Key Indicators Report Jordan Population and Family Health Survey (JPFHS)

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Key Indicators Report 2017-18 Jordan Population and Family Health Survey (JPFHS)

The 2017-18 Jordan Population and Family Health Survey (2017-18 JPFHS) was implemented by the Department of Statistics (DOS) from October 2017 to January 2018. The funding for the JPFHS was provided by the Government of Jordan, United States Agency for International Development (USAID), UNFPA, and UNICEF. ICF provided technical assistance through The DHS Program, a USAIDfunded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide.

Objectives The primary objective of the 2017-18 JPFHS project is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the JPFHS collected information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, childhood mortality, maternal and child health, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs), women s experience of violence.

The Survey The 2017-18 JPFHS is the 7th Demographic and Health Survey conducted in Jordan as part of The DHS Program. It is designed to provide estimates at the national level, for urban and rural areas, 3 regions, and, for most indicators, 12 governorates. This survey was also designed to be representative for 3 nationality domains: Jordanians, Syrians, and other nationalities.

Sample Design Sampling Frame: 2015 Jordan Population and Housing Census (JPHC 2015) First Stage: 970 clusters (blocks or groups of blocks) selected from JPHC; all households in these clusters were listed by DOS staff Second Stage: 20 households were selected per cluster, for a total sample size of 19,384 households Selected households were visited and interviewed; evermarried women age 15-49 in all selected households and men age 15-59 in half of the selected households were interviewed.

Questionnaires Household Questionnaire Woman s Questionnaire Man s Questionnaire Biomarker Questionnaire Questionnaires were translated into Arabic

Household Questionnaire Lists usual members and visitors to identify eligible individuals Basic characteristics of each person in the household collected (age, sex, education, etc.) Housing characteristics (access to drinking water, sanitation facilities, etc.) Identify women and men eligible for individual interview Women and children under 5: anthropometry and anemia testing Child discipline Health Expenditures and Diabetes

Woman s Questionnaire Background characteristics (education, media exposure, etc.) Reproductive history Knowledge and use of family planning methods Fertility preferences Antenatal and delivery care Breastfeeding and infant feeding practices Vaccinations and childhood illnesses Domestic Violence Awareness and behaviour about HIV and other STIs Early Childhood Development Other health problems (including smoking)

Man s Questionnaire Background characteristics Reproductive history Knowledge of family planning methods Fertility preferences Employment Awareness and behaviour about HIV and other STIs Other health problems (including smoking)

Pretest July 2017: Survey Trainings 3+ weeks, 56 trainees Rural and urban clusters in Amman Main Survey Training: Aug-Sept 2017 in Amman 153 participants 3 stages: Biomarker data (anthropometry and blood samples, 40 people) Interviewer training (153 people) CAPI training and tablets and fieldwork

Fieldwork and Data Processing Total of 27 teams (consisting of 1 supervisor, 3 female interviewers, 1 male interviewer, 1 biomarker measurer, 1 driver) Fieldwork conducted from October 2017- January 2018 Electronic data files sent to DOS every few days via IFSS for data processing Secondary editing completed in February 2018

Results of the Household and Individual Interviews All Household Interviews Households selected 19,384 Households occupied 19,136 Households interviewed 18,802 Response rate 98% Interviews with ever-married Women age 15-49 Eligible women 14,870 Women interviewed 14,689 Response rate 99% Interviews with Men age 15-59 Eligible men 6,640 Men interviewed 6,429 Response rate 97%

Key Indicators 2017-18 Jordan Population and Family Health Survey (JPFHS)

Trends in Distribution of Ever-Married Women by Age Percent distribution JPFHS 2009 JPFHS 2012 JPFHS 2017-18 11 11 11 19 20 18 19 19 18 19 17 18 17 18 17 17 13 14 3 2 3 15-19 20-24 25-29 30-34 35-39 40-44 45-49

Trends in Educational Attainment of Ever-Married Women Age 15-49 32 31 36 43 45 42 Higher Secondary Preparatory Elementary No education 16 15 13 7 8 7 3 2 2 JPFHS 2009 JPFHS 2012 JPFHS 2017-18

Educational Attainment of Ever-Married Women and Men Age 15-49 36 33 42 47 Higher Secondary Preparatory Elementary No education 13 13 7 6 2 2 Women Men

Distribution of Respondents by Nationality Percent distribution Women Men 87 89 9 6 5 6 Jordanian Syrian Other nationalities

Trends in Fertility Births per woman for the 3-year period before the survey 5.6 4.4 3.7 3.6 3.8 3.5 2.7 1990 1997 2002 2007 2009 2012 2017-18

Fertility by Governorate Births per woman for the 3-year period before the survey Amman Balqa Zarqa Madaba Irbid Mafraq Jarash Aljun Karak Tafiela Ma'an Aqaba 2.3 2.6 2.7 3.1 3.1 3.5 3.5 2.3 3.1 2.6 2.6 4.1

Fertility by Nationality Births per woman for the 3-year period before the survey 4.7 2.7 2.6 1.9 Total Jordanian Syrian Other

Teenage Childbearing by Nationality Percent of women age 15-19 who are mothers or pregnant with their first child 28 5 3 Too few cases Total Jordanian Syrian Other

Fertility Preferences of Married Women Percent distribution of currently married women age 15-49 by desire for children Declared infecund 7% Have another soon 17% Want no more or sterilised 49% Have another later 18% Have another, undecided when Undecided 2% 7%

Fertility Preferences of Married Men Percent distribution of currently married women age 15-49 by desire for children Declared infecund 2% Want no more or sterilised 28% Have another soon 25% Have another later 9% Undecided 31% Have another, undecided when 5%

