National Demographic and Health Survey 2008 - Philippines

Abstract
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The 2008 National Demographic and Health Survey (2008 NDHS) is a nationally representa­tive survey of 13,594 women age 15-49 from 12,469 households successfully interviewed, covering 794 enumeration areas (clusters) throughout the Philippines. This survey is the ninth in a series of demographic and health sur­veys conducted to assess the demographic and health situation in the country. The survey obtained detailed information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, and knowledge and attitudes regarding HIV/AIDS and tuberculosis. Also, for the first time, the Philippines NDHS gathered information on violence against women.

The 2008 NDHS was conducted by the Phil­ippine National Statistics Office (NSO). Techni­cal assistance was provided by ICF Macro through the MEASURE DHS program. Funding for the survey was mainly provided by the Gov­ernment of the Philippines. Financial support for some preparatory and processing phases of the survey was provided by the U.S. Agency for International Development (USAID).

Like previous Demographic and Health Surveys (DHS) conducted in the Philippines, the 2008 National Demographic and Health Survey (NDHS) was primarily designed to provide information on population, family planning, and health to be used in evaluating and designing policies, programs, and strategies for improving health and family planning services in the country. The 2008 NDHS also included questions on domestic violence. Specifically, the 2008 NDHS had the following objectives:

- Collect data at the national level that will allow the estimation of demographic rates, particularly, fertility rates by urban-rural residence and region, and under-five mortality rates at the national level.
- Analyze the direct and indirect factors which determine the levels and patterns of fertility.
- Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region.
- Collect data on family health: immunizations, prenatal and postnatal checkups, assistance at delivery, breastfeeding, and prevalence and treatment of diarrhea, fever, and acute respiratory infections among children under five years.
- Collect data on environmental health, utilization of health facilities, prevalence of common non­communicable and infectious diseases, and membership in health insurance plans.
- Collect data on awareness of tuberculosis.
- Determine women's knowledge about HIV/AIDS and access to HIV testing.
- Determine the extent of violence against women.

MAIN RESULTS

FERTILITY

Fertility Levels and Trends. There has been a steady decline in fertility in the Philippines in the past 36 years. From 6.0 children per woman in 1970, the total fertility rate (TFR) in the Phil­ippines declined to 3.3 children per woman in 2006. The current fertility level in the country is relatively high compared with other countries in Southeast Asia, such as Thailand, Singapore and Indonesia, where the TFR is below 2 children per woman.

Fertility Differentials. Fertility varies substan­tially across subgroups of women. Urban women have, on average, 2.8 children compared with 3.8 children per woman in rural areas. The level of fer­tility has a negative relationship with education; the fertility rate of women who have attended college (2.3 children per woman) is about half that of women who have been to elementary school (4.5 children per woman). Fertility also decreases with household wealth: women in wealthier households have fewer children than those in poorer households.

FAMILY PLANNING

Knowledge of Contraception. Knowledge of family planning is universal in the Philippines- almost all women know at least one method of fam-ily planning. At least 90 percent of currently married women have heard of the pill, male condoms, injectables, and female sterilization, while 87 percent know about the IUD and 68 percent know about male sterilization. On aver­age, currently married women know eight meth­ods of family planning.

Unmet Need for Family Planning. Unmet need for family planning is defined as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. The 2008 NDHS data show that the total unmet need for family planning in the Philip­pines is 22 percent, of which 13 percent is limiting and 9 percent is for spacing. The level of unmet need has increased from 17 percent in 2003.

Overall, the total demand for family planning in the Philippines is 73 percent, of which 69 percent has been satisfied. If all of need were satisfied, a contraceptive prevalence rate of about 73 percent could, theoretically, be expected. Comparison with the 2003 NDHS indicates that the percentage of de­mand satisfied has declined from 75 percent.

MATERNAL HEALTH

Antenatal Care. Nine in ten Filipino mothers received some antenatal care (ANC) from a medical professional, either a nurse or midwife (52 percent) or a doctor (39 percent). Most women have at least four antenatal care visits. More than half (54 per­cent) of women had an antenatal care visit during the first trimester of pregnancy, as recommended. While more than 90 percent of women who received ante­natal care had their blood pressure monitored and weight measured, only 54 percent had their urine sample taken and 47 percent had their blood sample taken. About seven in ten women were informed of pregnancy complications. Three in four births in the Philippines are protected against neonatal tetanus.

