The Rwanda 2010 DHS is the latest in a regular series of DHS surveys that began in 1992, although hostilities had delayed the next survey until 2000. The 2010 survey interviewed 13,671 women ages 15 to 49 and 6,329 men ages 15 to 59 from September 2010 to March 2011. The total fertility rate (TFR — the average number of children would bear in her lifetime if the birth rate of a particular year were to remain constant) obtained in the survey was 4.6 for the three-year period preceding the survey. For urban women, the TFR was 3.4 and for rural women, who were a 85 percent of the sample, 4.8. The TFR saw its fastest decline in the 2010 DHS. From the 2007-08 Interim DHS to the 2010 survey, the TFR fell by 1.1 children nationwide — by 1.3 in urban areas and 0.9 in rural areas in a period of only four and a half years. This is sharpest drop in a sub-Saharan TFR I can ever remember seeing. As an indicator of future fertility plans, 56.2 percent of women with three living children said that they not wish to have any more children as did 76 percent of those with four living children. It is clear that the large family size of eight children per woman is truly a thing of the past.
Note: TFRs are for the three years before the surveys. 2007-2008 data from Interim DHS.
Source: National Institute of Statistics of Rwanda, Ministry of Finance and Economic Planning, Ministry of Health Rwanda, MEASURE DHS, ICF Macro, Demographic and Health Survey 2010, Preliminary Report.
The new Demographic and Health Survey (DHS) in Zimbabwe presents evidence that the country’s progress on reproductive and maternal and child health has stagnated in recent years.
The 2010-2011 Zimbabwe DHS interviewed 9,171 women ages 15 to 49 and 7,480 men ages 15 to 54. The total fertility rate (TFR — the average number of children would bear in her lifetime if the birth rate of a particular year were to remain constant) obtained in the survey was 4.1 for the three-year period preceding the survey and is an increase from the previous DHS in 2005-2006. For urban women, the TFR was 3.1 and, for rural women, who were 61.3 percent of the sample, 4.8. The TFR has been relatively stable since the 1994 DHS, particularly in rural areas. But there has been a noticeable resurgence in the TFR in urban areas in the past five years. The proportion of women who say that they do not wish to have any more children can be an indicator of childbearing intentions. When asked about their future childbearing desires, 49.5 percent of percent of married women with three living children said that they wanted no more and, among women with four living children, 65.2 percent said that they wanted no more. It would seem that the very large families of the past are no longer desired.
Note: TFRs are for the three years before the surveys, except the 1988 survey, which is for five years.
The Burkina Faso 2010 DHS interviewed 17,087 women ages 15 to 49 and 7,307 men ages 15-to 59 from May 2010 to January 2011. The survey was a combined DHS-Multiple Indicator Cluster Survey (MICS), the latter a survey often undertaken by UNICEF to gather additional information, such as child health. The total fertility rate (TFR) obtained in the survey was 6.0 for the three-year period preceding the survey. For urban women, the TFR was 3.9 and, for rural women, who were a little over 72.9 percent of the sample, 6.7. In the capital, Ouagadougou, the TFR was 3.4, but this was higher than in the 2003 DHS, when it was 3.1. Successive surveys indicate that there has been a very slow decline in the TFR over the years and that the pace of decline between the last two surveys slowed. To put these rates into a longer perspective, the TFR was estimated from the 1985 Census at 7.2 and, from a 1991 government survey, at 7.3. As mentioned in previousblog posts on recent DHS, the desire to continue or ceasechildbearing can provide insight into possible future fertility trends. Of the women with 5 living children, 40.2 percent said that they did not wish to have any more children; among women with 6 or more living children, 61.4 percent said that they also wished to ceased childbearing. An additional 5 percent in both groups declared themselves infertile.
In the 2010 survey, 16 percent of currently married women said that they were using some form of family planning, 14.9 percent a modern method. The three most common modern methods were injectables (6.2 percent), implants (3.4 percent), and the pill (3.2 percent). Family planning has increased from the 2003 DHS, when it was 13.8 percent for all methods, modern and traditional, and 8.6 percent for modern methods.
Note: TFRs are for the five years before the surveys except 2010, which is three years.
Source: Ministère de l’Economie et des Finances, Institut National de la Statistique et de la Démographie, MEASURE DHS ICF Macro Enquête Démographique et de Santé (EDS-IV) et à Indicateurs Multiples (MICS) EDSBF-MICS IV.
