The 1998 Kenya Demographic and Health Survey (KDHS) is a nationally representative survey of 7,881 women age 15-49 and 3,407 men age 15-54. The KDHS was implemented by the National Council for Population and Development (NCPD) and the Central Bureau of Statistics (CBS), with significant technical and logistical support provided by the Ministry of Health and various other governmental and nongovernmental organizations in Kenya. Macro International Inc. of Calverton, Maryland (U.S.A.) provided technical assistance throughout the course of the project in the context of the worldwide Demographic and Health Surveys (DHS) programme, while financial assistance was provided by the U.S. Agency for International Development (USAID/Nairobi) and the Department for International Development (DFID/U.K.). Data collection for the KDHS was conducted from February to July 1998. Like the previous KDHS surveys conducted in 1989 and 1993, the 1998 KDHS was designed to provide information on levels and trends in fertility, family planning knowledge and use, infant and child mortality, and other maternal and child health indicators. However, the 1998 KDHS went further to collect more in-depth data on knowledge and behaviours related to AIDS and other sexually transmitted diseases (STDs), detailed “calendar” data that allows estimation of contraceptive discontinuation rates, and information related to the practice of female circumcision. Further, unlike earlier surveys, the 1998 KDHS provides a national estimate of the level of maternal mortality (i.e. related to pregnancy and childbearing). The KDHS data are intended for use by programme managers and policymakers to evaluate and improve health and family planning programmes in Kenya. OBJECTIVES OF THE SURVEY The principal aim of the 1998 KDHS project is to provide up-to-date information on fertility and childhood mortality levels, nuptiality, fertility preferences, awareness and use of family planning methods, use of maternal and child health services, and knowledge and behaviours related to HIV/AIDS and other sexually-transmitted diseases. It was designed as a follow-on to the 1989 KDHS and 1993 KDHS, national-level surveys of similar size and scope. Ultimately, the 1998 KDHS project seeks to: Assess the overall demographic situation in Kenya; Assist in the evaluation of the population and reproductive health programmes in Kenya; Advance survey methodology; and Assist the NCPD to strengthen its capacity to conduct demographic and health surveys. The 1998 KDHS was specifically designed to: Provide data on the family planning and fertility behaviour of the Kenyan population, and to thereby enable the NCPD to evaluate and enhance the national family planning programme; Measure changes in fertility and contraceptive prevalence and at the same time study the factors which affect these changes, such as marriage patterns, desire for children, availability of contraception, breastfeeding habits, and important social and economic factors; Examine the basic indicators of maternal and child health in Kenya, including nutritional status, use of antenatal and maternity services, treatment of recent episodes of childhood illness, and use of immunisation services; Describe levels and patterns of knowledge and behaviour related to the prevention of AIDS and other sexually transmitted infection; Measure adult and maternal mortality at the national level; and Ascertain the extent and pattern of female circumcision in the country. MAIN RESULTS Fertility. The survey results demonstrate a continuation of the fertility transition in Kenya. Marriage. The age at which women and men first marry has risen slowly over the past 20 years. Fertility Preferences. Fifty-three percent of women and 46 percent of men in Kenya do not want to have any more children. Family Planning. Knowledge and use of family planning in Kenya has continued to rise over the last several years. Early Childhood Mortality. Results from the 1998 KDHS data make clear that childhood mortality conditions have worsened in the early-mid 1990s;Maternal Health. Utilisation of antenatal services is high in Kenya; in the three years before the survey, mothers received antenatal care for 92 percent of births (Note: These data do not speak to the quality of those antenatal services). Childhood Immunisation. The KDHS found that 65 percent of children age 12-23 months are fully vaccinated: this includes BCG and measles vaccine, and at least 3 doses of both DPT and polio vaccines. Infant Feeding. Almost all children (98 percent) are breastfed for some period of time; however, only 58 percent are breastfed within the first hour of life, and 86 percent within the first day after birth. Nutritional Status The results indicate that one-third of children in Kenya are stunted (i.e., too short for their age), a condition reflecting chronic malnutrition; and 1 in 16 children are wasted (i.e., very thin), a problem indicating acute or short-term food deficit. Knowledge, Attitudes and Behaviour regarding HIV/AIDS and Other Sexually Transmitted Infections. As a measure of the increasing toll taken by AIDS on Kenyan society, the percentage of respondents who reported “personally knowing someone who has AIDS or has died from AIDS” has risen from about 40 percent of men and women in the 1993 KDHS to nearly three-quarters of men and women in 1998. Female Circumcision. The results indicate that 38 percent of women age 15-49 in Kenya have been circumcised. The prevalence of FC has however declined significantly over the last 2 decades from about one-half of women in the oldest age cohorts to about one-quarter of women in the youngest cohorts (including daughters age 15+).
