Demographic and Health Survey 2006-2007 (Eswatini)

Abstract

The 2006-07 Swaziland Demographic and Health Survey (SDHS) is a nationally represe­ntative survey of 4,843 households, 4,987 women age 15-49, and 4,156 men age 15-49. The SDHS also included individual interviews with boys and girls age 12-14 and older adults age 50 and over. The survey of persons age 12-14 and age 50 and over was carried out in every other household selected in the SDHS. Interviews were completed for 459 girls and 411 boys age 12-14, and 661 women and 456 men age 50 and over.

The 2006-07 SDHS is the first national survey conducted in Swaziland as part of the De­mographic and Health Surveys (DHS) programme. The data are intended to furnish programme managers and policymakers with de­tailed information on levels and trends in fertility; nuptiality; sexual activity; fertility prefer­ences; awareness and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; ma­ternal and child health; and awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections. The survey also collected information on malaria prevention and treat­ment.

The 2006-07 SDHS is the first nationwide survey in Swaziland to provide population-based prevalence estimates for anaemia and HIV. Children age 6 months and older as well as adults were tested for anaemia. Children age 2 years and older as well as adults were tested for HIV.

The principal objective of the 2006-07 Swaziland Demographic and Health Survey (SDHS) was to provide up-to-date information on fertility, childhood mortality, marriage, fertility preferences, awareness, and use of family planning methods, infant feeding practices, maternal and child health, maternal mortality, HIV/AIDS-related knowledge and behaviour and prevalence of HIV and anaemia.

More specifically the 2006-07 SDHS was aimed at achieving the following;
- Determine key demographic rates, particularly fertility, under-five mortality, and adult mor­tality rates
- Investigate the direct and indirect factors which determine the level and trends of fertility
- Measure the level of contraceptive knowledge and practice of women and men by method
- Determine immunization coverage and prevalence and treatment of diarrhoea and acute res­piratory diseases among children under five
- Determine infant and young child feeding practices and assess the nutritional status of chil­dren 6-59 months, women age 15-49 years, and men aged 15-49 years
- Estimate prevalence of anaemia
- Assess knowledge and attitudes of women and men regarding sexually transmitted infections and HIV/AIDS, and evaluate patterns of recent behaviour regarding condom use
- Identify behaviours that protect or predispose the population to HIV infection
- Examine social, economic, and cultural determinants of HIV
- Determine the proportion of households with orphans and vulnerable children (OVCs)
- Determine the proportion of households with sick people taken care at household level
- Determine HIV prevalence among males and females age 2 years and older
- Determine the use of iodized salt in households
- Describe care and protection of children age 12-14 years, and their knowledge and attitudes about sex and HIV/AIDS.

This information is intended to provide data to assist policymakers and programme implementers to monitor and evaluate existing programmes and to design new strategies for demographic, social and health policies in Swaziland. The survey also provides data to monitor the country's achievement towards the Millenium Development Goals.

MAIN RESULTS

- Fertility in Swaziland has been declining ra­pidly, with the TFR falling from 6.4 births per woman in 1986 to 3.8 births at the time of the SDHS. As expected, fertility is higher in rural areas (4.2 births per woman) than in urban areas (3.0 births per woman). Fertility differentials by education and wealth are substantial. Women with no education have on average 4.9 children compared with 2.4 children for women with tertiary education. Fertility varies widely according to household wealth. Women in the highest wealth quintile have 2.9 chil­dren fewer than women in the lowest quintile (2.6 and 5.5 births per woman, respectively).

- Knowledge of family planning is universal in Swaziland. The most widely known method is the male condom (99 percent for both males and females). Among women, other widely known methods include injectables (96 percent), the pill (95 percent), and the female condom (91 per­cent). For men, the best known methods besides the male condom are the female condom (94 percent) and the pill and injectables (84 percent each).

- Children are considered fully vaccinated when they receive one dose of BCG vaccine, three doses each of DPT and polio vaccines, and one dose of measles vaccine. BCG coverage among children age 12-23 months is nearly uni­versal (97 percent); coverage is also high for the first doses of DPT (96 percent) and polio (97 percent). The proportion of children receiving subsequent do­ses of DPT and polio vaccines drops slightly, with 92 percent of children receiving the third dose of DPT and 87 percent receiving the third dose of polio. Ninety-two percent of children had received a mea­sles vaccination by the time of the SDHS. Overall, 82 percent of children age 12-23 months are fully im­munised.

- In Swaziland, almost all women who had a live birth in the five years preceding the survey received antenatal care from health professionals (97 percent); 9 percent received care from a doctor, and 88 percent received care from a trained nurse or midwife. Only 3 percent of mothers did not receive any antenatal care

- Overall, 87 percent of children in Swaziland are breastfed for some period of time (ever breastfed). The median duration of any breast-feeding in Swaziland is almost 17 months. How­ever, the median duration of exclusive breast-feeding is much shorter (0.7 months).

- In interpreting the malaria programme indicators in Swaziland, it is important to recognise that the dis­ease affects an estimated 30 percent of the population where malaria is most prevalent (the Lubombo Pla­teau, the lowveld, and parts of the middleveld). Malaria is also seasonal, occurring mainly during or after the rainy season (from November to March). A substantial part of the SDHS field­work took place outside of this period.

- Results from the HIV testing component in the 2006-07 SDHS indicate that 26 percent of Swazi adults age 15-49 are infected with HIV. Among women, the HIV rate is 31 percent, com­pared with 20 percent among men. HIV preva­lence peaks at 49 percent for women age 25-29, which is almost five times the rate among wo­men age 15-19 and more than twice the rate ob­served among women age 45-49. HIV preva­lence increases from 2 percent among men in the 15-19 age group to 45 percent in the age group 35-39 and then decreases to 28 percent among men age 45-49. HIV prevalence for women and men age 50 or over is 12 percent and 18 percent, respectively. Among the population age 2-14 years, 4 percent of girls and boys are infected.