Delivery and Postnatal Care. Only 44 per­cent of births in the Philippines occur in health facilities-27 percent in a public facility and 18 percent in a private facility. More than half (56 percent) of births are still delivered at home. Sixty-two percent of births are assisted by a health professional-35 percent by a doctor and 27 percent by a midwife or nurse. Thirty-six percent are assisted by a traditional birth atten­dant or hilot. About 10 percent of births are de­livered by C-section.

The Department of Health (DOH) recom­mends that mothers receive a postpartum check within 48 hours of delivery. A majority of women (77 percent) had a postnatal checkup within two days of delivery; 14 percent had a postnatal checkup 3 to 41 days after delivery.

CHILD HEALTH

Childhood Mortality. Childhood mortality continues to decline in the Philippines. Cur­rently, about one in every 30 children in the Philippines dies before his or her fifth birthday. The infant mortality rate for the five years be­fore the survey (roughly 2004-2008) is 25 deaths per 1,000 live births and the under-five mortality rate is 34 deaths per 1,000 live births. This is lower than the rates of 29 and 40 reported in 2003, respectively. The neonatal mortality rate, representing death in the first month of life, is 16 deaths per 1,000 live births. Under-five mortal­ity decreases as household wealth increases; children from the poorest families are three times more likely to die before the age of five as those from the wealthiest families.

There is a strong association between under-five mortality and mother's education. It ranges from 47 deaths per 1,000 live births among chil­dren of women with elementary education to 18 deaths per 1,000 live births among children of women who attended college. As in the 2003 NDHS, the highest level of under-five mortality is observed in ARMM (94 deaths per 1,000 live births), while the lowest is observed in NCR (24 deaths per 1,000 live births).

NUTRITION

Breastfeeding Practices. Eighty-eight percent of children born in the Philippines are breastfed. There has been no change in this practice since 1993. In addition, the median durations of any breastfeeding and of exclusive breastfeeding have remained at 14 months and less than one month, re­spectively. Although it is recommended that infants should not be given anything other than breast milk until six months of age, only one-third of Filipino children under six months are exclusively breastfed. Complementary foods should be in­troduced when a child is six months old to re­duce the risk of malnutrition. More than half of children ages 6-9 months are eating complemen­tary foods in addition to being breastfed.

The Infant and Young Child Feeding (IYCF) guidelines contain specific recommendations for the number of times that young children in vari­ous age groups should be fed each day as well as the number of food groups from which they should be fed. NDHS data indicate that just over half of children age 6-23 months (55 percent) were fed according to the IYCF guidelines.

HIV/AIDS

Awareness of HIV/AIDS. While over 94 percent of women have heard of AIDS, only 53 percent know the two major methods for pre­venting transmission of HIV (using condoms and limiting sex to one uninfected partner). Only 45 percent of young women age 15-49 know these two methods for preventing HIV transmis­sion. Knowledge of prevention methods is higher in urban areas than in rural areas and in­creases dramatically with education and wealth. For example, only 16 percent of women with no education know that using condoms limits the risk of HIV infection compared with 69 percent of those who have attended college.

TUBERCULOSIS

Knowledge of TB. While awareness of tubercu­losis (TB) is high, knowledge of its causes and symptoms is less common. Only 1 in 4 women know that TB is caused by microbes, germs or bacteria. Instead, respondents tend to say that TB is caused by smoking or drinking alcohol, or that it is inherited. Symptoms associated with TB are better recognized. Over half of the respondents cited coughing, while 39 percent mentioned weight loss, 35 percent men­tioned blood in sputum, and 30 percent cited cough­ing with sputum.

WOMEN'S STATUS

Women's Status and Employment. Sixty percent of currently married women age 15-49 interviewed in the 2008 NDHS were employed in the year before the survey. Among those who are employed, most earn cash, while 6 percent are unpaid. Most women decide how their earn­ings are spent jointly with their husbands. Only four percent report that mainly their husband decides how their earnings are spent.

