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Armenia
Demographic and
Health Survey
2005
National Statistical Service
Yerevan, Armenia
Ministry of Health
Yerevan, Armenia
ORC Macro
Calverton, Maryland USA
December 2006
National Statistical
Service Ministry of Health
This report summarizes the findings of the 2005 Armenia Demographic and Health Survey
(ADHS), which was conducted by the National Statistical Service and the Ministry of Health of
the Republic of Armenia. ORC Macro provided technical assistance and the U.S. Agency for
International Development (USAID) provided funding under the terms of contract number GPO-
C-00-03-00002-00. The opinions expressed herein are those of the authors and do not necessarily
reflect the views of USAID.
The ADHS is part of the worldwide MEASURE DHS program, which is designed to collect data
on fertility, family planning, and maternal and child health. Additional information about the
ADHS may be obtained from the National Statistical Service, 3 Government House, Republic
Avenue, 375010 Yerevan, Armenia (Telephone: 37410 524-326 and Fax: 37410 521-921).
Additional information about the DHS project may be obtained from ORC Macro, 11785
Beltsville Drive, Calverton, MD 20705 (Telephone 301-572-0200 and Fax 301-572-0999).
Recommended citation:
National Statistical Service [Armenia], Ministry of Health [Armenia], and ORC Macro. 2006.
Armenia Demographic and Health Survey 2005. Calverton, Maryland: National Statistical
Service, Ministry of Health, and ORC Macro.
CONTENTS
Page
Tables and Figures...........................................................................................................................vii
Acknowledgments...........................................................................................................................xv
Preface..........................................................................................................................................xvii
Summary of Findings......................................................................................................................xix
Map of Armenia...........................................................................................................................xxiv
CHAPTER 1 INTRODUCTION
1.1 Territory....................................................................................................................1
1.2 Demographic Characteristics.....................................................................................1
1.3 Health Care System in Armenia.................................................................................1
1.4 Objectives and Organization of the Survey................................................................5
1.5 Response Rates..........................................................................................................7
CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
2.1 Characteristics of the Population................................................................................9
2.2 Housing Characteristics............................................................................................18
2.3 Wealth Quintiles.....................................................................................................24
2.4 Birth Registration.....................................................................................................25
CHAPTER 3 BACKGROUND CHARACTERISTICS OF RESPONDENTS
3.1 Background Characteristics of Respondents.............................................................27
3.2 Educational Level of Respondents............................................................................29
3.3 Exposure to Mass Media..........................................................................................31
3.4 Employment............................................................................................................31
3.5 Occupation.............................................................................................................36
3.6 Employment............................................................................................................39
CHAPTER 4 FERTILITY
4.1 Current Fertility.......................................................................................................41
4.2 Fertility Differentials by Background Characteristics.................................................42
4.3 Fertility Trends.........................................................................................................44
4.4 Fertility Rates From NSS and the ADHS...................................................................44
Contents | iii
4.5 Children Ever Born and Living.................................................................................44
4.6 Birth Intervals..........................................................................................................45
4.7 Age at First Birth......................................................................................................47
4.8 Teenage Pregnancy and Motherhood......................................................................49
CHAPTER 5 CONTRACEPTION
5.1 Knowledge of Contraceptive Methods.....................................................................51
5.2 Ever Use of Contraception.......................................................................................52
5.3 Current Use of Contraception..................................................................................55
5.4 Current Use by Background Characteristics..............................................................57
5.5 Number of Children at First Use..............................................................................58
5.6 Knowledge of the Fertile Period...............................................................................59
5.7 Access to Family Planning........................................................................................60
5.8 Discontinuation Within 12 Months of Use...............................................................62
5.9 Reasons for Using Traditional Methods....................................................................63
5.10 Intention to Use Family Planning among Nonusers..................................................63
5.11 Exposure to Family Planning Messages in the Mass Media........................................66
5.12 Contact of Nonusers with Family Planning Providers................................................69
5.13 Men’s Attitudes toward Family Planning..................................................................70
5.14 Informed Choice.....................................................................................................71
CHAPTER 6 ABORTION
