About the 2010 ADHSThe 2010 Armenia Demographic and Health Survey (ADHS) is designed to provide data for monitoring thepopulation and health situation in Armenia. The 2010 ADHS is the third Demographic and Health Surveyconducted in Armenia. The objective of the survey was to provide up-to-date information on infant andchild mortality, fertility preferences, family planning behavior, reproductive and adult health, health careutilization, child health, child discipline and child labor, women’s status, and knowledge and behaviorregarding HIV/AIDS and other sexually transmitted infections.Who participated in the survey?A nationally representative sample of 5,922 women age 15–49 in all selected households and 1,584 menage 15–49 in one-third of selected households were interviewed. This represents a response rate of 98% forwomen and 97% for men. This sample provides estimates for Armenia as a whole, for urban and rural areas,and, for most indicators, an estimate for each of the 11 study regions.2010 Armenia Demographic and Health Survey Page 1
AbortionPregnancy outcome Trends in Pregnancy OutcomesAmong all the pregnancies that occurred in the Percent among all pregnancies in the 3 years before the surveythree years before the 2010 ADHS, 63% resulted in a 2000 2005 2010live birth and 29% ended in induced abortion. This 63represents a sizable decrease in induced abortions 55 48 45since 2005 when 45% of pregnancy ended in 38 29abortion. 7 7 8Induced abortions were most common among older Live birth Induced Miscarriage/ 7women and those with multiple earlier pregnancies. abortion stillbirthLifetime experience with abortionJust under one-third (31%) of Armenian women haveever had an abortion. History of abortion is mostcommon among older women and women withmore children. More than half of women with two Use of Contraception Before Pregnancyor more children have had an abortion compared to Percent distribution of pregnancy outcome17% of women with only one child. in the 3 years before the survey 6 11Among women who have ever had an abortion, 64% 10have had two or more abortions; 17% have had four Modern method 36 usedor more abortions. Traditional 43 method usedUse of contraception before abortion 84 53 No methodJust over half of pregnancies that ended in abortion usedoccurred while the woman was using no method Live birth Induced abortionof family planning; more than one-third ofpregnancies that ended in abortion occurred whilethe woman was using a traditional method of familyplanning. A modern method of contraception wasbeing used in only 11% of cases that resulted inpregnancy and subsequent abortion.Reason and method for recent abortionsAmong women with an abortion in the three yearsbefore the survey, the most common reasons givenfor having the abortion were: did not want children(39%), socioeconomic reasons (15%), and spacingnext pregnancy (15%).More than half of abortions that occurred in thethree years of the survey were carried out bydilation and curetting (57%); vacuum aspiration wasused in 39% of cases.Four-fifths of women with an abortion in the fiveyears before the survey did not discuss familyplanning with a health worker after the abortion.Page 4 2010 Armenia Demographic and Health Survey
Family PlanningKnowledge of family planningKnowledge of family planning methods inArmenia is nearly universal; 98% of all women age Lori 36% Shirak Tavush 10%15–49 know at least one modern method of family 18%planning. The most commonly known methods aremale condoms (97%), pill (88%), and IUD (87%). Aragatsotn 22% Kotayk 14%Current use of family planning Armavir 23% Gegharkunik 19%More than one-quarter of married women (27%) Yerevan 42%currently use a modern method of family planning. Ararat 23% Vayots DzorAnother 28% are using a traditional method. The 11%male condom (15%) and IUD (10%) are the most Syunik 21%commonly used modern methods among married Use of Modern Methods by Regionwomen, while 25% use withdrawal. Percentage of currently married women currently using a modern method of contraceptionUse of modern family planning methods is higherin urban areas than in rural areas (33% and 19%,respectively). Modern contraceptive use ranges froma low of 10% of married women in Tavush to a highof 42% in Yerevan.Modern contraceptive use increases with education Trends in Use of Family Planningand wealth. Women with higher education are Percent of married women currently using aalmost twice as likely to use a modern method as method of family planningwomen with only basic education (39% versus 21%). 