................................................ 137 10.1 Birth Weight.................................................................................................................... 137 10.2 Vaccination of Children................................................................................................... 138 10.3 Symptoms of Acute Respiratory Infection...................................................................... 141 10.4 Fever................................................................................................................................ 142 10.5 Diarrheal Disease............................................................................................................. 142 iv Contents  10.5.1 Prevalence of Diarrhea and Treatment-seeking Behavior.................................. 142 10.5.2 Feeding Practices............................................................................................... 142 10.5.3 Oral Rehydration Therapy and Other Treatments.............................................. 143 10.6 Treatment of Childhood Illness: Summary...................................................................... 144 10.7 Disposal of Children’s Stools.......................................................................................... 144 11 BREASTFEEDING, COMPLEMENTARY FEEDING, AND MICRONUTRIENT SUPPLEMENTATION.............................................................................................................. 161 11.1 Infant and Young Child Feeding..................................................................................... 161 11.1.1 Initiation of Breastfeeding................................................................................. 162 11.1.2 Breastfeeding Status and Complementary Feeding by Age............................... 163 11.1.3 Duration of Breastfeeding.................................................................................. 164 11.2 Micronutrient Intake and Supplementation among Children........................................... 164 11.3 Micronutrient Intake among Mothers.............................................................................. 165 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR.......................... 173 12.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods.................................... 173 12.2 Knowledge about Mother-to-Child Transmission........................................................... 175 12.3 Discriminatory Attitudes towards People Living with HIV............................................ 175 12.4 Multiple Sexual Partners................................................................................................. 176 12.5 Coverage of HIV Testing Services.................................................................................. 176 12.5.1 Awareness of HIV Testing Services and Experience with HIV Testing........... 176 12.6 HIV/AIDS-Related Knowledge and Behavior among Young People............................. 177 12.6.1 Knowledge......................................................................................................... 177 12.6.2 First Sex............................................................................................................. 178 12.6.3 Premarital Sex.................................................................................................... 178 12.6.4 Multiple Sexual Partners.................................................................................... 178 12.6.5 Coverage of HIV Testing Services.................................................................... 178 13 HEALTH CARE UTILIZATION AND FINANCING............................................................ 189 13.1 Health Insurance.............................................................................................................. 189 13.1.1 Health Insurance Coverage................................................................................ 190 13.1.2 PhilHealth Insurance Coverage.......................................................................... 190 13.2 Recent Health Care Treatment........................................................................................ 191 13.3 Hospital Care................................................................................................................... 191 13.4 Cost of Treatment............................................................................................................ 192 14 WOMEN’S EMPOWERMENT................................................................................................ 201 14.1 Married Women’s Employment...................................................................................... 202 14.2 Control over Women’s Earnings..................................................................................... 202 14.3 Control over Men’s Earnings.......................................................................................... 203 14.4 Women’s Ownership of Assets....................................................................................... 203 14.5 Bank Accounts and Mobile Phones................................................................................. 204 14.6 Women’s Participation in Decision Making.................................................................... 204 14.7 Attitudes towards Wife Beating...................................................................................... 205 14.8 Negotiating Sexual Relations.......................................................................................... 206 15 VIOLENCE AGAINST WOMEN............................................................................................. 219 15.1 Measurement of Violence................................................................................................ 220 15.2 Women’s Experience of Physical Violence.................................................................... 220 15.2.1 Perpetrators of Physical Violence...................................................................... 221 15.3 Experience of Sexual Violence........................................................................................ 221 Contents v  15.3.1 Prevalence of Sexual Violence.......................................................................... 221 15.3.2 Perpetrators of Sexual Violence......................................................................... 222 15.4 Experience of Different Forms of Violence.................................................................... 222 15.5 Marital Control by Husband/Partner............................................................................... 222 15.6 Forms of Spousal Violence.............................................................................................. 223 15.6.1 Prevalence of Spousal Violence......................................................................... 223 15.7 Injuries to Women due to Spousal Violence................................................................... 225 15.8 Violence Initiated by Women against Husbands............................................................. 225 15.9 Help Seeking among Women Who Have Experienced Violence.................................... 226 15.9.1 Sources for Help................................................................................................ 226 REFERENCES......................................................................................................................................... 