Afghanistan - Multiple Indicator Cluster Survey - 2003

Publication date: 2003

AFGHANISTAN - PROGRESS OF PROVINCES Multiple Indicator Cluster Survey 2003 Produced with the support of Transitional Islamic State of Afghanistan Central Office of Statistics P H O TO : U N IC E F A FG A /0 02 96 S /IS A A C PROGRESS OF PROVINCES 2003 MULTIPLE INDICATOR CLUSTER SURVEY 2003 MAY 2004 CENTRAL STATISTICS OFFICE AFGHANISTAN TRANSITIONAL AUTHORITY FOREWORD 6 NOTE FOR THE READER 8 SUMMARY OF INDICATORS 10 RANKING OF PROVINCES 12 PREGNANCY AND DELIVERY 14 • Mothers’ last delivery taken place at home (in last two years) 16 • Last delivery of mother assisted by unskilled birth attendant (in last two years) 18 • Ante-natal consultations not taken from doctor/trained birth attendant during last pregnancy 20 • Ever married women under 50 years of age not aware of a method to delay pregnancy 22 • Married women under 50 years of age currently not using a method to delay pregnancy 24 IMMUNIZATION 26 • Children under 5 years of age not received BCG immunization 28 • Children aged 12-23 months that have not received 3 doses of DPT Immunization 30 • Children aged 12-23 months that have not received 3+ doses of polio immunization 32 • Children aged 9-59 months that have not received measles immunization 34 DIARRHOEA 36 • Diarrhoea prevalence in last 15 days (<5 years children) 38 • Children <5 years not received increased fluid or feeding during diarrhoea 40 • ORS/home-made fluid not given to <5 years children during diarrhoea 40 • More liquid not given to <5 years children during diarrhoea 41 • More/same solid food not given to <5 years children during diarrhoea 41 ACUTE RESPIRATORY INFECTION 42 • ARI prevalence in last 15 days (<5 years children) June-July 2003 44 • Advice or treatment not sought from hospital/health centre during ARI (<5 years children) 46 Contents PROGRESS OF PROVINCES 2003 2 3 CONTENTS P H O TO : U N IC E F A FG A /0 01 24 S /N O O R A N I BREASTFEEDING 48 • Children aged 12-15 months and 20-23 months that are not breastfed 50 • Children aged 0-3 months that did not exclusively receive breastmilk during last 24 hours 50 • Children aged 6-9 months that have no timely complementary feeding 51 • Children aged 0-23 months that were not breastfed in first 23 hours 51 • Mothers of children 0-23 months who discarded colostrum before breastfeeding 51 DISABILITY AND IMPAIRMENT 52 • Children 1-4 years and 7-17 years that are disabled or impaired 54 • Children aged 6-59 months that have not received vitamin-A supplementation 56 SALT USE 58 • Households consuming non-iodized salt 60 EDUCATION 62 • Illiteracy rate (15+ years) 64 • Children aged 7-12 years not enrolled in school - 2003 66 • Cause of not enrolling in school - 2003 68 CHILD LABOUR 70 • Children aged 7-12 years that worked for at least half-a-day (4-12 hours) for income in/out of household 72 • Children aged 7-12 years that did domestic chores for at least half-a-day (4-12 hours) 73 WATER AND SANITATION 74 • Households with no safe drinking water from pump/protected spring 76 • Households not having a sanitary latrine 78 • Children aged under 5 years with no fixed place for disposal of faeces 80 • Mothers with children under 5 years of age that do not always wash their own hands with soap/ash after their own or child defecation 82 ACCESS TO MEDIA 84 • Households without a radio 86 • Households where women do not listen to radio 88 CHILD RIGHTS 90 • Children not living with both parents 92 • Children aged under 5 years that citizenship card (Tazkera) not shown 93 • Girls 15-19 years of age currently in union 94 POPULATION AND DEMOGRAPHY 96 • Population age distribution 98 • Population <18 years 98 • Population pyramid 99 • Total fertility rate 100 • Infant mortality rate 102 • Under-five mortality rate 102 • Female headed households 103 METHODOLOGY 106 ANNEXEURES 114 • Number of households covered by provinces and cities 115 • Confidence intervals 116 • Definitions 121 • Questionnaire 126 • Non-response by each question 138 • Acknowledgements 139 Contents PROGRESS OF PROVINCES 2003 4 5 FOREWORD The information presented in this report result from the nation-wide MultipleIndicator Cluster Survey completed in Afghanistan during mid 2003. The aim is to show the range of fulfilment of children’ s rights around the country. The household survey was the first of such scale in decades and provides key baseline, planning and evaluation data for interventions in Afghanistan aimed at improving the life of children and women. It is hoped that this report and following initiatives will spark an effective response to ensuring the rights of the Afghan child. The