Trends in Contraceptive Use Births per woman for the 3-year period before the survey 42 Modern method 42 37 17 Traditional method 19 14 2009 2012 2017-18

Trends in Contraceptive Use by Method Percent of currently married women age 15-49 2009 2012 2017-18 23 21 21 131413 8 8 8 8 6 5 3 4 4 2 2 1 1 1 2 1 1 1 IUD Pill Male condom Female Injectables LAM Periodic Withdrawal sterilization abstinence

Modern Contraceptive Use by Governorate Percent of currently married women age 15-49 using a modern method Amman Balqa Zarqa Madaba Irbid Mafraq Jarash Aljun Karak Tafilh Ma'an Aqaba 25 38 32 40 37 38 32 43 41 36 40 32

Modern Contraceptive Use by Nationality Percent of women age 15-49 who are currently using a method of family planning 14 15 37 38 13 10 32 32 Traditional methods Modern methods Total Jordanian Syrian Other

Trends in Unmet Need and Demand Satisfied Percent of currently married women 52 58 59 58 58 57 Demand satisfied with modern methods 40 27 20 15 14 13 12 14 Unmet need for family planning 1900 1997 2002 2007 2009 2012 2017-18

Unmet Need and Demand Satisfied by Nationality Percent of currently married women Unmet need Demand satisfied by modern methods 57 58 51 52 14 14 19 19 Total Jordanian Syrian Other

Childhood Mortality Deaths per 1,000 live births for the 5-year period before the survey 11 6 17 3 19 Neonatal mortality Post-neonatal mortality Infant mortality Child mortality Under-5 mortality

Trends in Childhood Mortality Deaths per 1,000 live births for the 5-year period before the survey 39 Under-5 mortality 34 34 27 29 Infant mortality 22 5 6 5 Child mortality 21 19 2 28 21 19 23 17 17 5 4 3 1990 1997 2002 2007 2009 2012 2017-18

Trends in Maternal Health Skilled provider at delivery 97 98 99 100 100 87 97 99 99 93 98 Health facility delivery 79 79 79 7+ ANC visits 1990 1997 2002 2007 2012 2017-18

Antenatal Care by Nationality Percent of women age 15-49 with a live birth in the 5 years before the survey Antenatal care from skilled provider 7+ ANC visits 98 98 97 96 79 82 74 62 Total Jordanians Syrians Other nationalities

Delivery Care by Nationality Delivered by skilled provider Delivered in health facility 100 98 100 99 100 98 92 94 Total Jordanians Syrians Other nationalities

Childhood Vaccinations Percent of children age 12-23 months vaccinated 93 93 91 90 93 90 84 88 86 7 BCG 1 2 3 1 2 3 Measles-I All basic None DPT-IPV-Hib Polio

Childhood Vaccinations by Nationality Percent of children age 12-23 months vaccinated All basic None 86 88 76 75 20 7 6 9 Total Jordanians Syrians Other nationalities

Basic Vaccination Coverage by Governorate Percent of children age 12-23 months with all basic vaccinations Amman Balqa Zarqa Madaba Irbid Mafraq Jarash Aljun Karak Tafilh Ma'an Aqaba 64 76 85 89 86 87 87 87 88 91 88 91

Trends in Vaccination Coverage Percent of children age 12-23 months with all basic vaccinations 87 93 86 27 15 21 28 1990 1997 2002 2007 2009 2012 2017-18

Breastfeeding Status Under 6 Months Percent distribution of youngest children under 6 months who are living with their mother by breastfeeding status Breast milk plus complementary foods 17% Not breastfed 20% Breast milk plus water, other milk, or other non-milk liquids 37% Exclusively breastfed 26%

Trends in Exclusive Breastfeeding Percent of children age 0-5 months who are exclusively breastfed 39 27 22 23 26 11 1990 1997 2002 2007 2012 2017-18

Trends in Anaemia in Children Percent of children 6-59 months JPFHS 2009 JPFHS 2012 JPFHS 2017-18 34 32 32 19 20 21 15 12 11 Any anaemia Mild anaemia Moderate anaemia

Trends in Anaemia in Women Percent of ever-married women 15-49 JPFHS 2009 JPFHS 2012 JPFHS 2017-18 43 34 37 29 36 19 15 8 6 Any anaemia Mild anaemia Moderate anaemia

Anemia by Nationality Anemia in children Anemia in women 43 43 45 43 32 32 34 31 Total Jordanians Syrians Other nationalities

SDG Summary: KIR SDG # Indicator JPFHS Data 3.1.2 Proportion of births attended by skilled health personnel >99% 3.2.1 Under-5 mortality rate 19 3.2.2 Neonatal mortality rate 11 3.7.1 Need for family planning satisfied by modern methods 57% 5.6.1 Women who make their own informed decisions about sexual relations, contraceptive use and reproductive health care 58%

SDG Indicators in Final Report: SDG # Indicator 3.7.2 Adolescent birth rate 3.b.1 Vaccination coverage 5.2.1 Spousal violence (physical, sexual, emotional) 5.3.1 Women married before age 15 and 18 5.b.1 Mobile phone ownership 6.1.1 Population using safe drinking water 6.2.1 Population using safely managed sanitation including handwashing area 7.1.1 Population with access to electricity 7.1.2 Population with primarily reliance on clean fuels and technology 8.7.2 Adults with a bank account or other financial institution 16.9.1 Children with registered birth 17.8.1 Percent of individuals using the internet

Key Findings Women have an average of 2.7 children, a decline since 2009. The modern contraceptive prevalence rate among married women is 37%. Infant mortality rate is 17 deaths per 1,000 live births and under-5 mortality rate is 19 deaths per 1,000 live births. 98% of births were delivered in a health facility. 86% of children received are fully vaccinated. 32% of children and 43% of women are anaemic.