For New Yorkers, the High-Level meetings at the United Nations often mark a period of blocked traffic, increased security, and general inconvenience. However, this week’s High-Level Meeting on Non-Communicable Diseases marked an important opportunity for the Population Reference Bureau. At the Extended SUN Workshop on Sept. 21, 2011, PRB launched its very first ENGAGE presentation under the RENEW Project. RENEW is a global initiative funded by The Gates Foundation to raise the visibility of malnutrition, mobilize commitment and resources, and accelerate the implementation of proven and promising new approaches.
The objective of the Extended Workshop was to bring leaders and stakeholders together to discuss the first year of progress of the SUN movement, to highlight the links between malnutrition, during the 1000 day window of opportunity, and challenges later in life (including noncommunicable diseases), and to strengthen action in taking the movement forward. Country representatives from Uganda, Benin, Burkina Faso, Ethiopia, Ghana, Guatemala, Lao PDR, Mali, Malawi, Mauritania, Mozambique, Nepal, Niger, Peru, Senegal, the Gambia, Tanzania, Zambia, Zimbabwe, and Bangladesh were recognized for their commitment to scaling-up nutrition interventions, raising expectations about nutrition outcomes, and delivering important policy and programmatic results in a short period of time.
Continuing my recent practice of posting a quick summary of results from new demographic surveys in developing countries, here is another new Demographic and Health Survey (DHS) preliminary report, this time from a sub-Saharan African country. This will help readers of this blog to stay right up-to-date with the latest developments.
The Ethiopia 2011 DHS interviewed 16,515 women ages 15 to 49 and 14,110 men ages 15 to 59 from September 2010 to June 2011. The total fertility rate (TFR — the average number of children would bear in her lifetime if the birth rate of a particular year were to remain constant) obtained in the survey was 4.8 for the three-year period preceding the survey. For urban women, the TFR was 2.6 and for rural women, who were a little over 75 percent of the sample, 5.5. There appears to have been an acceleration of TFR decline from the 2005 to the 2011 survey compared with the 2000 DHS, which had a three-year TFR of 5.5.* In 1990, a government survey had shown the TFR as 6.4. The desire to continue or cease childbearing provides one insight into possible future fertility trends. Of the women with 5 living children, 55.8 percent said that they did not wish to have any more children; among women with 6 or more living children, 68.6 percent said that they also wished to ceased childbearing.
Note: TFRs are for the three years before the surveys, except five years before the 2000 survey
Source: Ethiopian Central Statistics Agency (CSA) and ICF Macro, Ethiopia Demographic and Health Survey (EDHS) 2011, Preliminary Report.
It’s been a big couple of weeks for progress on the global immunization front. This week, the Global Alliance on Vaccines and Immunizations (GAVI) announced a major development: exceeding expectations, the U.S. and European countries have committed to $4.3 billion to fight childhood diseases, which will save more than four million lives in the next four years.
The U.K. is the single-largest contributor, with $1.3 billion committed. The U.K.’s commitment is even more impressive considering its current fiscal environment of austerity and budget cuts. David Cameron’s government was voted into power last year largely on the strength of its commitment to balancing Britain’s budget and slashing spending. But when it comes to global public health, Cameron has decided to follow in the footsteps of previous Labour governments’ support of international aid. Under Tony Blair and Gordon Brown, from 2001 to 2008, the U.K.’s net official development assistance was 0.3 percent to 0.4 percent of total gross national income, significantly higher than the U.S. during the same time period (0.1 percent to 0.2 percent). Clearly, children’s health remains a priority for the U.K.
Photo credit: Creative Commons/Gates Foundation
A few days before the GAVI announcement, UNICEF (who supplies vaccines to nearly 60 percent of the world’s children) announced that it would publicize the prices it pays for vaccines. It’s hoped that the greater transparency will lead to greater competition among manufacturers, making vaccines more affordable and accessible to those who need it most. The disclosure has shown rising vaccines prices over the past decade and a big price discrepancy, with Western drug companies often charging double what Indian and Indonesian drug companies charge. The prices of measles, polio, and tetanus vaccines have doubled in 10 years.
Almost 2 million children worldwide still die every year from completely preventable causes: diseases that we in developed countries haven’t had to worry about in decades thanks to widespread vaccination and basic improvements in public health. Pneumonia, malaria, and diarrheal diseases are among the biggest killers of children under five in developing countries.
Note: TFRs are for the three years before the surveys. 2007-2008 data from Interim DHS.