6.1 Pregnancy Outcomes...............................................................................................73
6.2 Lifetime Experience with Induced Abortion.............................................................75
6.3 Rates of Induced Abortion.......................................................................................77
6.4 Trends in Induced Abortion......................................................................................78
6.5 Use of Contraceptive Methods Before Abortion.......................................................80
CHAPTER 7 OTHER PROXIMATE DETERMINANTS OF FERTILITY
7.1 Marital Status...........................................................................................................81
7.2 Age at First Marriage and Sexual Intercourse............................................................82
7.3 Recent Sexual Activity..............................................................................................87
7.4 Postpartum Amenorrhea, Abstinence, and Insusceptibility.......................................90
7.5 Menopause.............................................................................................................90
CHAPTER 8 FERTILITY PREFERENCES
8.1 Fertility Preferences.................................................................................................91
8.2 Need for Family Planning........................................................................................93
8.3 Fertility Planning......................................................................................................95
iv | Contents
8.4 Ideal Number of Children........................................................................................96
8.5 Wanted and Unwanted Fertility...............................................................................98
CHAPTER 9 INFANT AND CHILD MORTALITY
9.1 Assessment of Data Quality......................................................................................99
9.2 Levels and Trends in Childhood Mortality.............................................................100
9.3 Infant Mortality Rates from the National Statistical Service and the ADHS............102
9.4 Socioeconomic Differentials in Childhood Mortality.............................................104
9.5 Demographic Differentials in Childhood Mortality................................................106
9.6 Perinatal Mortality................................................................................................107
9.7 High-Risk Fertility Behavior...................................................................................108
CHAPTER 10 REPRODUCTIVE HEALTH
10.1 Antenatal Care......................................................................................................113
10.2 Assistance and Medical Care at Delivery...............................................................117
10.3 Postnatal Care......................................................................................................120
10.4 Women’s Health Care..........................................................................................123
CHAPTER 11 CHILD HEALTH
11.1 Characteristics of Delivery.....................................................................................127
11.2 Vaccination Coverage...........................................................................................127
11.3 Acute Respiratory Infection...................................................................................131
11.4 Fever ...................................................................................................................132
11.5 Diarrhea...............................................................................................................132
11.6 Disposal of Children’s Stools.................................................................................136
CHAPTER 12 NUTRITION
12.1 Nutritional Status of Children................................................................................139
12.2 Breastfeeding and Supplementation......................................................................142
12.3 Infant And Young Child Feeding (IYCF) Practices...................................................150
12.4 Anemia in Children..............................................................................................154
12.5 Micronutrient Intake in Children...........................................................................156
12.6 Nutritional Status of Women................................................................................158
12.7 Anemia in Women...............................................................................................160
12.8 Micronutrient Intake in Women...........................................................................162
Contents | v
CHAPTER 13 HIV/AIDS AND SEXUALLY TRANSMITTED INFECTIONS
13.1 Knowledge of HIV/AIDS and Methods of HIV Prevention.....................................163
13.2 Rejection of Misconceptions About AIDS Transmission and
Comprehensive Knowledge of AIDS.....................................................................167
13.3 Social Aspects of HIV/AIDS...................................................................................170
13.4 Multiple Sexual Partnerships.................................................................................173
13.5 Paid Sex...............................................................................................................176
13.6 Prevalence of Sexually Transmitted Infections.......................................................176
13.7 Prevalence of Injections........................................................................................178
13.8 HIV/AIDS-Related Knowledge and Behavior among Youth....................................180
13.9 Age at First Sex among Youth and Condom Use...................................................182
CHAPTER 14 ADULT HEALTH
14.1 Access to and Utilization of Health Care Services..................................................187
14.2 Use of Smoking Tobacco......................................................................................196
14.3 Tuberculosis.........................................................................................................198
14.4 Hypertension........................................................................................................205
CHAPTER 15 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC
AND HEALTH OUTCOMES
15.1 Employment and Cash Earnings............................................................................211
15.2 Use of Earnings.....................................................................................................212
15.3 Household Decisionmaking..................................................................................214