DOMESTIC VIOLENCE

Spousal Violence. Emotional and other forms of non-personal violence-such as insults, humiliation, and threats of harm-are the most common types of spousal violence: 23 percent of ever-married women report having experienced such violence by their husbands, with 15 percent reporting these types of violence occurred in the year prior to the survey.

Geographic coverage
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National. The NDHS sample was designed to represent each of the country's 17 administrative regions.

Analysis unit
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- Household
- Women age 15-49
- Men age 15-54
- Children under five years

Universe
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The population covered by the 1998 Phillipines NDS is defined as the universe of all females age 15-49 years, who are members of the sample household or visitors present at the time of interview and had slept in the sample households the night prior to the time of interview, regardless of marital status and all men age 15-54 living in the household.

Kind of data
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Sample survey data

Sampling procedure
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The 2008 NDHS used the 2003 master sample created by NSO for its household-based surveys. The 2008 NDHS used one of the four replicates of the master sample. The NDHS sample was designed to represent each of the country's 17 administrative regions. In each region, a stratified three-stage sample design was employed. At the first stage, primary sampling units (PSUs) were selected with probability proportional to the estimated number of households from the 2000 Census. PSUs consisted of one barangay or a group of contiguous barangays. At the second stage, enumeration areas (EAs) were selected within sampled PSUs with probability proportional to size. At the third stage, housing units were selected with equal probability within sampled EAs.

An EA is defined as an area with discernable boundaries within barangays and consisting of about 150 contiguous households. These EAs were identified during the 2000 Census.

The 2008 NDHS sample contains 794 enumeration areas (EAs). From each EA, an average of 17 housing units was selected using systematic sampling. All households in a sampled housing unit were interviewed, except when there were three or more households in the housing unit. For such a housing unit, three households were selected using simple random sampling. Over 13,500 households were selected for the 2008 NDHS. The sampled households per EA ranged from as low as 3 to as high as 32.

Mode of data collection
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Face-to-face

Research instrument
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Three questionnaires were used for the 2008 NDHS: a) the Household Questionnaire, b) the Women's Questionnaire and c) the Women's Safety Module. These questionnaires were based on the standard questionnaires developed by the MEASURE DHS program and modified-as recommended by the technical working groups and approved by the Steering Committee-to address relevant family planning and health issues in the Philippines. The three questionnaires were translated from English into six major dialects-Tagalog, Cebuano, Ilocano, Bicol, Hiligaynon, and Waray.

a) The Household Questionnaire was used to list all the usual members and visitors in the selected households, as well as some background information on each person listed such as age, sex, relationship to head of the household, health insurance coverage, and education. The main purpose of the Household Questionnaire was to identify women who were eligible for the individual interview. Information on characteristics of the household's dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor, roof, and walls of the house, and ownership of various durable goods was recorded in the Household Questionnaire. These items are indicators of the household's socioeconomic status. Finally, this questionnaire was used to gather information on prevalence of common noncommuni­cable and infectious diseases, health-seeking behavior, and utilization of health facilities by household members.

b) The Women's Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics:
- Background characteristics (e.g., education, media exposure)
- Reproductive history
- Knowledge and use of family planning methods
- Prenatal, delivery, and postnatal care and breastfeeding
- Child immunization and health and nutrition of mothers and children
- Marriage and sexual activity
- Fertility preferences
- Woman's work and husband's background characteristics
- Awareness and behavior regarding HIV/AIDS
- Other health issues

c) The Women's Safety Module was used to interview one respondent selected from all eligible women age 15 to 49 years who were identified from the Household Questionnaire. It collected information on the following topics:
- Women's experience of violence since age 15 and in the 12 months preceding the survey
- Violence during pregnancy
- Marital control
- Interspousal violence
- Experience of forced sex at sexual initiation
- Help-seeking behavior by women who have experienced violence

Three pretests were conducted in 2008 prior to finalizing the survey instruments. The first was conducted in March, the second in April, and the third in May. The pretests primarily aimed to test the questionnaires for clarity and correctness of the new questions; the suitability of the translations in the six dialects (Tagalog, Cebuano, Ilocano, Bicol, Hiligaynon, and Waray); the sustainability of respondents' participation in the survey; and the actual field operation procedures.