251 APPENDIX A SAMPLE DESIGN........................................................................................................ 253 A.1 Introduction..................................................................................................................... 253 A.2 Sample Frame.................................................................................................................. 253 A.3 Sample Design and Implementation................................................................................ 256 A.4 Sample Probabilities and Sampling Weights................................................................... 259 APPENDIX B ESTIMATES OF SAMPLING ERRORS................................................................... 261 APPENDIX C DATA QUALITY TABLES......................................................................................... 285 APPENDIX D PERSONS INVOLVED IN THE NATIONAL DEMOGRAPHIC AND HEALTH SURVEY (NDHS) 2017............................................................................... 289 APPENDIX E QUESTIONNAIRES..................................................................................................... 299 vi Contents TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY.............................................................. 1 Table 1.1 Results of the household and individual interviews............................................... 4 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION................................ 5 Table 2.1 Household drinking water.................................................................................... 13 Table 2.2 Drinking water source according to region and wealth........................................ 14 Table 2.3 Availability of water............................................................................................ 14 Table 2.4 Household sanitation facilities............................................................................. 15 Table 2.5 Sanitation facility type according to region and wealth....................................... 16 Table 2.6 Sanitation facility waste removal......................................................................... 17 Table 2.7 Household characteristics.................................................................................... 18 Table 2.8 Tenure status of housing unit............................................................................... 19 Table 2.9 Household possessions......................................................................................... 20 Table 2.10 Wealth quintiles................................................................................................... 20 Table 2.11 Handwashing....................................................................................................... 21 Table 2.12 Household population by age, sex, and residence................................................ 22 Table 2.13 Household composition....................................................................................... 22 Table 2.14 Birth registration of children under age 5............................................................ 23 Table 2.15.1 Educational attainment of the female household population............................... 24 Table 2.15.2 Educational attainment of the male household population.................................. 25 Table 2.16 School attendance ratios...................................................................................... 26 Figure 2.1 Household drinking water by residence................................................................. 6 Figure 2.2 Household toilet facilities by residence................................................................. 7 Figure 2.3 Household wealth by residence.............................................................................. 8 Figure 2.4 Population pyramid................................................................................................ 9 Figure 2.5 Birth registration by household wealth................................................................ 10 Figure 2.6 Secondary school attendance by household wealth............................................. 12 3 CHARACTERISTICS OF RESPONDENTS............................................................................. 27 Table 3.1 Background characteristics of respondents.......................................................... 35 Table 3.2 Residence characteristics of respondents............................................................. 36 Table 3.3 Educational attainment......................................................................................... 36 Table 3.4 Exposure to mass media....................................................................................... 37 Table 3.5 Internet usage....................................................................................................... 38 Table 3.6 Employment status............................................................................................... 39 Table 3.7 Occupation........................................................................................................... 40 Table 3.8 Type of employment............................................................................................ 41 Table 3.9 Health insurance coverage................................................................................... 42 Table 3.10 Tobacco smoking................................................................................................. 43 Table 3.11 Smokeless tobacco use and any tobacco use........................................................ 44 Table 3.12 Alcohol consumption........................................................................................... 45 Figure 3.1 Education by residence........................................................................................ 28 Figure 3.2 Trends in education.............................................................................................. 28 Figure 3.3 Complete secondary education complete or higher by region............................. 29 Figure 3.4 Exposure to mass media....................................................................................... 30 Tables and Figures vii  Figure 3.5 Occupation by residence...................................................................................... 31 Figure 3.6 Health insurance coverage by residence.............................................................. 32 Figure 3.7 Health insurance coverage by household wealth................................................. 32 4 MARRIAGE AND EXPOSURE TO THE RISK OF PREGNANCY...................................... 47 Table 4.1 Current marital status........................................................................................... 52 Table 4.2 Age at first marriage............................................................................................ 52 Table 4.3 Median age at first marriage by background characteristics................................ 53 Table 4.4 Age at first menstruation...................................................................................... 53 Table 4.5 Age at first sexual intercourse.............................................................................. 