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### Viewing cable 04LAGOS1247, INITIATION OF EMBASSY EST&H REPORTING:

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
04LAGOS1247 | 2004-06-18 08:27 | 2011-08-25 00:00 | UNCLASSIFIED | Consulate Lagos

`

    This record is a partial extract of the original cable. The full text of the original cable is not available.

    180827Z Jun 04

` `

    UNCLAS SECTION 01 OF 03 LAGOS 001247

    SIPDIS

    FOR S/GAC

    E.O. 12958: N/A
    TAGS: TBIO SOCI ECON PGOV NI
    SUBJECT: INITIATION OF EMBASSY EST&H REPORTING:
    FINDINGS OF THE 2003 DEMOGRAPHIC AND HEALTH SURVEY;
    FERTILITY, FAMILY PLANNING, HIV/AIDS: PART I OF III

    ¶1. Introduction.  This report is the first of what will
    become regular reports by the officer responsible for
    environment, science, technology, and health (EST&H) at
    Embassy Abuja.  Pending the assignment in Abuja of such
    an officer, the Mission's economic officers, assisted
    by USAID colleagues, will produce the initial reports.
    For the foreseeable future, the thrust will be on
    Nigerian developments relating to the President's
    Emergency Plan for AIDS Relief (PEPFAR). Readers should
    expect most of the reports to address the social and
    economic factors that influence the spread of this
    disease. The reports will be geared toward the needs
    and interests of officials within the Office of the
    Global AIDS Coordinator, as well as other interested
    parties within the interagency community.  End
    introduction.

    ¶2.  Summary.  The findings below and in the two cables
    that follow are lifted from the executive summary of
    the 2003 Nigeria Demographic and Health Survey.  The
    findings provide baseline data that much of our
    subsequent reports will reflect.  This one presents the
    most recent aggregate data on Nigerian fertility,
    family planning, and HIV/AIDS and other sexually
    transmitted infections.  The second report addresses
    women's health and social status.  The third centers on
    malaria control, and child health and nutrition.   We
    will follow the evolution of the relevant indicators
    closely, not only because of their importance to
    PEPFAR, but also because of their relationship to the
    Millennium Development Goals.   End summary.

    ¶3. The 2003 Nigeria Demographic and Health Survey (2003
    NDHS), published in April 2004, is the third national
    demographic and health survey conducted in Nigeria. The
    2003 NDHS is based on a nationally representative
    sample of over 7,000 households. All women 15-49 years
    of age in these households and all men aged 15-59 in a
    sub-sample of one-third of the households were
    individually interviewed. The survey provides up to
    date information on population and public health in
    Nigeria.  The 2003 NDHS records current information on
    fertility levels and preferences, awareness and use of
    family planning methods, maternal and child health,
    breastfeeding practices, nutritional status of women
    and young children, childhood mortality, use of anti-
    malaria bed nets, female circumcision, marriage, sexual
    activity, and awareness of and behavioral responses to
    AIDS and other sexually transmitted infections in
    Nigeria.

    FERTILITY

    ¶4. Fertility Levels, Trends, and Preferences.  The 2003
    NDHS established that the total fertility rate (TFR) in
    Nigeria was 5.7 in 2003.  This means that, at current
    fertility levels, the average Nigerian woman who is at
    the beginning of her childbearing years will give birth
    to 5.7 children by the end of her lifetime. (In other
    words, for every 10 Nigerian women who are at the
    beginning of their childbearing years, 57 children will
    be born during the women's lifetime. Multiplying the
    birth data below by a factor of 10 will yield whole
    numbers.) Compared with previous national surveys, the
    2003 survey shows a modest decline in fertility over
    the last two decades: from a TFR of 6.3 in the 1981-82
    National Fertility Survey to 6.0 in the 1990 NDHS and
    5.7 in the 2003 NDHS. However, the 2003 NDHS rate of
    5.7 is significantly higher than the 1999 NDHS rate of
    5.2, which underestimated the level of fertility then
    prevailing in Nigeria.

    ¶5. The 2003 NDHS shows that, on average, rural women
    will have one more child than will urban women (6.1 and
    4.9, respectively) during their childbearing years.
    Fertility varies considerably by region of residence,
    lower rates being recorded in the south and higher
    rates in the north. Fertility is also strongly
    correlated negatively with a woman's educational
    attainment.

    ¶6. Most Nigerians, irrespective of their number of
    living children, want large families. The ideal number
    of children was 6.7 for all women and 7.3 for currently
    married women at the time of the survey.  Nigerian men
    want even more children than do women. The ideal number
    of children for all men was 8.6 and for currently
    married men 10.6. Clearly, one reason for the slow
    decline in Nigerian fertility is the desire for large
    families.

    ¶7. Birth Intervals. A 36-month interval between
    deliveries is best for mother and child. The median
    birth interval in Nigeria was 31 months in 2003. The
    median interval was lowest among mothers aged 15-19 (26
    months) and highest among mothers 40-49 years of age
    (39 months). While there was no difference in birth
    intervals between urban and rural women, birth
    intervals varied considerably by region of residence.
    Women in the South West have the longest median birth
    interval (37 months) and women in the South East the
    shortest (27 months), a difference of almost one year.

