Armenia - Demographic and Health Survey - 2001

Publication date: 2000

2000 A rm enia 2000 D em ographic and H ealth Survey Armenia Demographic and Health Survey Armenia Demographic and Health Survey 2000 National Statistical Service Yerevan, Armenia Ministry of Health Yerevan, Armenia ORC Macro Calverton, Maryland USA December 2001 National Statistical Service Ministry of Health ORC Macro This report summarizes the findings of the 2000 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. Funding was provided by the U.S. Agency for International Development (USAID). This publication was made possible through support provided by the U.S. Agency for International Development under the terms of Contract No. HRN-C-00-97-00019-00. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for International Development. 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: 3741 523- 217, 523-997, or 524-460 and Fax: 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. 2001. Armenia Demographic and Health Survey 2000. Calverton, Maryland: National Statistical Service, Ministry of Health, and ORC Macro. Contents * iii CONTENTS Page List of tables and figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Summary of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix Map of Armenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiv CHAPTER 1 INTRODUCTION S. Mnatsakanyan and A. Zeynalyan 1.1 Territory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Demographic Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.3 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.4 The Transition Period from Soviet Republic to Independent State . . . . . . . . . . 2 1.5 Population Migration between 1988 and 2000 . . . . . . . . . . . . . . . . . . . . . . . . 3 1.6 Health Care System and Epidemiological Situation in Armenia . . . . . . . . . . . . 3 1.7 Family Planning Policies and Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1.8 Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1.9 Objectives and Organization of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS H. Petrosyan and J. Magluchants 2.1 Characteristics of the Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.2 Housing Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 CHAPTER 3 BACKGROUND CHARACTERISTICS OF RESPONDENTS H. Petrosyan and J. Magluchants 3.1 Background Characteristics of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . 25 3.2 Educational Level of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 3.3 Exposure to Mass Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 3.4 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 3.5 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 3.6 Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 3.7 Use of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 3.8 Household Decisionmaking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 3.9 Attitude toward Wife Beating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 3.10 Attitude toward Refusing Sexual Relations . . . . . . . . . . . . . . . . . . . . . . . . . . 47 iv * Contents Page CHAPTER 4 FERTILITY M. Khachikyan, S. Gharibyan, and H. Newby 4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 4.2 Current Fertility Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 4.3 Fertility Differentials by Background Characteristics . . . . . . . . . . . . . . . . . . . 55 4.4 Fertility Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 4.5 Comparison of Fertility Rates from the Government of Armenia and the ADHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 4.6 Children Ever Born and Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 4.7 Birth Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 4.8 Age at First Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 4.9 Teenage Pregnancy and Motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 CHAPTER 5 CONTRACEPTION K. Arustamyan and G. Avagyan 5.1 Knowledge of Contraceptive Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 5.2 Ever Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 5.3 Current Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 5.4 Current Use by Background Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 70 5.5 Contraceptive Prevalence Rates from Other Surveys . . . . . . . . . . . . . . . . . . . 72 5.6 Discontinuation within 12 Months of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 5.7 Current Use by Women’s Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 5.8 Number of Children at First Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 5.9 Knowledge of the Fertile Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 5.10 Source of Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 5.11 Informed Choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 5.12 Intention to Use Family Planning among Nonusers . . . . . . . . . . . . . . . . . . . . 78 5.13 Exposure to Family Planning Messages in the Mass Media . . . . . . . . . . . . . . 80 5.14 Contact of Nonusers of Family Planning with Family Planning Providers . . . . 82 5.15 Couples’ Communication about Family Planning . . . . . . . . . . . . . . . . . . . . . . 83 5.16 Attitudes toward Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 CHAPTER 6 ABORTION R. Abrahamyan and G. Avagyan 6.1 Pregnancy Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 6.2 Lifetime Experience with Induced Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . 88 6.3 Rates of Induced Abortions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 6.4 Trends in Induced Abortions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 6.5 Use of Contraceptive Methods before Abortions . . . . . . . . . . . . . . . . . . . . . . 93 Contents * v Page CHAPTER 7 OTHER PROXIMATE DETERMINANTS OF FERTILITY M. Khachikyan and S. Gharibyan 7.1 Marital Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 7.2 Age at First Marriage and Sexual Intercourse . . . . . . . . . . . . . . . . . . . . . . . . 96 7.3 Recent Sexual Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 7.4 Postpartum Amenorrhea, Abstinence, and Insusceptibility . . . . . . . . . . . . . . 101 7.5 Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 CHAPTER 8 FERTILITY PREFERENCES H. Petrosyan, J. Magluchants, and K. Arustamyan 8.1 Fertility Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 8.2 Need for Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 8.3 Fertility Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 8.4 Ideal Number of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 8.5 Wanted and Unwanted Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 CHAPTER 9 INFANT AND CHILD MORTALITY K. Saribekyan, K. Ter-Voskanyan, R. Asatyan, and J. Sullivan 9.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 9.2 Assessment of Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 9.3 Levels and Trends in Childhood Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . 112 9.4 Infant Mortality Rates from the NSS and the ADHS . . . . . . . . . . . . . . . . . . 114 9.5 Socioeconomic Differentials in Childhood Mortality . . . . . . . . . . . . . . . . . . 116 9.6 Demographic Differentials in Childhood Mortality . . . . . . . . . . . . . . . . . . . . 117 9.7 Mortality Differentials by Women’s Status . . . . . . . . . . . . . . . . . . . . . . . . . . 118 9.8 Perinatal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 9.9 High-Risk Fertility Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 CHAPTER 10 MATERNAL AND CHILD HEALTH K. Saribekyan, R. Abrahamyan, M. Balasanyan, and A. Hovhannisyan 10.1 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 10.2 Assistance and Medical Care at Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 10.3 Characteristics of Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 10.4 Postnatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 10.5 Women’s Status and Reproductive Health Care . . . . . . . . . . . . . . . . . . . . . . 131 10.6 Vaccination Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 10.7 Acute Respiratory Infection and Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 10.8 Hand-Washing Materials in Households . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 10.9 Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 vi * Contents Page CHAPTER 11 NUTRITION OF WOMEN AND CHILDREN K. Saribekyan, O. Inchikyan, R. Abrahamyan, and G. Avagyan 11.1 Breastfeeding and Supplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 11.2 Iodine Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 11.3 Micronutrient Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 11.4 Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 11.5 Nutritional Status of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 11.6 Nutritional Status of Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 CHAPTER 12 HIV/AIDS AND SEXUALLY TRANSMITTED INFECTIONS S. Grigoryan, K. Babayan, and S. Mondjyan 12.1 Knowledge of HIV/AIDS and Methods of HIV Prevention . . . . . . . . . . . . . . 165 12.2 Social Aspects of HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 12.3 Testing for the AIDS Virus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 12.4 Knowledge of Symptoms of Sexually Transmitted Infections . . . . . . . . . . . . 182 12.5 Prevalence and Treatment of Sexually Transmitted Infections . . . . . . . . . . . 184 12.6 Sexual Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 12.7 Knowledge and Use of Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 CHAPTER 13 ADULT HEALTH K. Saribekyan, L. Episkoposyan, M. Safaryan, and H. Newby 13.1 Women’s Access to and Utilization of Health Care Services . . . . . . . . . . . . 197 13.2 Women’s Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 13.3 Use of Smoking Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 13.4 Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 APPENDIX A SAMPLE DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 APPENDIX B ESTIMATES OF SAMPLING ERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 APPENDIX C DATA QUALITY TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 APPENDIX D PERSONS INVOLVED IN THE 2000 ARMENIA DEMOGRAPHIC AND HEALTH SURVEY . . . . . . . . . . . . . . . . . . . . . . . . . 249 APPENDIX E QUESTIONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 APPENDIX F UNICEF WORLD SUMMIT FOR CHILDREN: END-DECADE INDICATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Tables and Figures * vii TABLES AND FIGURES Page CHAPTER 1 INTRODUCTION Table 1.1 Results of the household and individual interviews . . . . . . . . . . . . . . . . . . . . . . 9 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS Table 2.1 Household population by age, residence, and sex . . . . . . . . . . . . . . . . . . . . . . . 12 Table 2.2 Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Table 2.3 Children’s living arrangements and orphanhood . . . . . . . . . . . . . . . . . . . . . . . 14 Table 2.4 Educational attainment of household population . . . . . . . . . . . . . . . . . . . . . . . 16 Table 2.5 School attendance ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Table 2.6 Grade repetition and dropout rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Table 2.7 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Table 2.8 Housing characteristics by region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Table 2.9 Household durable goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Table 2.10 Household durable goods by region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Figure 2.1 Population Pyramid of Armenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Figure 2.2 Age-Specific Attendance Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 CHAPTER 3 BACKGROUND CHARACTERISTICS OF RESPONDENTS Table 3.1 Background characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Table 3.2.1 Educational attainment by background characteristics: women . . . . . . . . . . . . 27 Table 3.2.2 Educational attainment by background characteristics: men . . . . . . . . . . . . . . 28 Table 3.3 Exposure to mass media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 3.4.1 Women’s employment status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Table 3.4.2 Men’s employment status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Table 3.5.1 Occupation of women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Table 3.5.2 Occupation of men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Table 3.6 Employer and form of earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Table 3.7 Decision on use of earnings and contribution of earnings to household expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Table 3.8 Control over earnings according to contribution to household expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Table 3.9 Household decisionmaking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Table 3.10.1 Final say in household decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Table 3.10.2 Men’s attitude towards a wife’s role in household decisionmaking . . . . . . . . . 43 Table 3.11.1 Women’s attitude toward wife beating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Table 3.11.2 Men’s attitude toward wife beating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Table 3.12.1 Women’s attitude toward refusing sexual relations . . . . . . . . . . . . . . . . . . . . . . 48 viii * Tables and Figures Page Table 3.12.2 Men’s attitude toward wife refusing sex with husband . . . . . . . . . . . . . . . . . . 49 Table 3.13 Men’s agreement with certain actions husbands are justified in taking if a wife refuses sexual relations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Figure 3.1 Percent Distribution of Women Age 15-49 by Employment Status . . . . . . . . . . 31 Figure 3.2 Percent Distribution of Men Age 15-54 by Employment Status or Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Figure 3.3 Percent Distribution of Currently Employed Women Age 15-49 by Type of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Figure 3.4 Percent Distribution of Women by Number of Decisions in Which They Participate in the Final Say . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 CHAPTER 4 FERTILITY Table 4.1 Current fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Table 4.2 Fertility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Table 4.3 Trends in age-specific fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Table 4.4 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Table 4.5 Birth intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Table 4.6 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Table 4.7 Median age at first birth by background characteristics . . . . . . . . . . . . . . . . . . 62 Table 4.8 Teenage pregnancy and motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Figure 4.1 Age-specific Fertility Rates for Women Age 15-49 by Residence . . . . . . . . . . . 55 Figure 4.2 Trends in the Total Fertility Rate (TFR) among Women Age 15-39 according to the ADHS and the National Statistical Service . . . . . . . . . . . . . . 57 Figure 4.3 Trends in Age-Specific Fertility Rates for Women Age 15-39 according to the ADHS and the National Statistical Service . . . . . . . . . . . . . . . . . . . . . . . . 58 Figure 4.4 Percent Distribution of Currently Married Women Age 15-49 by Number of Children Ever Born . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 CHAPTER 5 CONTRACEPTION Table 5.1 Knowledge of contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Table 5.2 Knowledge of contraceptive methods by background characteristics . . . . . . . . 67 Table 5.3 Ever use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Table 5.4 Current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Table 5.5 Current use of contraception by background characteristics . . . . . . . . . . . . . . . 71 Table 5.7 Reasons for discontinuing contraceptive methods . . . . . . . . . . . . . . . . . . . . . . 73 Table 5.8 Current use of contraception by women’s status . . . . . . . . . . . . . . . . . . . . . . . . 75 Table 5.9 Number of children at first use of contraception . . . . . . . . . . . . . . . . . . . . . . . . 76 Table 5.10 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Table 5.11 Source of modern contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Table 5.12 Informed choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Table 5.13 Future use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Tables and Figures * ix Page Table 5.14 Reasons for not intending to use contraception . . . . . . . . . . . . . . . . . . . . . . . . 79 Table 5.15 Preferred method of contraception for future use . . . . . . . . . . . . . . . . . . . . . . . 80 Table 5.16 Exposure to family planning messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Table 5.17 Contact of nonusers with family planning providers . . . . . . . . . . . . . . . . . . . . . 83 Table 5.18 Discussion of family planning with husband . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Table 5.19 Attitudes of couples toward family planning . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Figure 5.1 Current Use of Contraception among Married Women by Method Type . . . . . . 69 Figure 5.2 Current Use of Contraception among Married Women by Residence . . . . . . . . 72 Figure 5.3 Contraceptive Discontinuation Due to Method Failure: Proportion of Users Who Discontinued Use Within 12 Months . . . . . . . . . . . . . . . . . . . . . . . . 74 Figure 5.4 Percentage of Women Exposed to Family Planning Messages by Residence . . . 83 CHAPTER 6 ABORTION Table 6.1 Pregnancy outcomes by background characteristics . . . . . . . . . . . . . . . . . . . . . 88 Table 6.2 Lifetime experience with induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Table 6.3 Induced abortion rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Table 6.4 Induced abortion rates by background characteristics . . . . . . . . . . . . . . . . . . . 91 Table 6.5 Trends in induced abortion rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Table 6.6 Use of a method of contraception before pregnancies . . . . . . . . . . . . . . . . . . . . 94 Figure 6.1 Age-specific Fertility Rates (ASFRs) and Age-Specific Abortion Rates (ASARs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Figure 6.2 Total Abortion Rates by Background Characteristics . . . . . . . . . . . . . . . . . . . . . 92 CHAPTER 7 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table 7.1 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Table 7.2 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Table 7.3 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Table 7.4 Median age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Table 7.5 Median age at first intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Table 7.6 Recent sexual activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Table 7.7 Postpartum amenorrhea, abstinence, and insusceptibility . . . . . . . . . . . . . . . . 102 Table 7.8 Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Figure 7.1 Marital Status of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Figure 7.2 Recent Sexual Activity (in the Past 4 Weeks) among Women 15-49 . . . . . . . 101 CHAPTER 8 FERTILITY PREFERENCES Table 8.1 Fertility preferences by number of living children . . . . . . . . . . . . . . . . . . . . . . 103 Table 8.2 Desire to limit childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 x * Tables and Figures Page Table 8.3 Need for family planning: currently married women . . . . . . . . . . . . . . . . . . . 105 Table 8.4 Fertility planning status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Table 8.5 Ideal number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Table 8.6 Mean ideal number of children by background characteristics . . . . . . . . . . . . 108 Table 8.7 Wanted fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Figure 8.1 Desire for More Children among Currently Married Women . . . . . . . . . . . . . . 104 CHAPTER 9 INFANT AND CHILD MORTALITY Table 9.1 Early childhood mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Table 9.2 Comparison of infant mortality estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Table 9.3 Early childhood mortality by background characteristics . . . . . . . . . . . . . . . . 116 Table 9.4 Early childhood mortality by demographic characteristics . . . . . . . . . . . . . . . 117 Table 9.5 Early childhood mortality by women’s status indicators . . . . . . . . . . . . . . . . 118 Table 9.6 Perinatal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Table 9.7 High-risk fertility behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Figure 9.1 Trends in Infant Mortality Based on Rates from the National Statistical Service and the ADHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 CHAPTER 10 MATERNAL AND CHILD HEALTH Table 10.1 Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Table 10.2 Number of antenatal care visits and timing of first visit . . . . . . . . . . . . . . . . . 125 Table 10.3 Antenatal care content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Table 10.4 Place of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Table 10.5 Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Table 10.6 Delivery characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Table 10.7 Postnatal care by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 131 Table 10.8 Women’s status and reproductive health care . . . . . . . . . . . . . . . . . . . . . . . . . 132 Table 10.9 Availability of health card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Table 10.10 Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Table 10.11 Vaccinations in first year of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Table 10.12 Prevalence and treatment of symptoms of ARI and fever . . . . . . . . . . . . . . . . 136 Table 10.13 Hand-washing materials in household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Table 10.14 Prevalence of diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Table 10.15 Knowledge of ORS packets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Table 10.16 Diarrhea treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Table 10.17 Feeding practices during diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Figure 10.1 Antenatal Care Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Figure 10.2 Measles Vaccination Coverage among Children 24-35 Months . . . . . . . . . . . . 135 Figure 10.3 Prevalence of ARI Symptoms, Fever, and Diarrhea in the Two Weeks Preceding the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Tables and Figures * xi Page CHAPTER 11 NUTRITION OF WOMEN AND CHILDREN Table 11.1 Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 Table 11.2 Breastfeeding status by child’s age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Table 11.3 Median duration of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Table 11.4 Frequency of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Table 11.5 Foods consumed by children in preceding 24 hours . . . . . . . . . . . . . . . . . . . . 150 Table 11.6 Frequency of foods consumed by children in preceding 24 hours . . . . . . . . . . 151 Table 11.7 Frequency of foods consumed by children in preceding 7 days . . . . . . . . . . . . 