importance of such a response relates to the fact that over half of the population in Afghanistan are children. These are the future of the nation, without adequate investment in children the nation is very unlikely to achieve a prosperous future. The needs of children in Afghanistan are too great for the government alone to be able to respond to. Years of neglect demand collective action starting with families all the way to the international community. The findings and brief analysis presented in this report are, therefore, for all those who are involved in the wellbeing of children one way or another. We all need to understand and realise the significance of meeting children’ s rights and aspirations. It is only then that society can witness an improvement in the lives of children. This report aims to provoke discussion about children’s issues and how to improve the plight of children. The report does not aim to judge the performance of organisations or official bodies, but to highlight the situation and allow readers to consider causal effects and solutions. MOHAMMAD ALI WATANYAR SHARAD SAPRA President Representative Central Statistics Office of Afghanistan UNICEF Afghanistan The essential needs of children should be given high priority in the allocation of resources, in bad times as well as good times, at national and international as well as family levels. To give every child a better future. UN Convention on the Rights of the Child. Foreword 7 PROGRESS OF PROVINCES 2003 6 P H O TO : U N IC E F A FG A /0 08 35 P Notes for the Reader 9 PROGRESS OF PROVINCES 2003 8 RANKING Provinces are ranked in ascending order according to the sum of standardised value of percent-not-acheived of ten selected indicators. The indicators are: Measles immunization, Vitamin-A Supplementation, Disablity for 1-4 years and 7-17 years, Salt Iodization, School Enrollment, Child Labour, Drinking Water, Sanitation and Access to Radio. Lowest rank indicates the best situation. Standardization was done by subtracting the mean value and dividing by standard deviation of the series to translate the variation of each indicator into a common scale. NON-ACHIEVEMENT Statistical publications usually report achievements. In this case, however, we feel there is so much work to do that focusing on achievement detracts from the gravity of what is still left to accomplish. For instance, every child not immunized is a child whose right to health is violated. Every girl out of school is a girl whose right to education is violated. This report highlights "non-achievement" in order to show what needs to be done in order to realize the rights of all children, everywhere. INSECURITY ACCESS Insecurity and access denials made it impossible to visit a few locations in Afghanistan. This comprises only about 1 per cent of all areas and hence should not reflect on the overall data. An alternative sample area was selected for data collection. OTHER NON-COVERAGE The nomad population known as "Kuchi" are not covered in this survey. Again, the sampling frame had a number of villages missing due to loss of census documents over so many years. The loss is estimated at 10 per cent of all villages spread all over the country. Assuming that the missing villages have the same characteristics as those included in the census list, this survey gives a reasonable picture of the country except "Kuchis". POPULATION FIGURES Population figures are estimated on the basis of growth rate estimated from this survey on the 1979 census population. Except the major cities, the census population figures were available for almost all villages of Afghanistan. This dataset was a used as sampling frame for this survey. In this survey the current population was estimated for the sample villages by the NOTES FOR THE READER survey team and a growth rate is estimated for each province comparing with the 1979 census. For major cities and Nuristan Province, data from Regional EPI Management Team (REMT) on National Immunization Day’s Polio coverage in 2002 or UN Habitat data were used for sampling as well as population figures. NUMBERS In absence of updated census figures, the numbers used in the tables are extrapolated from the population figures estimated by this survey. They are presented to indicate the possible quantum of the non-achievement or problem and have limited statistical validity. GIRL:BOY RATIO The 'Girl:Boy’ ratio is derived by dividing the coverage figures for girls by those for boys. A value of one (1) indicates no disparity. A ratio of more than one indicates disparity against girls and vice versa. The area with gender discrimination of 20 per cent or more for the