Cleaning operations
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Data processing was carried out at the NSO central office in Manila. It consisted of manual editing, data entry, verification, and editing of computer-identified errors. Forty-five hired data processors who underwent training October 6-17, 2008 processed the 2008 NDHS data.

An ad hoc group composed of eight employees from the Demographic and Social Statistics Division, the Information Resources Division, and the Information Technology Operations Division of the NSO was created. They worked full time at the NDHS Data Processing Center and were responsible for various aspects of the NDHS data processing.

Manual editing began October 7, 2008 and data entry began October 21, 2008. The computer software package called CSPro (Census and Survey Processing System) was used for data entry. The data entry program was developed in Manila at NSO with the assistance of data processing specialists from ICF Macro. Data processing was completed on December 22, 2008.

Response rate
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In the 2008 NDHS a total of 13,764 households were selected in the sample, of which 12,555 households were occupied. Of these households, 12,469 were successfully interviewed, yielding a household response rate of 99 percent.

In the interviewed households 13,833 women were identified for the individual interview. A total of 13,594 women were successfully interviewed, yielding a response rate of 98 percent. A total of 9,458 women were identified as eligible for the Women's Safety Module, of whom 9,316 were interviewed with privacy, yielding a response rate of 99 percent. Response rates in urban and rural areas were similar.

Sampling error estimates
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Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents se­lected in the 2008 NDHS is only one of many samples that could have been selected from the same popu­lation, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calcu­late confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2008 NDHS sam­ple is the result of a multi-stage stratified design, and, consequently, it was necessary to use more com­plex formulae. The computer software used to calculate sampling errors for the 2008 NDHS is a Macro SAS procedure. This procedure used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated-replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

The Jackknife repeated-replication method derives estimates of complex rates from each of sev­eral replications of the parent sample, and calculates standard errors for these estimates using simple for­mulae. Each replication considers all but one cluster in the calculation of the estimates. Pseudo-independent replications are thus created. In the 2008 NDHS, there were 792 non-empty clusters. Hence, 792 replications were created.

In addition to the standard error, the procedure computes the design effect (DEFT) for each esti­mate, which is defined as the ratio between the standard error using the given sample design and the stan­dard error that would result if a simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error because of the use of a more complex and less statistically efficient design. The procedure also computes the relative error and confidence limits for the estimates.

Sampling errors for the 2008 NDHS are calculated for selected variables considered to be of pri­mary interest. The results are presented in an appendix to the Final Report for the country as a whole, for urban and rural areas, and for each of the 17 geographical regions. For each variable, the type of statistic (mean, propor­tion, or rate) and the base population are given in Table B.1 of the Final Report. Tables B.2 to B.21 present the value of the statistic (R), its standard error (SE), the number of unweighted (N-UNWE) and weighted (N-WEIG) cases, the design effect (DEFT), the relative standard error (SE/R), and the 95 percent confidence limits (R±2SE), for each variable. The DEFT is considered undefined when the standard error considering sim­ple random sample is zero (when the estimate is close to 0 or 1). In the case of the total fertility rate, the number of unweighted cases is not relevant, as there is no known unweighted value for woman-years of exposure to childbearing.

The confidence interval (e.g., as calculated for children ever born to women 40-49) can be inter­preted as follows: the overall average from the national sample is 3.964 and its standard error is 0.060. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 3.964±2×0.060. There is a high probability (95 percent) that the true average number of children ever born to all women is between 3.845 and 4.083. For the total sample, the value of the DEFT, averaged over all variables, is 1.219. This means that, because of multi-stage clustering of the sample, the average standard error is increased by a factor of 1.219 over that in an equivalent simple random sample.