152 Table 11.8 Iodization of household salt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Table 11.9 Children with access to iodized salt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Table 11.10 Micronutrient intake among mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Table 11.11 Prevalence of anemia in children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Table 11.12 Prevalence of anemia in women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Table 11.13 Prevalence of anemia in children with anemic mothers . . . . . . . . . . . . . . . . . 160 Table 11.14 Nutritional status of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Table 11.15 Nutritional status of women by background characteristics . . . . . . . . . . . . . . 164 Figure 11.1 Distribution of Children by Breastfeeding Status, According to Age in Months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Figure 11.2 Prevalence of Anemia in Children Age 6-59 Months by Region . . . . . . . . . . . . 158 Figure 11.3 Prevalence of Stunting by Age of Child and Region . . . . . . . . . . . . . . . . . . . . 162 CHAPTER 12 HIV/AIDS AND SEXUALLY TRANSMITTED INFECTIONS Table 12.1 Knowledge of HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Table 12.2.1 Knowledge of ways to avoid HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . 168 Table 12.2.2 Knowledge of ways to avoid HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . 169 Table 12.3.1 Knowledge of programmatically important ways to avoid HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Table 12.3.2 Knowledge of programmatically important ways to avoid HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Table 12.4.1 Knowledge of HIV/AIDS-related issues: women . . . . . . . . . . . . . . . . . . . . . . . 173 Table 12.4.2 Knowledge of HIV/AIDS-related issues: men . . . . . . . . . . . . . . . . . . . . . . . . . 174 Table 12.5.1 Social aspects of HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Table 12.5.2 Social aspects of HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 Table 12.6.1 Communication and confidentiality issues concerning HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Table 12.6.2 Communication and confidentiality issues concerning HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Table 12.7.1 Discussion of AIDS in the media: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Table 12.7.2 Discussion of AIDS in the media: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Table 12.8.1 Testing for the AIDS virus: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Table 12.8.2 Testing for the AIDS virus: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Table 12.9.1 Knowledge of symptoms of STIs: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Table 12.9.2 Knowledge of symptoms of STIs: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184 xii * Tables and Figures Page Table 12.10.1 Self-reporting of sexually transmitted infections and STI symptoms: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Table 12.10.2 Self-reporting of sexually transmitted infections and STI symptoms: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Table 12.11 Source of treatment of STIs among women . . . . . . . . . . . . . . . . . . . . . . . . . . 188 Table 12.12 Protection of partner by women with STIs . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Table 12.13.1 Number of sexual partners among women . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 Table 12.13.2 Number of sexual partners among men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Table 12.14.1 Knowledge of source for male condoms: women . . . . . . . . . . . . . . . . . . . . . . 193 Table 12.14.2 Knowledge of source for male condoms: men . . . . . . . . . . . . . . . . . . . . . . . . . 194 Table 12.15.1 Use of condoms with cohabiting partner: women . . . . . . . . . . . . . . . . . . . . . . 195 Table 12.15.2 Use of condoms with partner: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 Figure 12.1 Knowledge of Programmatically Important Ways to Avoid HIV/AIDS . . . . . . 172 Figure 12.2 Self-reporting of Genital Sores or Ulcers in the 12 Months Preceding Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 CHAPTER 13 ADULT HEALTH Table 13.1 Utilization of health care and barriers to care . . . . . . . . . . . . . . . . . . . . . . . . . 198 Table 13.2 Last visit to a gynecologist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Table 13.3 Last breast examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Table 13.4 Use of smoking tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Table 13.5.1 Knowledge of and exposure to tuberculosis: women . . . . . . . . . . . . . . . . . . . 204 Table 13.5.2 Knowledge of and exposure to tuberculosis: men . . . . . . . . . . . . . . . . . . . . . . 205 Table 13.6.1 Knowledge of treatment of tuberculosis: women . . . . . . . . . . . . . . . . . . . . . . 206 Table 13.6.2 Knowledge of treatment of tuberculosis: men . . . . . . . . . . . . . . . . . . . . . . . . . 207 Table 13.7.1 Knowledge of symptoms of tuberculosis: women . . . . . . . . . . . . . . . . . . . . . . 208 Table 13.7.2 Knowledge of symptoms of tuberculosis: men . . . . . . . . . . . . . . . . . . . . . . . . 209 Table 13.8.1 Symptoms of tuberculosis that would convince respondents to seek medical assistance: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Table 13.8.2 Symptoms of tuberculosis that would convince respondents to seek medical assistance: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212 APPENDIX A SAMPLE DESIGN Table A.1 Sample allocation by region and by residence . . . . . . . . . . . . . . . . . . . . . . . . 218 Table A.2 Sample implementation: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 Table A.3 Sample implementation: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 APPENDIX B ESTIMATES OF SAMPLING ERRORS Table B.1 List of selected variables for sampling errors . . . . . . . . . . . . . . . . . . . . . . . . . 226 Table B.2 Sampling errors for the total population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 Table B.3 Sampling errors for the urban population . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228 Tables and Figures * xiii Page Table B.4 Sampling errors for the rural population . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 Table B.5 Sampling errors for Yerevan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Table B.6 Sampling errors for Aragatsotn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Table B.7 Sampling errors for Ararat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 Table B.8 Sampling errors for Armavir . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 Table B.9 Sampling errors for Gegharkunik . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Table B.10 Sampling errors for Lori . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Table B.11 Sampling errors for Kotayk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Table B.12 Sampling errors for Shirak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 Table B.13 Sampling errors for Syunik . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 Table B.14 Sampling errors for Vayots Dzor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Table B.15 Sampling errors for Tavush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240 Table B.16 Sampling errors for fertility rates for the total population by residence and region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 Table B.17 Sampling errors for the abortion rates for the total population by residence and region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 Table B.18 Sampling errors for mortality rates for the total population . . . . . . . . . . . . . . 242 Table B.19 Sampling errors for mortality rates for the total population by residence . . . . 242 APPENDIX C DATA QUALITY TABLES Table C.1 Household age distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Table C.2.1 Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . 244 Table C.2.2 Age distribution of eligible and interviewed men . . . . . . . . . . . . . . . . . . . . . . 244 Table C.3 Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Table C.4 Births by calendar year since birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246 Table C.5 Reporting of age at death in days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Table C.6 Reporting of age at death in months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248 APPENDIX F UNICEF WORLD SUMMIT FOR CHILDREN END-DECADE INDICATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Preface * xv PREFACE The Armenia Demographic and Health Survey (ADHS) is the first multipurpose health survey to be conducted in Armenia. It is also the most recent comprehensive research project on health. The ADHS was conducted through the close collaboration of the Ministry of Health, the National Statistical Service, and ORC Macro, an American research organization. This project was financed by the United States Agency for International Development and with technical assistance was provided by ORC Macro. The purpose of the ADHS was to define the factors that contribute to the health problems of women of reproductive age and the health of their children. Within the framework of ADHS, information was also collected regarding knowledge of and attitudes regarding HIV/AIDS and tuberculosis. The ADHS results will provide consistent data on women’s and children’s health to assess the effectiveness of implemented programs, to define priorities in health care, to elaborate appropriate strategy, and to implement policy towards the aforementioned topics. The final report summarizes the data collected in the ADHS. This report is the aggregated result of more than a half-year of preparatory work and more than a year of data collection, processing and analysis. The preparatory work began in early 2000 and the fieldwork was conducted during October-December 2000. I acknowledge the work of the technical staff of the ADHS, the input of field staff and data quality teams, and the valuable contribution of all experts and organizations, whose joint efforts ensured the effective implementation of the survey. I would also like to emphasize my appreciation of the support of the 5,980 households whose participation enabled to obtain the reliable information pursued in the survey. Ararat Mkrtchyan Minister of Health Republic of Armenia Foreword * xvii FOREWORD The Armenia Demographic and Health Survey (ADHS) final report is the first comprehensive and detailed publication of the National Statistical Service of the Republic of Armenia on demographic and health issues. The final report focuses primarily on indicators of the reproductive health of the population. This final report was prepared by the Ministry of Health of the Republic of Armenia with the assistance of experts from ORC Macro and financing from the U.S. Agency for International Development. The success of the ADHS was achieved thanks to the joint efforts of the above- mentioned organizations. First of all, it is the U.S. Agency for International Development which provided the financing for the survey. Furthermore, technical assistance for the entire survey process was provided by specialists from ORC Macro. Thanks to them, the implementation of the survey and the preparation and publication of this report were accomplished in a short period of time. It is also necessary to mention the staff involved in the fieldwork; thanks to their careful work good quality data were collected. This report presents statistical data on fertility, infant mortality, induced abortion, use of contraception, antenatal and postnatal care and assistance, maternal and child nutritional status, and anemia in Armenia. Many indicators are also given for each of the regions. These data are calculated according to the principles of modern statistical methodology, thus allowing for international comparisons. The ADHS final report is intended to provide information to both specialists and to a wide variety of readers including health and scientific research organizations, state and local self- governing bodies, non-governmental and international organizations, mass media, and others who need detailed statistical information on the health conditions of the Armenian population. S. Mnatsakanyan President National Statistical Service of the Republic of Armenia xxiv * Map of Armenia Summary of Findings * xix SUMMARY OF FINDINGS The Armenia Demographic and Health Survey (ADHS) is a nationally representative survey of 6,430 women age 15-49 and 1,719 men age 15- 54. Survey fieldwork was conducted during the period of October through December 2000. The ADHS was conducted by the National Statis- tical Service and the Ministry of Health of the Republic of Armenia. The Measure DHS+ Project provided technical support for the survey. The U.S. Agency for International Development (USAID)/Armenia provided funding, and the United Nations Children’s Fund (UNICEF)/ Armenia provided support through the donation of equipment. CHARACTERISTICS OF RESPONDENTS Armenia is an ethnically homogeneous country; virtually all respondents are Armenian and report that they are Christians. The majority, approximately 60 percent, live in urban areas. Yerevan accounts for more than one-third of all respondents. Nearly all households in Armenia (99 percent) have electricity. A majority of households in the country have water piped into the residence, a flush toilet, a finished floor, and a place for hand-washing. Almost all men and women in the sample have attended school. Approximately one-third have attended secondary school, one-third have attended secondary-special school, and one-fifth have attended university. Thirty-four percent of women and 56 percent of men were employed in the 12 months prior to the survey. Twenty-one percent of men reported that they were looking for work at the time of the survey. FERTILITY Fertility rates. A useful index of the level of fertility is the total fertility rate (TFR), which indicates the number of children a woman would have if she passed through the childbearing ages at the current age-specific fertility rates. For the three years preceding the survey, the survey estimate of the TFR was 1.7 children per wom- an. This is substantially higher than the official estimate of 1.2 children per woman for the period 1998-2000. One possible reason for the difference between estimates is the substantial net emigration from Armenia that has occurred since 1989. Because of net emigration the resident population of Armenia may be smaller than the estimated population figures used for calculating the official fertility rates. When data from the 2001 Population Census become available, this issue should be resolved. The survey found that the TFR is lower by about half a child in urban areas (1.5 children per woman) than in rural areas (2.1 children per woman). Time trends. Official estimates indicate that current fertility is less than half the level of the mid-1980s. The ADHS also found a significant decade-long decline in fertility, although at a rate less rapid than that indicated by official estimates. Age at first birth. Research has shown that childbearing in the teenage years is associated with increased social and health problems for both the mother and her child. The survey found that only 4 percent of women age 15-19 had given birth. Moreover, almost all births to teenage women occurred at ages 18 and 19. Thus, the median age at initiation of childbear- ing in Armenia is about 21 years. Birth intervals. Research has shown that children born soon after a previous birth, especially those born within two years of the previous birth, have an increased risk of mor- bidity and mortality. In Armenia, 34 percent of second and higher order births occur after a birth interval of less than two years. The percentage of births after an interval of less than two years was greater among rural women (40 percent) than among urban women (28 percent). The proportion of births after a short birth interval was particularly high in xx * Summary of Findings Aragatsotn (46 percent), Gegharkunik (44 percent) and Kotayk (42 percent). CONTRACEPTION Knowledge and ever use. Knowledge of contra- ception is widespread in Armenia. Among mar- ried women, knowledge of at least one method is universal (99 percent). On average, married women reported knowledge of seven methods of contraception. Eighty-two percent of married women reported having used a method of con- traception at some time. Current use. Among married women, 61 per- cent reported current use of contraception: 22 percent using modern methods and 37 percent using traditional methods. By far, the most commonly used method was withdrawal. More than half of all users (32 out of 61 percent) were using withdrawal. The IUD, the second most common method, was used by 9 percent of married women. Overall levels of contraceptive use were similar for women in urban and rural areas and across regions and educational categories (between 50 and 65 percent). Nevertheless, urban women and women with a higher education showed distinctive behavior patterns by relying more on modern methods (the IUD and condom) and less on traditional methods (in particular, with- drawal). Method failure. A woman may discontinue use of contraception for many reasons, including the desire to have more children, health concerns, or lack of exposure to the risk of pregnancy. In Armenia, the single most prevalent reason for discontinuation is method failure, i.e, becoming pregnant while using a method. The method most commonly used in Armenia, withdrawal, was also the method with the highest failure rate. Twenty-nine percent of women practicing withdrawal experience a contraceptive failure within 12 months of starting use. Future use. Among married women who were not using contraception, 36 percent reported that they intended to use in the future. When asked which method they would prefer to use, there was a clear difference between older and younger women. The preferred methods of women age 30 and above were withdrawal (37 percent) and the IUD (21 percent). However, the ranking of these methods by younger women was just the reverse: the IUD (33 per- cent) and withdrawal (14 percent). This sug- gests that, at least in terms of method prefer- ence, younger women are less satisfied with reliance on withdrawal as their method of contraception. Source of supply. Most modern method users obtained their methods through the public sector (67 percent), primarily hospitals and polyclinics. Twenty-four percent obtained their contraceptives from the private sector, primar- ily pharmacies. Fertility preferences. Among currently mar- ried women, 77 percent reported that they either wanted no more children (72 percent) or that they were infecund or sterilized (6 per- cent). Another 19 percent wanted another child, and 4 percent were undecided about having another child. INDUCED ABORTION In Armenia, as in all of the former Soviet Un- ion, induced abortion has been a primary means of fertility control for many years. Abortion rates. The use of abortion can be measured by the total abortion rate (TAR) which indicates the number of abortions a woman would have in her lifetime if she passed through her childbearing years at the current age-specific abortion rates. The survey estimate of the TAR indicates that a woman in Armenia will have an average of 2.6 abortions during her lifetime. This rate is less than the recently reported rate for Armenia’s Caucasian neighbor Georgia (4.7 abortions per woman) but higher than the rates reported for the Central Asian countries of Kazakhstan and the Kyrgyz Repub- lic (1.4 and 1.6 abortions per woman, respec- tively). Summary of Findings * xxi Abortion differentials. The TAR was signifi- cantly higher in rural areas (3.4 abortions per woman) than in urban areas (2.1 abortions per woman). This is the reverse of findings in recent surveys in Kazakhstan and the Kyrgyz Republic. However, the higher rates of abortion in rural areas is consistent with the greater reliance on withdrawal as a method of contraception in rural areas than in urban areas. Contraceptive failure and abortion. When formulating policies designed to improve the reproductive health of women, it is useful to know the contraceptive behavior of women who resort to abortion as a means of fertility control. Two-thirds (64 percent) of all abortions were to women who were using contraception and experienced method failure. More than half of all abortions occurred after method failure while using withdrawal (46 percent) or periodic absti- nence (6 percent). This suggests that greater access to and use of more reliable methods would reduce the incidence of abortion. INFANT MORTALITY Until 1995, official statistics on live births and infant deaths in Armenia were collected accord- ing to a set of definitions developed during the Soviet period. Those definitions result in the classification of fewer events as infant deaths than would be the case if the definitions recom- mended by the World Health Organization (WHO) had been used. In 1995, Armenia adopt- ed the WHO definitions, although the pace at which those definitions have been implemented in all areas of the country is uncertain. In the ADHS, data on infant mortality were collected according to the definitions of live birth and infant death recommended by the World Health Organization. IMR levels. For the 1996-2000 period, the survey estimate of infant mortality is 36 per 1,000 live births. The official government esti- mate of the infant mortality rate for this period is 15 per 1,000. IMR differentials. The survey found levels of infant mortality to be about 50 percent higher in rural areas than in urban areas. Infant mor- tality levels were also much higher among children of women with primary or secondary education than among children of women with secondary-special or higher education. In terms of the interval between successive births, infant mortality was about twice as high for births after an interval of less than three years than for births after an interval of three or more years. MATERNAL AND CHILD HEALTH AND NUTRITION Antenatal care. Armenia has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. Overall, the levels of antenatal care and deliv- ery assistance are high. Ninety-two percent of mothers receive antenatal care from profes- sional health providers (doctors, nurses, and trained midwives). In urban areas, 92 percent of care is provided by doctors, as opposed to 74 percent in rural areas. Almost two-thirds of women with antenatal care make four or more visits, although there is a significant urban- rural differential. In terms of content of care, it is notable that during their ANC visits only six in ten women were informed about pregnancy complications. Delivery care. Overall, almost all births are delivered under the supervision of a trained medical professional (97 percent). Most births (91 percent) occur at a health facility. Whereas health facility deliveries are almost universal in urban areas (99 percent), in rural areas home deliveries occur frequently (16 percent). This is particularly the case in Gegharkunik where 41 percent of all births occur at home. Vaccinations. The health cards maintained at the health facilities are the primary source of vaccination data. Almost all children age 12-23 months have received vaccinations for BCG, DPT1 and polio 1. Coverage is also high for the second and third doses of both DPT and polio. Seventy-nine percent of children age 12-23 xxii * Summary of Findings months have received the measles vaccination. The data show that there has been significant progress in timely vaccination coverage over the last five years. Treatment of diarrhea. The ADHS asked about the treatment of children who suffered from diarrhea during the two weeks preceding the survey. Overall, 60 percent of mothers gave either oral rehydration salts or increased fluids to their sick children (oral rehydration therapy). Whereas rural mothers are more likely than urban mothers to give oral rehydration salts to their sick children, urban mothers are more likely than rural mothers to offer more liquids than usual. More important, almost one-quarter of rural mothers engage in the hazardous prac- tice of curtailing fluid intake when their children have diarrhea. Breastfeeding. Eighty-eight percent of all chil- dren born in the five years preceding the survey were breastfed. Although the median duration of breastfeeding is nine months, the duration of exclusive and predominant breastfeeding (breastfeeding plus plain water) is short (a little more than one month and three months, respec- tively). Nutritional status. In the ADHS, the height and weight of children under five years of age were measured. These data are used to determine the nutritional status of children, i.e., the percentage of children who are stunted (measured in terms of height-for-age), wasted (weight-for-height), or underweight (weight-for-age). Stunting is a sign of chronic, long-term undernutrition; wasting is a sign of acute, short-term undernutrition; and underweight is a composite measure that takes into account both chronic and acute undernutri- tion. In a well-nourished population of children, it is expected that slightly more than 2 percent of children will be stunted or wasted. In Armenia, 13 percent of children under age five are stunt- ed, and 3 percent are severely stunted. There is considerable regional variation, ranging from 8 percent in Yerevan and Kotayk to 32 percent in Gegharkunik. Overall, 2 percent of children are wasted and 3 percent are underweight. Anthropometric data were also collected from all women age 15-49. According to the findings of the ADHS, approximately four in ten Arme- nian women weigh more than they should: 27 percent are overweight and 14 percent are obese. There is a positive relationship between age and obesity: the prevalence of obesity, for example, increases from a few percent among women under age 20 to one-third of women age 40-45. More than half of women age 35 and older are either overweight or obese; this indicates that most older women do not have a healthy lifestyle and presents a serious public health challenge for Armenia. Anemia. Determining anemia levels among women and their children under five years of age was one component of the ADHS. Overall, 24 percent of children suffer from anemia: 10 percent have moderate anemia and less than 1 percent have severe anemia. The prevalence of anemia among children living in rural areas is twice as high as among children living in urban areas (33 percent versus 16 percent). There is also significant variation by region, ranging from a low of 11 percent in Vayots Dzor and Kotayk to a high of 39 percent in Tavush. Twelve percent of Armenian women suffer from some degree of anemia. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS The currently low level of the HIV epidemic in Armenia provides a unique window of opportu- nity for early targeted interventions to prevent further spread of the disease. However, the increases in the cumulative incidence of HIV infection suggest that this window of opportu- nity is rapidly closing. Knowledge and attitudes. Almost all respon- dents reported that they have heard of HIV/AIDS. However, only 62 percent of women and 73 percent of men believe that there is a way to avoid the virus. Among those respon- dents who had heard of HIV/AIDS, the most frequently reported means of prevention is condom use. More than half of all men and a Summary of Findings * xxiii quarter of all women spontaneously mentioned condom use. More than 90 percent of both women and men reported that it is acceptable for AIDS to be discussed in the mass media. Given the Arme- nian population’s high level of exposure to broadcast media, televison and radio messages could be an important component of HIV/AIDS prevention strategies. Sexually transmitted infections. Forty-two percent of women and 15 percent of men had no knowledge of sexually transmitted infections (STIs). Almost two-thirds of all women who knew of STIs were able to name at least one symptom of an STI in a woman. Eighty-one percent of men who knew about STIs were able to name at least one male symptom. Condom use. Seventy-nine percent of women and 91 percent of men could cite a place where they could obtain a condom. Seven percent of cohabiting women and seven percent of cohabit- in men say that they used a condom during the last sexual intercourse with their partner. The likelihood of using a condom increases more than sixfold for men who had sex with a noncohabiting partner. ADULT HEALTH The major causes of death in Armenia are similar to those in industrialized countries (cardiovascular diseases, cancer, and acci- dents), but there is also a rising incidence of certain infectious diseases, such as tuberculosis. Women’s health. More than half of all women had not been seen by a gynecologist in the past five years. Only one-fifth of Armenian women had visited a gynecologist during the 12 months preceding the survey. Given the high incidence of abortion in Armenia, it is likely that many of the visits to the gynecologist are for this purpose and not for routine examina- tions. Only 15 percent of Armenian women know how to give themselves a breast exam. Among women who reported knowledge of breast self- exams, most had not performed a self-exam recently. Furthermore, less than 1 percent of women reported that a doctor had ever given them a breast exam. These data underscore the need to improve women’s health services in Armenia. Tuberculosis. Most men and women have heard of tuberculosis. Among those respon- dents who had heard of the infection, approxi- mately two-thirds were able to correctly iden- tify the mode of tuberculosis transmission (through the air when coughing). The most commonly cited symptom that would convince the respondent to seek medical assistance was, among women, prolonged coughing and, among men, coughing with sputum. Introduction * 1 INTRODUCTION 1 S. Mnatsakanyan and A. Zeynalyan 1.1 TERRITORY The Republic of Armenia is a small, mountainous country, 90 percent of which is located more than 1,000 meters above sea level. The country is located in southwestern Asia, between the Caucasus and Near Asia (the area between the Kur and Araks rivers). The country is bordered by Georgia and Azerbaijan on the north and east and by Turkey and Iran on the west and south. The area of the country is 29,743 square kilometers, 46 percent of which is agricultural lands, 35 percent mountains and highlands, 13 percent forests, and 6 percent water surface. In Armenia, the largest lake is Sevan, which has a surface area of 1,260 square kilometers. The longest river is the Araks. The highest point in the country is the peak of Aragats (4,090 meters); the lowest point is the Debet River (390 meters). The longest distance between the northwest and the southeast is 360 kilometers, and the longest distance between west and east is 200 kilometers. The county is subdivided into 11 regions (marzes), which includes the region of Yerevan, the capital city of Armenia. 1.2 DEMOGRAPHIC CHARACTERISTICS As of January 1, 2001, the official population of the Republic of Armenia was 3.8 million. The country’s population is composed almost entirely of ethnic Armenians, although there are some Yazidis, Kurds, Russians, Ukrainians, Asserians, Greeks, and other national minorities. Most ethnic Armenians live outside the borders of the republic (approximately 5 million Armenians live in 66 countries). The location and size of the various Armenian diaspora communities is related to the available living conditions and security of the given areas. The formation of the Armenian diaspora began during the First World War (1914-1918), when the territory of Armenia was divided between the fighting empires. The Ottoman Empire owned the largest part of the historical territory of Armenia—West Armenia—and the Russian Empire owned East Armenia. 1.3 HISTORY The Armenian highland is one of the origins of civilization, where human beings have lived since the Stone Age. The Armenian nation is one of the oldest nations in the world. Its ancient history dates back almost 5,000 years, and the Armenian nation has long been famous for its material and spiritual culture. The most important two Old World trade and strategic routes connecting the East and the West went through Armenia, which made it an arena for war. In the ninth through the sixth centuries B.C., the Urartu (Ararat) Kingdom, with its unique and ancient civilization, flourished in the Armenian highland. The ruins of Erebuni City, which was 2 * Introduction founded by King Argishti of Urartu in 782 B.C., testify to this great culture. In the Ararat Kingdom, the construction of stronghold cities was very popular, as were handicrafts, blacksmithing, jewelry, stone and wood working, and other material cultures. The culture, architecture, theater, literature, and other arts were highly developed. After the collapse of Urartu, during the kingdom of King Tigran Mets (95-55 B.C.), Armenia continued to grow and develop. The Armenian Church was established in A.D. 301 by Grigor Lusavorich and the center was located in the city of Echmiadzin, where it has remained until the present day. In 2001, Armenia celebrated the 1,700th anniversary of the adoption of Christianity as the official religion. In 1375, the collapse of the Kingdom of Kilikia marked the end of Armenia’s freedom. Survival in an alien empire was kept in the memory of the Armenian nation as a history of humiliating concessions, retreats, and pressures. In the nineteenth century, this memory served as the basis of a new ideological awakening. In 1827, East Armenia was unyoked from the Persians and incorporated into the Russian Empire The First World War had a serious impact on the fate of the Armenian nation. Taking advantage of the war situation, in 1915, the Ottoman Empire committed genocide against the Armenians living in the territory. As a result, 1.5 million Armenians fell prey to that genocide, the rest became refugees and migrated to different countries. In fact, Turkey’s governors were able to clear the Armenian people from the whole territory of West Armenia through genocide and migration. As a result of assistance from the Russian Empire, Armenians had the opportunity to establish a free state in 1918. After the genocide, war, and revolution, Armenia found itself in a political crisis, with a collapsed economy, refugees, and unemployment. Furthermore, Armenia was without allies or a developed ideology. That republic endured for only two and a half years because national democratic values could not survive the period of ideological turmoil and the attack of the Red Army. This first Armenian republic, however, with all its weaknesses and disadvantages, became an important historical precedent by creating a system of democracy, from a national assembly and university to banking and an army. On November 29, 1920, Armenia was incorporated into the USSR. Armenia remained in the Soviet Union for about 70 years, during which time the Armenians were able to develop in the spheres of culture, science, art, and economy within the territory of their historic homeland. From 1921 to 1991, Armenians in their second republic gained unique experience in self-governance and developed a national self-consciousness, without which the formation of the third republic would have been impossible. 1.4 THE TRANSITION PERIOD FROM SOVIET REPUBLIC TO INDEPENDENT STATE On September 21, 1990, the Supreme Council of the Republic of Armenia adopted a declaration of independence. Three months later, Armenia became a part of Commonwealth of Independent States, and on March 2, 1992, it became a member of the United Nations. Armenia became a member of the European Council on February 18, 2001. The state language is Armenian, which belongs to the Indo-European language group; the national currency is the dram, which has been in circulation since November 1993. The Republic of Armenia is a self-governing, democratic, social, and legal country (Constitution of RA, Chapter 1, Article 1). In the Republic of Armenia, authority belongs to the Introduction * 3 people. The president of the country is responsible for the independence, the territorial integrity, and the security of the country. In the Republic of Armenia, the National Assembly is the legislative authority. People exercise their rights through free elections, as well as by state and local self- governance bodies and official bodies suggested by the Constitution (Constitution of RA, Chapter 1, Article 2). State authority is implemented according to the Constitution and laws based on the principle of distinguishing the legislative, administrative, and judicial authorities (Constitution of RA, Chapter 1, Article 5). 1.5 POPULATION MIGRATION BETWEEN 1988 AND 2000 During the 1980s, large-scale migration began to occur in Armenia. The population movements were a result of interethnic fighting, the Karabakh crisis, a devastating earthquake centered in the north of the country, and post-Soviet political, social and economic transitions. As a result of all of these factors, Armenia experienced net out-migration during the crisis period, especially from 1992 to 1994. Unfortunately, the current system of administrative registration of the population does not provide sufficient data on the migration that occurred during the 10 years preceding the survey; this is because some emigrants leave the Republic and live abroad for long periods of time without registering their departure. The porous borders between Armenia and other CIS countries, together with the lack of registration at border crossings, means that some population movements have not been included in the statistics on migration. The above factors account for the fact that according to official statistics, during the 1992- 2000 period, the Republic registered a net loss of 94,200. Other data, however, indicate that the real level of out-migration was higher. For example, according to the data on registration of passengers implemented by the General Department of Civil Aviation in the period 1992-2000 the cumulative net loss of people from the Republic comprised about 644,000. Furthermore, data collected at railway stations during May and June 2000 and data on border crossing by vehicles confirm that the current (available) population in the Republic is significantly lower because of out- migration. Thus, it is clear that the underregistration of migration has resulted in a paucity of reliable data on the current resident population. Furthermore, although some quantitative data on population movements by air, railway and vehicle transport are available, the age and sex structure of the migration streams is unknown. As previously mentioned, the calculation of the resident population of the Republic is based on official statistical data. In turn, all demographic indicators are calculated using the resident population in the denominator. Data collected in the Population Census, conducted in October 2001, will be used to recalculate demographic indicators. 1.6 HEALTH CARE SYSTEM AND EPIDEMIOLOGICAL SITUATION IN ARMENIA Until recently, Armenia’s health care system, which developed as part of the Soviet-planned system, could be seen as a planned public service provided by the state, with all health personnel being state employees. The system was highly centralized and standardized. Services were free to patients, provided in state-owned facilities, and financed mostly by the state budget. Heavy emphasis was placed on training large numbers of doctors and providing large numbers of hospital beds. The system was intended to provide comprehensive health coverage and universal access to services with a focus on disease prevention. 4 * Introduction Health services were provided through a network of primary health care institutions, including ambulatories, polyclinics, hospitals, and doctor’s assistant/midwife posts. For management purposes, the country was divided into health care delivery areas, each representing between 2,000 and 3,000 people. Specialized services were provided through secondary and tertiary health systems. The Soviet health care system was successful in providing access to comprehensive health services for most of the country’s population, including those who resided in rural and remote areas. However, maintaining such a system required substantial and continuous budgetary support and enormous manpower resources and managerial skills. Although the Soviet health care system met many of its goals, the system itself and the health of the population has deteriorated of late, largely due to the political and economic turmoil that accompanied the collapse of the Soviet Union. As a result, Armenia inherited a health care system that was in a chronic state of disarray. Even in the years that preceded the collapse, the Soviet Union was the only major country where the percentage of the gross domestic product (GDP) going to health care decreased, and it was already in the range of just 3 to 4 percent. This percentage compares with average health care expenditures of 6 to 10 percent of the GDP in most developed countries. After the collapse of the Soviet Union, the GDP fell by as much as 50 percent and funding to the health sector in Armenia decreased to about 1 to 3 percent of the GDP. This has resulted in declines in life expectancy, increased morbidity, poor conditions in hospitals and other facilities, and overall public dissatisfaction with health services. This situation, as well as the guarantee of free basic health care in the 1995 Constitution, prompted the country to search for other ways to fund health services. In 1997, the government-run health care institutions began a process of privatization, resulting in the re-registration of the state institutions into closed joint-stock companies, run as for-profit business organizations, but managed by the government. The network of pharmacies has now been completely privatized, while the dental service industry is almost completely privatized. While searching for an efficient funding mechanism, the country took major steps in restructuring the health care system with the intent to redirect resources to the primary health care sector. Efforts to restructure the primary care delivery system in Armenia have focused on creating a network of doctor’s assistant/midwife posts. On the other hand, abrupt increases in the market price of medications coupled with the poor financial condition of the health care sector have made health care inaccessible to large portions of the population. Admissions to both ambulatory and stationary medical facilities have decreased significantly. In-patient occupancy rates rarely exceed 35 to 40 percent. House calls have decreased by more than 30 percent. These phenomena are not due to improvements in patient health; rather, there are increases in the incidence of illnesses and mortality rates. From an epidemiological standpoint, Armenia has features of both developed and developing countries. The major causes of death are similar to those of industrialized countries: cardiovascular disease, cancer, and accidents. The decline in life expectancy is not due to infectious diseases, but to increases in cardiovascular mortality, accidents, and cancer. Infectious diseases account for a relatively low percentage of overall mortality, generally less than 20 percent. At the same time, there is a rising incidence of tuberculosis, especially multi-drug-resistant forms. Because of its likelihood to consume a large proportion of the limited resources available to the health sector and its potential to spread to other countries, tuberculosis is of great public health Introduction * 5 concern in Armenia. During the last 2-3 years, a slight increase in infant mortality has been observed. Among children, acute respiratory infections and childhood diarrheal diseases are the main causes of death. The insufficiency of the health industry mirrors declines in the country’s socioeconomic condition, as people are increasingly unable to pay medical costs. The search for alternative health care systems as well as a means to finance the health care system has become a difficult political issue; health care reform has become a priority issue for many. In recent years, many international organizations have supported various public health initiatives including maternal and child health and immunization programs, programs aiming to decrease mortality due to acute respiratory infections and diarrheal diseases, breastfeeding promotion, family planning campaigns, primary health care reform, tuberculosis control, and preventive care for women. 1.7 FAMILY PLANNING POLICIES AND PROGRAMS Maternal and child health issues in Armenia are the responsibility of the government, as written into the republic’s Constitution and legislation. National maternal and child health care strategy is based upon the state’s health care model. The legislative bases for child health care, as well as for the population as a whole, are the Constitution of the Republic of Armenia, the Armenian Laws on Child Rights and the Health Care and Services of the Population, upon which the right to use reproductive and family planning services is based. The main objectives of the family planning programs in Armenia are to ensure safe motherhood among women of reproductive age, to decrease health risks during pregnancy, and to reduce reliance upon abortion as a method of family planning while promoting more modern and effective methods of contraception. In this respect, the legal right to terminate a pregnancy has been granted by both the Ministry of Health and the Ministry of Justice. The government of the Republic of Armenia has also legalized procedures for medical sterilization. A draft of a nationwide law on human reproduction has been developed and is under discussion. However, many issues concerning both legal and medical aspects of the reproductive health of women still need to be addressed. Stemming from analyses of reproductive health data, there has been increasing demand to regulate family planning in Armenia. Networks of family planning services in Armenia had not been adequately developed until 1996 when the Reproductive Health Improvement national program was jointly implemented by the Armenian Ministry of Health, the World Health Organization (WHO), and the United Nations Population Fund (UNFPA). With the framework for family planning services now in place in every region, 77 family planning clinics were opened by 1997. In September 2000, the public relations department at Johns Hopkins University in the United States, with financial support from the U.S. Agency for International Development (USAID), implemented a media campaign called Green Road, designed to increase the public’s knowledge of family planning issues. In Armenia, abortion is a common method used to terminate unwanted pregnancies. Although originally outlawed in 1920, abortion was legalized by the Soviet Union in 1955 due to increases in mortality associated with illegal abortions. Today, abortion is legal during the first 12 weeks of pregnancy. In certain cases, it may be performed until 22 weeks of gestation if there are medical or social justifications. Abortions are performed in hospitals by trained medical staff. Despite decreases in recent years, the incidence of abortion remains an important issue for Armenian health care because of its negative effects on women’s health. 