54 Table 4.6 Median age at first sexual intercourse according to background characteristics. 54 Table 4.7 Recent sexual activity.......................................................................................... 55 Table 4.8 Spousal separations.............................................................................................. 56 Figure 4.1 Marital status........................................................................................................ 48 Figure 4.2 Trends in early sexual intercourse and marriage.................................................. 48 Figure 4.3 Women’s median age at first marriage by residence........................................... 48 Figure 4.4 Median age at first sex and first marriage............................................................ 49 5 FERTILITY................................................................................................................................... 57 Table 5.1 Current fertility.................................................................................................... 63 Table 5.2 Fertility by background characteristics................................................................ 63 Table 5.3.1 Trends in age-specific fertility rates..................................................................... 64 Table 5.3.2 Trends in age-specific and total fertility rates...................................................... 64 Table 5.4 Children ever born and living.............................................................................. 64 Table 5.5 Birth intervals...................................................................................................... 65 Table 5.6 Postpartum amenorrhea, abstinence, and insusceptibility.................................... 66 Table 5.7 Median duration of amenorrhea, postpartum abstinence, and postpartum insusceptibility..................................................................................................... 67 Table 5.8 Menopause........................................................................................................... 67 Table 5.9 Age at first birth................................................................................................... 68 Table 5.10 Median age at first birth....................................................................................... 68 Table 5.11 Teenage pregnancy and motherhood................................................................... 69 Table 5.12 Sexual and reproductive health behaviors before age 15..................................... 69 Table 5.13 Early pregnancy and motherhood........................................................................ 70 Figure 5.1 Trends in fertility by residence............................................................................ 58 Figure 5.2 Fertility by region................................................................................................ 58 Figure 5.3 Fertility by household wealth............................................................................... 58 Figure 5.4 Median age at first birth by residence.................................................................. 61 Figure 5.5 Teenage pregnancy and motherhood by region................................................... 61 Figure 5.6 Teenage and youth pregnancy and motherhood by household wealth................. 62 6 FERTILITY PREFERENCES..................................................................................................... 71 Table 6.1 Fertility preferences by number of living children.............................................. 75 Table 6.2 Fertility preferences according to age.................................................................. 76 Table 6.3 Desire to limit childbearing................................................................................. 76 Table 6.4 Ideal number of children by number of living children....................................... 77 Table 6.5 Ideal number of children by background characteristics..................................... 77 Table 6.6 Fertility planning status........................................................................................ 78 Table 6.7 Wanted fertility rates............................................................................................ 78 Table 6.8 Couples’ consensus on family size...................................................................... 79 viii Tables and Figures  Figure 6.1 Desire to limit childbearing by number of living children................................... 72 Figure 6.2 Ideal family size by number of living children.................................................... 73 Figure 6.3 Fertility planning status........................................................................................ 73 Figure 6.4 Trends in wanted and actual fertility.................................................................... 74 7 FAMILY PLANNING.................................................................................................................. 81 Table 7.1 Knowledge of contraceptive methods.................................................................. 88 Table 7.2 Knowledge of contraceptive methods according to background characteristics.. 89 Table 7.3 Current use of contraception by age.................................................................... 90 Table 7.4.1 Trends in current use of contraception................................................................. 91 Table 7.4.2 Current use of contraception according to background characteristics................ 92 Table 7.5 Timing of sterilization.......................................................................................... 93 Table 7.6 Knowledge of fertile period................................................................................. 93 Table 7.7 Knowledge of fertile period by age...................................................................... 93 Table 7.8 Source of modern contraceptive methods............................................................ 94 Table 7.9 Cost of modern contraceptive methods................................................................ 95 Table 7.10 Informed choice................................................................................................... 96 Table 7.11.1 Need and demand for family planning among currently married women........... 97 Table 7.11.2 Need and demand for family planning among all women and among sexually active unmarried women...................................................................................... 98 Table 7.12 Decision making about family planning.............................................................. 99 Table 7.13 Future use of contraception................................................................................ 100 Table 7.14 Exposure to family planning messages.............................................................. 100 Table 7.15 Contact of nonusers with family planning providers......................................... 101 Table 7.16 Attitude toward minors’ use of contraception.................................................... 