2000 ADHS 2005 ADHS 2010 ADHSTrends in family planning use 38Modern method among married women use has 34 27 28increased from 20% in 2005. This is due mostly 22 20to an increase in the use of condoms from 8% in 152005 to 15% in 2010. Use of traditional methods has 78 9 9 10dropped, from 34% in 2005 to 28% in 2010. Use of 1 1 2withdrawal, in particular, has declined, from 32% Any modern Male Pill IUD Any traditional method condom methodin 2000 to 28% in 2005 to 25% in 2010. The decreasein the use of withdrawal is most striking amongcurrently married women in rural areas (40% in2000, 31% in 2005, and 28% in 2010).Source of family planning methodsThe private medical sector, such as privatehospitals, clinics, but mostly pharmacies, providecontraceptives to 61% of current users, while thepublic sector provides methods to 37% of users. Pillsand male condoms are obtained almost exclusivelyfrom the private medical sector (96% each), whileIUDs are obtained primarily from the public sector(96%).2010 Armenia Demographic and Health Survey Page 5
Childhood Mortality and Child HealthChildhood mortality Trends in Childhood MortalityChildhood mortality rates have decreased markedly Deaths per 1,000 live birthsin Armenia. Currently, the infant mortality rate is 13 2000 ADHS 2005 ADHS 2010 ADHSdeaths per 1,000 live births for the five year period 39before the survey compared with 26 deaths reported 36 30in the 2005 ADHS. Under-five mortality rates have 26decreased accordingly, from 30 deaths per 1,000 live 16births in 2005 to 16 deaths per 1,000 in 2010. 13 3 4 3Mortality rates are slightly higher in rural thanurban areas. Infant mortality, for example, is 22 Infant Child Under-five mortality mortality mortalitydeaths per 1,000 live births in rural areas comparedto only 16 in urban areas.Vaccination coverageAccording to the 2010 ADHS, 92% of Armenian Trends in Vaccination Coveragechildren age 18-29 months have received all Percent of children age 18-29 monthsrecommended vaccines—one dose each of BCG WHO recommended MOH recommended vaccines (BCG, measles, vaccines (WHOand measles and three doses each of DPT and and 3 doses each recommended vaccinespolio. Eighty-seven percent have received all of DPT and polio) plus hepatitis)of the recommended vaccines AND the three 91 92 87recommended hepatitis vaccinations. Vaccination 78 74coverage is consistently high across education andwealth groups.Trends in vaccination coverage N/AVaccination coverage has increased dramatically 2000 2005 2010since 2005 when only 78% of children had received ADHS ADHS ADHSall of the basic recommended vaccines and 74% hadreceived the basic vaccines in addition to the threehepatitis vaccines.Childhood illnessesIn the two weeks before the survey, 5% of children During the two weeks before the survey, 9% ofunder five had symptoms of an acute respiratory Armenian children under five had diarrhea. The rateinfection (ARI). Of these, 57% were taken to a health was highest (15%) among children 6–11 months old.facility or a health provider and 36% received Less than half (42%) of children with diarrhea wereantibiotics. Twelve percent of children had a fever taken to a health provider. Children with diarrheain the two weeks before survey. Fever is much more should drink more fluids, particularly through oralcommon in urban areas than in rural areas (15% rehydration salts (ORS). The large majority (90%) ofversus 8%). Among children with fever, 54% were children with diarrhea were treated with ORS ortaken to a facility or provider and 29% were given increased fluids.antibiotics.2010 Armenia Demographic and Health Survey Page 7