6 * Introduction The main barrier to the spread of family planning services and contraception is insufficient knowledge of modern family planning methods. There is also the lack of access to modern methods of family planning due to the changes in the Armenian health sector and underfunding of family planning services. Under the framework of the Reproductive Health Improvement Program, although contraceptives are distributed free of charge, medical consultations are not free. For many years, oral contraceptives were not commonly available in Armenia, due to the order “On the Side Effects and Complications of Oral Contraceptives” published by the Ministry of Health of the former Soviet Union in 1974. This document in effect banned the distribution and use of oral contra- ceptives. 1.8 FINANCING Due to the far-reaching nature of the Armenian health care system, and its principle of three stages of health care, maternal and child health care should theoretically be available to all. Specialized obstetrics and gynecological services are found primarily in the main cities and are administered through specialized medical genetics centers, family planning clinics, prenatal diagnostic laboratories, and maternity wards. Children’s health care is implemented through stationary and ambulatory polyclinics and boarding house health care services. The collapse of the socialist system adversely affected the country’s maternal and child health care system. Socioeconomic crises have worsened these problems. The deterioration of the communications infrastructure has severely reduced access to health care: the three-stage principle of health care cannot effectively operate, it has become almost impossible to organize specialized health care outside the republic, and emergency health care can be organized only with great difficulty. The problems are most apparent with regard to diagnostics, child nutrition, medication, and vaccinations, which are currently imported primarily by humanitarian organizations. No study has yet been conducted to calculate the cost of administering health care through separate services. Currently, however, economic reforms are being implemented by the Ministry of Health that would allocate funds to medical institutions on a per-patient basis. Budget allocations for the health care system are conducted annually in the framework of the state’s goal-oriented programs. However, budget allocations for the health sector are decreasing (2.7 percent of the GDP in 1990 and 1.4 percent in 1999). In spite of the fact that 30-40 percent of the health care budget is allocated to maternal and child health, there still exists insufficient funds to cover many services; in 2000, the health care system overall received only one-half of its predicted budget. Budget shortfalls have limited access to and the quality of health care, resulting in increases in mortality and morbidity. 1.9 OBJECTIVES AND ORGANIZATION OF THE SURVEY The Armenia Demographic and Health Survey (ADHS) was a nationally representative sample survey designed to provide information on population and health issues in Armenia. The primary goal of the survey was to develop a single integrated set of demographic and health data, the first such data set pertaining to the population of the Republic of Armenia. In addition to integrating measures of reproductive, child, and adult health, another feature of the DHS survey is that the majority of data are presented at the marz level. The ADHS was conducted by the National Statistical Service and the Ministry of Health of the Republic of Armenia during October through December 2000. ORC Macro provided technical Introduction * 7 support for the survey through the MEASURE DHS+ project. MEASURE DHS+ is a worldwide project, sponsored by the USAID, with a mandate to assist countries in obtaining information on key population and health indicators. USAID/Armenia provided funding for the survey. The United Nations Children’s Fund (UNICEF)/Armenia provided support through the donation of equipment. The ADHS collected national- and regional-level data on fertility and contraceptive use, maternal and child health, adult health, and AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well. Data are presented by marz wherever sample size permits. The ADHS results are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of and health services for the people of Armenia. The ADHS also contributes to the growing international database on demographic and health-related variables. Sample Design and Implementation The sample was designed to provide estimates of most survey indicators (including fertility, abortion, and contraceptive prevalence) for Yerevan and each of the other ten administrative regions (marzes). The design also called for estimates of infant and child mortality at the national level for Yerevan and other urban areas and rural areas. The target sample size of 6,500 completed interviews with women age 15-49 was allocated as follows: 1,500 to Yerevan and 500 to each of the ten marzes. Within each marz, the sample was allocated between urban and rural areas in proportion to the population size. This gave a target sample of approximately 2,300 completed interviews for urban areas exclusive of Yerevan and 2,700 completed interviews for the rural sector. Interviews were completed with 6,430 women. Men age 15-54 were interviewed in every third household; this yielded 1,719 completed interviews. A two-stage sample was used. In the first stage, 260 areas or primary sampling units (PSUs) were selected with probability proportional to population size (PPS) by systematic selection from a list of areas. The list of areas was the 1996 Data Base of Addresses and Households constructed by the National Statistical Service. Because most selected areas were too large to be directly listed, a separate segmentation operation was conducted prior to household listing. Large selected areas were divided into segments of which two segments were included in the sample. A complete listing of households was then carried out in selected segments as well as selected areas that were not segmented. The listing of households served as the sampling frame for the selection of households in the second stage of sampling. Within each area, households were selected systematically so as to yield an average of 25 completed interviews with eligible women per area. All women 15-49 who stayed in the sampled households on the night before the interview were eligible for the survey. In each segment, a subsample of one-third of all households was selected for the men’s component of the survey. In these households, all men 15-54 who stayed in the household on the previous night were eligible for the survey. Questionnaires Three questionnaires were used in the ADHS: a Household Questionnaire, a Women’s Questionnaire, and a Men’s Questionnaire. The questionnaires were based on the model survey 8 * Introduction instruments developed for the MEASURE DHS+ program. The model questionnaires were adapted for use during a series of expert meetings hosted by the Center of Perinatology, Obstetrics, and Gynecology. The questionnaires were developed in English and translated into Armenian and Russian. The questionnaires were pretested in July 2000. The Household Questionnaire was used to list all usual members of and visitors to a household and to collect information on the physical characteristics of the dwelling unit. The first part of the household questionnaire collected information on the age, sex, residence, educational attainment, and relationship to the household head of each household member or visitor. This information provided basic demographic data for Armenian households. It also was used to identify the women and men who were eligible for the individual interview (i.e., women 15-49 and men 15- 54). The second part of the Household Questionnaire consisted of questions on housing characteristics (e.g., the flooring material, the source of water, and the type of toilet facilities) and on ownership of a variety of consumer goods. The Women’s Questionnaire obtained information on the following topics: • Background characteristics • Pregnancy history • Antenatal, delivery, and postnatal care • Knowledge and use of contraception • Attitudes toward contraception and abortion • Reproductive and adult health • Vaccinations, birth registration, and health of children under age five • Episodes of diarrhea and respiratory illness of children under age five • Breastfeeding and weaning practices • Height and weight of women and children under age five • Hemoglobin measurement of women and children under age five • Marriage and recent sexual activity • Fertility preferences • Knowledge of and attitude toward AIDS and other sexually transmitted infections. The Men’s Questionnaire focused on the following topics: • Background characteristics • Health • Marriage and recent sexual activity • Attitudes toward and use of condoms • Knowledge of and attitude toward AIDS and other sexually transmitted infections. Field Staff Thirteen interviewing teams were involved in data collection; each team consisted of four female interviewers, a male interviewer, a health technician, a field editor, and a team supervisor. The health technicians received special training in anthropometric measurement and anemia testing and were responsible for the collection of data on height and weight and anemia levels. Training of the survey field staff occurred during a three-week period in September 2000. Training for all field staff, except the health technicians, was conducted by the National Statistical Service. Training for the health technicians was conducted by the Ministry of Health. Training Introduction * 9 Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence, Armenia 2000____________________________________________________ Residence_________________ Result Urban Rural Total ____________________________________________________ Household interviews Households sampled 3,629 2,895 6,524 Households occupied 3,386 2,764 6,150 Households interviewed 3,260 2,720 5,980 Household response rate 96.3 98.4 97.2 Individual interviews: women Number of eligible women 3,699 2,986 6,685 Number of eligible women interviewed 3,545 2,885 6,430 Eligible woman response rate 95.8 96.6 96.2 Individual interviews: men Number of eligible men 1,045 868 1,913 Number of eligible men interviewed 943 776 1,719 Eligible man response rate 90.2 89.4 89.9 consisted of lectures, practice in the classroom, and two days of practice in the field. Field practice was conducted on a team basis with interviewers and health technicians working in the same households. Fieldwork and Data Processing The main fieldwork began in early October and was completed by early December. All callbacks and reinterviews were completed in early January 2001. Two special quality control teams, consisting of a female interviewer, a male interviewer, and a health technician, visited the teams in the field to check on the quality of the fieldwork. After a team had completed interviewing in a cluster, questionnaires were returned promptly to the National Statistical Service in Yerevan for data processing. The office editing staff first checked that questionnaires for all selected households and eligible respondents had been received from the field staff. In addition, a few questions that had not been precoded (e.g., occupation) were coded at this time. Using the ISSA (Integrated System for Survey Analysis) software, a specially trained team of data processing staff entered the questionnaires and edited the resulting data set on microcomputers. The process of office editing and data processing was initiated soon after the beginning of fieldwork and was completed by the end of January 2001. Response Rates Table 1.1 presents household and individual response rates for the survey. A total of 6,524 households were selected for the sample, of which 6,150 were occupied at the time of fieldwork. The main reason for the difference is that some of the dwelling units that were occupied during the household listing operation were either vacant or the household was away for an extended period at the time of interviewing. Of the occupied households, 97 percent were successfully interviewed. 10 * Introduction In these households, 6,685 women were identified as eligible for the individual interview (i.e., age 15-49). Interviews were completed with 96 percent of them. Of the 1,913 eligible men identified, 90 percent were successfully interviewed. The principal reason for non-response among eligible women and men was the failure to find them at home despite repeated visits to the household. The refusal rate was low. The overall response rates, the product of the household and the individual response rates, were 94 percent for women and 87 percent for men. Household Population and Housing Characteristics * 11 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2 H. Petrosyan and J. Magluchants This chapter provides a summary of the demographic and socioeconomic characteristics of the household population in the ADHS, including age, sex, place of residence, educational status, and household characteristics. Information collected on the characteristics of the households and respondents is important in understanding and interpreting the findings of the survey and also provides indicators of the representativeness of the survey. A household is defined as a person or group of related and unrelated persons who live together in the same dwelling unit(s) or in connected premises, who acknowledge one adult member as head of the household, and who have common arrangements for cooking and eating their food. The questionnaire for the ADHS distinguishes between the de jure population (persons who usually live in a selected household) and the de facto population (persons who stayed the night before the interview in the household). According to the ADHS data, the differences between these populations are small. Tabulations for the household data presented in this chapter are primarily based on the de facto population. Due to the way the sample was designed, the number of cases in some regions may appear small since they are weighted to make the regional distribution nationally representative. Throughout this report, numbers in the tables reflect weighted numbers. To ensure statistical reliability, percentages based on 25 to 49 unweighted cases are shown within parentheses, and percentages based on fewer than 25 unweighted cases are suppressed. 2.1 CHARACTERISTICS OF THE POPULATION Age-Sex Structure Age and sex are important demographic variables and form the primary basis of demographic classification in vital statistics, censuses, and surveys. They are also important variables in the study of mortality, fertility, and nuptiality. Table 2.1 presents the percent distribution of the de facto population by five-year age groups, according to urban-rural residence and sex. The information is used to construct the population pyramid shown in Figure 2.1. The total de facto population was 24,372. The data show that 54 percent of the population is female; the gender disparity is more pronounced in urban areas than in rural areas (83 versus 90 men per 100 women). Among the youngest age groups, however, the sex ratio is more balanced; it is not until the 15-19 age cohort that the percentage of women is higher than the percentage of men. Overall, this imbalance in the sex ratio strongly suggests that the outmigration from Armenia in the decade of the 1990s was disproportionately selective of men. About 63 percent of the population is in the 15-64 age group, also referred to as the economically active population. The proportion of the population falling within this age group is significantly higher in urban areas (66 percent) than in rural areas (59 percent). This difference may be largely attributed to high levels of rural-urban migration, especially among the young in search 12 * Household Population and Housing Characteristics Table 2.1 Household population by age, residence, and sex Percent distribution of the de facto household population by five-year age group, according to sex and urban-rural residence, Armenia 2000 ______________________________________________________________________________________ Urban Rural Total _____________________ ____________________ _____________________ Age Male Female Total Male Female Total Male Female Total ______________________________________________________________________________________ 0-4 7.9 4.8 6.2 9.5 6.7 8.0 8.6 5.6 7.0 5-9 8.6 7.0 7.8 10.7 9.1 9.9 9.5 7.9 8.6 10-14 11.4 8.5 9.8 12.0 10.3 11.1 11.6 9.3 10.4 15-19 8.0 9.2 8.7 8.1 9.5 8.8 8.1 9.3 8.7 20-24 7.3 8.7 8.1 6.9 7.2 7.1 7.1 8.1 7.7 25-29 6.9 6.2 6.5 5.9 6.1 6.0 6.4 6.2 6.3 30-34 5.0 6.0 5.5 6.6 6.4 6.5 5.7 6.2 5.9 35-39 7.1 7.8 7.5 7.6 7.5 7.5 7.3 7.7 7.5 40-44 8.0 7.9 7.9 7.7 7.2 7.4 7.8 7.6 7.7 45-49 6.9 7.9 7.4 5.0 4.8 4.9 6.1 6.6 6.4 50-54 5.4 5.6 5.5 2.8 3.7 3.3 4.3 4.8 4.6 55-59 3.0 3.0 3.0 2.2 2.4 2.3 2.6 2.8 2.7 60-64 4.9 6.1 5.6 4.9 6.1 5.5 4.9 6.1 5.5 65-69 4.0 3.9 3.9 3.8 4.5 4.1 3.9 4.1 4.0 70-74 3.6 4.1 3.9 4.2 5.1 4.7 3.9 4.5 4.2 75-79 1.3 2.0 1.7 1.3 2.0 1.7 1.3 2.0 1.7 80 + 0.7 1.3 1.0 0.9 1.5 1.2 0.8 1.4 1.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 6,423 7,732 14,155 4,847 5,370 10,217 11,271 13,101 24,372 Household Population and Housing Characteristics * 13 Table 2.2 Household composition Percent distribution of households by sex of head of household and household size, according to urban-rural residence, Armenia 2000 _____________________________________________________ Residence _________________ Characteristic Urban Rural Total _____________________________________________________ Sex of household head Male 68.7 74.9 71.1 Female 31.3 25.1 28.9 Total 100.0 100.0 100.0 Number of usual members 1 9.3 7.0 8.4 2 13.5 11.6 12.7 3 14.5 9.6 12.6 4 22.3 16.4 20.0 5 18.8 21.0 19.7 6 12.0 17.5 14.1 7 4.9 10.0 6.9 8 1.8 3.5 2.5 9+ 2.9 3.4 3.1 Total 100.0 100.0 100.0 Mean size 4.1 4.7 4.3 _____________________________________________________ Note: Table is based on de jure members, i.e., usual residents. of jobs and higher education. The disproportionately low percentage of the population in the 55-59 age group is probably due to low levels of fertility during World War II (Figure 2.1). The data further indicate that slightly more than one-fourth of the population consists of children under 15 years of age. As table 2.1 shows, the proportion under 15 is greater in the rural population than in the urban population (29 and 24 percent, respectively). This is evidence of higher fertility in the rural areas. The 10- to 14-year-old cohort is the largest of the five-year age groups. This may largely be due to the fertility peaks of both 1986 and 1990-1991—the second of which was the so-called “compensation period” following the earthquake of 1988. Household Composition Table 2.2 presents the distribution of households in the ADHS sample by sex of the head of the household and by household size for urban and rural areas. These characteristics are important because they are often associated with differences in household socioeconomic levels. For example, female-headed households are frequently poorer than households headed by males. In addition, the size and composition of the household affects the allocation of financial and other resources among household members, which in turn influences the overall well-being of these individuals. Household size is also associated with crowding in the dwelling, which can lead to unfavorable health conditions. 14 * Household Population and Housing Characteristics Table 2.3 Children’s living arrangements and orphanhood Percent distribution of de jure children under age 15 by children’s living arrangements and survival status of parents, according to background characteristics, Armenia 2000 ____________________________________________________________________________________________________ Living Living with mother with father but not father but not mother Not living with either parent Missing Living ____________ _______________ ___________________________ informa- with Only Only tion on Number Background both Father Father Mother Mother Both father mother Both father/ of characteristic parents alive dead alive dead alive alive alive dead mother Total children ____________________________________________________________________________________________________ Age 0-1 94.1 4.9 0.4 0.2 0.2 0.3 0.0 0.0 0.0 0.0 100.0 640 2-4 92.0 4.9 1.2 0.7 0.2 0.3 0.1 0.0 0.0 0.6 100.0 1,095 5-9 89.8 5.3 2.9 0.4 0.5 0.6 0.1 0.1 0.1 0.3 100.0 2,150 10-14 88.0 4.6 4.9 0.5 0.7 0.4 0.2 0.1 0.2 0.6 100.0 2,550 Sex Male 90.2 4.7 3.0 0.5 0.4 0.4 0.0 0.0 0.1 0.5 100.0 3,418 Female 89.5 5.2 3.2 0.4 0.6 0.5 0.2 0.1 0.1 0.3 100.0 3,017 Residence Urban 87.0 6.9 3.4 0.4 0.8 0.3 0.1 0.1 0.2 0.6 100.0 3,402 Rural 93.0 2.7 2.8 0.5 0.2 0.5 0.1 0.0 0.0 0.2 100.0 3,033 Region Yerevan 87.5 6.3 3.8 0.4 0.9 0.3 0.2 0.0 0.1 0.5 100.0 1,747 Aragatsotn 96.0 1.3 1.4 0.6 0.0 0.5 0.0 0.0 0.0 0.2 100.0 365 Ararat 93.8 2.0 3.0 0.8 0.3 0.1 0.0 0.0 0.0 0.0 100.0 784 Armavir 89.0 3.8 4.9 0.4 0.4 1.1 0.0 0.0 0.0 0.5 100.0 644 Gegharkunik 94.9 2.6 1.1 0.2 0.6 0.3 0.2 0.0 0.0 0.2 100.0 610 Lori 81.8 10.2 4.8 1.2 0.0 0.2 0.0 0.5 0.5 0.7 100.0 505 Kotayk 90.9 6.3 1.3 0.5 0.8 0.3 0.0 0.0 0.0 0.0 100.0 453 Shirak 87.4 5.6 4.3 0.2 0.6 0.2 0.0 0.2 0.4 0.9 100.0 602 Syunik 89.7 5.3 2.5 0.0 0.4 1.4 0.2 0.0 0.0 0.4 100.0 276 Vayots Dzor 94.2 3.5 0.8 0.4 0.0 0.8 0.2 0.0 0.0 0.2 100.0 130 Tavush 92.7 4.2 1.5 0.0 0.2 0.7 0.0 0.0 0.2 0.5 100.0 317 Total 89.9 4.9 3.1 0.5 0.5 0.4 0.1 0.1 0.1 0.4 100.0 6,435 ____________________________________________________________________________________________________ Note: Orphans are children with both parents dead. In general, heads of household in Armenia are male (71 percent). However, there is a greater proportion of female-headed households in urban areas (31 percent) than in rural areas (25 percent). The average household size in Armenia is 4.3 persons. The data show that rural households (4.7 members) are larger than urban households (4.1 members). Detailed information on living arrangements and orphanhood for children under 15 years of age is presented in Table 2.3. This shows that the vast majority (90 percent) of children under 15 live with both parents. Countrywide, 9 percent of children live with only one of their parents, in most cases the mother. In Lori, the proportion of children under 15 living with both parents is much lower than in the rest of the country. There, a full 15 percent of children live only with their mother and not their father. This is likely because many men have left the region, which was devastated in the 1988 earthquake, in search of work. Aragatsotn has the highest proportion of children living with both parents (96 percent). Almost no children (0.1 percent) are orphans, i.e., had both of their parents die. Although still small, the highest proportion of orphans is in the earthquake zone of Lori and Shirak. Household Population and Housing Characteristics * 15 Education The educational attainment of household members is an important determinant of their opportunities and behaviors. Many phenomena such as use of health facilities, reproductive behavior, health of children, and proper hygienic habits are associated with the educational level of household members, especially women. The school system in Armenia has three levels. The first level, primary education, consists of grades one through three for students age 7-9. The second level, or middle school, consists of grades four through eight for students age 10-14. The first two levels together are called total general education and are compulsory. Secondary school, the third level of school, comprises grades nine and ten. The three levels together are referred to as a full secondary education. Students who have completed a minimum of eight grades may enroll in secondary-special education. There are two tracks within secondary-special education. The first track consists of professional-technical institutions that train students in a variety of specializations. Students who have completed at least primary and middle school are eligible for this secondary-special track. The second track prepares specialists with mid-level qualifications, such as teachers, midwives, and mechanics. This track can be completed in two years by students who have completed the tenth grade or can be completed in four years by students who completed the eighth grade. University and postgraduate education prepares higher level specialists. Students who complete a full secondary education may enroll in university. Table 2.4 presents information on the educational attainment of the Armenian population age 7 and over. Virtually all Armenians have gone to school. The median number of years of schooling is 10 for both women and men. Individuals residing in urban areas have significantly higher levels of university education than those in rural areas. Approximately one-fourth of those living in the capital city of Yerevan have attended university. The proportion of the population with no education is low, with the highest levels being seen among those 65 years and older. 