Demographic and Health Survey

The Demographic and Health Survey (PNG DHS) provides data for monitoring the health situation of the population in Papua New Guinea. The 2016-18 PNG DHS is the first Demographic and Health Survey supported by The DHS Program.

The 2016-18 PNG DHS was implemented by the National Statistical Office from October 2016 to December 2018. Funding for the 2016-18 PNG DHS was provided by the Government of Papua New Guinea (GOPNG), the Australian Government Department of Foreign Affairs and Trade (DFAT), the United Nations Population Fund (UNFPA), and the United Nations Children’s Fund (UNICEF). ICF provided technical assistance through The DHS Program, a project funded by the United States Agency for International Development (USAID) that provides support and technical assistance in the implementation of population and health surveys in countries worldwide.

Key Findings of The 2016-18 DHS

1. Housing Characteristics and Household Population

  • Drinking water: In Papua New Guinea, less than half of households have access to an improved source of drinking water; the most common source is an unprotected spring (29% of households).

  • Toilet facilities: Only 29% of households use improved sanitation facilities; about one in five households has no facility and uses open defecation).
  • Electricity: Nationally, 15% of households have electricity.
  • Household possessions: Mobile phones are common; in 56% of households, someone owns one. One-quarter of households have radios.
  • Hand washing: One-third of the population lives in households with a place to wash hands that has both soap and water.
  • Household population and composition: More than 4 in 10 people in Papua New Guinea are under age 15 (42%), while only 3% are age 65 and older.
  • Children’s living arrangements: 6% of children under age 18 have lost at least one of their biological parents. Fourteen percent of children do not live with either of their biological parents.
  • Education: Almost one-third of women and one-quarter of men age 6 and older have never attended school.

2. Characteristics of respondents

  • Education: Almost one in four women (23%) and 13% of men age 15-49 have no formal education.
  • Literacy: Two-thirds of women and 80% of men age 15- 49 are literate.
  • Exposure to mass media: Media coverage is not widespread in Papua New Guinea; only 6% of women and 12% of men age 15-49 read a  newspaper, watch television, and listen to the radio at least once a week.
  • Internet usage: Only 11% of women and 18% of men age 15-49 used the internet in the 12 months before the survey.
  • Employment: Three in ten women (29%) and 45% of men were employed in the 7 days preceding the survey; agriculture is the most common occupation for both sexes.
  • Health insurance: Health insurance coverage is extremely rare; only 3% of women and 6% of men are covered.
  • Tobacco use: Smoking is common; 26% of women and 60% of men smoke tobacco.

3. Marriage and sexual activity

  • Current marital status: Two-thirds of women and 54% of men age 15-49 are currently in a marital union.
  • Polygyny: Almost 1 in 5 currently married women (18%) report that their husband has another  wife/wives.
  • Age at first marriage: Marriage is nearly universal in Papua New Guinea, although women marry about 5 years earlier than men. The median age at first marriage is just over 20 years among women and 25 years among men age 25-49.
  • Sexual initiation: The median age at first sexual  intercourse is 19.7 for both women and men age 25-49.

4. Fertility

  • Total fertility rate: The total fertility rate for the 3 years preceding the survey is 4.2 children per woman, a slight decline from the rate reported in 2006 (4.4 children per woman).
  • Patterns of fertility: Fertility levels are lower in urban areas than in rural areas (3.5 and 4.3, respectively). Fertility decreases with increasing educational attainment and household wealth.
  • Birth intervals: The median interval between births is almost 3 years (33.2 months).
  • Age at first birth: The median age at first birth among women age 25-49 is 21.9 years.
  • Teenage pregnancy: Among women age 15-19, 12% have started childbearing (i.e., they have already had a birth or are pregnant with their first child).

5. Fertility preferences

  • Limiting childbearing: Almost half (46%) of currently married women age 15-49 do not want another child orhave been sterilised. Generally, women are more likely than men to want no more children, no matter how many children they already have. Overall, 40% of married men want to limit childbearing.
  • Ideal family size: Women consider 3.0 children to be ideal on average, while men prefer 3.6 children.
  • Unwanted births: Seven in 10 births were wanted at the time of conception, while 11% were mistimed and 17% were unwanted.
  • Wanted births: Women are giving birth to over one child more than they want; the actual fertility rate (4.2) exceeds the wanted fertility rate (3.0) by 1.2 children.

