Demographic and Health Survey – Final Report
About Vanuatu Demographic and Health Survey.
The Vanuatu Demographic and Health Survey – MICS 2013 (VDHS – MICS 2013) is a nationwide survey of men and women of reproductive age that is designed to provide information on fertility and child mortality levels; fertility preferences; use of family planning methods; maternal, child and newborn health, including breastfeeding practices, nutrition levels, anaemia and the presence of iodine in cooking salt; knowledge and attitudes towards HIV/AIDS and other sexually transmitted infections (STI); and community-level data on accessibility and availability of health and family planning services.
The VDHS – MICS 2013 is the first survey of its kind conducted in the Pacific that integrates different components of the Multiple Indicator Cluster Survey (MICS). The VDHS – MICS 2013 was the first ever DHS to be conducted in Vanuatu. Other major health surveys that have been conducted in Vanuatu include MICS, the Malaria Indicators Survey, and the World Health Organisation Non-communicable Disease STEPS Survey.
This important undertaking was a partnership between the Vanuatu Ministry of Health, the Vanuatu National Statistics Office, and the Secretariat of the Pacific Community (SPC). The primary objective of this survey was to provide up-to-date information for policy-makers, planners, researchers and programme managers, for use in planning, implementing, monitoring and evaluating population and health programmes within the country. The survey was intended to provide key estimates of Vanuatu’s demographics and health situation.In addition, the content of the survey was expanded to include questions on disability and gender-related violence.
The findings of the VDHS – MICS 2013 are very important for measuring the achievements of family planning and other health programmes. To ensure better understanding and use of these data, the results of this survey should be widely disseminated at different planning levels. Different dissemination techniques
will be used to reach different segments of society.
Financial assistance was provided by the Asian Development Bank, United Nations Population Fund, United
Nations Children’s Fund, and the Australian Agency for International Development. SPC is greatly appreciated for having offered important technical support.
The survey would not have been successfully conducted without the dedicated support and involvement of a large number of institutions and individuals. Because of their efforts, data could be made available in a timely fashion.
Summary of Key Findings.
The Vanuatu Demographic and Health Survey – MICS 2013 (VDHS – MICS 2013) is a nationally representative survey of 2,508 women aged 15–49 and 1,333 men aged 15–54. The VDHS – MICS 2013 is the first for the country. The primary purpose of the VDHS is to furnish policy-makers and planners with detailed information on fertility, family planning, infant and child mortality, maternal and child health and nutrition, and knowledge of HIV and AIDS and other sexually transmitted infections.
Survey results indicate that the total fertility rate (TFR) for Vanuatu is 4.2 births per woman. TFR is marginally higher for rural women (4.7) than for urban women (3.3). The marginal difference between total and rural values reflects the fact that most of Vanuatu’s population lives in rural areas (the proportion living in urban areas is 25%, according to the 2009 population census). The difference in fertility level between urban women and rural women is relatively small, and suggests there is somewhat better access to reproductive health services for women in urban areas. There are, however, distinct differences in fertility between Rural 1 and Rural 2 areas, with Rural 2 being more remote in terms of access to reproductive health services.
Overall, knowledge of family planning is high in Vanuatu, with 91% of all women, and 98% of all men aged 15–49 knowing at least one contraceptive method. The level of awareness among married men and sexually active unmarried men is universal at around 99%, whereas for women it is higher for currently married women than for all women. Modern contraceptive methods are most widely known: 90% of all women know of a modern method compared with 62% who know of a traditional method. Commonly known modern methods among all women include the male condom (84%), followed by birth control pills (80%), injectable contraceptives (78%) and female sterilization (72%). Emergency contraception, which is an emergency measure of contraception, is one of the two least known contraceptives, with only 16% of all women knowing about it. Implants are only known by 7% of all women. Implants are currently not available in Vanuatu. Women who have implants would have had them inserted elsewhere before coming to Vanuatu. Among traditional methods, the withdrawal method is used by 48% of women followed by the rhythm method at 47%, and folk methods at 10%.
Many factors fall under antenatal care such as a pregnant woman and her partner’s knowledge of the importance of making antenatal care appointments early on after the birth of the child. Importance of compliance with scheduled appointments to ensure blood checks and screenings are conducted, and blood pressure and weight monitoring are conducted. Counselling is also conducted with guidance on management and treatment of reproductive health conditions.