16 * Household Population and Housing Characteristics Table 2.4 Educational attainment of household population Percent distribution of the de facto male and female household populations age seven and over by highest level of education attended, according to background characteristics, Armenia 2000______________________________________________________________________________________________ Highest level of schooling attended Number Median___________________________________________________ of number Background No Primary/ Second- Secondary- Univer- males/ of characteristic education middle ary special sity Higher Total females years______________________________________________________________________________________________ MALES______________________________________________________________________________________________ Age 7-9 3.3 96.7 0.0 0.0 0.0 0.0 100.0 668 0.7 10-14 0.8 99.2 0.0 0.1 0.0 0.0 100.0 1,311 4.6 15-19 0.5 36.7 43.9 7.7 11.2 0.0 100.0 910 8.6 20-24 0.2 19.5 39.4 20.2 20.3 0.3 100.0 806 9.8 25-29 0.6 11.0 35.1 30.4 22.4 0.6 100.0 726 10.9 30-34 0.5 6.9 30.9 40.5 20.3 0.8 100.0 639 11.5 35-39 0.5 8.0 28.5 42.2 20.0 0.8 100.0 827 11.4 40-44 0.3 10.1 29.2 41.3 18.8 0.3 100.0 883 11.4 45-49 0.5 9.5 25.5 38.5 25.1 0.9 100.0 687 11.8 50-54 1.5 8.3 29.2 33.8 26.3 0.9 100.0 482 11.5 55-59 0.3 15.1 32.5 31.7 19.5 0.9 100.0 295 11.0 60-64 0.7 31.4 25.3 23.0 19.0 0.5 100.0 552 9.7 65+ 3.9 49.0 18.8 13.3 14.6 0.4 100.0 1,111 7.7 Residence Urban 0.7 32.0 23.7 22.7 20.2 0.7 100.0 5,711 9.7 Rural 1.8 42.0 25.6 22.1 8.5 0.0 100.0 4,186 9.2 Region Yerevan 0.4 30.2 22.9 21.5 23.8 1.0 100.0 3,121 9.9 Aragatsotn 2.1 36.0 25.3 25.3 11.0 0.4 100.0 472 9.4 Ararat 2.2 40.6 24.2 22.9 10.0 0.1 100.0 1,098 9.2 Armavir 1.7 43.1 24.8 21.3 9.0 0.1 100.0 893 9.1 Gegharkunik 0.7 37.6 28.0 23.7 9.8 0.1 100.0 825 9.3 Lori 1.1 39.6 22.7 25.0 11.4 0.2 100.0 769 9.3 Kotayk 2.1 37.0 23.4 26.0 11.4 0.2 100.0 704 9.4 Shirak 1.0 34.8 27.3 19.9 16.8 0.3 100.0 949 9.5 Syunik 0.4 38.7 25.0 25.4 10.2 0.0 100.0 412 9.4 Vayots Dzor 1.9 37.4 28.3 23.3 9.1 0.0 100.0 188 9.3 Tavush 1.0 43.8 24.7 17.8 12.5 0.1 100.0 468 9.1 Total 1.1 36.2 24.5 22.5 15.3 0.4 100.0 9,897 9.5______________________________________________________________________________________________ FEMALES ______________________________________________________________________________________________ Age 7-9 2.4 97.6 0.0 0.0 0.0 0.0 100.0 660 0.8 10-14 0.4 99.4 0.2 0.0 0.0 0.0 100.0 1,212 4.7 15-19 0.0 23.4 52.3 13.4 11.0 0.0 100.0 1,220 9.1 20-24 0.2 8.2 29.9 35.4 25.8 0.4 100.0 1,062 11.3 25-29 0.1 3.8 36.8 38.1 20.5 0.7 100.0 809 11.3 30-34 0.4 4.0 31.6 43.4 19.9 0.7 100.0 807 11.5 35-39 0.4 5.3 35.0 42.9 16.4 0.1 100.0 1,004 11.2 40-44 0.3 6.7 35.4 41.2 16.3 0.1 100.0 996 11.1 45-49 0.4 8.8 30.6 38.0 21.9 0.3 100.0 864 11.4 50-54 0.8 12.6 32.3 29.9 23.9 0.4 100.0 628 11.2 55-59 0.3 27.1 34.8 19.3 18.4 0.0 100.0 364 9.7 60-64 3.0 34.3 34.4 18.2 9.9 0.2 100.0 801 9.3 65+ 9.4 48.3 19.5 12.4 10.3 0.1 100.0 1,578 7.2 Residence Urban 1.0 25.1 25.3 27.9 20.3 0.4 100.0 7,174 9.9 Rural 2.9 39.2 32.7 19.9 5.3 0.0 100.0 4,829 9.1 Region Yerevan 0.8 22.9 24.5 26.6 24.7 0.5 100.0 3,995 10.5 Aragatsotn 3.7 36.1 32.5 20.0 7.3 0.3 100.0 540 9.2 Ararat 4.1 35.6 30.6 23.4 6.3 0.0 100.0 1,255 9.3 Armavir 2.7 37.3 29.9 22.2 7.8 0.0 100.0 1,012 9.2 Gegharkunik 3.7 39.3 33.2 18.8 4.9 0.0 100.0 938 9.1 Lori 0.9 32.6 30.6 26.7 9.3 0.0 100.0 972 9.5 Kotayk 1.8 33.7 25.6 28.8 10.1 0.0 100.0 874 9.5 Shirak 0.8 29.1 29.1 24.5 16.3 0.2 100.0 1,155 9.6 Syunik 0.6 33.6 28.8 28.8 8.2 0.0 100.0 500 9.5 Vayots Dzor 1.3 32.8 39.3 20.6 5.8 0.1 100.0 208 9.3 Tavush 1.6 37.5 28.2 21.6 11.1 0.0 100.0 553 9.3 Total 1.8 30.8 28.2 24.7 14.2 0.2 100.0 12,003 9.6 1 Students who are overage for a given level of schooling may have started school overage, may have repeated one or more grades in school, or may have dropped out of school and later returned. Household Population and Housing Characteristics * 17 Data on net attendance ratios (NARs) and gross attendance ratios (GARs) by school level, sex, residence, and region are shown in Table 2.5. The NAR indicates participation in primary/middle school for the population age 7-14 and secondary school for the population age 15- 16. The GAR measures participation at each level of schooling among those of any age from 6 to 24. The GAR is nearly always higher than the NAR for the same level because the GAR includes participation by those who may be older or younger than the official age range for that level.1 An NAR of 100 percent would indicate that all those in the official age range for the level are attending at that level. The GAR can exceed 100 percent if there is significant overage or underage participation at a given level of schooling. In Armenia, school attendance among school-age household members is high. The NAR for primary/middle school is 95 percent and for secondary school is 87 percent. Attendance ratios are, in general, higher for girls than for boys. Attendance ratios are virtually the same among urban and rural populations. A comparison of NARs and GARs indicates that approximately 6 percent of students in primary/middle school and 5 percent of students in secondary school are either underage or overage. Figure 2.2 presents the age-specific attendance ratios (ASAR) for the population 6-24 by sex. The ASAR indicates participation in schooling at any level, from primary through higher education. The closer the ASAR is to 100 percent, the higher the proportion of a given age attending school. In Armenia, almost all youths of primary to middle school age (7-14) attend school as there are no significant differences by gender. Among the secondary-school age population (15-16), attendance ratios begin to decline, particularly among males. It should be noted that among 17 to 20 year olds, a significantly higher proportion of females than males are attending school. 18 * Household Population and Housing Characteristics Table 2.5 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de jure household population by level of schooling and sex, according to background characteristics, Armenia 2000 ___________________________________________________________________________________ Net attendance ratio 1 Gross attendance ratio 2 Background __________________________ _________________________ characteristic Male Female Total Male Female Total ___________________________________________________________________________________ PRIMARY/MIDDLE SCHOOL ___________________________________________________________________________________ Residence Urban 93.5 95.6 94.5 100.4 101.8 101.1 Rural 94.1 95.0 94.5 101.3 101.0 101.2 Region Yerevan 93.5 95.4 94.4 100.9 101.4 101.1 Aragatsotn 94.9 94.9 94.9 100.8 106.1 103.2 Ararat 93.0 92.7 92.8 99.1 96.7 97.9 Armavir 94.6 96.8 95.6 100.0 101.1 100.5 Gegharkunik 96.0 94.3 95.2 105.6 101.9 103.9 Lori 90.0 95.7 92.9 97.1 101.4 99.3 Kotayk 91.7 93.5 92.5 97.2 95.2 96.3 Shirak 92.5 96.8 94.5 98.1 108.6 103.0 Syunik 98.9 99.0 98.9 109.9 102.0 105.8 Vayots Dzor 96.0 96.6 96.3 101.0 100.0 100.5 Tavush 95.2 95.0 95.1 106.0 100.0 102.7 Total 93.8 95.3 94.5 100.8 101.4 101.1 ___________________________________________________________________________________ SECONDARY SCHOOL ____________________________________________________________________________________ Residence Urban 83.8 90.6 87.2 89.1 94.3 91.7 Rural 82.3 89.7 86.0 87.8 95.6 91.7 Region Yerevan 82.5 89.2 85.9 88.8 92.1 90.5 Aragatsotn 84.7 87.9 86.5 91.8 90.9 91.3 Ararat 82.3 91.4 86.3 86.4 99.1 92.0 Armavir 78.4 90.9 84.2 83.3 98.9 90.5 Gegharkunik 85.8 86.2 86.0 92.9 95.4 94.1 Lori 79.5 92.8 86.0 83.0 97.6 90.1 Kotayk 82.4 94.5 88.7 88.2 99.1 93.9 Shirak 87.1 86.2 86.6 92.5 89.4 90.9 Syunik 88.9 95.6 92.5 91.9 97.3 94.8 Vayots Dzor 89.2 90.4 89.8 93.7 97.4 95.6 Tavush 83.3 91.7 87.4 87.7 95.4 91.5 Total 83.1 90.2 86.7 88.5 94.9 91.7 ____________________________________________________________________________________ 1 The NAR for primary/middle school is the percentage of the primary/middle-school-age (7-14 years) population that is attending primary/middle school. The NAR for secondary school is the percentage of the secondary-school-age (15-16 years) population that is attending secondary school. By definition the NAR cannot exceed 100 percent. 2 The GAR for primary/middle school is the total number of primary/middle school students, expressed as a percentage of the official primary/middle-school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. Household Population and Housing Characteristics * 19 Table 2.6 Grade repetition and dropout rates Repetition and dropout rates for the de jure household population age 6-24 years by school grade, according to background characteristics, Armenia 2000 __________________________________________________________________________ School grade Background ___________________________________________________ characteristic 1 2 3 4 5 6 7 8 __________________________________________________________________________ REPETITION RATE 1 __________________________________________________________________________ Sex Male 0.5 0.0 0.2 1.5 0.7 0.8 0.0 0.0 Female 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.8 Residence Urban 0.6 0.0 0.0 1.0 0.0 0.4 0.0 0.5 Rural 0.0 0.1 0.2 0.5 0.9 0.5 0.0 0.3 Region Yerevan 1.2 0.0 0.0 2.1 0.0 0.0 0.0 0.9 Aragatsotn 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Ararat 0.0 0.0 0.0 0.0 0.0 1.6 0.0 0.0 Armavir 0.0 0.0 0.0 0.0 2.3 0.0 0.0 0.0 Gegharkunik 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Lori 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Kotayk 0.0 0.0 0.0 0.0 0.0 2.1 0.0 0.0 Shirak 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Syunik 0.0 0.0 1.9 4.5 0.0 0.0 0.0 2.0 Vayots Dzor 0.0 2.4 0.0 0.0 0.0 0.0 0.0 0.0 Tavush 0.0 0.0 0.0 0.0 2.4 0.0 0.0 0.0 Total 0.3 0.1 0.1 0.8 0.4 0.4 0.0 0.4 ____________________________________________________________________________ DROPOUT RATE 2 ____________________________________________________________________________ Sex Male 0.8 0.0 0.0 0.4 0.5 0.8 0.5 10.5 Female 0.0 0.0 0.0 0.0 0.0 0.4 0.0 4.5 Residence Urban 0.5 0.0 0.0 0.0 0.0 0.0 0.0 5.6 Rural 0.4 0.0 0.0 0.5 0.6 1.4 0.6 9.8 Region Yerevan 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.4 Aragatsotn 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.8 Ararat 0.0 0.0 0.0 2.2 0.0 1.6 0.0 15.7 Armavir 2.0 0.0 0.0 0.0 2.3 2.6 0.0 11.8 Gegharkunik 2.3 0.0 0.0 0.0 0.0 0.0 0.0 2.6 Lori 0.0 0.0 0.0 0.0 0.0 2.4 0.0 4.3 Kotayk 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.3 Shirak 0.0 0.0 0.0 0.0 0.0 0.0 2.8 10.5 Syunik 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Vayots Dzor 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.3 Tavush 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.4 Total 0.4 0.0 0.0 0.2 0.2 0.6 0.3 7.4 ____________________________________________________________________________ 1 The repetition rate is the percentage of students in a given grade who are repeating that grade. 2 The dropout rate is the percentage of students in a given grade in the previous school year who are not attending school. 20 * Household Population and Housing Characteristics Table 2.7 Housing characteristics Percent distribution of households by housing characteristics, according to urban-rural residence, Armenia 2000 _____________________________________________________ Residence _________________ Characteristic Urban Rural Total _____________________________________________________ Electricity 99.1 98.6 98.9 Source of drinking water Piped into residence 86.4 26.2 62.8 Piped into yard/plot 10.2 45.7 24.1 Public tap 1.4 10.3 4.9 Open well in yard/plot 0.2 0.7 0.4 Spring 1.2 12.6 5.7 River/stream 0.0 0.4 0.1 Tanker truck 0.3 2.5 1.1 Other 0.3 1.6 0.9 Total 100.0 100.0 100.0 Time to water source <15 minutes 97.5 81.6 91.3 Sanitation facilities Own flush toilet 90.3 20.5 62.9 Traditional pit toilet 9.2 79.1 36.6 Other 0.5 0.4 0.5 Total 100.0 100.0 100.0 Flooring material Earth, sand 0.7 2.7 1.4 Wood planks 34.7 74.7 50.4 Parquet, polished wood 54.8 6.5 35.9 Lynoleum 4.2 3.4 3.9 Cement 1.4 11.1 5.2 Carpet 4.1 1.6 3.1 Other material 0.1 0.1 0.1 Missing 0.1 0.0 0.1 Total 100.0 100.0 100.0 Place for hand washing In dwelling/yard/plot 99.2 94.2 97.2 Nowhere 0.8 5.8 2.8 Total 100.0 100.0 100.0 Type of cooking fuel Electricity 48.5 20.4 37.4 LPG, natural gas 12.7 15.5 13.8 Liquid gas 28.1 9.5 20.8 Kerosene 1.9 0.7 1.4 Charcoal 0.6 0.5 0.6 Firewood, straw 6.3 29.3 15.3 Tezek (dung) 1.7 24.2 10.5 Other 0.2 0.0 0.1 Missing 0.0 0.0 0.0 Total 100.0 100.0 100.0 Total 3,633 2,347 5,980 Repetition and dropout rates, shown in Table 2.6, describe the flow of students through the school system. Repetition and dropout rates often vary across grades, indicating points in the school system where students are not regularly promoted to the next grade. In Armenia, the repetition rates for grades one through eight are very low—less than 1 percent. Dropout rates are also less than 1 percent for grades one through seven. The dropout rate after eighth grade, however, is more than 7 percent, meaning that these children stop studying after the compulsory years of school. 2.2 HOUSING CHARACTERISTICS To assess the socioeconomic con- ditions under which the population lives, respondents were asked to give specific information about their household envi- ronment. Tables 2.7 and 2.8 present major housing characteristics by urban- rural residence. Type of water source, sanitation facilities, and floor material are characteristics that affect the health status of household members and particularly of children. They also indicate the socioeco- nomic status of households. Virtually all households in Arme- nia (99 percent) have electricity. A major- ity of households in the country have water piped into the residence, a flush toilet, a finished floor, and a place for handwashing. Overall, most of the re- spondents in urban areas live in environ- ments with adequate sanitary conditions. In rural areas, living conditions are more mixed. Household Population and Housing Characteristics * 21 Table 2.8 Housing characteristics by region Percent distribution of households by housing characteristics, according to region, Armenia 2000 ___________________________________________________________________________________________________ Region _________________________________________________________________ Aragat- Arma- Geghar- Vayots Characteristic Yerevan sotn Ararat vir kunik Lori Kotayk Shirak Syunik Dzor Tavush Total ____________________________________________________________________________________________________ Electricity 99.1 99.3 99.2 99.1 98.3 98.1 99.7 98.7 99.3 97.5 99.2 98.9 Source of drinking water Piped into residence 91.0 33.8 30.5 31.1 33.3 52.4 77.9 69.0 83.7 57.0 36.5 62.8 Piped into yard/plot 8.2 26.7 55.3 44.9 39.7 28.1 14.1 18.2 11.2 36.6 29.6 24.1 Public tap 0.2 12.8 13.0 1.2 14.6 4.2 3.9 2.8 0.2 5.0 13.8 4.9 Open well in yard/plot 0.0 0.0 0.0 0.5 1.7 1.4 0.0 0.6 0.0 0.2 0.0 0.4 Spring 0.4 26.0 0.4 9.8 6.9 10.4 3.3 8.9 4.0 1.1 16.3 5.7 River/stream 0.0 0.0 0.0 0.0 1.2 0.5 0.0 0.0 0.0 0.0 0.0 0.1 Tanker truck 0.0 0.0 0.8 11.0 0.0 0.0 0.0 0.0 0.0 0.0 3.1 1.1 Other 0.3 0.7 0.0 1.5 2.6 3.1 0.8 0.4 0.9 0.0 0.8 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Time to water source <15 minutes 99.6 79.9 90.3 90.9 78.6 86.1 93.1 89.6 95.6 95.5 75.0 91.3 Sanitation facilities Own flush toilet 93.0 24.3 27.9 35.7 24.3 54.0 72.7 74.9 80.0 49.5 46.1 62.9 Traditional pit toilet 6.4 75.4 71.8 63.3 75.5 46.0 27.3 24.2 19.8 50.5 53.7 36.6 Other 0.6 0.2 0.4 0.9 0.2 0.0 0.0 0.8 0.2 0.0 0.2 0.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Flooring material Earth, sand 1.1 0.7 1.5 0.5 2.7 0.9 3.0 1.9 0.4 5.2 0.6 1.4 Wood planks 26.9 74.7 74.0 70.3 67.4 47.4 36.5 62.8 59.1 42.0 70.4 50.4 Parquet, polished wood 67.6 10.2 11.8 19.9 12.3 32.1 38.4 11.0 36.3 32.3 17.9 35.9 Lynoleum 1.0 2.4 2.3 0.7 3.1 11.6 0.3 16.2 0.7 2.5 3.3 3.9 Cement 1.1 12.1 8.0 6.5 14.5 3.5 3.3 6.7 1.5 14.8 5.2 5.2 Carpet 2.1 0.0 2.3 2.1 0.0 4.5 18.2 1.3 2.0 3.2 1.9 3.1 Other 0.1 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.8 0.1 Missing 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Place for handwashing In dwelling/yard/plot 99.4 99.3 98.3 97.4 93.4 92.0 99.7 92.4 99.8 96.4 98.8 97.2 Nowhere 0.6 0.7 1.7 2.6 6.6 8.0 0.3 7.6 0.2 3.6 1.2 2.8 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Type of cooking fuel Electricity 46.0 25.5 32.6 34.6 10.8 28.1 53.3 55.2 45.3 32.3 4.8 37.4 LPG, natural gas 10.4 5.0 22.5 21.3 19.3 6.4 17.7 16.9 10.3 9.3 10.7 13.8 Liquid gas 39.1 7.6 20.8 21.0 6.2 8.7 16.6 8.0 7.7 8.9 4.8 20.8 Kerosene 2.0 0.5 0.8 2.1 0.4 1.4 1.1 2.2 0.2 0.2 0.0 1.4 Charcoal 0.8 0.0 0.6 0.7 0.4 0.2 0.3 0.2 0.4 1.4 1.2 0.6 Firewood, straw 1.2 12.3 13.5 11.9 22.9 44.8 8.6 3.0 30.5 8.9 78.3 15.3 Tezek (dung) 0.2 49.2 9.0 8.4 39.5 10.1 2.5 14.5 5.5 39.1 0.2 10.5 Other 0.2 0.0 0.0 0.0 0.6 0.2 0.0 0.0 0.0 0.0 0.0 0.1 Missing 0.1 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total 1,946 248 580 496 507 519 413 602 258 111 300 5,980 22 * Household Population and Housing Characteristics Table 2.9 Household durable goods Percentage of households possessing various durable consumer goods, by urban-rural residence, Armenia 2000 ______________________________________________________ Residence _________________ Durable consumer goods Urban Rural Total ______________________________________________________ Radio 47.5 23.6 38.1 Television 91.8 83.7 88.6 Telephone 74.9 40.4 61.3 Refrigerator 80.9 66.9 75.4 Bicycle 5.3 8.4 6.6 Motorcycle 0.8 2.8 1.6 Car/truck 21.0 27.6 23.6 None of the above 2.6 6.9 4.3 Number of households 3,633 2,347 5,980 In urban areas, drinking water is most often piped directly into the household (86 percent). In rural areas, the most common source is water that has been piped into the yard (46 percent), and only one-fourth (26 percent) of households have drinking water that has been piped directly into the residence. Flush toilets are widespread in urban areas (90 percent), while pit latrines are more common in rural areas (79 percent). Yerevan has the best sanitary conditions of the country: 93 percent of the population in the capital use a flush toilet, and 99 percent have a convenient place for handwashing. In other regions, the proportion of households with a flush toilet ranges from 80 percent in Syunik to 24 percent in Aragatsotn and Gegharkunik, where many people live in rural areas and pit toilets are common. Finished wood floors are most common in urban areas (55 percent). In rural areas, the majority of households have wooden plank floors (75 percent), and 3 percent of households have an earth or sand floor. In the urban areas, most cooking is done with electricity (49 percent) or liquid gas (28 percent). In rural areas, however, wood and tezek (dung) are more commonly used. Firewood is most commonly used in Tavush and in Lori, which are famous for huge forests (78 percent and 45 percent, respectively). Tezek is more commonly used in Aragatsotn, Gegharkunik, and Vayots Dzor, where cattle breeding is one of the primary economic activities. Household Durable Goods The availability of durable goods is a proximate measure of household socioeconomic status. Tables 2.9 and 2.10 provide information on household ownership of durable goods (radios, televisions, telephones, and refrigerators) and modes of transportation (bicycles, motorcycles, and automobiles). Table 2.9 shows that urban households are more likely than rural households to own durable goods, while rural households are more likely to own a means of transportation. Overall, 89 percent of Armenian households have televisions and 75 percent have refrigerators. Telephones Household Population and Housing Characteristics * 23 Table 2.10 Household durable goods by region Percentage of households possessing various durable consumer goods, by region, Armenia 2000 ___________________________________________________________________________________________________ Aragat- Arma- Geghar- Vayots Durable consumer good Yerevan sotn Ararat vir kunik Lori Kotayk Shirak Syunik Dzor Tavush Total ____________________________________________________________________________________________________ Radio 53.2 32.2 38.4 22.0 19.7 21.2 32.3 26.4 69.0 49.1 33.2 38.1 Television 94.0 81.1 93.1 88.1 85.0 79.2 87.8 89.2 79.3 86.8 83.1 88.6 Telephone 81.6 32.4 53.8 43.9 51.4 44.8 62.4 43.7 69.0 76.1 64.1 61.3 Refrigerator 86.9 62.6 85.3 71.7 60.9 57.5 76.0 69.5 75.2 74.1 64.7 75.4 Bicycle 5.3 3.1 16.2 13.3 4.8 6.4 4.4 3.5 4.0 4.5 3.3 6.6 Motorcycle 0.2 4.3 6.3 1.6 1.2 0.9 0.8 1.3 1.1 2.7 2.3 1.6 Car/truck 22.9 21.3 30.5 31.5 22.9 18.6 27.6 15.8 24.2 26.6 22.1 23.6 None of the above 1.6 8.7 1.7 4.7 6.7 10.4 4.7 6.3 2.2 3.4 5.6 4.3 Number of households 1,946 248 580 496 507 519 413 602 258 111 300 5,980 are much more common in urban areas than in rural areas (75 percent versus 40 percent). In Aragatsotn, for example, less than one-third of households have a telephone, compared with 82 percent of households in the capital city of Yerevan. Throughout the country, automobiles are much more common than either bicycles or motorcycles. In Armenia, almost a fourth of households possess a car or truck, while only 7 percent have a bicycle, and less than 2 percent have a motorcycle. Background Characteristics of Respondents * 25 BACKGROUND CHARACTERISTICS OF RESPONDENTS 3 H. Petrosyan and J. Magluchants The purpose of this chapter is to provide a demographic and socioeconomic profile of the ADHS sample. Information on the basic characteristics of women and men interviewed in the survey is essential for the interpretation of findings presented later in the report and can provide an approximate indication of the representativeness of the survey. 