102 Figure 7.1 Contraceptive use................................................................................................. 82 Figure 7.2 Trends in contraceptive use................................................................................. 83 Figure 7.3 Modern contraceptive use by region.................................................................... 83 Figure 7.4 Source of modern contraceptive methods............................................................ 84 Figure 7.5 Demand for family planning................................................................................ 85 Figure 7.6 Unmet need by residence..................................................................................... 86 Figure 7.7 Unmet need by region.......................................................................................... 86 8 INFANT AND CHILD MORTALITY...................................................................................... 103 Table 8.1 Early childhood mortality rates.......................................................................... 107 Table 8.2 Five-year early childhood mortality rates according to background characteristics..................................................................................................... 107 Table 8.3 Ten-year early childhood mortality rates according to additional characteristics..................................................................................................... 108 Table 8.4 Perinatal mortality.............................................................................................. 109 Table 8.5 High-risk fertility behavior................................................................................ 110 Figure 8.1 Trends in early childhood mortality rates.......................................................... 104 Figure 8.2 Childhood mortality by previous birth interval.................................................. 105 Figure 8.3 Under-5 mortality by region.............................................................................. 105 Figure 8.4 Under-5 mortality by household wealth............................................................. 105 9 MATERNAL HEALTH CARE................................................................................................. 111 Table 9.1 Antenatal care.................................................................................................... 120 Table 9.2 Number of antenatal care visits and timing of first visit.................................... 121 Table 9.3 Components of antenatal care............................................................................ 122 Table 9.4 Tetanus toxoid injections................................................................................... 123 Tables and Figures ix  Table 9.5 Problems experienced during pregnancy and delivery...................................... 124 Table 9.6 Pre-term births................................................................................................... 125 Table 9.7 Place of delivery................................................................................................ 126 Table 9.8 Reasons for not delivering in a health facility................................................... 127 Table 9.9 Assistance during delivery................................................................................. 128 Table 9.10 Caesarean section............................................................................................... 129 Table 9.11 Duration of stay in health facility after birth...................................................... 130 Table 9.12 Cost of delivery.................................................................................................. 130 Table 9.13 Timing of first postnatal check for the mother................................................... 131 Table 9.14 Type of provider of first postnatal check for the mother................................... 132 Table 9.15 Timing of first postnatal check for the newborn................................................ 133 Table 9.16 Type of provider of first postnatal check for the newborn................................. 134 Table 9.17 Content of postnatal care for newborns............................................................. 135 Table 9.18 Problems in accessing health care...................................................................... 136 Figure 9.1 Trends in antenatal care coverage...................................................................... 112 Figure 9.2 Trends in place of birth...................................................................................... 114 Figure 9.3 Health facility births by birth order.................................................................... 115 Figure 9.4 Assistance during delivery................................................................................. 115 Figure 9.5 Skilled assistance at delivery by household wealth........................................... 116 Figure 9.6 Postnatal care by place of delivery.................................................................... 117 10 CHILD HEALTH........................................................................................................................ 137 Table 10.1 Child’s size and weight at birth.......................................................................... 146 Table 10.2 Vaccinations by source of information.............................................................. 147 Table 10.3 Possession and observation of vaccination cards according to background characteristics..................................................................................................... 148 Table 10.4.1 Vaccinations by background characteristics...................................................... 149 Table 10.4.2 Vaccinations by residence and region................................................................ 150 Table 10.5 Prevalence and treatment of symptoms of ARI................................................. 151 Table 10.6 Source of advice or treatment for children with symptoms of ARI................... 152 Table 10.7 Prevalence and treatment of fever...................................................................... 153 Table 10.8 Source of advice or treatment for children with fever....................................... 154 Table 10.9 Prevalence and treatment of diarrhea................................................................. 155 Table 10.10 Feeding practices during diarrhea...................................................................... 156 Table 10.11 Oral rehydration therapy, zinc, and other treatments for diarrhea..................... 157 Table 10.12 Source of advice or treatment for children with diarrhea................................... 158 Table 10.13 Disposal of children’s stools.............................................................................. 159 Figure 10.1 Childhood vaccinations...................................................................................... 140 Figure 10.2 Trends in childhood vaccinations...................................................................... 140 Figure 10.3 Vaccination coverage by region......................................................................... 141 Figure 10.4 Feeding practices during diarrhea...................................................................... 143 Figure 10.5 Treatment of diarrhea......................................................................................... 