6. Family planning

  • Contraceptive use: Contraceptive use among currently married women has increased in the past decade, from 32% in 2006 to 37% in 2016-18. Use of modern methods has increased over the same period, from 24% to 31%.
  • Methods used: Among currently married women, the most widely used contraceptive methods are injectables and implants (each used by 9%) and female sterilisation (used by 8%).
  • Sources of modern methods: Almost 9 in 10 users of modern contraceptive methods obtained their method from a public (government) source; only 5% obtained it from private medical sector sources.
  • Contraceptive discontinuation: In the 5 years preceding the survey, only 16% of all new contraceptive users discontinued use of their method within 12 months; 4% switched to another method.
  • Unmet need for family planning: One quarter of currently married women (26%) have an unmet need for family planning.
  • Percentage of demand for family planning satisfied: Over half (59%) of currently married women have their demand for family planning satisfied.

7. Infant and child mortality

  • Current levels: For the 5-year period preceding the survey, the under-5 mortality rate was 49 deaths per 1,000 live births and the infant mortality rate was 33 deaths per 1,000 live births. This means that 1 in 20 children in Papua New Guinea die before reaching age 5. Two-thirds of these deaths occur during infancy.
  • Trends: Under-5 mortality decreased from 75 deaths per 1,000 births for the 5-year period before the 2006 PNG DHS to 49 deaths per 1,000 births in 2016-18. Infant mortality declined from 57 to 33 deaths per 1,000 births over the same period.
  • Mortality differentials: Overall, childhood mortality is higher in the Highlands region than in other regions. It is also higher among births occurring less than 2 years after a prior birth and births of order 7 or above. Childhood mortality generally decreases with increasing mother’s education and household wealth.

8. Maternal health care

  • Antenatal care: Three quarters (76%) of women in Papua New Guinea who gave birth in the 5 years preceding the survey received antenatal care (ANC) from a skilled provider. Just under half of women had at least four ANC visits during their last pregnancy; however, only 17% had an ANC visit during their first trimester of pregnancy.
  • Components of antenatal care: Almost 9 in 10 pregnant women (87%) who received ANC had their blood pressure measured, 8 in 10 (78%) had a blood sample taken, and 46% had a urine sample taken. Seven in 10 women took iron supplements during pregnancy.
  • Protection against neonatal tetanus: Only 38% of women’s most recent births were protected against neonatal tetanus.
  • Delivery: Over half (55%) of births in Papua New Guinea are delivered in a health facility. Fifty-six percent of births are assisted by skilled providers.
  • Caesarean sections: Only 3% of births are delivered via caesarean section.
  • Postnatal care: 46% of women and 45% of newborns received a postnatal check within the first 2 days of birth.
  • Problems in accessing health care: The main problems women face in accessing health care for themselves are getting money for treatment and distance to a health facility.

9. Child health

  • Birth weight: Information on birth weight was available for about half of births occurring in the 5 years before the survey. Among children with known birth weights, 14% weighed less than 2.5 kg at birth.
  • Vaccinations: 35% of children age 12-23 months had received all basic vaccinations by the time of the survey.
  • Symptoms of acute respiratory infection (ARI): Advice or treatment was sought for 63% of children under age 5 who had symptoms of ARI in the 2 weeks before the survey.
  • Fever: Advice or treatment was sought for 50% of children under age 5 who had a fever in the 2 weeks before the survey.
  • Diarrhoea: Advice or treatment was sought for 38% of children under age 5 who had diarrhoea in the 2 weeks before the survey. Sixty-five percent of children with diarrhoea received ORT, while 24% received no treatment.

10. Nutrition of children and women

  • Breastfeeding: The majority (91%) of children born in the 2 years before the survey were breastfed at some point. Fiftyfour percent of children started breastfeeding within 1 hour of birth, and 62% of children under age 6 months are exclusively breastfed.
  • Complementary feeding: 32% of children have an adequately diverse diet (i.e., they are given food from at least five food groups), 44% receive meals at the minimum frequency, and 18% are fed a minimum acceptable diet.
  • Coverage of vitamin A and  eworming in children: During the 6 months before the survey, 31% of children age 6-59 months received a vitamin A capsule and 20% received deworming medication.
  • Coverage of iron supplementation and deworming in women: 8% of women age 15-49 with a child born in the past 5 years took iron tablets for at least 90 days, and 18% took deworming medication during the pregnancy of their last child.
  • Salt iodisation: All households with tested salt have iodised salt.