3.1 BACKGROUND CHARACTERISTICS OF RESPONDENTS Table 3.1 presents the percent distribution of interviewed women age 15-49 and men age 15-54 by background characteristics including age, marital status, place of residence, educational level, ethnicity, and religion. As noted in Chapter 1, all women age 15-49 who were usual residents or present in the household on the night before the interviewer’s visit were eligible to be interviewed in the ADHS. Men age 15-54 were interviewed in every third household. In order not to double-count respondents, the tables in this report are based on the de facto population, that is, those who stayed in the household the previous night. The male and female populations represented in the sample are evenly distributed by age with some noticeable exceptions. There are 50 percent more women age 15-19 than women age 25- 29 or 30-34 (18 percent versus 12 percent). There are more than twice as many men age 15-19 (15 percent) and age 40-44 (16 percent) than age 50-54 (7 percent). Approximately two-thirds of both women and men are currently married. Seven percent of women are divorced, separated, or widowed as opposed to 2 percent of men. Twenty-nine percent of women and 31 percent of men have never been married. The majority of the respondents, approximately 60 percent, live in urban areas. Yerevan accounts for more than a third of the respondents. The distribution of the respondents in other regions ranges from approximately 10 percent in Ararat to less than 2 percent in Vayots Dzor. All but five women in the sample have ever attended school. Nine percent have attended only primary/middle school, 36 percent have attended secondary school, 36 percent have attended a secondary-special institution, and 19 percent have had at least some higher education. Men have approximately the same levels of educational attainment as women. Armenia is an ethnically homogeneous country; virtually all respondents are Armenian and report that they are Christians. 26 * Background Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men by background characteristics, Armenia 2000 ________________________________________________________________________________________________ Number of women Number of men _____________________ _____________________ Background Weighted Un- Weighted Un- characteristic percent Weighted weighted percent Weighted weighted ________________________________________________________________________________________________ Age 15-19 18.0 1,160 1,168 15.3 263 266 20-24 15.7 1,007 991 12.5 215 223 25-29 12.0 769 763 11.3 194 192 30-34 11.9 763 764 11.9 205 202 35-39 15.0 962 972 13.8 237 237 40-44 14.7 947 966 16.0 275 270 45-49 12.8 822 806 11.8 203 209 50-54 na na na 7.3 126 120 Marital status Never married 28.8 1,851 1,796 30.8 530 534 Married 63.7 4,098 4,173 67.3 1,157 1,155 Living together 0.4 27 25 0.2 4 4 Divorced, separated 3.8 245 241 1.3 22 21 Widowed 3.3 210 195 0.3 5 5 Residence Urban 61.3 3,942 3,545 59.6 1,024 943 Rural 38.7 2,488 2,885 40.4 695 776 Region Yerevan 34.3 2,206 1,604 33.9 582 448 Aragatsotn 4.3 279 484 4.5 78 139 Ararat 10.0 642 564 10.3 177 139 Armavir 8.6 553 495 10.0 172 145 Gegharkunik 7.5 484 489 7.2 124 117 Lori 7.6 489 409 6.9 119 87 Kotayk 7.9 505 445 8.0 137 127 Shirak 9.5 611 492 9.3 161 139 Syunik 4.2 271 494 3.8 65 119 Vayots Dzor 1.8 113 458 1.5 25 101 Tavush 4.3 278 496 4.6 79 158 Education Primary/middle 9.2 593 612 14.2 245 243 Secondary 36.4 2,341 2,475 29.7 510 540 Secondary-special 35.7 2,295 2,271 34.2 588 583 Higher 18.7 1,201 1,072 21.9 376 353 Ethnicity Armenian 97.9 6,298 6,304 98.5 1,693 1,696 Other 2.1 132 126 1.5 26 23 Religion Christian 98.6 6,339 6,329 98.3 1,689 1,683 Other 1.4 91 101 1.7 30 36 Total 100.0 6,430 6,430 100.0 1,719 1,719 ___________________________________________________________________________________________________ Note: Education categories refer to the highest level of educational institution ever attended, whether or not that level was ever completed. na = Not applicable Background Characteristics of Respondents * 27 Table 3.2.1 Educational attainment by background characteristics: women Percent distribution of women by highest level of schooling attended, and median number of years of schooling, according to background characteristics, Armenia 2000 _______________________________________________________________________________________ Highest level of schooling attended ________________________________________ Second- Number Median Background Grades Grades ary- Univer- of years of characteristic 1-8 9-10 special sity Higher Total women schooling _________________________________________________________________________________________ Age 15-19 22.6 51.0 14.4 11.9 0.0 100.0 1,160 9.2 20-24 8.2 30.2 36.2 25.1 0.4 100.0 1,007 11.3 25-29 3.5 35.8 40.2 19.7 0.8 100.0 769 11.3 30-34 4.0 32.1 43.9 19.2 0.8 100.0 763 11.4 35-39 5.1 35.7 42.8 16.3 0.1 100.0 962 11.2 40-44 7.2 34.6 41.7 16.3 0.1 100.0 947 11.1 45-49 8.8 31.0 38.0 22.0 0.3 100.0 822 11.3 Residence Urban 6.3 29.4 38.6 25.1 0.5 100.0 3,942 11.4 Rural 13.8 47.5 31.1 7.7 0.0 100.0 2,488 9.7 Region Yerevan 6.1 27.6 35.8 29.7 0.8 100.0 2,206 11.6 Aragatsotn 10.5 46.5 32.0 10.5 0.4 100.0 279 9.8 Ararat 10.1 42.9 37.9 9.0 0.0 100.0 642 9.9 Armavir 16.2 42.2 30.5 11.1 0.0 100.0 553 9.7 Gegharkunik 15.5 47.9 30.3 6.3 0.0 100.0 484 9.7 Lori 9.0 40.3 37.4 13.2 0.0 100.0 489 10.0 Kotayk 10.6 34.4 42.5 12.6 0.0 100.0 505 10.4 Shirak 6.1 35.8 36.2 21.7 0.2 100.0 611 11.2 Syunik 7.5 37.2 43.1 12.1 0.0 100.0 271 10.6 Vayots Dzor 8.1 52.8 30.3 8.5 0.2 100.0 113 9.8 Tavush 12.3 41.1 31.7 14.9 0.0 100.0 278 9.9 Total 9.2 36.4 35.7 18.4 0.3 100.0 6,430 10.5 3.2 EDUCATIONAL LEVEL OF RESPONDENTS Tables 3.2.1 and 3.2.2 show the educational level of female and male respondents by selected background characteristics. Urban women have attained a higher level of education than rural women; more than one-fourth (26 percent) of urban women have attained a university or higher level of education, compared with 8 percent of rural women. Women in Yerevan and Shirak have the highest proportion of university-level or higher education (31 percent and 22 percent, respectively), while only 6 percent of women in Gegharkunik and 9 percent of women in both Ararat and Vayots Dzor have attended university. As Table 3.2.2 shows, men in urban areas also generally have a higher level of education than their rural counterparts: 29 percent compared with 11 percent having some university-level education or higher. Shirak and Yerevan have the highest proportion of men with at least university-level schooling (37 and 32 percent, respectively), while Lori, Gegharkunik, and Kotayk have the lowest proportions. 28 * Background Characteristics of Respondents Table 3.2.2 Educational attainment by background characteristics: men Percent distribution of men by highest level of schooling attended, and median number of years of schooling, according to background characteristics, Armenia 2000 _______________________________________________________________________________________ Highest level of schooling attended ________________________________________ Second- Number Median Background Grades Grades ary- Univer- of years of characteristic 1-8 9-10 special sity Higher Total men schooling _________________________________________________________________________________________ Age 15-19 32.5 39.8 10.4 17.3 0.0 100.0 263 8.8 20-24 21.2 32.6 26.5 19.6 0.0 100.0 215 9.9 25-29 12.6 36.8 31.6 17.7 1.3 100.0 194 10.2 30-34 7.9 32.9 38.4 19.6 1.2 100.0 205 11.3 35-39 6.7 26.1 45.9 20.2 1.1 100.0 237 11.7 40-44 7.6 26.8 45.5 20.0 0.0 100.0 275 11.8 45-49 7.5 17.0 43.6 31.3 0.6 100.0 203 12.3 50-54 15.6 21.4 32.5 27.7 2.8 100.0 126 11.8 Residence Urban 11.2 26.9 32.6 28.1 1.2 100.0 1,024 11.4 Rural 18.5 33.9 36.6 11.0 0.0 100.0 695 9.9 Region Yerevan 11.6 26.1 30.4 30.6 1.3 100.0 582 11.4 Aragatsotn 10.8 38.1 36.7 14.4 0.0 100.0 78 10.0 Ararat 12.9 30.9 38.8 16.5 0.7 100.0 177 10.8 Armavir 18.6 36.6 29.7 15.2 0.0 100.0 172 9.9 Gegharkunik 16.2 36.8 37.6 9.4 0.0 100.0 124 9.9 Lori 16.1 28.7 46.0 9.2 0.0 100.0 119 10.6 Kotayk 18.1 29.1 43.3 8.7 0.8 100.0 137 10.5 Shirak 12.9 21.6 28.1 36.0 1.4 100.0 161 12.1 Syunik 13.4 28.6 42.0 16.0 0.0 100.0 65 10.8 Vayots Dzor 4.0 57.4 21.8 16.8 0.0 100.0 25 9.8 Tavush 22.8 30.4 31.0 15.8 0.0 100.0 79 9.9 Total 14.2 29.7 34.2 21.2 0.7 100.0 1,719 10.9 3.3 EXPOSURE TO MASS MEDIA The ADHS collected information on the exposure of women to both the broadcast and print media. This information is important because it can help program managers plan the dissemination of information on health, family planning, nutrition, and other programs. At least once a week, 88 percent of Armenian women watch television, 29 percent read a newspaper, and 32 percent listen to the radio (Table 3.3). Only 9 percent do not regularly have access to mass media. Women with higher levels of education are more likely to read a newspaper, watch television, and listen to the radio than their less educated counterparts. Urban women are twice as likely to read a newspaper or listen to the radio as rural women and are three-and-a-half times as likely to have access to all three media. Women from Yerevan and Syunik are the most likely to read a newspaper or listen to the radio frequently. In all of the regions, more than eight in ten women watch television at least once a week with the exception of women in Aragatsotn (76 percent). Overall, women in Aragatsotn and women with a primary/middle school education have less exposure to mass media than other women; approximately one in five have no mass media exposure on a weekly basis. Background Characteristics of Respondents * 29 Table 3.3 Exposure to mass media Percentage of women who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by background characteristics, Armenia 2000__________________________________________________________________________________ Type of mass media exposure __________________________________________ Reads a Watches Listens to newspaper television the radio at least at least at least All No Number Background once once once three mass of characteristic a week a week a week media media women _____________________________________________________________________________________ Age 15-19 29.6 89.3 35.9 16.5 7.7 1,160 20-24 34.5 89.3 35.8 17.9 7.0 1,007 25-29 29.1 87.4 31.1 14.3 9.8 769 30-34 26.4 88.9 28.3 12.5 7.8 763 35-39 27.6 87.7 31.5 14.6 10.1 962 40-44 27.8 87.4 31.0 13.9 9.3 947 45-49 26.8 88.2 30.3 12.5 9.8 822 Residence Urban 36.0 91.0 40.0 20.4 6.3 3,942 Rural 18.0 84.2 20.1 5.9 12.6 2,488 Region Yerevan 39.8 92.0 49.6 26.6 5.4 2,206 Aragatsotn 12.4 76.0 27.1 5.4 17.6 279 Ararat 26.1 92.7 27.0 10.3 5.3 642 Armavir 23.8 84.0 19.2 8.3 13.5 553 Gegharkunik 18.6 83.2 17.2 5.1 13.5 484 Lori 25.2 86.8 14.2 4.2 10.5 489 Kotayk 15.7 86.1 22.5 4.7 11.0 505 Shirak 26.8 86.4 16.3 9.8 11.4 611 Syunik 38.3 90.5 54.7 25.5 3.8 271 Vayots Dzor 28.8 91.0 34.9 12.9 5.9 113 Tavush 22.0 87.9 27.0 9.9 9.7 278 Education Primary/middle 12.2 74.7 19.5 5.9 22.0 593 Secondary 19.1 87.1 25.1 8.0 10.1 2,341 Secondary-special 30.1 90.4 34.2 15.0 6.7 2,295 Higher 54.8 93.7 48.9 32.1 3.4 1,201 Total 29.0 88.4 32.3 14.8 8.7 6,430 3.4 EMPLOYMENT According to statistics released by the Armenian government, women were dispropor- tionately affected by unemployment in the year 2000; they comprised 58 percent of the unem- ployed. More than 90 percent of the officially unemployed lived in urban areas, particularly cities such as Gyumri, Vanadzor, and Yerevan. Official levels of unemployment (calculated by dividing the number of registered unemployed individuals by the total economically active population) reached almost 12 percent nationwide, with the regions of Shirak, Syunik, and Lori being particularly affected (23 percent, 21 percent, and 17 percent, respectively) (NSS, 2001a). In the ADHS, respondents were asked a number of questions to determine their employment status at the time of the survey and continuity of employment in the 12 months prior to the survey. Table 3.4.1 shows this information for women, according to different background characteristics. 30 * Background Characteristics of Respondents Table 3.4.1 Women's employment status Percent distribution of women by employment status in the 12 months preceding the survey and continuity of employment for those who worked, according to background characteristics, Armenia 2000 ______________________________________________________________________________________________________ Employed in last 12 months Not Continuity of employment among women ______________ em- in the 12 months preceding the survey Cur- Not ployed _____________________________________ rently cur- in the Number Occa- Number Background em- rently last 12 of All Season- sion- of characteristic ployed employed months Total women year ally ally Missing Total women _________________________________________________________________________________________________ Age 15-19 6.5 0.8 92.8 100.0 1,160 25.1 61.2 12.3 1.3 100.0 84 20-24 22.5 1.3 76.2 100.0 1,007 66.6 26.5 6.9 0.0 100.0 240 25-29 30.8 1.8 67.4 100.0 769 61.1 35.2 2.7 1.0 100.0 251 30-34 36.8 1.8 61.4 100.0 763 53.2 40.3 5.6 0.9 100.0 295 35-39 42.3 2.3 55.3 100.0 962 58.0 36.5 5.2 0.3 100.0 430 40-44 46.6 2.0 51.4 100.0 947 63.7 30.6 4.8 0.8 100.0 460 45-49 47.3 0.6 52.1 100.0 822 71.3 25.1 3.6 0.0 100.0 394 Marital status Never married 20.5 0.9 78.6 100.0 1,851 71.0 20.0 7.7 1.3 100.0 395 Currently married 35.6 1.7 62.8 100.0 4,125 57.0 38.4 4.3 0.2 100.0 1,535 Formerly married 46.5 2.3 51.3 100.0 455 70.9 22.7 5.3 1.2 100.0 222 Number of living children 0 21.6 1.2 77.2 100.0 2,121 71.2 20.8 7.0 1.1 100.0 483 1-2 34.6 1.5 63.9 100.0 2,590 67.9 26.5 5.1 0.4 100.0 935 3-4 40.6 1.6 57.7 100.0 1,630 46.6 49.3 3.8 0.3 100.0 689 5+ 46.2 5.1 48.7 100.0 89 29.9 68.0 2.2 0.0 100.0 45 Residence Urban 28.8 1.5 69.6 100.0 3,942 81.4 10.6 7.4 0.7 100.0 1,197 Rural 37.0 1.4 61.6 100.0 2,488 35.5 62.0 2.1 0.4 100.0 955 Region Yerevan 28.2 1.7 70.1 100.0 2,206 84.8 6.0 8.3 0.8 100.0 660 Aragatsotn 26.7 0.4 72.9 100.0 279 45.8 46.6 7.6 0.0 100.0 76 Ararat 24.3 0.5 75.2 100.0 642 53.6 45.0 1.4 0.0 100.0 159 Armavir 44.4 2.0 53.5 100.0 553 41.7 54.8 3.0 0.4 100.0 257 Gegharkunik 50.5 1.2 48.3 100.0 484 30.0 67.2 2.4 0.4 100.0 250 Lori 29.1 4.6 66.3 100.0 489 45.7 45.7 7.2 1.4 100.0 165 Kotayk 34.8 1.3 63.8 100.0 505 50.3 41.6 7.5 0.6 100.0 183 Shirak 22.0 0.4 77.6 100.0 611 94.5 4.5 0.9 0.0 100.0 137 Syunik 37.9 0.6 61.5 100.0 271 66.8 30.5 2.6 0.0 100.0 104 Vayots Dzor 40.8 1.5 57.6 100.0 113 54.1 44.8 0.5 0.5 100.0 48 Tavush 40.3 0.6 59.1 100.0 278 52.2 45.8 2.0 0.0 100.0 114 Education Primary/middle 22.9 1.0 76.1 100.0 593 22.4 71.4 6.2 0.0 100.0 142 Secondary 23.3 1.5 75.2 100.0 2,341 31.7 62.0 6.0 0.4 100.0 580 Secondary-special 36.1 1.5 62.4 100.0 2,295 67.9 26.1 5.3 0.6 100.0 864 Higher 45.6 1.6 52.9 100.0 1,201 90.2 5.6 3.5 0.7 100.0 566 Total 32.0 1.5 66.5 100.0 6,430 61.0 33.4 5.1 0.5 100.0 2,152 According to the ADHS data, 32 percent of women were employed at the time of the survey; 67 percent of women had not worked within the 12 months immediately preceding the survey (Figure 3.1). Of those who had been employed within the preceding 12 months, 61 percent had worked all year, while a third had engaged in seasonal work. Younger women, especially those age 15-19 and 20-24, were less likely to be employed than women in other age groups, possibly due to their being in school or in training, rather than in the job market. As women get older, their like- Background Characteristics of Respondents * 31 lihood of being employed increases. More than one-third of women age 30 and older reported being employed at the time of the survey. Additionally, older women who are employed are more likely to have stable, year-round employment than women in their teens. As women have more children, they are more likely to be employed or to have been employed within the previous 12 months. However, this is most often seasonal, rather than permanent work; employed women with zero or one to two children are more likely to have worked all year (71 percent and 68 percent, respectively) than women with three to four or five or more children (47 percent and 30 percent, respectively). Women in rural areas are far more likely to have seasonal work, compared with urban women (62 percent versus 11 percent). Women in Gegharkunik have the highest rate of employment (51 percent currently employed) but the lowest rate of year-round employment (30 percent of employed women). Shirak, which has the lowest rate of employment among women (22 percent) has the highest proportion of women working all year (95 percent of employed women). Although educational levels positively correlate with employment status, less than half of women with a higher education were employed in the 12 months preceding the survey. Table 3.4.2 shows the corresponding employment information for men. In general, employment rates among men are higher than among women; 56 percent of men were employed in the 12 months prior to the survey. Twenty-one percent of men reported that they were looking for work at the time of the survey (Figure 3.2). Two-thirds of men age 15-19 are currently in school, compared with only nine percent who are currently employed. Among men age 20-24, almost as many are looking for work as are employed (31 percent and 37 percent, respectively). More than half of men age 25 and older are currently employed, while approximately one in five are looking for work. Male respondents with either some secondary-special or higher education had higher rates of current employment than the general population, but, similar to levels among women, a little more than half of men with a higher education were currently employed. 32 * Background Characteristics of Respondents Table 3.4.2 Men’s employment status Percent distribution of men by employment status or (if not employed) main activity during 12 months preceding the survey, according to background characteristics, Armenia 2000 ______________________________________________________________________________________________________ Employed in last 12 months _________________ Could not Worked Was going Was work, Number Background Currently in past to school, looking Was handi- of characteristic employed 12 months studying for work inactive capped Other Total men ____________________________________________________________________________________________________ Age 15-19 8.7 1.8 66.7 15.7 3.3 3.0 0.7 100.0 263 20-24 37.1 9.8 8.3 30.6 9.2 2.1 2.9 100.0 215 25-29 54.1 13.9 1.3 22.7 7.4 0.6 0.0 100.0 194 30-34 53.0 15.9 0.0 22.4 7.5 1.1 0.0 100.0 205 35-39 58.0 11.1 0.0 19.3 8.9 1.6 1.1 100.0 237 40-44 55.1 10.5 0.5 21.8 8.3 3.7 0.0 100.0 275 45-49 63.5 4.7 0.0 16.2 10.9 4.6 0.0 100.0 203 50-54 53.7 5.3 0.0 25.8 9.8 4.3 1.0 100.0 126 Marital Status Never married 22.0 5.9 36.3 25.8 6.8 2.2 1.0 100.0 530 Currently married 57.9 10.7 0.4 19.2 8.5 2.8 0.5 100.0 1,161 Formerly married (48.1) (4.6) (0.0) (32.1) (8.6) (2.0) (4.7) (100.0) 28 Residence Urban 42.6 7.8 12.9 23.6 9.9 2.5 0.8 100.0 1,024 Rural 52.6 11.2 9.4 18.3 5.2 2.8 0.5 100.0 695 Region Yerevan 40.8 8.0 13.4 23.9 10.9 1.6 1.3 100.0 582 Aragatsotn 75.5 6.5 9.4 0.0 7.9 0.0 0.7 100.0 78 Ararat 64.7 6.5 9.4 11.5 2.9 4.3 0.7 100.0 177 Armavir 24.1 0.0 9.7 60.0 2.1 4.1 0.0 100.0 172 Gegharkunik 83.8 4.3 2.6 3.4 4.3 1.7 0.0 100.0 124 Lori 36.8 35.6 5.7 10.3 6.9 3.4 1.1 100.0 119 Kotayk 41.7 3.9 18.1 13.4 19.7 3.1 0.0 100.0 137 Shirak 35.3 12.9 15.1 28.1 5.8 2.9 0.0 100.0 161 Syunik 49.6 12.6 10.9 16.0 4.2 5.9 0.8 100.0 65 Vayots Dzor 26.7 30.7 16.8 10.9 10.9 2.0 2.0 100.0 25 Tavush 62.0 5.1 10.8 15.8 4.4 1.9 0.0 100.0 79 Education Primary/middle 34.2 8.3 20.0 25.3 6.4 5.8 0.1 100.0 245 Secondary 38.8 10.4 13.9 25.8 7.5 2.9 0.7 100.0 510 Secondary-special 53.7 10.0 3.2 20.8 9.7 1.8 0.8 100.0 588 Higher 54.3 6.6 15.6 14.0 7.0 1.3 1.1 100.0 376 Total 46.7 9.1 11.5 21.4 8.0 2.6 0.7 100.0 1,719 ____________________________________________________________________________________________________ Note: Figures in parentheses are based on 25 to 49 unweighted cases. Background Characteristics of Respondents * 33 Current employment among men is higher in rural areas (53 percent) than in urban areas (43 percent), with almost a fourth of urban men looking for work. The regions of Armavir, Vayots Dzor, Shirak, and Lori show low levels of current employment; in these regions, between 24 and 37 percent of men are currently employed. The regions with the highest proportions of currently employed men are Aragatsotn, Ararat, and Gegharkunik (76 percent, 65 percent, and 84 percent, respectively). It is notable that in each of these regions, more than 60 percent of currently employed men report that they are engaged in agricultural work on their own land (data not shown). 3.5 OCCUPATION In the survey, respondents who indicated that they were currently working were asked about the kind of work that they did. Their responses were recorded verbatim and served as the basis for the coding of occupation that occurred in the central office. As shown in Tables 3.5.1 and 3.5.2, almost one-third of both employed men and employed women work in the agricultural sector. In rural communities, the primary occupation for both women and men is agricultural work on their own land. In urban areas, agricultural work is rare. Sixty percent of urban women work in professional, technical, or managerial positions. Among urban men, 36 percent work in professional, technical, or managerial positions, 31 percent are employed as skilled manual laborers, and 15 percent work in sales and services. Women age 15-19 are primarily employed in agricultural work on their own land (59 percent). Among women older than 20, more than 40 percent work in professional positions. 