Data appraisal
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Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numer­ous efforts were made during the implementation of the 2008 Philippines National Demographic and Health Survey (NDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

摘要
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2008年菲律宾全国人口与健康调查（2008年NDHS）是对12,469个成功采访的家庭中的13,594名15-49岁女性的全国代表性调查。该调查覆盖了菲律宾全国794个（群）统计区域。此次调查是该系列人口与健康调查的第九次，旨在评估国家的 demographics 和健康状况。调查获得了关于生育水平、婚姻、生育偏好、计划生育方法的认知和使用、母乳喂养实践、妇女和婴幼儿的营养状况、儿童死亡率、母婴健康以及关于HIV/AIDS和结核病的知识和态度的详细信息。此外，菲律宾NDHS首次收集了关于针对妇女的暴力的信息。

2008年NDHS由菲律宾国家统计局（NSO）执行。技术援助由ICF Macro通过MEASURE DHS项目提供。调查的资金主要由菲律宾政府提供。调查的某些准备和处理阶段的资金由美国国际开发署（USAID）提供。

与菲律宾之前进行的其他人口与健康调查（DHS）一样，2008年国家人口与健康调查（NDHS）的主要目的是提供有关人口、计划生育和健康的信息，以便评估和设计改善国家健康和计划生育服务的政策、项目和战略。2008年NDHS还包括有关家庭暴力的调查。具体而言，2008年NDHS有以下目标：

- 收集国家级数据，以估计人口增长率，特别是城市-农村居住地和地区的生育率，以及全国5岁以下死亡率。
- 分析决定生育水平和模式的直接和间接因素。
- 衡量按方法、城市-农村居住地和地区衡量的避孕知识与实践水平。
- 收集关于家庭健康的数据：免疫接种、孕前和产后检查、分娩援助、母乳喂养以及5岁以下儿童中腹泻、发热和急性呼吸道感染的发生率和治疗。
- 收集关于环境卫生、健康设施的使用、常见非传染性和传染性疾病的流行率和健康保险计划的成员资格的数据。
- 收集关于结核病认知的数据。
- 确定妇女对HIV/AIDS的知识和HIV检测的获取。
- 确定针对妇女的暴力的程度。

主要结果

生育率

生育水平和趋势。过去36年里，菲律宾的生育率一直在稳步下降。从1970年的每名女性6.0个孩子，菲律宾的总生育率（TFR）下降到2006年的每名女性3.3个孩子。与东南亚其他一些国家（如泰国、新加坡和印度尼西亚）相比，该国的生育率相对较高，这些国家的TFR低于每名女性2个孩子。

生育率差异。生育率在女性子群体之间差异很大。城市女性的平均生育率是2.8个孩子，而农村地区的生育率是每名女性3.8个孩子。生育率与教育水平呈负相关；受过大学教育的女性的生育率（每名女性2.3个孩子）大约是受过小学教育的女性的生育率（每名女性4.5个孩子）的一半。生育率也随着家庭财富的增加而降低：富裕家庭的女性比贫困家庭的女性有更少的孩子。

计划生育

避孕知识的了解。在菲律宾，计划生育的知识是普遍的——几乎所有的女性都知道至少一种计划生育方法。目前，至少90%的已婚女性听说过避孕药、男用避孕套、注射剂和女性绝育术，而87%的人知道宫内节育器，68%的人知道男性绝育术。平均而言，目前已婚女性知道8种计划生育方法。

计划生育未满足的需求。计划生育未满足的需求是指目前已婚女性中那些既不希望再要孩子或想要在下一个出生之前等待，但又不使用任何计划生育方法的百分比。2008年NDHS数据显示，菲律宾的计划生育未满足的需求总量为22%，其中13%是限制性需求，9%是间隔需求。未满足需求水平自2003年的17%以来有所上升。

总体而言，菲律宾的计划生育需求总量为73%，其中69%得到了满足。如果所有需求都得到满足，理论上避孕的普及率可以达到73%左右。与2003年NDHS的比较表明，需求得到满足的百分比已从75%下降。

孕产妇健康

孕前保健。十位菲律宾母亲中有九位接受了来自医疗专业人员（护士或助产士的52%）或医生的39%的孕前保健（ANC）。大多数女性至少有四次孕前保健访问。超过一半（54%）的女性在怀孕的第一个 trimester期间进行了孕前保健访问，这是推荐的。虽然超过90%接受孕前保健的女性接受了血压监测和体重测量，但只有54%的人接受了尿液样本检测，47%的人接受了血液样本检测。大约七成女性被告知了怀孕并发症。菲律宾的出生中，有四分之三受到新生儿破伤风的保护。