11. Malaria

  • Ownership of insecticide-treated nets: 69% of households own at least one insecticide-treated net (ITN).
  • Use of ITNs: 46% of the household population slept under an ITN the  night before the survey.
  • Intermittent preventive treatment (IPTp) during pregnancy: 24% of women age 15-49 with a live birth in the 2 years before the survey reported taking three or more doses of SP/Fansidar during their last pregnancy.
  • Source of advice or treatment: Among children under age 5 with a fever in the 2 weeks preceding the survey for whom advice or treatment was sought, 90% went to public health facilities, while 5% went to the private medical sector.
  • Artemisinin-based combination therapy: Among children under age 5 with a fever in the 2 weeks preceding the survey who took any antimalarial medication, 72% received artemisinin-based combination therapy (ACT).

12. HIV/AIDS-Related knowledge, attitudes and behaviour

  • Knowledge about HIV transmission and prevention:  23% of women and 27% of men have comprehensive knowledge about HIV.
  • Knowledge of mother-to-child transmission (MTCT) of HIV: 52% of women and 54% of men know that HIV can be transmitted during pregnancy, 54% of women and 56% of men know that HIV can be  transmitted during labour, and 53% of women and 48% of men know that HIV can be transmitted during breastfeeding.
  • Discriminatory attitudes towards people living with HIV: 44% of women and 43% of men expressed discriminatory attitudes towards people living with HIV.
  • HIV testing: 58% of women and 63% of men know where to get an HIV test, and 25% of women and 19% of men have ever been tested and received the results.
  • Self-reported prevalence of STIs: 11% of women and 9% of men who had ever had sexual intercourse reported having had a sexually transmitted infection (STI) and/or STI symptoms in the 12 months preceding the survey.

13. Adult and maternal mortality

  • Adult mortality: The adult mortality rate is 2.56 deaths per 1,000 population among women and 2.96 deaths per 1,000 population among men.
  • Lifetime risk of maternal death: The lifetime risk of maternal death indicates that one in 125 women in Papua New Guinea will die from a maternal cause.
  • Maternal mortality ratio: The maternal mortality ratio for the 7-year period before the 2016-18 PNG DHS is estimated at 171 maternal deaths per 100,000 live births.
  • Pregnancy-related mortality ratio: The pregnancyrelated mortality ratio (including deaths from accidents or violence) for the 7-year period before the 2016-18 PNG DHS is estimated at 205 pregnancy-related deaths per 100,000 live births.

14. Women's Empowerment

  • Employment and control over earnings: Men are more likely to be employed than women in Papua New Guinea. Sixty-four percent of  currently married men were employed in the past 12 months, as compared with only 36% of currently married women. Forty-six percent of currently married women with cash earnings decide independently on how their earnings are used. About half of women and men report that they make joint decisions regarding husbands’ cash earnings.
  • Ownership of property: More men than women own a house (60% versus 49%) and land (65% versus 44%). Cumulatively, of women and of men own a house, while of women and of men own land.
  • Participation in decision making: More than 8 in 10 currently married women participate, either by themselves or jointly with their husband, in decisions regarding their own health care, while 70% decide alone or jointly on making major household purchases and 79% decide  alone or jointly on visiting their family or relatives. Sixty-two percent participate in all three decisions, while 10% do not participate in any of the decisions.
  • Attitudes towards wife beating: 70% of women and 72% of men believe that a husband is justified in beating his wife in at least one of five specified situations.
  • Empowerment and health outcomes: Use of a contraceptive method is higher among women who participate in one or more household decisions. In most cases, women’s participation in decision making is positively associated with reproductive health
    seeking behaviour related to antenatal care, delivery from a skilled provider, and postnatal checks.

15. Domestic violence

  • Experience of violence: 56% of women age 15-49 in Papua New Guinea have experienced physical violence since age 15, and 28% have experienced sexual violence. Eighteen percent of women who have ever been pregnant have experienced violence during pregnancy.
  • Spousal violence: 63% of ever-married women have experienced spousal physical, sexual, or emotional violence. The most common type of spousal violence is physical violence (54%), followed by emotional violence (51%). Twenty-nine percent of women have experienced spousal sexual violence.
  • Injuries due to spousal violence: 57% of women who have experienced spousal physical or sexual violence have sustained injuries. Cuts, bruises, or aches are the most common types of injuries reported.
  • Help seeking: 35% of women who have ever experienced physical or sexual violence have sought help, while 13% have never sought help but have told someone about the violence. Thirty-nine percent of women who have experienced any type of physical or sexual violence have not sought help or told anyone about the violence.

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