34 * Background Characteristics of Respondents Table 3.5.1 Occupation of women Percent distribution of currently employed women by occupation (agricultural or nonagricultural) and type of agricultural land worked or type of nonagricultural employment, according to background characteristics, Armenia 2000________________________________________________________________________________________________________ Agricultural Nonagricultural _______________________ __________________________________________ Profes- Sales Manual Other/ sional/ and ___________ Domes- don’t Number Background Own Family Rented Other tech./ serv- Un- tic know/ of characteristic land land land land manag. Clerical ices Skilled skilled service missing Total women ___________________________________________________________________________________________________________________ Age 15-19 58.7 13.6 0.0 0.0 9.6 0.7 4.0 8.9 1.5 1.5 1.6 100.0 75 20-24 22.1 3.0 1.4 0.9 43.1 7.2 14.9 6.0 1.5 0.0 0.0 100.0 226 25-29 28.8 2.5 0.2 0.7 46.6 8.4 7.0 4.7 0.9 0.0 0.0 100.0 237 30-34 32.4 3.5 0.2 1.5 43.9 3.0 8.7 3.0 3.7 0.0 0.0 100.0 281 35-39 29.2 2.8 0.6 1.5 46.9 4.9 5.6 4.8 3.5 0.2 0.0 100.0 407 40-44 23.3 4.0 0.6 0.1 41.6 8.8 6.5 8.9 5.7 0.0 0.4 100.0 441 45-49 19.6 2.8 0.8 1.0 48.8 5.8 8.4 5.1 6.7 0.8 0.0 100.0 389 Marital status Never married 15.9 2.8 0.3 0.6 47.8 10.1 11.7 7.7 2.4 0.3 0.3 100.0 379 Currently married 31.4 3.8 0.8 0.7 43.2 4.6 6.9 4.7 3.6 0.2 0.1 100.0 1,466 Formerly married 15.0 3.0 0.0 2.5 41.9 9.9 7.9 9.9 9.7 0.3 0.0 100.0 211 Number of living children 0 16.4 3.0 0.2 0.5 48.0 9.8 11.2 7.3 3.0 0.2 0.3 100.0 458 1-2 19.2 2.7 0.3 1.3 53.5 6.2 6.9 6.0 3.2 0.5 0.2 100.0 895 3-4 42.3 4.7 1.1 0.6 29.7 3.9 7.2 4.6 5.7 0.0 0.1 100.0 662 5+ (58.8) (7.8) (2.4) (0.0) (18.1) (0.0) (3.4) (2.4) (7.1) (0.0) (0.0) (100.0) 41 Residence Urban 4.7 1.1 0.0 0.2 59.7 8.6 12.0 7.8 5.1 0.5 0.2 100.0 1,136 Rural 54.2 6.5 1.4 1.7 24.4 3.2 2.8 3.2 2.7 0.0 0.0 100.0 920 Region Yerevan 1.1 0.0 0.0 0.0 62.9 7.7 16.1 7.3 4.4 0.2 0.2 100.0 623 Aragatsotn 26.4 13.2 0.8 1.6 35.7 5.4 6.2 6.2 4.7 0.0 0.0 100.0 74 Ararat 43.8 0.0 0.0 0.0 42.3 5.8 1.5 4.4 2.2 0.0 0.0 100.0 156 Armavir 51.4 5.9 0.9 4.5 26.4 2.7 3.2 2.3 2.3 0.5 0.0 100.0 246 Gegharkunik 61.9 3.6 1.6 0.8 16.2 4.9 2.0 5.3 3.2 0.4 0.0 100.0 244 Lori 21.8 14.3 0.8 0.8 37.0 3.4 5.9 11.8 3.4 0.0 0.8 100.0 142 Kotayk 34.2 0.6 1.3 0.6 32.3 5.8 9.0 9.7 6.5 0.0 0.0 100.0 176 Shirak 3.7 0.0 0.0 0.0 79.6 10.2 3.7 1.9 0.0 0.9 0.0 100.0 134 Syunik 12.3 15.5 0.0 1.1 46.5 7.0 4.8 3.7 8.6 0.5 0.0 100.0 103 Vayots Dzor 43.3 1.6 0.0 1.6 29.9 8.0 5.3 4.3 4.8 0.0 1.1 100.0 46 Tavush 45.0 1.0 2.0 0.0 32.5 6.5 5.0 1.0 7.0 0.0 0.0 100.0 112 Education Primary/middle 60.6 6.3 3.2 3.7 3.7 0.2 8.1 3.8 10.4 0.0 0.0 100.0 136 Secondary 54.0 6.2 0.7 1.8 8.7 5.0 8.6 7.6 7.1 0.0 0.3 100.0 545 Secondary-special 19.9 3.4 0.4 0.5 45.8 8.0 11.0 7.0 3.3 0.6 0.2 100.0 829 Higher 1.9 0.4 0.2 0.0 86.0 6.0 2.5 2.5 0.5 0.0 0.0 100.0 547 Total 26.8 3.5 0.6 0.9 43.9 6.2 7.9 5.8 4.0 0.3 0.1 100.0 2,056 _________________________________________________________________________________________________________________ Note: Professional/tech./manag. includes professional, technical, and managerial occupations. Note: Figures in parentheses are based on 25 to 49 unweighted cases. There is a relationship between the number of children that a person has and his or her occupation. Women with more than five children are far more likely to work on their own farm than to have other types of work. Women with fewer than three children are more likely to work professional jobs. In regions where agricultural work is scarce, such as Yerevan and Shirak, a large proportion of women work in professional positions. Working women with higher levels of education are more likely to be employed as professionals; 46 percent of women with a secondary-special education and 86 percent of those with a higher degree work in professional positions. Men with a higher education are also more likely to have professional positions (62 percent). Background Characteristics of Respondents * 35 Table 3.5.2 Occupation of men Percent distribution of currently employed men by occupation (agricultural or nonagricultural) and type of agricultural land worked or type of nonagricultural employment, according to background characteristics, Armenia 2000 _________________________________________________________________________________________________ Agricultural Nonagricultural ______________________ ____________________________________ Profes- Sales Manual sional/ and ____________ Domes- Number Background Own Family Rented Other tech./ serv- Un- tic of characteristic land land land land manag. Clerical ices Skilled skilled service Total men ___________________________________________________________________________________________________________ Age 15-19 * * * * * * * * * * * 23 20-24 25.9 5.8 2.7 1.7 9.3 0.0 18.0 26.4 3.7 6.6 100.0 80 25-29 26.9 0.0 0.0 1.3 31.8 3.2 14.7 12.8 6.1 3.2 100.0 105 30-34 32.4 6.3 1.5 0.0 23.2 2.3 9.5 18.3 3.0 3.4 100.0 109 35-39 36.2 2.2 0.8 0.0 22.5 1.4 5.7 22.4 4.1 4.8 100.0 138 40-44 22.6 2.5 1.0 0.9 24.0 1.7 9.5 27.2 9.1 1.6 100.0 152 45-49 14.3 0.0 0.8 1.5 31.6 2.7 7.9 28.5 9.5 3.2 100.0 129 50-54 12.4 0.0 0.7 0.0 25.2 0.0 11.5 38.0 9.6 2.5 100.0 68 Marital status Never married 36.6 3.5 2.3 1.2 17.1 2.0 12.0 18.4 3.9 3.0 100.0 116 Currently married 24.6 2.1 0.8 0.7 24.7 1.7 9.8 25.3 6.9 3.4 100.0 672 Formerly married * * * * * * * * * * * 13 Number of living children 0 35.0 3.2 1.7 0.9 21.2 1.5 10.8 18.0 2.8 4.9 100.0 160 1-2 16.1 1.8 0.7 0.4 31.4 1.8 12.5 23.6 8.3 3.3 100.0 364 3-4 33.2 2.6 0.8 1.2 16.4 1.8 7.2 27.8 6.2 2.8 100.0 261 5+ * * * * * * * * * * * 17 Residence Urban 3.9 0.5 0.1 0.3 35.5 2.1 15.1 31.1 7.5 4.0 100.0 436 Rural 53.6 4.4 2.0 1.3 10.2 1.2 4.3 15.2 5.0 2.7 100.0 365 Education Primary/middle 35.3 5.8 3.1 4.9 4.4 0.0 4.5 34.4 6.2 1.4 100.0 84 Secondary 38.1 2.4 0.8 0.0 9.8 2.7 9.1 27.2 8.1 1.7 100.0 198 Secondary-special 28.0 2.7 1.2 0.6 13.3 1.3 13.7 28.0 7.5 3.7 100.0 316 Higher 9.6 0.0 0.0 0.0 62.1 2.1 8.1 9.8 2.9 5.3 100.0 205 Total 26.6 2.3 1.0 0.7 24.0 1.7 10.2 23.8 6.3 3.4 100.0 802 __________________________________________________________________________________________________________ Note: Professional/tech./manag. includes professional, technical, and managerial occupations. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 3.6 EARNINGS Table 3.6 displays the percent distribution of currently employed women by employer and type of earnings. Women who reported being currently employed were asked about their employer—whether they were employed by a relative, a non-relative, or were self-employed. Additionally, they were asked whether they were paid in cash, in kind, or not at all. Overall, two- thirds of employed women earn cash; 30 percent received no payment (Figure 3.3). 36 * Background Characteristics of Respondents Table 3.6 Employer and form of earnings Percent distribution of currently employed women by employer and type of earnings (cash, in-kind, no payment), according to background characteristics, Armenia 2000 ________________________________________________________________________________________________ Employed by Employed by Self-employed a nonrelative a relative ________________ ________________ ________________ Does not Does not Does not Number Background Earns earn Earns earn Earns earn of characteristic cash cash cash cash cash cash Total women ________________________________________________________________________________________________ Age 15-19 3.4 28.7 17.4 1.8 4.4 44.2 100.0 75 20-24 3.1 12.0 69.2 0.0 1.1 14.6 100.0 226 25-29 1.7 15.4 64.1 0.5 2.6 15.7 100.0 237 30-34 4.4 16.4 56.7 1.2 0.8 20.6 100.0 281 35-39 4.4 14.3 58.6 2.0 2.6 18.1 100.0 407 40-44 3.7 13.2 60.7 1.2 3.5 17.7 100.0 441 45-49 1.6 9.6 69.4 1.7 2.9 14.8 100.0 389 Residence Urban 4.4 3.9 83.4 1.5 3.3 3.5 100.0 1,136 Rural 1.8 26.2 33.6 1.0 1.5 35.9 100.0 920 Region Yerevan 4.4 1.3 87.9 1.3 4.4 0.7 100.0 623 Aragatsotn 3.9 20.2 48.1 3.9 7.0 17.1 100.0 74 Ararat 4.4 11.7 51.1 1.5 1.5 29.9 100.0 156 Armavir 1.8 2.3 36.4 0.5 1.8 57.3 100.0 246 Gegharkunik 0.4 65.2 30.4 0.4 0.0 3.6 100.0 244 Lori 3.4 0.8 50.4 5.0 0.8 39.5 100.0 142 Kotayk 6.5 8.4 53.5 0.6 2.6 28.4 100.0 176 Shirak 0.9 4.6 90.7 0.9 1.9 0.9 100.0 134 Syunik 0.0 8.6 66.8 0.5 1.1 23.0 100.0 103 Vayots Dzor 7.0 2.7 44.4 1.6 2.7 41.7 100.0 46 Tavush 2.5 41.5 48.5 0.0 1.0 6.5 100.0 112 Education Primary/middle 5.8 32.5 19.8 1.3 1.0 39.6 100.0 136 Secondary 3.6 27.6 31.5 1.1 2.5 33.6 100.0 545 Secondary-special 3.5 9.6 67.8 1.8 2.4 15.0 100.0 829 Higher 1.7 1.9 90.8 0.7 3.0 1.8 100.0 547 Occupation Agricultural 1.2 42.0 1.8 0.7 0.9 53.4 100.0 655 Nonagricultural 4.2 0.7 88.9 1.6 3.2 1.5 100.0 1,401 Total 3.2 13.9 61.1 1.3 2.5 18.0 100.0 2,056 ____________________________________________________________________________________________ Note: Earns cash includes both women who receive only cash and those who receive both cash and in-kind payment. Does not earn cash includes both women who receive only in-kind payment and those who receive no payment. Background Characteristics of Respondents * 37 According to the data, most employed women residing in urban areas earn money through hired work with a non-relative. In rural areas, however, almost two-thirds of employed women are not paid in cash, and most work for a relative or for themselves. Ninety-one percent of women with higher levels of education are employed by a non-relative and are paid in cash. Meanwhile, three-fourths of women with only a primary/middle school education and two-thirds of women who have attended secondary school are paid either in kind or not paid at all. 3.7 USE OF EARNINGS Employed women receiving cash earnings were asked who the primary decisionmaker is regarding their earnings. This information allows the assessment of women’s control over their own earnings. Table 3.7 shows how women’s control over their earnings varies by background characteristics. Among women receiving cash earnings, half decide by themselves how to use the money, 41 percent decide jointly with another person, and 9 percent have no say in the allocation of earnings. Married women are more likely to share decisionmaking with another person, while formerly married and never-married women are more likely to make these decisions themselves. Urban women are more independent in decisions involving money than rural women. To assess the importance of women’s wages in paying household expenditures, employed women earning cash were asked what proportion of their household’s expenditures were paid for by their earnings. This information allows an evaluation of the relative importance of women’s earnings in the household economy. As shown in Table 3.7, the money earned by women often meets only part of the household expenditures; 27 percent of women report that their earnings account for none or almost none of the household expenditures, while 51 percent of women report that their earnings account for less than half of the household’s expenditures. Only 5 percent report that their earnings cover all the household’s expenditures. However, among formerly married women, 18 percent report that their earnings account for all of the household’s expenditures. 38 * Background Characteristics of Respondents Table 3.7 Decision on use of earnings and contribution of earnings to household expenditures Percent distribution of currently employed women receiving cash earnings by person who decides how earnings are to be used and by proportion of household expenditures met by earnings, according to background characteristics, Armenia 2000 ______________________________________________________________________________________________ Person who decides Proportion of household Number how earnings are used expenditures met by earnings of _________________________ _______________________________ women Some- Almost Less Half receiving Background Self one none/ than or cash characteristic only Jointly1 else2 Total none half more All Total earnings ______________________________________________________________________________________________ Age 15-19 * * * * * * * * * 19 20-24 59.2 25.0 15.8 100.0 35.4 47.4 13.9 3.3 100.0 166 25-29 45.2 40.7 14.1 100.0 26.7 55.3 15.0 3.1 100.0 162 30-34 37.8 51.7 10.6 100.0 25.6 57.4 13.8 3.1 100.0 174 35-39 49.7 39.8 10.5 100.0 25.0 51.9 17.6 5.5 100.0 267 40-44 53.1 40.8 6.1 100.0 23.5 53.8 17.9 4.7 100.0 299 45-49 50.7 45.9 3.4 100.0 24.5 44.7 23.3 7.5 100.0 287 Marital status Never married 70.8 18.3 10.9 100.0 32.5 45.2 17.3 5.0 100.0 302 Currently married 35.6 54.3 10.1 100.0 26.7 54.7 16.4 2.3 100.0 902 Formerly married 88.5 9.4 2.1 100.0 14.7 43.6 23.9 17.8 100.0 170 Number of living children 0 65.3 23.5 11.3 100.0 30.3 45.6 18.8 5.4 100.0 362 1-2 47.5 45.2 7.3 100.0 23.1 54.5 18.5 3.9 100.0 674 3-4 38.1 51.1 10.7 100.0 29.2 50.1 14.4 6.4 100.0 325 5+ * * * * * * * * * 12 Residence Urban 53.8 39.0 7.3 100.0 25.5 50.0 19.4 5.0 100.0 1,035 Rural 38.1 46.5 15.4 100.0 29.4 54.9 11.6 4.2 100.0 340 Region Yerevan 55.5 38.8 5.7 100.0 23.1 49.1 22.6 5.3 100.0 602 Aragatsotn 43.4 42.1 14.5 100.0 26.3 60.5 10.5 2.6 100.0 44 Ararat 50.0 42.3 7.7 100.0 37.2 48.7 14.1 0.0 100.0 89 Armavir 43.2 48.9 8.0 100.0 47.7 39.8 10.2 2.3 100.0 98 Gegharkunik 32.9 42.1 25.0 100.0 35.5 56.6 6.6 1.3 100.0 75 Lori 49.2 44.6 6.2 100.0 29.2 40.0 18.5 12.3 100.0 78 Kotayk 56.7 30.9 12.4 100.0 28.9 47.4 15.5 8.2 100.0 110 Shirak 40.6 47.5 11.9 100.0 6.9 74.3 14.9 4.0 100.0 126 Syunik 46.5 37.8 15.7 100.0 26.8 55.1 14.2 3.9 100.0 70 Vayots Dzor 42.6 38.6 18.8 100.0 30.7 53.5 15.8 0.0 100.0 25 Tavush 45.2 47.1 7.7 100.0 29.8 49.0 14.4 6.7 100.0 58 Education Primary/middle (50.5) (26.0) (23.6) (100.0) (14.7) (57.5) (19.7) (8.1) (100.0) 36 Secondary 52.6 33.1 14.3 100.0 22.0 51.5 21.2 5.3 100.0 205 Secondary-special 49.4 39.8 10.8 100.0 30.6 49.7 14.9 4.8 100.0 610 Higher 49.4 46.1 4.6 100.0 24.2 52.5 18.9 4.4 100.0 523 Total 49.9 40.8 9.3 100.0 26.5 51.2 17.5 4.8 100.0 1,374 ______________________________________________________________________________________________ Note: Figures in parentheses are based on 25 to 49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases. 1 With husband or someone else 2 Includes husband Background Characteristics of Respondents * 39 Table 3.8 Control over earnings according to contribution to household expenditures Percent distribution of currently employed women receiving cash earnings by person who decides how earnings are used and current marital status, according to perceived proportion of household expenditures met by earnings, Armenia 2000 ____________________________________________________________________________________________________ Currently married Not married _____________________________________________ ________________________________ Jointly Jointly Some- Jointly Some- with with Hus- one Number with one Number Contribution to Self hus- someone band else of Self someone else of household expenditures only band else only only Total women only else only Total women ____________________________________________________________________________________________________ Almost none/none 40.8 45.6 1.9 9.7 2.1 100.0 241 87.4 6.6 6.0 100.0 123 Less than half 33.8 53.4 2.3 8.6 1.9 100.0 493 69.4 20.4 10.1 100.0 210 Half or more 28.8 62.4 2.0 6.4 0.4 100.0 148 78.6 17.1 4.4 100.0 93 All * * * * * * 21 (81.9) (9.4) (8.7) (100.0) 45 Total 35.6 52.2 2.1 8.4 1.7 100.0 902 77.1 15.1 7.8 100.0 472 ____________________________________________________________________________________________________ Note: Not married includes never-married, divorced, widowed, and separated women. Figures in parentheses are based on 25 to 49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases. Table 3.8 presents differences in the two measures related to the use of women’s earnings. According to Table 3.8, slightly more than half of currently married women decide jointly with their husband about how their earnings are to be used. About 10 percent of married women have no say in how earnings will be used. Among currently unmarried women, three-fourths decide by themselves how earnings are to be spent, while 8 percent have no say in the matter. It is notable that among married women, almost all have control over their own earnings or make decisions jointly with their husband no matter what their contribution to household expenditures. 3.8 HOUSEHOLD DECISIONMAKING To assess women’s household decisionmaking autonomy, female ADHS respondents were asked questions about who in the household has the final say in decisions related to the following five specific areas: her own health care, large household purchases, everyday household purchases, visits to friends or relatives, and what food to cook each day. Table 3.9 shows the percent distribution of women according to who in the household usually has the final say in each of these decisions. According to the data, one-third of married women make decisions on their own about their own health care, while one-fourth of married women have no say in decisions about their own health care. Although more than half of currently married women make decisions about the purchase of large household items jointly with their husband, 38 percent have no say in these matters. Married women are much more likely to make decisions about daily household purchases and are overwhelmingly in charge of deciding what food to cook. Regarding unmarried women, approximately half have no say in decisions about their own health care. About two-thirds of these women have no input on decisions about daily household purchases, large household purchases, or what foods to cook each day. 40 * Background Characteristics of Respondents Table 3.9 Household decisionmaking Percent distribution of women by person who has the final say in making specific household decisions and current marital status, according to type of decision, Armenia 2000 ____________________________________________________________________________________________________ Currently married Not married _____________________________________________ ________________________________ Jointly Jointly Jointly Some- with with Hus- Someone Number with one Number Self hus- someone band else of Self someone else of Household decision only band else only only Total women only else only Total women ____________________________________________________________________________________________________ Own health care 33.8 39.9 1.4 20.2 4.6 100.0 4,125 34.1 16.5 49.3 100.0 2,305 Large household purchases 9.8 50.2 2.2 27.7 10.1 100.0 4,125 17.2 18.5 64.1 100.0 2,305 Daily household purchases 42.3 24.5 3.0 18.0 12.1 100.0 4,125 22.3 14.1 63.4 100.0 2,305 Visits to family or relatives 10.7 64.1 3.1 16.2 5.9 100.0 4,125 29.4 28.1 42.2 100.0 2,305 What food to cook each day 72.4 7.5 7.6 1.3 11.1 100.0 4,125 22.6 16.8 60.3 100.0 2,305 _________________________________________________________________________________________________________________ Note: Not married includes never married, divorced, widowed, and separated women. Table 3.10.1 shows how participation in decisionmaking varies by background characteristics. In general, women have the final say in most household decision or participate in the final say jointly with someone else. Overall, two-thirds of women participate in the final say about their own health care, while slightly more than half are involved in decisionmaking about daily and large household purchases. Seven in ten women report that they participate in the final say in visits to family and friends and daily food preparation. Forty percent of women participate in all specified household decisions, while 13 percent report having no say in any household decisions (Figure 3.4). A woman’s employment status is an important predictor of her participation in household decisionmaking. Half of women who are employed and earning cash report having a say in all specific household decisions, while only 3 percent reported having no say in any decisions. This compares with one-third of women who are not employed having a say in all decisions and 17 percent having a say in no decisions. Young and unmarried women are more likely to report having no say in any decisions. Women from Gegharkunik are least likely to report having a final say in all decisions (18 percent), while more than 50 percent of the women in Lori, Shirak, and Syunik have the final say in all decisions. There is a strong correlation between age and decisionmaking. The percentage of women participating in all decisions increases from 11 percent among women 15-19 to 63 percent among women age 45-49. Furthermore, there is also a significant differential by the number of living children. One-fifth of women with no children participate in all specified decisions, compared with approximately half of women with one or more living child. Background Characteristics of Respondents * 41 Table 3.10.1 Final say in household decisions Percentage of women who say that they alone or jointly have the final say in specific household decisions, by background characteristics, Armenia 2000 ________________________________________________________________________________________________ Alone or jointly has final say in: _______________________________________________________________________ Making Visits to What Own Making daily family, food All No Number Background health large pur- relatives, to cook specified specified of characteristic care purchases chases friends daily decisions decisions women ________________________________________________________________________________________________ Age 15-19 31.2 18.2 19.5 39.2 23.8 10.8 46.4 1,160 20-24 54.3 35.0 34.2 60.9 50.0 19.7 19.7 1,007 25-29 68.6 44.9 51.1 71.5 72.3 31.9 6.9 769 30-34 78.1 61.8 71.5 75.9 86.4 44.7 3.8 763 35-39 80.7 69.4 79.0 84.2 90.6 54.6 1.8 962 40-44 81.7 72.8 80.7 85.0 93.4 58.9 2.0 947 45-49 83.5 79.0 83.6 88.8 93.7 63.3 1.3 822 Marital status Never married 41.2 25.0 26.1 50.0 28.7 16.2 37.2 1,851 Currently married 75.2 62.2 69.9 77.9 87.6 45.9 3.9 4,125 Formerly married 88.7 79.2 78.2 88.1 82.9 70.0 4.0 455 Number of living children 0 44.4 28.4 28.9 52.7 33.5 18.4 34.0 2,121 1-2 77.1 63.6 69.1 78.9 85.4 48.0 4.0 2,590 3-4 77.7 66.3 76.9 80.1 93.0 51.2 2.3 1,630 5+ 70.4 65.8 73.0 79.7 94.8 50.7 0.7 89 Residence Urban 69.3 55.7 59.3 75.0 70.1 41.9 11.8 3,942 Rural 61.7 47.8 55.6 63.6 70.7 34.7 16.1 2,488 Region Yerevan 70.4 56.7 58.2 77.9 68.3 40.4 9.7 2,206 Aragatsotn 66.3 51.9 55.6 64.7 74.2 38.4 12.4 279 Ararat 76.6 49.8 58.0 75.2 78.0 40.1 9.4 642 Armavir 66.9 51.5 53.7 63.0 67.9 34.9 13.7 553 Gegharkunik 40.7 31.5 43.8 40.7 58.1 17.8 28.4 484 Lori 72.6 65.5 68.9 74.3 78.5 51.8 9.0 489 Kotayk 53.9 42.5 55.3 66.3 69.2 30.6 18.2 505 Shirak 73.4 55.5 64.0 73.4 69.7 50.8 20.5 611 Syunik 72.7 61.5 64.6 80.2 75.3 53.0 10.3 271 Vayots Dzor 45.6 47.8 50.0 53.9 76.9 35.4 17.5 113 Tavush 52.6 50.6 58.5 67.7 72.4 27.8 11.7 278 Education Primary/middle 48.2 40.2 44.3 52.0 52.8 27.9 29.6 593 Secondary 61.6 49.2 54.7 64.7 69.8 37.0 16.7 2,341 Secondary-special 71.9 56.6 63.6 77.2 76.7 42.3 8.4 2,295 Higher 73.9 58.0 59.7 78.7 67.7 42.5 8.7 1,201 Current employment Not employed 61.6 47.0 52.2 65.9 66.3 34.9 17.3 4,374 For cash 81.9 67.8 71.4 86.0 77.5 50.4 3.4 1,374 Not for cash 65.6 58.4 66.8 69.6 81.8 43.0 9.2 682 Total 66.4 52.7 57.9 70.6 70.3 39.1 13.4 6,430 42 * Background Characteristics of Respondents Table 3.10.2 presents data on men’s attitudes toward a wife’s role in household decisionmaking. About four-fifths of men believe that a wife should have at least an equal say in certain household decisions, namely the number and timing of children, making daily purchases, and what to do with earnings. Fewer men, approximately six in ten, believe that a wife should have at least an equal say in making large purchases and visits to family and friends. Less than one-third of men, however, believe that wives should have at least an equal say in all five of the aforementioned decisions. Men who are currently or have formerly been married are less likely than never-married men to believe that a wife should have no final say in any decision. Older men and more educated men are more likely to report that wives should have at least an equal say in all household decisions. Nonetheless, it is worth noting that only one-third (34 percent) of men with higher education believe that women should have an equal say in all five decisions. Three-fourths of men (73 percent) in Kotayk report that women should have an equal say in all household decisions, compared with 22 percent of men in Ararat. Background Characteristics of Respondents * 43 Table 3.10.2 Men’s attitude towards a wife’s role in household decisionmaking Percentage of men who say that a wife should have at least an equal say in specific household decisions, by background characteristics, Armenia 2000 ________________________________________________________________________________________________ A wife should have at least an equal say in: _______________________________________________________________________ Making Visits to What Number Making daily family, to do and All No Number Background large pur- relatives, with timing specified specified of characteristic purchases chases friends earnings of children decisions decisions men ________________________________________________________________________________________________ Age 15-19 52.3 73.9 49.5 69.5 67.2 23.4 11.8 263 20-24 56.0 82.3 54.1 77.9 78.9 23.8 3.8 215 25-29 53.8 79.5 57.3 77.7 82.2 25.5 5.7 194 30-34 58.9 78.0 59.9 74.5 83.8 30.8 4.1 205 35-39 54.2 82.3 62.0 77.7 80.4 30.7 3.1 237 40-44 69.8 84.0 67.3 84.4 86.3 38.1 1.8 275 45-49 69.5 87.5 73.3 82.5 89.2 45.1 1.1 203 50-54 66.8 88.5 68.0 84.8 83.0 43.4 3.5 126 Marital status Never married 52.2 76.2 51.3 74.9 72.3 23.0 9.3 530 Currently married 63.8 83.7 65.3 79.9 84.9 36.3 2.4 1,161 Formerly married (41.7) (93.3) (62.5) (72.9) (80.1) (20.1) (0.0) 28 Residence Urban 58.6 81.9 65.6 81.3 82.9 32.2 2.7 1,024 Rural 61.7 80.9 54.1 73.7 78.1 31.6 7.2 695 Region Yerevan 50.0 78.8 63.4 78.6 81.7 24.8 1.8 582 Aragatsotn 50.4 89.2 66.2 77.0 77.7 30.2 2.9 78 Ararat 69.8 79.9 41.0 67.6 77.0 21.6 2.2 177 Armavir 62.8 73.8 39.3 76.6 68.3 23.4 15.2 172 Gegharkunik 32.5 74.4 64.1 70.9 74.4 27.4 17.1 124 Lori 71.3 82.8 63.2 71.3 85.1 36.8 1.1 119 Kotayk 94.5 96.1 82.7 97.6 99.2 73.2 0.0 137 Shirak 54.0 81.3 64.7 69.8 72.7 27.3 7.2 161 Syunik 78.2 90.8 76.5 91.6 89.1 49.6 0.0 65 Vayots Dzor 63.4 84.2 67.3 87.1 78.2 40.6 3.0 25 Tavush 75.3 91.1 60.8 96.2 98.7 48.7 0.0 79 Education Primary/middle 52.3 77.5 46.1 66.5 71.6 24.6 11.1 245 Secondary 58.5 80.1 56.8 79.0 77.7 29.6 5.5 510 Secondary-special 62.6 82.7 64.8 80.3 84.2 35.4 2.2 588 Higher 62.5 84.3 70.1 81.7 86.4 34.4 2.4 376 Total 59.9 81.5 60.9 78.2 80.9 31.9 4.5 1,719 ________________________________________________________________________________________________________ Note: Figures in parentheses are based on 25 to 49 unweighted cases. 