The 1993 Turkish Demographic and Health Survey (TDHS) is a nationally representative survey of ever-married women less than 50 years old. The survey was designed to provide information on fertility levels and trends, infant and child mortality, family planning, and maternal and child health. The TDHS was conducted by the Hacettepe University Institute of Population Studies under a subcontract through an agreement between the General Directorate of Mother and Child Health and Family Planning, Ministry of Health and Macro International Inc. of Calverton, Maryland. Fieldwork was conducted from August to October 1993. Interviews were carried out in 8,619 households and with 6,519 women. The Turkish Demographic and Health Survey (TDHS) is a national sample survey of ever-married women of reproductive ages, designed to collect data on fertility, marriage patterns, family planning, early age mortality, socioeconomic characteristics, breastfeeding, immunisation of children, treatment of children during episodes of illness, and nutritional status of women and children. The TDHS, as part of the international DHS project, is also the latest survey in a series of national-level population and health surveys in Turkey, which have been conducted by the Institute of Population Studies, Haeettepe University (HIPS). More specifically, the objectives of the TDHS are to: Collect data at the national level that will allow the calculation of demographic rates, particularly fertility and childhood mortality rates; Analyse the direct and indirect factors that determine levels and trends in fertility and childhood mortality; Measure the level of contraceptive knowledge and practice by method, region, and urban- rural residence; Collect data on mother and child health, including immunisations, prevalence and treatment of diarrhoea, acute respiratory infections among children under five, antenatal care, assistance at delivery, and breastfeeding; Measure the nutritional status of children under five and of their mothers using anthropometric measurements. The TDHS information is intended to assist policy makers and administrators in evaluating existing programs and in designing new strategies for improving family planning and health services in Turkey. MAIN RESULTS Fertility in Turkey is continuing to decline. If Turkish women maintain current fertility rates during their reproductive years, they can expect to have all average of 2.7 children by the end of their reproductive years. The highest fertility rate is observed for the age group 20-24. There are marked regional differences in fertility rates, ranging from 4.4 children per woman in the East to 2.0 children per woman in the West. Fertility also varies widely by urban-rural residence and by education level. A woman living in rural areas will have almost one child more than a woman living in an urban area. Women who have no education have almost one child more than women who have a primary-level education and 2.5 children more than women with secondary-level education. The first requirement of success ill family planning is the knowledge of family planning methods. Knowledge of any method is almost universal among Turkish women and almost all those who know a method also know the source of the method. Eighty percent of currently married women have used a method sometime in their life. One third of currently married women report ever using the IUD. Overall, 63 percent of currently married women are currently using a method. The majority of these women are modern method users (35 percent), but a very substantial proportion use traditional methods (28 percent). the IUD is the most commonly used modern method (I 9 percent), allowed by the condom (7 percent) and the pill (5 percent). Regional differences are substantial. The level of current use is 42 percent in tile East, 72 percent in tile West and more than 60 percent in tile other three regions. "File common complaints about tile methods are side effects and health concerns; these are especially prevalent for the pill and IUD. One of the major child health indicators is immunisation coverage. Among children age 12-23 months, the coverage rates for BCG and the first two doses of DPT and polio were about 90 percent, with most of the children receiving those vaccines before age one. The results indicate that 65 percent of the children had received all vaccinations at some time before the survey. On a regional basis, coverage is significantly lower in the Eastern region (41 percent), followed by the Northern and Central regions (61 percent and 65 percent, respectively). Acute respiratory infections (ARI) and diarrhea are the two most prevalent diseases of children under age five in Turkey. In the two weeks preceding the survey, the prevalence of ARI was 12 percent and the prevalence of diarrhea was 25 percent for children under age five. Among children with diarrhea 56 percent were given more fluids than usual. Breastfeeding in Turkey is widespread. Almost all Turkish children (95 percent) are breastfed for some period of time. The median duration of breastfeeding is 12 months, but supplementary foods and liquids are introduced at an early age. One-third of children are being given supplementary food as early as one month of age and by the age of 2-3 months, half of the children are already being given supplementary foods or liquids. By age five, almost one-filth of children arc stunted (short for their age), compared to an international reference population. Stunting is more prevalent in rural areas, in the East, among children of mothers with little or no education, among children who are of higher birth order, and among those born less than 24 months after a prior birth. Overall, wasting is not a problem. Two percent of children are wasted (thin for their height), and I I percent of children under five are underweight for their age. The survey results show that obesity is d problem among mothers. According to Body Mass Index (BMI) calculations, 51 percent of mothers are overweight, of which 19 percent are obese.