分娩和产后保健。在菲律宾，只有44%的分娩发生在医疗机构——27%在公共设施，18%在私人设施。超过一半（56%）的分娩仍然在家进行。62%的分娩由健康专业人员协助——35%由医生协助，27%由助产士或护士协助。36%由传统的接生员或hilot协助。大约10%的分娩是通过剖腹产进行的。卫生部门（DOH）建议母亲在分娩后48小时内接受产后检查。大多数女性（77%）在分娩后两天内接受了产后检查；14%在分娩后3-41天内接受了产后检查。

儿童健康

儿童死亡率。菲律宾的儿童死亡率持续下降。目前，每30名儿童中就有1名在5岁之前死亡。调查前五年（大致为2004-2008年）的婴儿死亡率是每1000名活产婴儿25人死亡，5岁以下死亡率是每1000名活产婴儿34人死亡。这低于2003年报告的29和40的比率。新生儿死亡率，代表出生后第一个月的死亡率，是每1000名活产婴儿16人死亡。5岁以下死亡率随着家庭财富的增加而降低；来自最贫困家庭的孩子在5岁之前死亡的可能性是来自最富裕家庭孩子的三倍。

5岁以下死亡率和母亲的受教育程度之间存在着强烈的关联。在受过小学教育的妇女的孩子中，这一比例为每1000名活产婴儿47人死亡，而在受过高等教育的妇女的孩子中，这一比例为每1000名活产婴儿18人死亡。与2003年NDHS一样，5岁以下死亡率最高的是ARMM（每1000名活产婴儿94人死亡），最低的是NCR（每1000名活产婴儿24人死亡）。

营养

母乳喂养实践。在菲律宾出生的88%的儿童都接受了母乳喂养。自1993年以来，这一做法没有发生变化。此外，任何母乳喂养和纯母乳喂养的中位持续时间分别保持在14个月和不到一个月。尽管建议婴儿在六个月大之前不应给予任何其他食物，只有三分之一的菲律宾6个月以下的儿童是纯母乳喂养的。在儿童六个月大时，应引入辅食以降低营养不良的风险。6-9个月大的儿童中，超过一半（55%）的儿童在母乳喂养的同时还在吃辅食。

婴儿和幼儿喂养（IYCF）指南包含针对各个年龄段幼儿每天应喂食的次数以及应从哪些食物组中喂食的具体建议。NDHS数据显示，6-23个月大的儿童中，有55%的儿童是根据IYCF指南喂养的。

HIV/AIDS

HIV/AIDS的认知。虽然94%以上的女性听说过艾滋病，但只有53%的人知道预防HIV传播的两种主要方法（使用避孕套和将性行为限制为一名未感染伴侣）。只有45%的15-49岁年轻女性知道这两种预防HIV传播的方法。预防方法的认知在城区高于农村地区，并且随着教育和财富的增加而显著提高。例如，只有16%的无教育女性知道使用避孕套可以降低HIV感染的风险，而受过高等教育的女性中，这一比例为69%。

结核病

对TB的认知。虽然对结核病（TB）的认知很高，但对它的原因和症状的认知较少。只有四分之一的女性知道TB是由微生物、细菌或细菌引起的。相反，受访者倾向于说TB是由吸烟或饮酒引起的，或者说是遗传的。与TB相关的症状更容易被识别。超过一半的受访者提到了咳嗽，39%的人提到了体重减轻，35%的人提到了痰中带血，30%的人提到了痰中带血。

妇女地位

妇女地位和就业。在2008年NDHS中采访的15-49岁已婚女性中，有60%在调查前一年就业。在就业者中，大多数人获得现金收入，而6%的人是无偿的。大多数女性与丈夫共同决定如何使用他们的收入。只有4%的人报告说主要是丈夫决定如何使用他们的收入。

家庭暴力

配偶暴力。情感和其他形式的非个人暴力——如侮辱、羞辱和伤害威胁——是最常见的配偶暴力类型：23%的已婚女性报告称曾遭受丈夫的此类暴力，其中15%的人报告称在调查前一年内发生了这类暴力。

地理覆盖范围
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全国。

分析单元
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- 家庭
- 15-49岁女性
- 15-54岁男性
- 5岁以下儿童