15.4 Attitudes towards Wife Beating.............................................................................217
15.5 Attitudes towards Refusing Sexual Relations..........................................................220
15.6 Indicators of Women’s Empowerment..................................................................223
15.7 Current Use of Contraception by Women’s Status................................................224
15.8 Women’s Status and Ideal Family Size and Unmet Need......................................225
15.9 Women’s Status and Reproductive Health Care....................................................226
REFERENCES................................................................................................................................229
APPENDIX A SAMPLE DESIGN.................................................................................................231
APPENDIX B ESTIMATES OF SAMPLING ERRORS...................................................................235
APPENDIX C DATA QUALITY TABLES......................................................................................267
APPENDIX D PERSONS INVOLVED IN THE ARMENIA 2005 DEMOGRAPHIC
AND HEALTH SURVEY........................................................................................275
APPENDIX E QUESTIONNAIRES..............................................................................................281
vi | Contents
TABLES AND FIGURES
CHAPTER 1 INTRODUCTION
Table 1.1 Results of the household and individual interviews.................................................7
CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS
Table 2.1 Household population by age, sex, and residence................................................10
Table 2.2 Household composition.......................................................................................11
Table 2.3 Children’s living arrangements and orphanhood...................................................12
Table 2.4.1 Educational attainment of the household population: Male..................................14
Table 2.4.2 Educational attainment of the household population: Female..............................15
Table 2.5 School attendance ratios......................................................................................17
Table 2.6 Housing characteristics.........................................................................................19
Table 2.7 Household drinking water....................................................................................21
Table 2.8 Household sanitation facility................................................................................22
Table 2.9 Household possessions.........................................................................................24
Table 2.10 Population distribution by wealth quintile............................................................25
Table 2.11 Birth registration of children under five................................................................26
Figure 2.1 Population pyramid..............................................................................................10
Figure 2.2 Age-specific school attendance rates, by sex.........................................................18
Figure 2.3 Households with electricity and LPG/Natural gas for cooking...............................20
Figure 2.4 Households with drinking water piped into the house and
flush toilet to piped sewer system, by residence...................................................23
CHAPTER 3 BACKGROUND CHARACTERISTICS OF RESPONDENTS
Table 3.1 Background characteristics of respondents...........................................................28
Table 3.2.1 Educational attainment by background characteristics: Women...........................29
Table 3.2.2 Educational attainment by background characteristics: Men.................................30
Table 3.3.1 Exposure to mass media: Women........................................................................32
Table 3.3.2 Exposure to mass media: Men..............................................................................33
Table 3.4 Employment status...............................................................................................35
Table 3.5.1 Occupation: Women...........................................................................................37
Table 3.5.2 Occupation: Men................................................................................................38
Table 3.6 Employment characteristics..................................................................................39
Figure 3.1 Percent distribution of women and men age 15-49 by employment status...........34
Figure 3.2 Respondents currently employed, by residence and education.............................36
Tables and Figures | vii
CHAPTER 4 FERTILITY
Table 4.1 Current fertility.....................................................................................................41
Table 4.2 Fertility by background characteristics..................................................................43
Table 4.3 Trends in age-specific fertility rates.......................................................................44
Table 4.4 Children ever born and living...............................................................................45
Table 4.5 Birth intervals.......................................................................................................46
Table 4.6 Age at first birth....................................................................................................47
Table 4.7 Median age at first birth by background characteristics.........................................48
Table 4.8 Teenage pregnancy and motherhood...................................................................49
Figure 4.1 Age-specific fertility rates for the three-year period preceding the survey,
by residence........................................................................................................42
Figure 4.2 Total fertility rates for the three years preceding the survey,
by residence and education.................................................................................47
Figure 4.3 Percentage of births occurring less than 24 months and a prior birth,
by residence and education
CHAPTER 5 CONTRACEPTION
Table 5.1 Knowledge of contraceptive methods...................................................................52
Table 5.2 Knowledge of contraceptive methods by background characteristics....................53
Table 5.3.1 Ever use of contraception: Women......................................................................54
Table 5.3.2 Ever use of contraception: Men............................................................................54