About 87% of children born in Vanuatu are weighed at birth. This is logical as most babies are born at health facilities. Birth weight is generally lower among children born to younger women (age at birth less than 20) and older women (age 35–49), first-born children, children of women with no education, children whose mothers smoke cigarettes or tobacco, and surprisingly, among babies in urban areas and babies whose mothers belong to the fourth wealth quintile households. One in three (33%) children aged 12–23 months had received all of the basic vaccinations (BCG, DPT, polio and measles) at some time before the survey. Immunisation coverage increases with mothers who have had a secondary school level education with coverage at 47% of all children. The vaccination coverage of children whose mother had only a primary school education was 25%. A vaccination card was seen for 57% of children aged 12–23 months.
In Vanuatu, 66% children aged less than 18 years live with both parents, while 13% live with their mother but not with their father even though the father is alive somewhere. Male children aged 0–9 years living in rural areas are more likely to be found living with their mothers. About 16% of children do not live with either biological parent. These children are likely to be between the ages of 2 and 17 years and living in both rural and urban areas, and living in middle and fourth wealth quintile households. The parents of about 4% of these children are dead. There is very little variation by sex.
Adequate nutrition is important for good health and development of a child, and the period from birth to age 2 years is critical. Unfortunately, this period is often marked by faltering growth, micronutrient deficiencies, and common childhood illnesses such as diarrhoea and acute respiratory infection. Optimal feeding practices include early initiation of breastfeeding, exclusive breastfeeding during the first six months of life, continued breastfeeding for up to age 2 years and beyond, the timely introduction of complementary foods at age 6 months, frequency of feeding solid and/or semisolid foods, and the diversity of food groups fed to children aged 6–23 months.
While the number of HIV cases is low, at only nine recorded cases, the high prevalence of sexually transmitted infections (STIs) and risky behaviour, in particular unsafe sex among young people, creates a context where HIV could rapidly spread. Increasing population mobility, both within Vanuatu as well as other countries in the Pacific Islands region, increases this risk. Factors such as poverty, high rates of gender-based violence, unstable political situation, and a heavy dependence on international technical and financial support are important challenges to an effective response to the prevention of HIV and STIs, and the treatment, care and support of people living with HIV.
About 63% of currently married women and nearly 98% of currently married men aged 15–49 were employed at some time in the year prior to the VDHS – MICS 2013. Men are more likely to work but not receive payment (41%) than women (42%). The percentage of currently employed women is lowest in the 15 19 age group and increases with age.
Overall, 26% of women decide for themselves how their earnings are spent, 50% make decisions jointly with their husband or partner, while 21% report that the decision is mainly made by their husband or partner. Only 3% of currently married who work report that their husband or partner does not bring in any money.
An infant death is the death of a child under 1 year of age. The infant mortality rate (IMR) is a measure of the number of infant deaths. The IMR is the number of deaths of babies under 1 year of age in a given year for every 1,000 live births in the same year. It is one of the key measures of the health and wellbeing of a country. The VDHS – MICS 2013 showed that 28 infants out of 1,000 live births will die before their first birthday.
In Vanuatu, 3% children aged 5–11 years engage in paid and/or economic work; most of these are females in rural areas. About 21% of young females aged 5 11 engage in 1 to more hours of work. Among children aged 2–14, 77% have been subjected to at least one form of psychological punishment by their mothers and/or caretaker or other household members. Children aged 5–9 years in rural areas are vulnerable to severe physical punishment.
Additionally, violent discipline is high in both rural areas (72%) and urban areas (70%). About 90% of households have water only (and no cleansing agents) for hand washing. About 74% of households in urban areas have soap and water for washing hands compared to 45% in rural areas.
Disability has been looked at in this survey in regards to population, age groups, educational attainment and marital status. In terms of population distribution, many respondents have experienced some type of difficulties. However, the prevalence of disability seems to occur more with increasing age.
The data also indicate that disability prevalence is higher in rural areas and with lower wealth status. It can also be seen in comparison to the level of education and marital status. The level of educational attainment among those aged 5 years and older by a disability status reported as being mild to severe disability is nearly 66%; those attending primary school is nearly 62% among those with moderate to severe disability; and is 31% for those with a severe disability.
Malaria represents a major public health concern in Vanuatu, especially among those who are particularly vulnerable such as pregnant women and children under 5 years of age. It is a leading cause of morbidity and mortality in Vanuatu, and poses a high burden in both societal and economic terms. Most parts of the country report transmission throughout the year, although the number of cases increases during and soon after the rainy season.
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Vanuatu Demographic and Health Survey