Maternal HealthAntenatal care Trends in Maternal Health CareAlmost all (99%) Armenian women receive some Percent of women 15-49 with a live birth in the 5 years before the surveyantenatal care (ANC) from a skilled provider, most 2000 ADHS 2005 ADHS 2010 ADHScommonly from a gynecologist (93%). This markscontinued improvement since 2005 when 6% of 99 99 97 98 100 92 93 91 97women had no ANC.Eighty percent of pregnant women had an antenatalcare visit by their fourth month of pregnancy,as recommended. Almost all (93%) received therecommended four or more visits. Still, some Antenatal Delivered in Delivery assistancecomponents of ANC were not received for many care by skilled a health facility* by skilled provider provider (% among live births inwomen. Only 29% received iron tablets, and only the 5 years before the survey)57% of women were informed of signs of pregnancycomplications. Blood pressure measurements andurine and blood samples were universal. Two-thirdsof women had a blood sample for HIV status taken.Three-quarters of women who gave birth in thefive years before the survey reported that they wereeligible for free ANC services and 54% were eligible Other health issuesto receive free medicines. Two-thirds of women age 15-49 report havingDelivery and postnatal care serious problems accessing health care when they are sick. The most commonly reported problem isVirtually all (99%) births in Armenia occur in health getting money for treatment (53%), followed by notfacilities, 94% in the public sector and 5% in private wanting to go alone (33%). Women who are poorsector facilities. Facility-based births have become and less educated are more likely to report problemsincreased slightly from 97% in 2005. accessing care.Ninety-seven percent of births are assisted by a More than three-quarters (78%) of Armenia womendoctor; an additional 2% are assisted by a nurse or 15-49 do not know about breast self-examinationmidwife. for early detection of breast cancer. Eleven percentThirteen percent of births in the five years before of women had performed a breast self-exam inthe survey were delivered by c-section. C-section is the three months before the survey. While thesemost common in Yerevan (20% of births) and least numbers are low, knowledge of breast self exam hascommon in Aragatsotn (5%). One-quarter of births to improved in recent years.women from the wealthiest households are delivered The large majority of women (85%) report that theyby c-section compared to only 7% of births to women were never given a breast examination by theirfrom the poorest households. health care provider. Ten percent report havingSixty percent of women who gave birth in a health had a manual exam. Less than 5% have had afacility in the five years before the survey were mammogram or ultrasound.eligible for free hospital care delivery services. Half Less than 10% of Armenian women age 15-49 havewere eligible for free medicines. ever had a pap smear test.Postnatal care helps prevent complications afterchildbirth. More than 90% of women received apostnatal checkup within two days of delivery; halfwere checked within 4 hours of delivery.Page 8 2010 Armenia Demographic and Health Survey
HIV/AIDS Knowledge and BehaviorKnowledge Knowledge of HIV PreventionAccording to the 2010 ADHS, 96% of Armenians age Percent who know that the15-49 have heard of HIV and AIDS, but knowledge risk of HIV can be reduced by:of HIV prevention measures is slightly lower. Sixty- 74nine percent of women and 80% of men know that Using condoms 83the risk of getting HIV can be reduced by usingcondoms and limiting sex to one faithful, uninfected 81 Limiting sex to onepartner. Prevention knowledge has remained uninfected partner 87essentially unchanged since 2005. Using condoms AND 69 WomenPrevention knowledge is higher among those with limiting sex to one 80 Menhigher levels of education and those from wealthier uninfected partnerhouseholds. Knowledge also varies by region. Only9% of women in Syunik know both prevention Mother-to-Child Transmissionmethods compared to 79% of women in Yerevan and Percent who know that:Kotayk. HIV can be transmitted 44Less than 60% of Armenian women and men age by breastfeeding 3518-49 agree that children age 12-14 should be taughtabout using a condom to avoid AIDS. Women and Transmission can be 17 reduced by mother takingmen with higher education and those from the 9 drugs during pregnancywealthiest households are most likely to supportcondom education.Less than half of women and only about one-thirdof men know that HIV can be transmitted bybreastfeeding. Even fewer know that the risk of Prior HIV testingmother-to-child transmission can be reduced by Forty-three percent of Armenian women and 35% oftaking drugs during pregnancy (17% among women Armenian men know where to get an HIV test. Onlyand 9% among men). 