Table 5.4 Current use of contraception...............................................................................55
Table 5.5 Trends in contraceptive use..................................................................................57
Table 5.6 Current use of contraception by background characteristics.................................58
Table 5.7 Number of living children at first use of contraception..........................................59
Table 5.8 Knowledge of fertile period..................................................................................59
Table 5.9 Source of modern contraceptive methods............................................................60
Table 5.10 Cost of modern contraceptive methods................................................................60
Table 5.11 Informed choice...................................................................................................62
Table 5.12 First-year contraceptive discontinuation rates.......................................................63
Table 5.13 Reasons for discontinuing contraceptive methods.................................................64
Table 5.14 Reasons for using traditional methods..................................................................65
Table 5.15 Future use of contraception.................................................................................65
Table 5.16 Reasons for not intending to use contraception....................................................66
Table 5.17 Preferred method of contraception for future use.................................................67
Table 5.18.1 Exposure to family planning messages: Women....................................................68
Table 5.18.2 Exposure to family planning messages: Men.........................................................69
Table 5.19 Contact of nonusers with family planning providers..............................................71
Figure 5.1 Contraceptive use among married women...........................................................56
Figure 5.2 Trends in current contraceptive use among married women................................56
Figure 5.3 Transportation to source of contraceptive supply..................................................61
Figure 5.4 Men’s attitudes toward contraception..................................................................70
viii | Tables and Figures
CHAPTER 6 ABORTION
Table 6.1 Pregnancy outcome by background characteristics...............................................74
Table 6.2 Lifetime experience with induced abortion..........................................................76
Table 6.3 Induced abortion rates.........................................................................................77
Table 6.4 Induced abortion rates by background characteristics...........................................78
Table 6.5 Use of a contraception before pregnancy.............................................................80
Figure 6.1 Trends in pregnancy outcomes.............................................................................75
Figure 6.2 Age-specific fertility rates and abortion rates, 2005...............................................78
Figure 6.3 Trends in age-specific abortion rates, 2000 and 2005...........................................79
CHAPTER 7 OTHER PROXIMATE DETERMINANTS OF FERTILITY
Table 7.1 Current marital status...........................................................................................81
Table 7.2 Age at first marriage.............................................................................................83
Table 7.3 Age at first sexual intercourse...............................................................................84
Table 7.4 Median age at first marriage.................................................................................85
Table 7.5 Median age at first sexual intercourse...................................................................86
Table 7.6.1 Recent sexual activity: Women............................................................................88
Table 7.6.2 Recent sexual activity: Men..................................................................................89
Table 7.7 Postpartum amenorrhea, abstinence, and insusceptibility.....................................90
Table 7.8 Menopause..........................................................................................................90
Figure 7.1 Marital status of respondents................................................................................82
Figure 7.2 Median age at first sexual intercourse among respondents,
by residence and education.................................................................................84
CHAPTER 8 FERTILITY PREFERENCES
Table 8.1 Fertility preferences by number of living children.................................................91
Table 8.2 Desire to limit childbearing..................................................................................93
Table 8.3 Need for family planning......................................................................................94
Table 8.4 Fertility planning status.........................................................................................95
Table 8.5 Ideal number of children......................................................................................96
Table 8.6 Mean ideal number of children............................................................................97
Table 8.7 Wanted fertility rates............................................................................................98
Figure 8.1 Desire for more children among currently married women and men....................92
CHAPTER 9 INFANT AND CHILD MORTALITY
Table 9.1 Early childhood mortality rates..........................................................................101
Table 9.2 Comparison of infant mortality rates..................................................................103
Table 9.3 Early childhood mortality rates by socioeconomic characteristics.......................105
Table 9.4 Early childhood mortality rates by demographic characteristics..........................106
Table 9.5 Perinatal mortality.............................................................................................107
Table 9.6 High-risk fertility behavior.................................................................................108
Tables and Figures | ix
Description:This report summarizes the findings of the 2005 Armenia Demographic and Health Survey minants of health; and a shift from the narrow biomedical model towards a social, in the system essentially exceed the actual demand for medical care, including the . English and translated into Armenian.