总体
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由1998年菲律宾NDS覆盖的人口定义为所有15-49岁女性，她们是样本家庭的成员或采访时的访客，并在采访前的夜晚在样本家庭中过夜，无论婚姻状况如何，以及所有居住在家庭中的15-54岁男性。

数据类型
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样本调查数据

抽样程序
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2008年NDHS使用了NSO为其家庭调查创建的2003年主样本之一。NDHS样本旨在代表国家的17个行政区域。在每个区域，采用了分层三阶段抽样设计。在第一阶段，选择具有与估计的家庭数量成比例的概率的初级抽样单位（PSU）。PSU由一个barangay或一组相邻的barangay组成。在第二阶段，在样本PSU内根据规模选择统计区域。在第三阶段，在样本统计区域内部以相等的概率选择住房单位。

一个统计区域定义为在barangay内有可识别边界的区域，并包含大约150个相邻的家庭。这些统计区域在2000年人口普查期间确定。

2008年NDHS样本包含794个统计区域（EA）。从每个统计区域，平均选择17个住房单位使用系统抽样。除了有三个或更多家庭的住房单位外，对样本住房单位中的所有家庭进行了采访。对于此类住房单位，使用简单随机抽样选择了三个家庭。为2008年NDHS选择了超过13,500个家庭。每个统计区域的样本家庭数量从最低的3个到最高的32个不等。

数据收集方式
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面对面

研究工具
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2008年NDHS使用了三个问卷：a）家庭问卷，b）女性问卷和c）女性安全模块。这些问卷基于MEASURE DHS项目开发的标准化问卷，并根据技术工作组建议和指导委员会批准进行了修改，以解决菲律宾相关的计划生育和健康问题。这三个问卷被翻译成六种主要方言——他加禄语、宿务语、伊洛科语、比科尔语、希利加农语和瓦莱语。

a）家庭问卷用于列出所选家庭中的所有常驻成员和访客，以及有关每个被列出人员的背景信息，例如年龄、性别、与户主的亲属关系、医疗保险覆盖范围和教育。家庭问卷的主要目的是确定符合个体采访条件的女性。在家庭问卷中记录了有关家庭住房单位特征的信息，例如水源、卫生设施类型、地板、屋顶和墙壁的材料以及各种耐用品的所有权。这些项目是家庭社会经济地位的指标。最后，此问卷用于收集有关家庭成员常见非传染性和传染性疾病的发病率、健康寻求行为以及家庭成员使用健康设施的信息。

b）女性问卷用于收集所有15-49岁女性的信息。这些女性被问及以下主题：
- 背景特征（例如，教育、媒体接触）
- 生殖史
- 计划生育方法的认知和使用
- 孕前、分娩和产后保健及母乳喂养
- 儿童免疫接种和母亲及儿童的健康与营养
- 婚姻和性行为
- 生育偏好
- 妇女工作和丈夫的背景特征
- 关于HIV/AIDS的认知和行为
- 其他健康问题

c）女性安全模块用于采访从家庭问卷中确定的符合条件的所有15至49岁女性中选出的受访者。它收集以下主题的信息：
- 自15岁以来和调查前12个月女性遭受的暴力经历
- 怀孕期间的暴力
- 婚姻控制
- 配偶间的暴力
- 性初始时的强迫性行为经历
- 女性遭受暴力时的寻求帮助行为

在2008年进行三次预测试，以在最终确定调查工具之前进行测试。第一次是在3月，第二次是在4月，第三次是在5月。预测试的主要目的是测试问卷的清晰度和新问题的正确性；六种方言（他加禄语、宿务语、伊洛科语、比科尔语、希利加农语和瓦莱语）翻译的适用性；受访者参与调查的可持续性；以及实际现场操作程序。

数据清理
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数据处理是在马尼拉国家统计局中央办公室进行的。它包括手动编辑、数据录入、验证和编辑计算机识别的错误。45名经过培训的数据处理员于2008年10月6日至17日处理了2008年NDHS数据。

一个由来自国家统计局人口和社会统计司、信息资源司和信息技术操作司的八名员工组成的临时小组被创建。他们在NDHS数据处理中心全职工作，负责NDHS数据处理的各种方面。

