Demographic and Health Survey 2005 (Moldova)

Abstract

Moldova's first Demographic and Health Survey (2005 MDHS) is a nationally representa­tive sample survey of 7,440 women age 15-49 and 2,508 men age 15-59 selected from 400 sample points (clusters) throughout Moldova (excluding the Transnistria region). It is designed to provide data to monitor the population and health situation in Moldova; it includes several indicators which follow up on those from the 1997 Moldova Repro­ductive Health Survey (1997 MRHS) and the 2000 Multiple Indicator Cluster Survey (2000 MICS). The 2005 MDHS used a two-stage sample based on the 2004 Population and Housing Census and was designed to produce separate estimates for key indicators for each of the major regions in Moldova, including the North, Center, and South regions and Chisinau Municipality. Unlike the 1997 MRHS and the 2000 MICS surveys, the 2005 MDHS did not cover the region of Transnis­tria. Data collection took place over a two-month period, from June 13 to August 18, 2005.

The survey obtained detailed information on fertility levels, abortion levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, adult health, and awareness and behavior regard­ing HIV infection and other sexually transmitted diseases. Hemoglobin testing was conducted on women and children to detect the presence of anemia. Additional features of the 2005 MDHS include the collection of information on interna­tional emigration, language preference for reading printed media, and domestic violence.
The 2005 MDHS was carried out by the National Scientific and Applied Center for Preventive Medicine, hereafter called the National Center for Preventive Medicine (NCPM), of the Ministry of Health and Social Protection. ORC Macro provided technical assistance for the MDHS through the USAID-funded MEASURE DHS project. Local costs of the survey were also supported by USAID, with additional funds from the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), and in-kind contributions from the NCPM.

MAIN RESULTS

CHARACTERISTICS OF RESPONDENTS

Ethnicity and Religion. Most women and men in Moldova are of Moldovan ethnicity (77 percent and 76 percent, respectively), followed by Ukrainian (8-9 percent of women and men), Rus­sian (6 percent of women and men), and Gagauzan (4-5 percent of women and men). Romanian and Bulgarian ethnicities account for 2 to 3 percent of women and men. The overwhelming majority of Moldovans, about 95 percent, report Orthodox Christianity as their religion.

Residence and Age. The majority of respondents, about 58 percent, live in rural areas. For both sexes, there are proportionally more respondents in age groups 15-19 and 45-49 (and also 45-54 for men), whereas the proportion of respondents in age groups 25-44 is relatively lower. This U-shaped age distribution reflects the aging baby boom cohort following World War II (the youngest of the baby boomers are now in their mid-40s), and their children who are now mostly in their teens and 20s. The smaller proportion of men and women in the middle age groups reflects the smaller cohorts following the baby boom gen­eration and those preceding the generation of baby boomers' children. To some degree, it also reflects the disproportionately higher emigration of the working-age population.

Education. Women and men in Moldova are universally well educated, with virtually 100 percent having at least some secondary or higher education; 79 percent of women and 83 percent of men have only a secondary or secondary special education, and the remainder pursues a higher education. More women (21 percent) than men (16 percent) pursue higher education.

Language Preference. Among women, preferences for language of reading material are about equal for Moldovan (37 percent) and Rus­sian (35 percent) languages. Among men, prefer­ence for Russian (39 percent) is higher than for Moldovan (25 percent). A substantial percentage of women and men prefer Moldovan and Russian equally (27 percent of women and 32 percent of men).

Living Conditions. Access to electricity is almost universal for households in Moldova. Ninety percent of the population has access to safe drinking water, with 86 percent in rural areas and 96 percent in urban areas. Seventy-seven percent of households in Moldova have adequate means of sanitary disposal, with 91 percent of households in urban areas and only 67 percent in rural areas.

Children's Living Arrangements. Com­pared with other countries in the region, Moldova has the highest proportion of children who do not live with their mother and/or father. Only about two-thirds (69 percent) of children under age 15 live with both parents. Fifteen percent live with just their mother although their father is alive, 5 percent live with just their father although their mother is alive, and 7 percent live with neither parent although they are both alive. Compared with living arrangements of children in 2000, the situation appears to have worsened.

FERTILITY

Fertility Levels and Trends. The total fer­tility rate (TFR) in Moldova is 1.7 births. This means that, on average, a woman in Moldova will give birth to 1.7 children by the end of her repro­ductive period. Overall, fertility rates have de­clined since independence in 1991. However, data indicate that fertility rates may have increased in recent years. For example, women of childbearing age have given birth to, on average, 1.4 children at the end of their childbearing years. This is slightly less than the total fertility rate (1.7), with the dif­ference indicating that fertility in the past three years is slightly higher than the accumulation of births over the past 30 years.

Fertility Differentials. The TFR for rural areas (1.8 births) is higher than that for urban areas (1.5 births). Results show that this urban-rural dif­ference in childbearing rates can be attributed almost exclusively to younger age groups.

CONTRACEPTION

Knowledge of Contraception. Knowledge of family planning is nearly universal, with 99 per­cent of all women age 15-49 knowing at least one modern method of family planning. Among all women, the male condom, IUD, pills, and with­drawal are the most widely known methods of family planning, with over 80 percent of all women saying they have heard of these methods. Female sterilization is known by two-thirds of women, while periodic abstinence (rhythm meth­od) is recognized by almost six in ten women. Just over half of women have heard of the lactational amenorrhea method (LAM), while 40-50 percent of all women have heard of injectables, male ster­ilization, and foam/jelly. The least widely known methods are emergency contraception, diaphragm, and implants.