143 Figure 10.6 Prevalence and treatment of childhood illness................................................... 144 11 BREASTFEEDING, COMPLEMENTARY FEEDING, AND MICRONUTRIENT SUPPLEMENTATION.............................................................................................................. 161 Table 11.1 Initial breastfeeding........................................................................................... 167 Table 11.2 Infant feeding practices by age.......................................................................... 168 Table 11.3 Median duration of breastfeeding...................................................................... 169 Table 11.4 Micronutrient intake among children................................................................. 170 Table 11.5 Iron tablets with folic acid................................................................................. 171 Table 11.6 Micronutrient intake among mothers................................................................. 172 x Tables and Figures  Figure 11.1 Trends in breastfeeding and prelacteal feeding.................................................. 162 Figure 11.2 Prelacteal feeding by household wealth............................................................. 163 Figure 11.3 Median duration of breastfeeding by household wealth.................................... 164 Figure 11.4 Micronutrient intake among children by residence............................................ 165 Figure 11.5 Iron tablet intake during pregnancy by region................................................... 166 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR.......................... 173 Table 12.1 Knowledge of HIV or AIDS.............................................................................. 180 Table 12.2 Knowledge of HIV prevention methods............................................................ 181 Table 12.3 Comprehensive knowledge about HIV.............................................................. 182 Table 12.4 Knowledge of prevention of mother-to-child transmission of HIV................... 182 Table 12.5 Discriminatory attitudes towards people living with HIV................................. 183 Table 12.6 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months........................................................................................................... 184 Table 12.7 Coverage of prior HIV testing........................................................................... 185 Table 12.8 Comprehensive knowledge about HIV among young women........................... 186 Table 12.9 Age at first sexual intercourse among young women........................................ 186 Table 12.10 Premarital sexual intercourse among young women......................................... 187 Table 12.11 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months among young women....................................................................... 187 Table 12.12 Recent HIV tests among young women............................................................. 188 Figure 12.1 Knowledge of HIV prevention among women by region.................................. 174 Figure 12.2 Knowledge of mother-to-child transmission (MTCT)....................................... 175 Figure 12.3 Discriminatory attitudes towards people living with HIV by household wealth................................................................................................................. 176 Figure 12.4 Knowledge of where to obtain an HIV test by region....................................... 177 Figure 12.5 Knowledge of where to obtain an HIV test by household wealth...................... 177 13 HEALTH CARE UTILIZATION AND FINANCING............................................................ 189 Table 13.1 Health insurance coverage................................................................................. 193 Table 13.2 Type of PhilHealth insurance............................................................................. 194 Table 13.3 Treatment-seeking behavior............................................................................... 195 Table 13.4 Specific types of health facilities utilized.......................................................... 196 Table 13.5 Reason for seeking health care........................................................................... 197 Table 13.6 Average travel time to health facility visited..................................................... 197 Table 13.7 In-patient hospital care....................................................................................... 198 Table 13.8 Aspects of in-patient care................................................................................... 199 Table 13.9 Average costs of care......................................................................................... 199 Figure 13.1 Trends in PhilHealth coverage........................................................................... 190 Figure 13.2 PhilHealth coverage by residence...................................................................... 191 Figure 13.3 Average costs of care......................................................................................... 192 14 WOMEN’S EMPOWERMENT................................................................................................ 201 Table 14.1 Employment and cash earnings of currently married women............................ 207 Table 14.2 Control over women’s cash earnings and relative magnitude of women’s cash earnings...................................................................................................... 208 Table 14.3 Women’s control over their own earnings and over those of their husbands.... 209 Table 14.4 Ownership of assets........................................................................................... 210 Table 14.5 Ownership and use of bank accounts and mobile phones.................................. 211 Table 14.6 Participation in decision making........................................................................ 212 Table 14.7 Women’s participation in decision making by background characteristics....... 212 Tables and Figures xi  Table 14.8 Attitude toward wife beating............................................................................. 213 Table 14.9 Attitudes toward negotiating safer sexual relations with husband..................... 214 Table 14.10 Ability to negotiate sexual relations with husband............................................ 215 Table 14.11 Indicators of women’s empowerment................................................................ 216 Table 14.12 Current use of contraception by women’s empowerment.................................. 216 Table 14.13 Ideal number of children and unmet need for family planning by women’s empowerment..................................................................................................... 217 Table 14.14 Reproductive health care by women’s empowerment....................................... 217 Table 14.15 Early childhood mortality rates by women’s status........................................... 218 Figure 14.1 Employment by age........................................................................................... 202 Figure 14.2 Control over women’s earnings......................................................................... 