手动编辑始于2008年10月7日，数据录入始于10月21日。用于数据录入的计算机软件包是CSPro（人口和调查处理系统）。数据录入程序是在马尼拉国家统计局开发的，得到了ICF Macro的数据处理专家的帮助。数据处理于2008年12月22日完成。

响应率
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在2008年NDHS中，共选择了13,764个家庭样本，其中12,555个家庭有人居住。在这些家庭中，12,469个家庭被成功采访，户囗响应率为99%。在采访的家庭中，确定了13,833名女性进行个别采访。总共采访了13,594名女性，响应率为98%。共确定了9,458名符合女性安全模块条件的女性，其中9,316名女性在私密的情况下接受了采访，响应率为99%。城市和农村地区的响应率相似。

抽样误差估计
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另一方面，抽样误差可以从统计上进行评估。2008年NDHS中选定的受访者样本只是从同一人口中可以选出的许多样本之一，使用相同的设计和预期规模。这些样本中的每一个都会产生与实际样本所选结果略有不同的结果。抽样误差是衡量所有可能样本之间差异的指标。虽然差异的程度无法确切知道，但它可以从调查结果中估计。

抽样误差通常以特定统计量（平均值、百分比等）的标准误差来衡量，这是方差的平方根。标准误差可用于计算置信区间，其中可以合理假设总体真实值位于该区间内。例如，对于从样本调查中计算出的任何给定统计量，该统计量的值将在95%的所有可能样本中相同规模和设计的情况下，加减两倍标准误差的范围内。

如果受访者样本被选为简单随机样本，则可以使用简单的公式来计算抽样误差。但是，2008年NDHS样本是多层次分层设计的产物，因此有必要使用更复杂的公式。用于计算2008年NDHS抽样误差的计算机软件是Macro SAS过程。该过程使用泰勒线性化方法估计调查估计的方差或比例。用于更复杂的统计量（如生育率和死亡率）的方差估计使用Jackknife重复复制方法。

Jackknife重复复制方法从父样本的每个重复中推导出复杂率估计，并使用简单的公式计算这些估计的标准误差。每个重复考虑了计算估计时除一个群组之外的所有群组。从而创建了伪独立重复。在2008年NDHS中，有792个非空群组。因此，创建了792个重复。

除了标准误差外，该程序还为每个估计计算设计效应（DEFT），它定义为使用给定样本设计和使用简单随机样本将导致的标准误差之间的比率。DEFT值为1.0表示样本设计与简单随机样本一样有效，而大于1.0的值表示由于使用更复杂且统计效率较低的样本设计而增加的抽样误差。程序还计算估计的相对误差和置信限。

2008年NDHS的抽样误差为选定变量计算，这些变量被认为是主要感兴趣的数据。结果在最终报告的附录中按国家整体、城市和农村地区以及每个地理区域进行呈现。对于每个变量，给出了统计量的类型（平均值、比例或比率）和基人口在最终报告表B.1中。表B.2到B.21显示了统计量的值（R）、其标准误差（SE）、未加权（N-UNWE）和加权（N-WEIG）案例的数量、设计效应（DEFT）、相对标准误差（SE/R）和95%置信限（R±2SE），每个变量。当考虑简单随机样本的标准误差为零时（当估计接近0或1时），DEFT被认为是未定义的。在总生育率的情况下，未加权案例的数量是不相关的，因为没有已知的未加权值，即暴露于生育的女性年数。

置信区间（例如，为女性40-49岁所生的孩子计算）可以这样解释：国家样本的总体平均值为3.964，其标准误差为0.060。因此，为了获得95%置信限，将两次标准误差加到样本估计值上，即3.964±2×0.060。有很高的可能性（95%）认为，所有女性实际出生的孩子总数在3.845和4.083之间。对于总样本，所有变量的平均值DEFT为1.219。这意味着，由于样本的多阶段聚类，平均标准误差比等效简单随机样本增加了1.219倍。

数据评估
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非抽样误差是由于在实施数据收集和数据处理过程中出现的错误而产生的结果，例如未能找到和采访正确的家庭，采访者或受访者对问题的误解，以及数据录入错误。尽管在实施2008年菲律宾国家人口与健康调查（NDHS）时做出了许多努力来最大限度地减少此类错误，但非抽样误差是无法避免的，并且很难从统计上进行评估。