3.9 ATTITUDE TOWARD WIFE BEATING Attitudes that see wife beating as justified are indicative of women’s lower status both absolutely and relative to men. The ADHS gathered information on women’s attitude toward wife beating, a proxy for women’s perception of their status. Women were asked whether a husband is justified in beating his wife under a series of circumstances. Possible reasons that justified a man beating his wife included her burning the food, her arguing with him, her going out without telling him, her neglecting the children, and her refusing sexual relations. The results are summarized in Table 3.11.1. 44 * Background Characteristics of Respondents Table 3.11.1 Women’s attitude toward wife beating Percentage of women who agree that a husband is justified in hitting or beating his wife for specific reasons, by background characteristics, Armenia 2000_____________________________________________________________________________________________ Husband is justified in hitting or beating his wife if she:_____________________________________________ Agrees Goes out Refuses with Burns Argues without Neglects to have at least one Number Background the with telling the sex specified of characteristic food him him children with him reason women______________________________________________________________________________________________ Age 15-19 5.8 14.5 20.2 27.2 5.2 33.5 1,160 20-24 4.9 14.6 20.6 27.2 5.8 32.6 1,007 25-29 3.7 13.3 17.2 25.2 5.2 29.9 769 30-34 5.3 17.0 20.8 27.7 7.4 34.9 763 35-39 5.4 13.6 21.3 28.7 6.5 34.1 962 40-44 5.5 14.5 21.0 28.4 7.9 32.2 947 45-49 3.3 12.4 17.4 24.7 8.3 28.4 822 Marital status Never married 4.8 11.6 16.1 22.9 4.1 27.7 1,851 Currently married 5.0 15.8 22.1 29.5 7.6 35.0 4,125 Formerly married 4.9 11.4 15.7 22.6 6.9 26.8 455 Number of living children 0 4.8 12.0 16.2 22.4 4.3 27.7 2,121 1-2 3.9 12.8 17.6 24.7 6.5 29.5 2,590 3-4 6.6 18.8 27.2 36.1 9.1 41.6 1,630 5+ 8.1 26.4 40.9 45.3 15.8 55.4 89 Residence Urban 2.4 9.1 11.7 17.9 4.1 22.0 3,942 Rural 8.9 22.4 32.9 41.8 10.4 48.8 2,488 Region Yerevan 1.4 6.1 7.2 10.5 2.7 13.3 2,206 Aragatsotn 10.3 25.0 38.4 49.8 14.0 56.2 279 Ararat 2.5 12.1 18.8 26.2 3.5 33.0 642 Armavir 6.1 20.4 30.5 45.7 7.9 49.7 553 Gegharkunik 18.0 31.3 44.8 57.7 16.8 64.2 484 Lori 4.6 17.1 20.8 25.9 8.3 35.0 489 Kotayk 7.6 20.0 30.3 43.4 9.2 48.8 505 Shirak 2.6 14.8 20.1 22.8 8.1 30.1 611 Syunik 3.6 10.9 16.4 22.3 4.0 24.7 271 Vayots Dzor 7.9 13.1 20.1 27.7 6.8 34.5 113 Tavush 8.5 18.3 22.4 34.9 6.9 44.4 278 Education Primary/middle 12.4 26.9 36.0 41.9 13.5 49.3 593 Secondary 6.4 18.3 27.5 34.9 8.4 41.3 2,341 Secondary-special 3.4 12.3 15.8 24.7 5.1 29.8 2,295 Higher 1.3 4.0 5.0 9.3 2.2 11.3 1,201 Current employment Not employed 4.5 14.3 19.7 26.3 6.4 32.3 4,374 For cash 2.9 8.2 10.9 17.4 4.1 19.5 1,374 Not for cash 11.4 26.1 39.6 52.2 12.6 58.3 682 Number of decisions with woman having final say1 0 8.1 17.5 22.4 27.9 7.0 34.5 865 1-2 5.7 16.2 22.3 30.4 7.0 36.3 1,437 3-4 4.7 14.0 22.0 31.1 6.4 36.4 1,614 5 3.5 12.2 16.3 22.4 6.2 26.6 2,514 Total 4.9 14.3 19.9 27.1 6.5 32.3 6,430______________________________________________________________________________________________ 1 Either by herself or jointly with others Background Characteristics of Respondents * 45 Thirty-two percent of women agree with at least one of the specified reasons justifying a husband beating his wife. Twenty-seven percent agree that a husband is justified in beating his wife if she neglects their children, 20 percent agree if she goes out without telling him, 14 percent agree if she argues with him, 7 percent agree if she refuses sexual relations with him, and 5 percent agree if she burns the food. Thirty-five percent of women who are currently married agree with at least one reason justifying a man beating his wife; this is a higher percentage than for never-married women or formerly married women (28 and 27 percent, respectively). Almost half of rural women (49 percent) agree with at least one reason justifying a wife’s beating, compared with 22 percent of urban women. Women with higher education are less likely to agree with any of the specified reasons, as are women who are employed for cash. Men were also asked about their opinion on the justification of wife beating under certain circumstances. As shown in Table 3.11.2, men are more likely to agree with one of the reasons justifying a husband’s beating of his wife (42 percent compared with 32 percent of women). About one-fourth of men agree that a husband has the right to beat his wife if she either neglects the children, argues with him, or goes out without telling him. Nine percent of men believe that a husband is justified in beating his wife if she refuses to have sex with him, while 6 percent believe he may beat her if she burns the food. Men in rural areas are more likely than those from urban areas to agree with at least one reason justifying a man beating his wife (52 versus 35 percent). Men who are either employed for cash or have a higher level of education are less likely to agree with any of the stated reasons. The percentage of men agreeing with at least one of these reasons varies by region, from 68 percent in Gegharkunik to only 9 percent in Kotayk. 46 * Background Characteristics of Respondents Table 3.11.2 Men’s attitude toward wife beating Percentage of men who agree that a husband is justified in hitting or beating his wife for specific reasons, by background characteristics, Armenia 2000_____________________________________________________________________________________________ Husband is justified in hitting or beating his wife if she:_____________________________________________ Agrees Goes out Refuses with Burns Argues without Neglects to have at least one Number Background the with telling the sex specified of characteristic food him him children with him reason men______________________________________________________________________________________________ Age 15-19 7.3 30.0 23.1 30.6 12.0 44.6 263 20-24 5.9 29.9 21.9 25.7 9.7 43.1 215 25-29 8.1 29.8 33.2 29.0 9.0 45.4 194 30-34 5.9 31.1 22.3 27.8 7.9 43.5 205 35-39 5.1 29.8 34.4 33.5 10.7 48.2 237 40-44 4.4 24.2 20.6 26.7 8.4 37.5 275 45-49 5.0 17.3 17.9 21.6 3.1 34.1 203 50-54 4.7 26.3 17.8 19.9 11.0 36.7 126 Marital status Never married 6.8 30.3 23.2 28.5 11.2 44.4 530 Currently married 5.2 26.0 24.4 27.1 8.1 40.6 1,161 Formerly married (13.5) (28.2) (31.2) (17.1) (4.6) (50.6) 28 Number of living children 0 6.3 29.1 23.3 27.3 10.7 43.3 615 1-2 5.6 24.5 23.9 25.1 5.8 38.8 626 3-4 5.4 28.3 24.7 29.5 10.7 43.2 455 5+ (4.7) (39.2) (41.9) (50.1) (15.3) (62.7) 23 Residence Urban 3.5 23.4 17.1 20.0 6.1 34.9 1,024 Rural 9.2 33.2 34.5 38.4 13.2 52.2 695 Region Yerevan 2.0 21.0 13.4 14.5 6.0 29.0 582 Aragatsotn 4.3 27.3 26.6 56.8 3.6 65.5 78 Ararat 12.2 31.7 46.0 40.3 14.4 54.7 177 Armavir 9.0 45.5 33.8 36.6 11.0 49.0 172 Gegharkunik 24.8 53.8 52.1 55.6 26.5 68.4 124 Lori 3.4 26.4 28.7 37.9 12.6 57.5 119 Kotayk 0.0 2.4 7.1 8.7 0.0 9.4 137 Shirak 5.0 28.1 20.1 23.7 7.9 49.6 161 Syunik 4.2 32.8 26.9 42.0 11.8 53.8 65 Vayots Dzor 0.0 31.7 24.8 32.7 9.9 43.6 25 Tavush 2.5 20.9 15.2 10.8 1.9 34.8 79 Education Primary/middle 10.6 33.3 30.1 33.2 15.3 47.3 245 Secondary 7.8 29.5 26.1 32.9 10.0 45.5 510 Secondary-special 3.8 26.6 25.0 26.2 6.5 42.2 588 Higher 3.1 21.7 16.2 18.2 7.3 33.0 376 Current employment Not employed 4.5 27.0 22.6 26.4 9.0 41.3 917 For cash 4.3 22.9 18.1 21.1 6.3 34.4 555 Not for cash 14.2 38.9 43.5 45.3 15.1 61.2 247 Number of decisions in which wife should have final say1 0 19.1 44.1 39.8 41.8 26.1 55.9 77 1-2 11.0 41.5 37.1 45.6 17.3 60.9 258 3-4 4.9 29.3 25.6 28.9 8.0 45.7 834 5 2.9 15.4 13.6 14.6 4.2 25.2 549 Total 5.8 27.4 24.1 27.4 9.0 41.9 1,719______________________________________________________________________________________________ Note: Figures in parentheses are based on 25 to 49 unweighted cases. 1 Either by herself or jointly with others Background Characteristics of Respondents * 47 3.10 ATTITUDE TOWARD REFUSING SEXUAL RELATIONS The extent of control women have over when and with whom they have sex has important implications for demographic and health outcomes. The ADHS included a question on whether the respondent thinks that a wife is justified in refusing to have sex with her husband under four circumstances: if she is tired or not in the mood, if she has recently given birth, if she knows her husband has sex with other women, or if she knows her husband has a sexually transmitted disease. These four circumstances were chosen because they are effective in combining issues of women’s rights and women’s health. Table 3.12.1 shows the percentage of women who say that women are justified in refusing to have sex with their husband by background characteristics. The table also shows how women’s opinions on refusing sex with their husband vary with their decisionmaking autonomy and their attitude toward wife beating, both important aspects of women’s empowerment. Overall, 58 percent of women in Armenia agree that a woman is justified in refusing to have sex with her husband for all four of the selected reasons. Specifically, 66 percent of women said that a woman can refuse to have sex with her husband if she is not in the mood or is tired, 79 percent said they can refuse if they have recently given birth, 81 percent said they can refuse if they know that the husband is having sexual relations with another woman, and 89 percent said they can refuse if they know the husband has a sexually transmitted infection (STI). Overall, only 9 percent of women do not agree with any of the given reasons for a wife to refuse sex with her husband. Younger women are more likely not to agree with any of the reasons; one-fourth of women 15-19 do not feel that a woman is justified in refusing sex with her husband in any of the specified circumstances. Women who have never been married or have no children are also more likely not to agree with any of the specified reasons. One-fourth of women with only a primary/middle education and 11 percent of women with a secondary school education disagree with all of the scenarios as opposed to 6 percent of women with a secondary-special education and 3 percent of women with a higher education. Among unemployed women, 11 percent do not agree with any of the reasons; this compares with 4 percent of women who are working. There is a relationship between a woman’s status and her attitude toward refusing sexual relations with her husband. For example, one-quarter of women who have no say in household decisionmaking do not agree with any of the specified reasons for a wife refusing to have sex. This compares with 6 percent of women who are the most active participants in household decisionmaking. Furthermore, among women who agree with five or more reasons justifying a husband beating his wife, 19 percent do not agree with any of the reasons that a wife might have to refuse to have sex with her husband. Table 3.12.2 shows the percentage of men who say that women are justified in refusing sex with their husband by background characteristics. Men are as likely as women to agree with all four of the selected reasons for a wife to withhold sex from her husband (59 percent). Specifically, 76 percent of men agree that a woman can refuse to have sex with her husband if she is not in the mood or is tired, 86 percent said they can refuse if they have recently given birth, only 68 percent said she can refuse if she knows that her husband is having sexual relations with another woman, and 84 percent said that she can refuse if she knows that her husband has an STI. 48 * Background Characteristics of Respondents Table 3.12.1 Women’s attitude toward refusing sexual relations Percentage of women who believe that a wife is justified in refusing to have sex with her husband for specific reasons, according to background characteristics, Armenia 2000_____________________________________________________________________________________________ Wife is justified in refusing sex with her husband if she:__________________________________ Knows Agrees Agrees husband Knows with with Is tired, Gave has sexual husband all no Number Background not in birth relations with has an specified specified of characteristic mood recently other women STI1 reasons reason women______________________________________________________________________________________________ Age 15-19 48.7 52.3 67.6 71.8 41.1 24.5 1,160 20-24 63.8 82.1 82.5 90.1 56.4 7.2 1,007 25-29 68.3 86.0 86.7 93.1 60.0 4.0 769 30-34 71.2 86.3 86.2 93.8 62.7 3.7 763 35-39 69.5 84.2 84.0 92.0 60.8 5.1 962 40-44 71.3 84.5 82.5 91.1 62.8 6.6 947 45-49 72.5 88.1 85.0 94.1 66.2 4.8 822 Marital status Never married 52.2 60.7 71.2 78.0 44.4 19.0 1,851 Currently married 71.2 86.7 85.8 92.8 63.0 4.4 4,125 Formerly married 69.2 85.0 82.0 92.7 63.3 7.0 455 Number of living children 0 53.5 63.0 72.1 79.3 45.6 17.5 2,121 1-2 71.0 87.8 87.1 93.8 64.4 4.1 2,590 3-4 72.2 86.1 84.1 92.2 63.0 5.0 1,630 5+ 70.6 81.6 79.1 88.2 52.7 4.7 89 Residence Urban 65.4 80.1 83.1 91.1 58.6 7.2 3,942 Rural 65.9 77.6 78.4 84.6 56.2 11.2 2,488 Region Yerevan 66.3 81.2 85.0 92.1 60.5 6.0 2,206 Aragatsotn 78.3 82.9 89.7 96.7 67.6 2.9 279 Ararat 70.6 79.6 71.6 84.2 53.7 10.3 642 Armavir 60.4 81.4 83.2 92.9 53.1 4.6 553 Gegharkunik 66.9 72.2 73.4 79.1 57.3 15.5 484 Lori 65.5 77.8 79.5 84.8 55.5 12.5 489 Kotayk 73.0 84.3 89.0 93.3 65.6 4.5 505 Shirak 52.6 73.8 80.9 87.6 49.8 11.0 611 Syunik 58.5 65.8 62.6 70.4 51.6 28.7 271 Vayots Dzor 69.9 77.1 85.2 86.7 62.4 8.7 113 Tavush 63.7 83.7 82.1 88.1 54.8 7.1 278 Education Primary/middle 52.1 60.6 65.6 71.9 43.7 23.4 593 Secondary 63.0 74.6 79.6 85.0 54.3 11.3 2,341 Secondary-special 68.8 83.9 83.5 92.6 60.9 5.6 2,295 Higher 71.2 87.9 88.2 96.0 65.0 2.8 1,201 Current employment Not employed 63.2 76.4 80.0 86.3 55.9 10.9 4,374 For cash 70.3 86.5 85.1 94.8 63.8 4.3 1,374 Not for cash 71.0 81.8 82.0 90.7 56.9 4.3 682 Number of decisions with woman having final say 2 0 51.6 57.8 67.5 70.7 45.6 25.2 865 1-2 62.3 75.5 81.7 88.9 52.9 8.3 1,437 3-4 65.9 85.7 85.3 92.8 57.6 4.5 1,614 5 72.0 84.3 83.2 91.8 64.6 6.1 2,514 Number of reasons to justify wife beating 0 66.7 80.6 82.1 89.6 60.6 8.7 4,352 1-2 62.5 76.8 80.7 89.1 50.4 6.9 1,309 3-4 63.6 74.3 78.7 82.6 51.5 11.0 636 5 68.9 74.3 71.9 77.9 62.7 18.7 134 Total 65.6 79.1 81.3 88.6 57.7 8.8 6,430______________________________________________________________________________________________ 1 Sexually transmitted infection 2 Either by herself or jointly with others Background Characteristics of Respondents * 49 Table 3.12.2 Men’s attitude toward wife refusing sex with husband Percentage of men who believe that a wife is justified in refusing to have sex with her husband for specific reasons, by background characteristics, Armenia 2000_____________________________________________________________________________________________ Wife is justified in refusing sex with husband if she:__________________________________ Knows Agrees Agrees husband Knows with with Is tired, Gave has sexual husband all no Number Background not in birth relations with has an specified specified of characteristic mood recently other women STI1 reasons reason women______________________________________________________________________________________________ Age 15-19 57.9 69.5 58.1 67.7 47.6 26.8 263 20-24 79.6 84.6 62.7 81.4 55.9 8.7 215 25-29 75.2 86.2 64.1 86.3 56.5 8.8 194 30-34 81.9 89.5 68.4 84.8 59.3 8.0 205 35-39 81.5 92.7 70.9 90.8 62.4 5.4 237 40-44 77.3 89.7 74.8 89.6 63.6 7.5 275 45-49 77.8 85.7 71.3 82.2 65.5 13.7 203 50-54 82.2 93.5 76.2 90.7 69.4 6.5 126 Marital status Never married 66.3 76.2 59.7 73.6 50.9 19.2 530 Currently married 80.2 90.0 71.5 88.2 63.0 7.7 1,161 Formerly married (82.1) (91.1) (74.3) (87.2) (69.7) (4.3) 28 Number of living children 0 67.5 77.8 61.4 76.1 51.8 17.1 615 1-2 82.0 91.2 73.0 88.9 66.3 6.9 626 3-4 78.4 88.8 70.8 86.4 60.8 9.6 455 5+ (86.4) (89.7) (46.5) (89.7) (43.2) (0.0) 23 Residence Urban 77.8 91.9 73.9 90.2 64.2 6.8 1,024 Rural 73.1 76.7 59.1 74.0 52.2 17.7 695 Region Yerevan 86.4 98.2 83.9 96.7 76.3 1.6 582 Aragatsotn 97.8 97.8 77.7 98.6 74.8 0.0 78 Ararat 88.5 85.6 72.7 89.2 63.3 3.6 177 Armavir 37.9 37.2 26.9 26.2 24.8 60.7 172 Gegharkunik 74.4 76.1 27.4 65.0 27.4 20.5 124 Lori 71.3 80.5 58.6 81.6 47.1 11.5 119 Kotayk 89.0 96.9 96.9 100.0 88.2 0.0 137 Shirak 40.3 82.7 38.8 74.8 16.5 16.5 161 Syunik 94.1 98.3 87.4 100.0 80.7 0.0 65 Vayots Dzor 66.3 76.2 75.2 87.1 55.4 9.9 25 Tavush 79.7 91.1 87.3 93.7 75.3 5.1 79 Education Primary/middle 63.1 73.9 59.1 68.6 49.2 23.5 245 Secondary 71.8 80.6 63.9 80.9 55.3 14.3 510 Secondary-special 81.4 90.3 72.4 86.6 62.8 7.1 588 Higher 81.2 93.3 72.0 92.6 66.0 5.4 376 Current employment Not employed 69.3 82.0 66.8 79.1 56.3 15.4 917 For cash 83.3 93.8 75.7 92.4 68.3 4.7 555 Not for cash 83.8 81.5 54.3 80.8 50.5 10.3 247 Number of decisions in which wife should have equal say2 0 33.6 66.9 14.7 27.9 13.0 61.8 77 1-2 70.5 81.4 61.0 78.5 50.8 14.2 258 3-4 77.9 89.1 68.2 86.2 59.3 8.5 834 5 81.5 90.0 78.3 90.1 70.1 6.7 549 Number of reasons to justify wife beating 0 77.5 86.5 74.8 86.8 67.3 11.3 999 1-2 75.0 87.6 61.0 84.5 52.0 9.3 449 3-4 72.5 81.0 51.9 71.1 39.6 12.9 222 5 68.4 75.2 62.8 69.4 55.1 19.2 50 Total 75.9 85.8 67.9 83.6 59.4 11.2 1,719 _______________________________________________________________________________________________________ Note: Figures in parentheses are based on 25 to 49 unweighted cases. 1 Sexually transmitted infection 2 Either by herself or jointly with others 50 * Background Characteristics of Respondents Overall, 11 percent of men do not agree with any of the four reasons given for a wife to refuse to have sex with her husband. Similar patterns among men and women are seen as to which groups are more likely not to agree with any of the given reasons. Younger men age 15-19 (27 percent), never-married men (19 percent), men with no children (17 percent), men from rural areas (18 percent), men with only a primary/middle education (24 percent), and unemployed men (15 percent) all have a higher than average likelihood of not agreeing with any reason given for a wife to withhold sex from her husband. Men were asked what actions a husband would be justified in taking if his wife refused to have sexual relations with him. Specifically, men were asked whether, when a wife refuses sex, a husband has the right to get angry and reprimand her, to refuse to give her money or financial support, to have sex with someone else, or to use force in order to have sex with her anyway. Table 3.13 shows the percentage of men who say that a husband has the right to take specific actions if the wife refuses to have sex with him when he wants. Overall, 40 percent of men agree with at least one of the actions for a man to take if his wife refuses to have sex with him when he wants to. Specifically, one-third of men believe that a husband has the right to get angry and reprimand his wife, 20 percent believe he has the right to have sex with someone else, 6 percent believe he has the right to refuse money or financial support, and 3 percent believe he has the right to use force to have sex with her against her will. The proportion of men who agreed to at least one action being justified varies little between men of different ages, marital status, residence, and educational background. There is significant variation, however, among men from different regions. Eighty percent of men from Gegharkunik agreed with at least one action, compared with five percent in Kotayk and 6 percent in Tavush and Armavir. Twelve percent of men in Gegharkunik and 9 percent of men in Lori believe that a husband has the right to use force to have sex with his wife when she refuses to have sex with him, compared with less than 5 percent of men in all other districts. Background Characteristics of Respondents * 51 Table 3.13 Men’s agreement with certain actions husbands are justified in taking if a wife refuses sexual relations Percentage of men who say that a husband has the right to take specific actions if the wife refuses to have sex with him when he wants to, by background characteristics, Armenia 2000 ___________________________________________________________________________________ Actions a husband has a right to take if wife refuses sex __________________________________ Get Have Agrees angry Refuse Use sex with and money, force, with at least Number Background reprimand financial have sex someone one of characteristic her support anyway else reason men ____________________________________________________________________________________ Age 15-19 34.9 10.4 4.5 19.7 38.6 263 20-24 32.3 5.1 2.6 21.7 40.2 215 25-29 40.3 6.9 4.4 24.9 45.9 194 30-34 31.9 5.4 1.1 22.8 41.0 205 35-39 38.6 3.9 1.1 20.5 44.3 237 40-44 33.4 5.6 2.3 17.5 40.8 275 45-49 26.8 2.9 3.5 15.2 33.9 203 50-54 26.6 1.8 1.3 12.6 29.6 126 Marital status Never married 34.4 8.1 3.8 22.8 41.1 530 Currently married 33.0 4.5 2.2 18.1 39.2 1,161 Formerly married (38.4) (0.0) (0.0) (21.7) (40.3) 28 Residence Urban 30.9 4.0 1.4 18.4 38.4 1,024 Rural 37.4 7.9 4.5 21.5 41.9 695 Region Yerevan 33.9 3.8 0.7 19.4 42.4 582 Aragatsotn 33.1 5.0 0.7 21.6 44.6 78 Ararat 66.9 10.1 2.2 35.3 72.7 177 Armavir 4.1 2.1 2.1 3.4 6.2 172 Gegharkunik 73.5 16.2 12.0 56.4 80.3 124 Lori 46.0 11.5 9.2 20.7 52.9 119 Kotayk 4.7 0.0 0.0 0.0 4.7 137 Shirak 19.4 4.3 2.9 5.8 23.0 161 Syunik 44.5 7.6 3.4 43.7 60.5 65 Vayots Dzor 49.5 5.9 4.0 19.8 55.4 25 Tavush 3.2 1.3 0.6 2.5 5.7 79 Education Primary/middle 36.9 10.3 5.2 21.2 42.1 245 Secondary 35.1 6.0 3.1 19.9 38.8 510 Secondary-special 33.1 5.4 1.7 19.3 42.0 588 Higher

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