203 Figure 14.3 Ownership of assets........................................................................................... 204 Figure 14.4 Women’s participation in decision making........................................................ 205 15 VIOLENCE AGAINST WOMEN............................................................................................. 219 Table 15.1 Experience of physical violence........................................................................ 228 Table 15.2 Persons committing physical violence............................................................... 229 Table 15.3 Experience of sexual violence............................................................................ 230 Table 15.4 Age at first experience of sexual violence......................................................... 231 Table 15.5 Persons committing sexual violence.................................................................. 232 Table 15.6 Experience of different forms of violence......................................................... 232 Table 15.7 Experience of violence during pregnancy.......................................................... 233 Table 15.8 Marital control exercised by husbands............................................................... 235 Table 15.9 Forms of spousal violence................................................................................. 237 Table 15.10 Spousal violence by background characteristics................................................ 238 Table 15.11 Spousal violence by husband’s characteristics and empowerment indicators... 240 Table 15.12 Violence by any husband/partner in the last 12 months.................................... 241 Table 15.13 Experience of spousal violence by duration of marriage................................... 241 Table 15.14 Injuries to women due to spousal violence........................................................ 242 Table 15.15 Violence by women against their husband by women’s background characteristics..................................................................................................... 243 Table 15.16 Violence by women against their husband by husband’s characteristics and empowerment indicators.................................................................................... 245 Table 15.17 Help seeking to stop violence............................................................................ 246 Table 15.18 Sources for help to stop the violence................................................................. 247 Table 15.19 Awareness of anti-violence protection orders.................................................... 248 Table 15.20 Awareness of places to seek help from violence............................................... 249 Figure 15.1 Women’s experience of violence by marital status............................................ 221 Figure 15.2 Spousal violence by region................................................................................ 224 Figure 15.3 Spousal violence by husband’s alcohol consumption........................................ 224 Figure 15.4 Help seeking by type of violence experienced................................................... 226 APPENDIX A SAMPLE DESIGN........................................................................................................ 253 Table A.1 Households and PSUs........................................................................................ 254 Table A.2 PSU Replicates.................................................................................................. 255 Table A.3 Sample allocation and completed interviews..................................................... 257 Table A.4 Housing unit allocation...................................................................................... 258 Table A.5 Sample implementation: Women....................................................................... 260 xii Tables and Figures APPENDIX B ESTIMATES OF SAMPLING ERRORS................................................................... 261 Table B.1 List of selected variables for sampling errors, Philippines NDHS 2017............ 263 Table B.2 Sampling errors: Total sample, Philippines NDHS 2017.................................. 264 Table B.3 Sampling errors: Urban sample, Philippines NDHS 2017................................. 265 Table B.4 Sampling errors: Rural sample, Philippines NDHS 2017.................................. 266 Table B.5 Sampling errors: National Capital Region sample, Philippines NDHS 2017.... 267 Table B.6 Sampling errors: Cordillera Administrative Region sample, Philippines NDHS 2017........................................................................................................ 268 Table B.7 Sampling errors: Ilocos Region sample, Philippines NDHS 2017..................... 269 Table B.8 Sampling errors: Cagayan Valley sample, Philippines NDHS 2017................. 270 Table B.9 Sampling errors: Central Luzon sample, Philippines NDHS 2017.................... 271 Table B.10 Sampling errors: CALABARZON sample, Philippines NDHS 2017................ 272 Table B.11 Sampling errors: MIMAROPA Region sample, Philippines NDHS 2017........ 273 Table B.12 Sampling errors: Bicol sample, Philippines NDHS 2017.................................. 274 Table B.13 Sampling errors: Western Visayas sample, Philippines NDHS 2017................ 275 Table B.14 Sampling errors: Central Visayas sample, Philippines NDHS 2017................. 276 Table B.15 Sampling errors: Eastern Visayas sample, Philippines NDHS 2017................. 277 Table B.16 Sampling errors: Zamboanga Peninsula sample, Philippines NDHS 2017........ 278 Table B.17 Sampling errors: Northern Mindanao sample, Philippines NDHS 2017........... 279 Table B.18 Sampling errors: Davao sample, Philippines NDHS 2017................................ 280 Table B.19 Sampling errors: SOCCSKSARGEN sample, Philippines NDHS 2017........... 281 Table B.20 Sampling errors: Caraga sample, Philippines NDHS 2017................................ 282 Table B.21 Sampling errors: Autonomous Region in Muslim Mindanao sample, Philippines NDHS 2017..................................................................................... 283 APPENDIX C DATA QUALITY TABLES......................................................................................... 285 Table C.1 Household age distribution................................................................................ 285 Table C.2 Age distribution of eligible and interviewed women......................................... 286 Table C.3 Completeness of reporting................................................................................. 286 Table C.4 Births by calendar years..................................................................................... 287 Table C.5 Reporting of age at death in days....................................................................... 287 Table C.6 Reporting of age at death in months.................................................................. 