Use of Contraception. Sixty-eight percent of currently married women are using a family planning method to delay or stop childbearing. Most are using a modern method (44 percent of married women), while 24 percent use a traditional method of contraception. The IUD is the most widely used of the modern methods, being used by 25 percent of married women. The next most widely used method is withdrawal, used by 20 percent of married women. Male condoms are used by about 7 percent of women, especially younger women. Five percent of married women have been sterilized and 4 percent each are using the pill and periodic abstinence (rhythm method).
The results show that Moldovan women are adopting family planning at lower parities (i.e., when they have fewer children) than in the past. Among younger women (age 20-24), almost half (49 percent) used contraception before having any children, compared with only 12 percent of women age 45-49.

MATERNAL HEALTH

Antenatal Care and Delivery Care. Among women with a birth in the five years pre­ceding the survey, almost all reported seeing a health professional at least once for antenatal care during their last pregnancy; nine in ten reported 4 or more antenatal care visits. Seven in ten women had their first antenatal care visit in the first trimester. In addition, virtually all births were deliv­ered by a health professional, in a health facility. Results also show that the vast majority of women have timely checkups after delivering; 89 percent of all women received a medical checkup within two days of the birth, and another 6 percent within six weeks.

CHILD HEALTH

Childhood Mortality. The infant mortality rate for the 5-year period preceding the survey is 13 deaths per 1,000 live births, meaning that about 1 in 76 infants dies before the first birthday. The under-five mortality rate is almost the same with 14 deaths per 1,000 births. The near parity of these rates indicates that most all early childhood deaths take place during the first year of life. Comparison with official estimates of IMRs suggests that this rate has been improving over the past decade.

NUTRITION

Breastfeeding Practices. Breastfeeding is nearly universal in Moldova: 97 percent of chil­dren are breastfed. However the duration of breast-feeding is not long, exclusive breastfeeding is not widely practiced, and bottle-feeding is not un­common. In terms of the duration of breastfeeding, data show that by age 12-15 months, well over half of children (59 percent) are no longer being breastfed. By age 20-23 months, almost all chil­dren have been weaned.

Exclusive breastfeeding is not widely prac­ticed and supplementary feeding begins early: 57 percent of breastfed children less than 4 months are exclusively breastfed, and 46 percent under six months are exclusively breastfeed. The remaining breastfed children also consume plain water, wa­ter-based liquids or juice, other milk in addition to breast milk, and complimentary foods.
Bottle-feeding is fairly widespread in Mol­dova; almost one-third (29 percent) of infants un­der 4 months old are fed with a bottle with a nip­ple.

Nutritional Status of Children. At the na­tional level, about 8 percent of children under age five are stunted (low height-for-age), while about 4 percent of children are wasted (low weight-for­height), and 4 percent are underweight (low weight-for-age).

HIV/AIDS KNOWLEDGE

Awareness of HIV/AIDS. Awareness of HIV/AIDS is almost universal among persons of reproductive age. Ninety-seven percent of men and women age 15-49 have heard of HIV/AIDS, but men are slightly better informed than women about specific ways to avoid contracting the dis­ease: 81 percent of women and 89 percent of men indicate that the chances of getting the AIDS virus can be reduced by limiting sex to one faithful partner; 78 percent of women and 87 percent of men are aware that condoms can reduce the risk of contracting HIV during sexual intercourse; and 63 percent of women and 85 percent of men know that abstaining from sex reduces the chances of getting the disease. Seventy-six percent of women and 78 percent of men know that a healthy-looking person can have the AIDS virus.

Knowledge patterns between men and women are reversed for mother-to-child transmis­sion of HIV: 68 percent of women compared with 53 percent of men know that HIV can be transmit­ted by breastfeeding; 86 percent of women and 79 percent of men know the disease can be transmit­ted from the mother to the child during pregnancy; and 82 percent of women and 76 percent of men know it can be transmitted during delivery.

HIV Testing. Thirty-six percent of women in Moldova have been tested for HIV at some time, compared with 30 percent of men. Thirty-four percent of women and 27 percent of men were tested and also received the results of their HIV test.

DOMESTIC VIOLENCE

Violence Since Age 15. MDHS data show that one-quarter of all women (27 percent) have experienced violence since they were age 15 and 13 percent experienced violence in the 12 months preceding the survey. The main perpetrators of violence against women are husbands (69 percent) and, to a lesser extent, fathers/stepfathers (14 per­cent), and mothers/stepmothers (7 percent).

Marital Violence. Twenty-three percent of ever-married women report having experienced emotional violence by husbands, 24 percent report physical violence, and 4 percent report sexual vio­lence. Almost one-third (32 percent) of ever-married women report suffering emotional, physi­cal, or sexual violence, while 3 percent have experienced all three forms of violence by their current or most recent husband.

The data further show that divorced or sepa­rated women are more than twice as likely as mar­ried women to have been abused emotionally, physically, and sexually, suggesting that the vio­lence might have been a factor in the termination of their marriages.

EMIGRATION

In Moldova, and in post-Soviet states in gen­eral, large-scale labor emigration is an important demographic phenomenon that has a substantial negative impact on the population growth as well as on the social and economic structure of society.

Emigrant Households. Seventeen percent of households in Moldova have at least one former member who emigrated. This percentage is about the same in urban and rural households. The high­est percentage of households with at least one emigrant is in the South region (21 percent) and the lowest is in Chisinau (13 percent).

Emigrant Characteristics. A slightly high­er proportion of emigrants are males (52 percent, compared with 48 percent for women). However, in Chisinau and the South region, a slightly higher proportion of emigrants are females. The distribu­tion of emigrants by age at emigration is similar for males and females. The most common age group for emigration is age 20-24 for both sexes. This age group accounts for roughly one-quarter of all emigrants (22 percent of females and 27 per­cent of males). Approximately three-quarters of all emigrants leave the country between age 15 and 39 (73 percent of females and 79 percent of males).