9% of women and 2% of men have ever been tested for HIV and received the results. HIV testing is mostMany Armenians still have misconceptions about common among women and men who have workedHIV/AIDS. Only 65% of women and 51% of men abroad, and among women living in Kotayk (23%know that a healthy-looking person can have HIV, ever tested and received results).52% of women and 41% of men know that AIDScannot be transmitted by kissing someone who is Recent HIV testing is also fairly rare among youth.infected. Nine percent of young women who have had sexual intercourse in the year before the survey were testedMultiple sexual partners and paid sex and received results from the last HIV test in theFifteen percent of men age 15-49 report having had past year.two or more sexual partners in the past year. Almostthree-quarters of these men report using a condomduring their last sexual intercourse. Men report anaverage of almost six lifetime sexual partners.Sixteen percent of men report having ever paid forsex. This is most common among men who haveworked abroad (23%) and those living in Yerevan(27%) and Gegharkunik (32%).Page 12 2010 Armenia Demographic and Health Survey
ADHS Key Indicators ResidenceFertility Total Urban Rural Yerevan Total fertility rate 1.7 1.6 1.8 1.5 Women age 15–19 who are mothers or now pregnant (%) 5 4 7 3 Median age at first marriage for women age 25–49 (years) 21.1 22.0 20.0 22.8 Median age at first intercourse for women age 25–49 (years) 21.1 21.9 20.0 22.7 Median age at first birth for women age 25-49 (years) 22.5 23.3 21.3 24.1 Married women (age 15–49) wanting no more children (%) 58 58 58 59 Mean ideal number of children for women 15–49 2.5 2.5 2.6 2.5 Women age 15-49 with an induced abortion (%) 31 30 33 30 Pregnancies in the 3 years before the survey ending in abortion (%) 29 29 28 29Family Planning Current use of any modern method (currently married women 15–49) (%) 27 33 19 42 Currently married women with an unmet need for family planning1 (%) 21 19 24 13Maternal and Child Health Maternity care (women who gave birth in past 5 years) Received antenatal care from a skilled provider2 (%) 99 98 100 99 Births assisted by a skilled provider2 (%) 100 100 99 100 Births delivered in a health facility (%) 99 100 99 99 Child vaccination Children 18-29 months fully vaccinated3 at any time before the survey (%) 92 91 92 *Nutrition Children <5 years who are stunted (moderate or severe) (%) 19 17 22 11 Children <5 years who are wasted (moderate or severe) (%) 4 3 5 3 Children <5 years who are underweight (moderate or severe) (%) 5 3 7 2 Children <5 who are overweight (moderate or severe) (%) 15 15 16 11Childhood Mortality Number of deaths per 1,000 births:4 Infant mortality (between birth and first birthday) 13 16 22 * Under–five mortality (between birth and fifth birthday) 16 18 26 *HIV and AIDS–related Knowledge and Behavior Knows ways to reduce the risk of getting HIV: Limiting sex to one uninfected partner (%) (women/men) 81/87 86/89 74/84 90/91 Using condoms (%) (women/men) 74/83 78/86 66/79 83/85 Ever tested for HIV and received results (%) (women/men) 9/2 10/2 8/1 9/3 Figures in parentheses are based on a limited number of cases; * indicate that there is not enough data 1. A woman has an unmet need for family planning if she wants no more children or wants to wait at least 2 years before the next birth but is not using contraception. 2. Skilled provider includes doctor, feldsher, nurse, or midwife 3. Fully vaccinated includes all of the WHO recommended vaccines (BCG, measles, and 3 doses each of DPT and polio vaccines) 4. Mortality is based on 10 year rates, except for the national figures in italics, which are 5-year rates.