288 Tables and Figures xiii PREFACE T he Philippine Statistics Authority (PSA) is presents the final report on the 2017 Philippines National Demographic and Health Survey (NDHS). The survey provides information on fertility, fertility preferences, family planning practices, childhood mortality, maternal and child health, knowledge and attitudes regarding HIV/AIDS, and violence against women. These indicators are crucial in policy-making, program planning, and monitoring and evaluation of population and health programs, including those anchored on the attainment of related Sustainable Development Goals (SDGs). The NDHS 2017 is the sixth DHS survey to be conducted in the Philippines in collaboration with the worldwide Demographic and Health Surveys (DHS) Program and the 11th national DHS overall. Fieldwork for the survey was carried out from August 14 to October 27, 2017, covering a national sample of over 31,000 households and more than 25,000 women age 15-49. The NDHS 2017 was funded by the Government of the Philippines. The United States Agency for International Development (USAID) provided technical assistance and equipment through ICF under The DHS Program. The PSA would like to express its deepest gratitude to the Department of Health and the University of the Philippines Population Institute for their invaluable contributions during the preparatory phase of the survey. Great appreciation is also extended to the survey team of the PSA for their hard work and dedication: the staff of the Social Sector Statistics Service, Demographic and Health Statistics Division (DHSD), who worked tirelessly throughout all stages of the survey; selected staff of the National Censuses Service and the Information Technology and Dissemination Service for their support during the training process; the Finance and Administrative Service for its assistance in managing the logistics for support operations; the staff of the Regional Statistical Services Offices and Provincial Statistical Offices for overseeing the data collection activities; and the 90 interviewing teams composed of team supervisors and interviewers. The PSA is equally grateful to the survey respondents who patiently shared their time and information during the interviews. LISA GRACE S. BERSALES, PhD Undersecretary National Statistician and Civil Registrar General Philippine Statistics Authority October 2018 Preface xv ABBREVIATIONS 4Ps Pantawid Pamilyang Pilipino Program AIDS acquired immune deficiency syndrome ANC antenatal care ARI acute respiratory infection ARMM Autonomous Region in Muslim Mindanao ART antiretroviral therapy ASFR age-specific fertility rate BCG Bacille Calmette-Guérin BHW barangay health worker BEmONC Basic Emergency Obstetric and Newborn Care CAPI computer-assisted personal interviewing CAR Cordillera Administrative Region CBR crude birth rate CDC Centers for Disease Control and Prevention CEmONC Comprehensive Emergency Obstetric and Newborn Care CPH Census of Population and Housing CSPro Censuses and Surveys Processing DEFT design effect DHS Demographic and Health Survey DHSD Demographic and Health Statistics Division DOH Department of Health DPT diphtheria-pertussis-tetanus DSWD Department of Social Welfare and Development EARF Enumeration Areas Reference File ENC essential newborn care EO Executive Order FASDs fetal alcohol spectrum disorders GAR gross attendance ratio GATS Global Adult Tobacco Survey GFR general fertility rate GPI gender parity index GPS global positioning system GSIS Government Service Insurance System HepB hepatitis B HFEP Health Facilities Enhancement Program Hib Haemophilus influenzae type b HIV human immunodeficiency virus HU housing unit HUC highly urbanized city ICF ICF (originally, Inner City Fund) IFSS Internet file streaming system IPV inactivated polio vaccine Abbreviations xvii  IUD intrauterine contraceptive device IYCF infant and young child feeding kg kilogram KMC kangaroo mother care LAM lactational amenorrhea method LGU local government unit LPG liquefied petroleum gas MCP Maternity Care Package MCW Magna Carta of Women MMR measles-mumps-rubella MNTE Maternal and Neonatal Tetanus Elimination MSF Master Sample Frame MTCT mother-to-child transmission NAR net attendance ratio NCR National Capital Region NCRFW National Commission on the Role of Filipino Women NDS National Demographic Survey NDHS National Demographic and Health Survey NGO nongovernmental organization NHIP National Health Insurance Program NHTS-PR National Household Targeting System for Poverty Reduction OPV oral polio vaccine ORS oral rehydration salts ORT oral rehydration therapy PNP Philippine National Police PSA Philippine Statistics Authority PSU primary sampling unit RA Republic Act RHF recommended homemade fluids RHU rural health unit SDGs Sustainable Development Goals SDM standard days method SE standard error SSS Social Security System SSU secondary sampling unit STI sexually transmitted infection TFR total fertility rate UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAD vitamin A deficiency VAW violence against women VIP ventilated improved pit latrine WHO World Health Organization xviii Abbreviations READING AND UNDERSTANDING TABLES FROM THE PHILIPPINES NATIONAL DEMOGRAPHIC AND HEALTH SURVEY 2017 (NDHS) T he NDHS 2017 final report is based on approximately 175 tables of data. They are Patterns by background characteristics Figure 7.2 Trends in contraceptive use located for quick reference through links in the Modern contraceptive use is highest among currently married women with 3-4 living Percentage of currently married women age 15-49 currently using a contraceptive method text (electronic version) and at the end of each chapter. children (50%) (Table 7.4.2). Currently married women in rural areas are Any modern method more likely than those in urban areas to use Additionally, this reader-friendly report features about 70 modern methods (42% versus 38%). 25 28 33 34 38 40 Any traditional method The modern contraceptive prevalence rate is figures that clearly highlight trends, subnational patterns, highest among women in Cagayan Valley (57%), largely as a result of the high percentage 15 1993 20 1998 16 2003 17 2008 18 2013 14 2017 of pill users (36%). Half (51%) of women in NDS NDHS NDHS NDHS NDHS NDHS and background characteristics. Colorful maps display SOCCSKSARGEN also use modern contraceptive methods Figure ( 7.3). Figure 7.3 Modern contraceptive use by region breakdowns by regions. The text highlights key points in The median age at sterilization among women is Percentage of currently married women age 15-49 32.1 years. Women were most likely to be sterilized at age 30-34 (36%)Table ( 7.5). bullets and clearly identifies indicator definitions in Knowledge of the Fertile Period Only 1 in 4 women (24%) correctly report that a boxes. woman is most at risk of pregnancy if she has intercourse halfway between two menstrual periods. Forty-three percent of women incorrectly believe that a woman is more likely to conceive immediately after her menstrual cycle has ended, and 16% report While the text and figures featured in each chapter that they do not know when the fertile period is. Among women who use cycle-related methods such as rhythm, only 38% have correct knowledge of the highlight some of the most important findings from the fertile period during the ovulatory cycleTable ( Women age 35-39 are most likely to have correct knowledge of the fertile period (30%)Table ( 7.6). 7.7). tables, not every finding can be discussed or displayed graphically. For this reason, NDHS data users should be comfortable reading and interpreting tables. 