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Key Indicators of Nepal Demographic and Health Survey 2016

The Nepal Demographic Health Survey (NDHS) 2016 is the ninth in a series of national-level population and health surveys and the fifth comprehensive survey conducted as part of the Global Demographic and Health Surveys (GDHS) program.

The survey was implemented by New ERA under the aegis of the Ministry of Health (MOH), Government of Nepal. Data collection for the survey took place from June 19, 2016, to January 31, 2017. The survey was funded by the United States Agency for International Development (USAID), and ICF provided technical support.

Objective:

The primary objective of the 2016 NDHS was to provide up-to-date estimates of basic demographic and health indicators. Specifically, the 2016 NDHS collected information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status, anemia, maternal and child health and mortality, awareness and behavior regarding HIV/AIDS, women’s empowerment and domestic violence, knowledge of HIV/AID/STD, and other health related issues such as smoking, knowledge of tuberculosis, and prevalence of hypertension. The 2016 NDHS also provides indicators relevant to the Nepal Health Sector Strategy (NHSS) – 2016-2021 and the Sustainable Development Goals (SDGs).

Sample design:

The sampling frame used for the 2016 NDHS is an updated version of the frame of the National Population and Housing Census (NPHC) conducted in Nepal in 2011, provided by the Central Bureau of Statistics (CBS). As of 10 March 2017, there has been a structural change in the classification of urban and rural locations officially known as Nagarpalika and Gaonpalika. The country now has 263 municipalities, seven federal states and 59% of the total population live in the urban areas.

Questionnaires:

Five questionnaires were used for the 2016 NDHS:

1. the Household Questionnaire,
2. the Woman’s Questionnaire,
3. the Man’s Questionnaire,
4. the Biomarker Questionnaire, and
5. the Verbal Autopsy Questionnaire for neonatal deaths.

This key indicators report presents a first look at selected findings of the 2016 NDHS. A comprehensive analysis of the data will be presented in a final report in September 2017.

KEY FINDINGS

Households interviewed: 11,040
Household response rate: 98.5

Household Sanitation:

  • 3 in 5 Nepalese households (62%) have improved sanitation facilities
  • 38% of households have unimproved sanitation facilities with 15% having no facilities at all.
  • Among households with a toilet facility, about a quarter have a facility in their own dwelling, while 70% have one in their own yard or plot.
  • Some 7% of households have a toilet facility elsewhere outside their compound.
  • Urban households are more likely to have toilets within their own dwelling (33%) compared with rural households (6%).
  • Though not within the dwelling, a majority of rural households (84%) have their toilet facility in their own yard or plot.

Teenage Pregnancy and Motherhood:

  • Overall, 17% of women age 15-19 had begun childbearing: 13% had had a live birth
  • The proportion of teenagers who had begun childbearing rises rapidly with age, from 2% at age 15 to 36% at age 19
  • Rural teenagers tend to start childbearing earlier than urban teenagers

Fertility Preferences:

  • 10% of women want to have another child soon (within the next 2 years),
  • 14% of women want to have another child later (in 2 or more years),
  • 50% of women want no more children,
  • 20% of women have already been sterilized,
  • 2% of women have not decided if they want another child,
  • 50% of women with no living children want a child soon, compared with only 2% of women with three or more children.

Family Planning:

  • Overall, 53% of currently married women use a method of family planning
  • 43% use a modern method (female sterilization, male sterilization, intrauterine contraceptive device (IUD), implants, injectable, the pill, condoms, and lactational amenorrhea method (LAM))
  • 10% use a traditional method (rhythm, withdrawal, and folk methods)
  • Among currently married women, the most popular methods are:
    • female sterilization (15%),
    • injectables (9%)
    • withdrawal (9%),
    • male sterilization (6%), and
    • the pill (5%)
  • The contraceptive prevalence rate (CPR) among married women varies with age, rising from 23% among women age 15-19, peaking at 69% of women age 35-44, and then slightly declining to 65% among women age 45-49
  • 24% of currently married women have an unmet need for family planning services

Source of Modern Contraception:

  • The government sector is the most popular source for modern contraception in Nepal, serving 70% of modern method users.
  • Government hospitals and clinics serve 32% of modern contraceptive users, with health posts and sub-health posts also prominent (20%).
  • Only 6% of users of modern methods of contraception receive methods from the nongovernmental sector.
  • Overall, 19% of users receive their contraceptives from the private medical sector with this sector being a common source for male condoms (57%), the pill (40%), and injectables (25%).
  • 2 in 5 male condom users get the condoms from pharmacies (40%).

Early Childhood Mortality:

  • Neonatal mortality rate: 21 deaths per 1,000 live births
  • Infant mortality rate: 32 per 1,000 live births
  • Under-5 mortality rate: 39 per 1,000 live births.
  • 82% of all deaths among children under age 5 in Nepal take place before a child’s first birthday, with 54% occurring during the first month of life.