    ¶8. Initiation of Sexual Behavior and Childbearing at
    Young Ages. One-third of women between the age of 25-49
    reported they had had sexual intercourse by age 15. By
    age 20 more than three-quarters of women and by age 25
    nine-tenths of them had had sexual intercourse. One-
    quarter of the teenage women surveyed had given birth
    or been pregnant. Early childbearing occurs more often
    in rural areas: 30 percent of rural women aged 15-19
    had begun childbearing compared with 17 percent of
    urban women in the same age group. The median age at
    first birth is nonetheless rising. Whereas median age
    at first birth was less than 19 years among women over
    age 35, it was 20.3 years among women aged 25-29.

    FAMILY PLANNING

    ¶9. Knowledge of Family Planning Methods. About eight in
    ten women and nine in ten men knew of at least one
    modern method of family planning in 2003. The pill,
    injectable contraceptives, and the male condom are the
    most widely known modern methods among both women and
    men. Mass media is an important source of information
    on family planning. Radio is the most frequent source
    of family planning messages: 40 percent of women and 56
    percent of men said they had heard at least one radio
    message about family planning during the year preceding
    the survey. Conversely, however, more than half of the
    women (56 percent) and 41 percent of the men had not
    been exposed to family planning messages by a mass
    media source.

    ¶10. Current Use. Thirteen percent of currently married
    women were using some method of family planning during
    the survey, including 8 percent using a modern method.
    The most common modern methods are the pill, injectable
    contraceptives, and the male condom (used by between
    1.6 and 3.4 percent of all women sexually active).
    Urban women are more than twice as likely as rural
    women to practice contraception (20 percent versus 9
    percent) and its use varies significantly by region.
    Thirty-three percent of married women in the South West
    practiced contraception compared with just 4 percent of
    women in the North East and 5 percent of women in the
    North West.

    ¶11. Source of Family Planning Methods. Fifty-eight
    percent of users had obtained their contraceptives from
    private health care providers.  Less than half as many
    had gotten them from the public sector (23 percent).
    The private sector is the most common source for the
    pill (74 percent) and male condoms (59 percent). The
    provision of injectable contraceptives for current
    users was shared equally by the private sector and the
    public sector (8 percent each).

    ¶12. Unmet Need for Family Planning. While most women
    want large families, a minority want to limit their
    family size or wait some time before having their next
    birth although they are not using contraceptives.
    Seventeen percent of currently married women were in
    these two categories and had an unmet need for family
    planning.

    ¶13. Contact of non-users with family planning providers
    is important for determining whether family planning
    initiatives are effective or not. During the year
    preceding the survey, only 4 percent of non-users
    reported they had been visited by a family planning
    service provider at home; 6 percent of non-users had
    visited a health facility and discussed family planning
    with a provider; and 24 percent of non-users who had
    visited a health facility had not discussed family
    planning. These data indicate missed opportunities for
    increasing family planning acceptance and use.

    HIV/AIDS AND OTHER STIs

    ¶14. Knowledge. Almost all men (97 percent) and most
    women (86 percent)participating in the survey reported
    they had heard of AIDS. Considerably fewer knew how to
    prevent transmission of the virus; men were better
    informed than women. Sixty-three percent of the men and
    45 percent of the women reported knowing that condom
    use protects against HIV/AIDS. More respondents (six in
    ten women and eight in ten men) reported knowing that
    limiting the number of sexual partners may prevent
    HIV/AIDS. Less than half of the sample population knew
    that mother to child transmission of HIV is possible
    through breastfeeding. Fewer people (less than one in
    ten) knew that a woman living with HIV can take drugs
    during pregnancy to reduce the risk of transmission.

    ¶15. HIV Testing and Counseling. Six percent of the
    women and 14 percent of the men had been tested for HIV
    and received the results of their test. During the 12
    months preceding the survey, only 3 percent of the
    women and 6 percent of the men had been tested and
    received test results. About 25 percent of the women
    had received counseling or information about HIV/AIDS
    during an pre-natal care visit.

    ¶16. High-risk Sex. A much higher percentage of men than
    women reported having had sex with a non-marital, non-
    cohabiting partner during the year preceding the survey
    (39 percent of the men versus 14 percent of the women).
    Less than half of the former (47 percent) and less than
    one-quarter of the latter (23 percent) reported having
    used a condom the last time they had had sex with a non-
    marital, non-cohabiting partner. Fifteen percent of the
    men who were then married or cohabiting reported having
    had high-risk sex in the prior 12 months.

    ¶17. Sexually Transmitted Infections (STI). Five percent
    of both men and women reported having had a sexually
    transmitted infection or an associated symptom during
    the 12 months preceding the survey. The never-married
    population of both men and women were most at risk.
    Eight percent of never-married women and 7 percent of
    never-married men reported having had an STI or STI
    symptom. Of these, 68 percent of the women and 83
    percent of the men had sought treatment for their STI
    or STI symptom; however, not everyone had gone to a
    health professional.

    KRAMER

`