indicator of interest is highlighted by 'Yellow. ' BEST AND WEAKEST PROVINCES For most indicators in this report, provinces are ranked as best to weakest according to 'non-achievement’ for that indicator both in terms of percentage and number of cases. Finally the best five and weakest five provinces are presented. CONFIDENCE INTERVALS Surveys such as MICS use a percentage of the population to gain a picture of the whole situation. In order to get an accurate picture it is necessary to allow for a margin of error. This is done through 'confidence interval' calculations. When studying an arbitrary population that is not necessarily normally distributed, one can only calculate an estimate of the mean (average) or percentage of the population. Using the mean from a large random sample of measurements, one must allow for a margin of error either side of that figure. This is the 'level of confidence’ and in this case the size of the error has been taken at 95 percent confidence, i.e., in 95 per cent cases the margin of error will be maintained. Such a range for the estimated (+ or -) mean or proportion is called a confidence interval. Each time a random sample is gathered, a different sample average or proportion will be found, thus, there will be a different confidence interval with each sample. Summary of IndicatorsPROGRESS OF PROVINCES 2003 10 11 SUMMARY OF INDICATORS INDICATORS NATIONAL URBAN RURAL MothersÕ last delivery taken place at home (in last two years) 88.5 67.5 96.2 Last delivery of mother assisted by unskilled birth attendant (in last two years) 85.7 65.2 93.1 Ante-natal consultations not taken from doctor/trained birth attendant during last pregnancy 83.9 61.7 92.0 Ever married women under 50 years of age not aware of a method to delay pregnancy 71.9 55.4 78.3 Married women under 50 years of age currently not using a method to delay pregnancy 89.7 79.0 93.9 Children under 5 years of age not received BCG immunization 40.2 27.0 45.1 Children aged 12-23 months that have not received 3 doses of DPT immunization 69.9 52.3 76.6 Children aged 12-23 months that have not received 3+ doses of polio immunization 49.2 28.7 56.7 Children aged 9-59 months that have not received measles immunization 24.0 16.3 26.8 Diarrhoea prevalence in last 15 days (<5 years children) 29.7 29.6 29.8 Children <5 years not received increased fluid or feeding during diarrhoea 46.0 47.0 45.6 ORS/home-made fluid not given to <5 years children during diarrhoea 30.8 30.5 30.8 More liquid not given to <5 years children during diarrhoea 44.9 45.9 44.6 More/same solid food not given to <5 years children during diarrhoea 54.2 53.6 54.4 Acute respiratory infection prevalence in last 15 days (<5 years children) : June-July 2003 19.0 18.9 19.0 Advice or treatment not sought from hospital/health centre during acute respiratory infection (<5 years children) 71.9 68.3 73.4 Children aged 12-15 months that are not breastfed 8.5 14.1 6.8 Children aged 20-23 months that are not breastfed 45.8 48.4 44.8 Children aged 0-3 months that did not exclusively receive breastmilk during last 24 hours 3.9 3.4 4.0 Children aged 6-9 months that have no timely complementary feeding 71.1 66.4 72.9 Children aged 0-23 months that were not breastfed in first 23 hours 7.3 8.3 6.9 Mothers of children 0-23 months who discarded colostrum before breastfeeding 39.2 42.2 38.0 Children aged 1-4 years that are disabled or impaired 2.5 3.2 2.2 Children aged 7-17 years that are disabled or impaired 3.0 4.1 2.6 Children aged 6-59 months that have not received vitamin-A supplimentation 14.4 10.1 16.0 Households consuming non-iodized salt 85.4 74.1 90.2 Illiteracy rate (15+ years) 71.3 56.0 77.8 Children aged 7-12 years not enrolled in school -2003 45.6 26.9 52.9 Boys aged 7-12 years not enrolled in school -2003 33.0 19.0 38.4 Girls aged 7-12 years not enrolled in school -2003 59.5 35.6 68.8 Children aged 7-12 years that worked for at least half-a-day (4-12 hours) for income 6.8 5.5 7.3 Children aged 7-12 years that did domestic chores for at least half-a-day (4-12 hours) 15.4 10.5 17.3 Households with no safe drinking water from pump/protected spring 59.8 39.0 68.8 Households not having a sanitary latrine 32.9 13.2 41.4 Children aged under 5 years with no fixed place for disposal of faeces 43.9 28.6 49.7 Mothers with children under 5 years of age that do not always wash their own hands with soap/ash after their own or child defecation 81.8 67.8 87.0 Households without a radio 33.0 25.0 36.5 Households where women do not listen to radio 34.1 26.5 37.4 Children not living with both parents 5.5 5.8 5.4 Children aged under 5 years that citizenship card (Tazkera) not shown 