Maternal Care:

  • 84% of women received antenatal care from a skilled provider at least once for their last birth.
  • 69% of women had four or more ANC visits.
  • Overall, 42% of women took the recommended dose of iron tablets for at least 180 days during their last pregnancy.
  • 89% of women with a birth in the 5 years before the survey received sufficient doses of tetanus toxoid
  • Birth attended by a skilled provider: 58%
  • Birth occurred in a health facility: 57%
  • 57% of women reported having received a PNC checkup in the first 2 days after birth

Vaccination:

  • 78% of children have received all basic vaccinations
  • BCG: 98%
  • DPT 1: 97%
  • Polio 1: 98%
  • DPT 3: 86%
  • Polio 3: 88%
  • Measles rubella: 90%
  • No vaccines: 1%

Childhood Acute Respiratory Infection, Fever, and Diarrhea:

  • treatment from a health facility or provider was sought for 85% of children with ARI symptoms and 80% of those with a fever
  • treatment was sought from a health facility or health provider for 64% of children with diarrhea
  • 37% of children with diarrhea received a rehydration solution from an oral rehydration salt (ORS) packet
  • 18% of children with diarrhea were given zinc supplements
  • 10% received both ORS and zinc supplements
  • Only 29% of children were given increased fluids and continued feeding during diarrhea as recommended

Nutritional Status:

  • Stunting (a child who is below minus two standard deviations (SD) from the reference median for height-for-age/short for his or her age/chronic malnutrition): 36%
  • Severe stunting (below -3 SD): 12%
  • Wasting (a child who is below minus two SD from the reference median for weight-for-height/too thin for his or her height/acute or recent nutritional deficits: 10%
  • Severely wasting: 2%
  • Underweight: 27%
  • Severely underweight: 5%
  • Overweight: 1%

Knowledge of HIV Prevention:

  • 81% percent of women and 98% of men have heard of AIDS
  • 72% of women and 92% of men age 15-49 know that consistent use of condoms is a means of preventing the spread of HIV
  • 77% of women and 93% of men know that limiting sexual intercourse to one faithful, uninfected partner can reduce the chance of contracting HIV.
  • The proportions of women and men who know that both using condoms and limiting sexual intercourse to one uninfected partner are means of preventing HIV are 70% and 89%, respectively.
  • 21% of young women and 27% of young men have comprehensive knowledge of HIV prevention.

Others:

  • Fertility: 2.3 births per woman
  • Exclusive breastfeeding: 66%
  • Vitamin A coverage (children age 6-59 months): 86%
  • 95% of children live in households that consume iodized salt
  • Overall, 53% of children suffered from some degree of anemia: 26% were classified as mildly anemic, 26% were moderately anemic, and less than 1% were severely anemic
  • Mean BMI among women age 15-49 is 22 kg/m2
  • Seventeen percent of women of reproductive age are thin or undernourished (BMI <18.5 kg/m2)
  • The proportions of women of reproductive age with mild thinness (17.0-18.4 kg/m2) and moderate and severe thinness (<17 kg/m2) are 11% and 6%, respectively.
  • 17% of women are overweight (BMI 25-29 kg/m2), and 5% are obese (BMI 30 kg/m2 and above).
  • 41% of women age 15-49 are anemic (Pregnant women with hemoglobin levels below 11.0 g/dl and nonpregnant women with hemoglobin levels below 12.0 g/dl were defined as anemic).
  • 34% of women age 15-49 are mildly anemic, 7% of women age 15-49 are moderately anemic, and less than 1% are severely anemic
  • 3% of men reported having had two or more sexual partners
  • 9% of men reported that they had sexual intercourse with a person who was neither their wife nor lived with them
  • men in Nepal have had an average of 2.4 sexual partners in their lifetime
  • 34% of women and 58% of men know of a place where they can get an HIV test
  • Young women age 15-19 and older women age 40-49 are slightly less likely to know a place to get an HIV test
  • 17% of women and 23% of men age 15 and above have hypertension in Nepal
  • About 2% of women and men have normal blood pressure and are taking medication to control their blood pressure
  • 32% of women and 36% of men age 55-59 have hypertension in Nepal
DOWNLOAD NDHS 2016 KEY FINDINGS

Nepal Demographic and Health Survey 2016 (NDHS 2016): Key Indicators Report (PDF, 745K)

>> The information presented above is excerpted from the following source:

  • Ministry of Health, Nepal; New ERA; and ICF. 2017. Nepal Demographic and Health Survey 2016: Key Indicators. Kathmandu, Nepal: Ministry of Health, Nepal.
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