7.2 SOURCE OFMODERN CONTRACEPTIVE METHODS Source of modern contraceptives The following pages provide an introduction to the The place where the modern meth od currently being used was obta ined the last time it was acquired Sample: Women age 15-49 currently using a modern contraceptive method organization of NDHS tables, the presentation of background characteristics, and a brief summary of sampling and understanding denominators. In addition, Family Planning 83 this section provides some exercises for users as they practice their new skills in interpreting NDHS tables. Reading and Understanding Tables from the NDHS 2017 xix  Example 1: Exposure to Mass Media A Question Asked of All Survey Respondents Table 3.4 Exposure to mass media 1 Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Philippines NDHS 2017 Reads a Accesses all Accesses none 3 newspaper at Watches Listens to the three media at of the three 2 Background least once a television at least radio at least least once a media at least Number of characteristic week once a week once a week week once a week women Age 15-19 16.8 78.6 36.9 9.9 14.8 4,897 20-24 15.3 76.9 38.1 10.0 15.6 4,175 25-29 13.8 76.8 35.4 8.9 16.4 3,717 30-34 13.6 76.7 35.1 7.0 14.8 3,243 35-39 15.3 75.8 36.1 8.2 15.6 3,360 40-44 14.3 76.7 35.2 8.6 16.5 2,837 45-49 13.3 77.8 36.0 8.1 14.5 2,845 Residence Urban 18.9 78.6 37.0 10.8 12.8 12,252 Rural 11.0 75.7 35.5 6.9 18.0 12,822 Region National Capital Region 25.1 73.6 38.4 13.0 11.5 4,400 Cordillera Admin. Region 21.5 66.1 30.2 14.9 27.5 440 I - Ilocos Region 16.2 90.3 51.0 11.0 5.7 1,258 II - Cagayan Valley 13.3 72.6 26.0 8.4 24.2 802 III - Central Luzon 15.1 87.8 24.0 10.5 9.4 2,453 IVA - CALABARZON 6.5 85.0 24.8 2.8 12.4 4,016 MIMAROPA Region 9.9 69.8 22.4 5.5 26.3 621 V - Bicol 5.1 79.8 35.6 3.1 13.6 1,551 VI - Western Visayas 15.2 80.4 54.7 10.6 9.4 1,498 VII - Central Visayas 30.3 75.2 56.2 19.6 14.2 1,607 VIII - Eastern Visayas 7.9 79.0 38.0 4.5 12.9 997 IX - Zamboanga Peninsula 9.5 76.7 41.4 6.8 15.3 764 X - Northern Mindanao 7.0 65.7 36.1 3.7 27.9 998 XI - Davao 16.1 64.9 34.1 7.6 24.0 1,203 XII - SOCCSKSARGEN 16.9 81.8 54.6 13.7 13.0 1,038 XIII - Caraga 14.6 70.0 38.9 9.7 21.1 648 ARMM 5.0 40.5 17.3 2.0 54.3 780 Education No education 3.8 34.3 23.9 3.3 56.9 200 Grades 1-6 4.8 63.0 32.4 3.0 27.5 3,245 Grades 7-10 11.5 78.5 36.0 7.1 14.5 11,558 Grade 11 20.8 83.3 36.3 12.4 11.1 934 Post-secondary 10.9 80.4 35.9 7.1 15.1 1,144 College 23.9 80.6 38.5 13.7 5 11.4 7,994 Wealth quintile Lowest 6.6 51.9 34.3 4.1 36.1 4,209 Second 9.5 77.1 36.5 5.5 16.6 4,629 Middle 13.8 83.9 36.4 8.9 10.7 4,918 Fourth 16.9 84.1 35.5 9.7 9.2 5,527 Highest 24.1 83.0 37.9 14.0 9.6 5,791 Total 4 14.8 77.1 36.2 8.8 15.5 25,074 Step 1: Read the title and subtitle—highlighted in orange in Example 1. They tell you the topic and specific population group being described. In this case, the table is about women age 15-49 and the frequency of their exposure to different types of media. All eligible female respondents age 15-49 were asked these questions. Step 2: Scan the column headings—highlighted in green in Example 1. They describe how the information is categorized. In this table, the first three columns of data show different types of media that women access at least once a week. The fourth column shows women who access all three types of media, while the fifth column shows women who do not access any of the three types of media at least once a week. The last column lists the number of women age 15-49 interviewed in the survey. Step 3: Scan the row headings—the first vertical column highlighted in blue in Example 1. These show the different ways the data are divided into categories based on population characteristics. In this case, the table presents women’s exposure to media by age, urban-rural residence, region, educational level, and wealth quintile. Most of the tables in the NDHS report will be divided into these same categories. xx Reading and Understanding Tables from the NDHS 2017 Step 4: Look at the row at the bottom of the table highlighted in pink in Example 1. These percentages represent the totals of all women age 15-49 and their access to different types of media. In this case, 14.8%* of women read a newspaper at least once a week, 77.1% watch television at least once a week, and 36.2% listen to the radio at least once a week. Step 5: To find out what percentage of women age 15-49 with college education access all three media at least once a week, draw two imaginary lines, as shown on the table. This shows that 13.7% of women age 15-49 with college education access all three types of media at least once a week. Step 6: By looking at patterns by background characteristics, we can see how exposure to mass media varies across the Philippines. Mass media are often used to communicate health messages. Knowing how mass media exposure varies among different groups can help program planners and policy makers determine how to most effectively reach their target populations. *For the purpose of this document data are presented exactly as they appear in the table including decimal places. However, the text in the remainder of this report rounds data to the nearest whole percentage point. Practice: Use the table in Example 1 to answer the following questions: a) What percentage of women in the Philippines do not access any of the three media at least once a week? b) Which age group of women are most likely to listen to the radio at least once a week? c) Compare women in urban areas to women in rural areas – which group is more likely to read a newspaper at least once a week? d) What are the lowest and highest percentages (range) of women who do not access any of the three media types at least once a week by region? e) Is there a clear pattern in exposure to radio at least once a week by education level? f) Is there a clear pattern in exposure to newspapers at least once a week by wealth quintile? newspaper on a weekly basis compared with 24.1% of women in the highest wealth quintile. f) Yes. Exposure to newspapers increases as household wealth increases; 6.6% of women in the lowest wealth quintile read a the radio on a weekly basis compared with 38.5% of women with college education. e) Yes. Exposure to radio generally increases as a woman’s level of education increases; 23.9% of women with no education listen to d) Women with no exposure to media at least once a week ranges from a low of 5.7% in Ilocos Region to a high of 54.3% in ARMM. c) Women in urban areas, 18.9% read a newspaper at least once a week, compared with 11.0% of women in rural areas b) Women age 20-24: 38.1% of women in this age group listen to the radio weekly a) 15.5% Answers: Reading and Understanding Tables from the NDHS 2017 xxi  Example 2: Prevalence and Treatment of Symptoms of ARI A Question Asked of a Subgroup of Survey Respondents Table 10.5 Prevalence and treatment of symptoms of ARI 1 Among children under age 5, percentage who had symptoms of acute respiratory infection (ARI) in the 2 weeks preceding the survey, and among children with symptoms of ARI in the 2 weeks preceding the survey, percentage for whom advice or treatment was sought, according to background characteristics, Philippines NDHS 2017 Among children under age 5: Among children under age 5 with symptoms of ARI: 2 Percentage with Percentage for whom advice or Percentage for whom advice or treatment was Background symptoms of Number of treatment was sought same or Number of characteristic ARI1 children sought2 next day children Age in months