93.7 88.5 95.7 Girls 15-19 years of age currently in union 7.0 6.1 7.3 Total fertility rate 6.3 6.0 6.4 Infant mortality rate 115.0 97.0 121.0 Under-five mortality rate 172.0 142.0 183.0 Female headed households INDICATORS NATIONAL URBAN RURAL 3.3 5.0 2.5 Ranking of Provinces by Selected Indicators 13 PROGRESS OF PROVINCES 2003 12 RANKING OF PROVINCES BY SELECTED INDICATORS PROVINCE RANK BADAKHSHAN 13 BADGHIS 29 BAGHLAN 30 BALKH 13 BAMYAN 32 FARAH 17 FARYAB 26 GHAZNI 20 GHOR 24 HERAT 2 HILMAND 3 JAWZJAN 24 KABUL 1 KANDAHAR 3 KAPISA 13 KHOST 19 KUNAR 9 KUNDUZ 28 LAGHMAN 13 LOGAR 5 NANGARHAR 5 NIMROZ 7 NURISTAN 26 PAKTIKA 9 PAKTYA 9 PARWAN 21 SAMANGAN 21 SARI PUL 21 TAKHAR 9 URUZGAN 31 WARDAK 7 ZABUL 17 P H O TO : U N IC E F A FG H A N IS TA N /K AT A R IN A P R E M FO R S 14 PREGNANCY & DELIVERY The parents or others responsible for the child have the primary responsibility to secure, within their abilities the condition of life necessary for the child development Article 27, Convention on the Right of the Child Reduce by three quarters the maternal mortality ratio by 2015 Target 6, Millennium Development Goals Support comprehensive policies for early child development, basic services and commodities and promote family and community care practices. UNICEF Medium Term Strategic Plan 2002-2006 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery 15 ANALYSIS • Most deliveries (88.5 per cent) took place at home and were attended by untrained people (85.7 per cent). • Even in urban areas, less than 40 per cent of the deliveries took place in a health facility or were attended by a trained person. • Ante-natal consultations with trained medical personnel also reflect a similar trend. • More than two-thirds of married women were not aware of a method to delay pregnancy. The awareness was more in urban areas (45 per cent) and lower in rural areas (22per cent). • Of those who were aware, less than half were practicing some method to delay pregnancy. ACTION POINTS • lack of access to information and services is the main reason for low utilization of both, safe delivery and family planning services. In the initial stages, increasing access could significantly increase the utilization of services. • A targeted awareness building campaign will be necessary to increase and sustain the utilization of services. P H O TO : U N IC E F A FG A /0 00 64 P /Z A ID I 17 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery MOTHERS’ LAST DELIVERY TAKEN PLACE AT HOME (IN LAST TWO YEARS) BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Mothers’ last delivery taken place at home (in last two years) < 85% 85% — 90% 90% — 95% > 95% Ensure that women, in particular adolescent expectant mothers, have ready and affordable access to essential obstetric care, well-equipped and adequately staffed maternal health-care services, skilled attendance at delivery, emergency obstetric care, effective referral and transport to higher level of care when necessary, post- partum care and family planning in order to, inter alia, promote safe motherhood. ( A World Fit for Children) 16 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NIMROZ SARI PUL KABUL NANGARHAR NURISTAN BADGHIS HERAT KHOST PAKTIKA ZABUL KANDAHAR LAGHMAN PAKTYA NURISTAN PARWAN KANDAHAR KAPISA BADAKHSHAN GHAZNI PROVINCE PERCENT NUMBER BADAKHSHAN 99.7 71,952 BADGHIS 100.0 30,903 BAGHLAN 97.7 61,195 BALKH 95.9 61,531 BAMYAN 97.8 38,469 FARAH 96.8 22,639 FARYAB 97.8 71,794 GHAZNI 94.0 82,508 GHOR 99.6 47,563 HERAT 87.9 102,517 HILMAND 98.4 59,491 JAWZJAN 89.7 22,867 KABUL 53.0 131,666 KANDAHAR 86.7 98,350 KAPISA 97.0 21,458 KHOST 81.6 29,943 KUNAR 98.9 23,729 KUNDUZ 96.6 40,589 LAGHMAN 86.4 23,171 LOGAR 91.9 25,223 NANGARHAR 77.9 64,347 NIMROZ 94.9 9,277 NURISTAN 100.0 9,627 PAKTIKA 98.9 14,325 PAKTYA 97.1 19,562 PARWAN 97.6 87,065 SAMANGAN 97.8 22,603 SARI PUL 100.0 56,432 TAKHAR 99.0 78,600 URUZGAN 99.6 69,128 WARDAK 94.1 51,792 ZABUL 100.0 24,891 URBAN 67.5 320,055 RURAL 96.2 1,255,151 NATIONAL 88.5 1,575,206 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery 1918 LAST DELIVERY OF MOTHER ASSISTED BY UNSKILLED BIRTH ATTENDANT (IN LAST TWO YEARS) BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Last delivery of mother assisted by unskilled birth attendant (in last two years) <60% 60%—75% 75%—90% >90% PROVINCE PERCENT NUMBER BADAKHSHAN 98.5 71,730 BADGHIS 88.4 27,210 BAGHLAN 94.5 59,182 BALKH 92.4 59,556 BAMYAN 92.4 36,347 FARAH 88.0 20,487 FARYAB 97.9 72,320 GHAZNI 92.8 81,758 GHOR 90.7 43,138 HERAT 76.0 88,560 HILMAND 98.4 59,294 JAWZJAN 90.7 23,105 KABUL 54.5 135,228 KANDAHAR 84.0 95,524 KAPISA 87.8 19,156 KHOST 82.2 30,069 KUNAR 96.9 23,392 KUNDUZ 94.2 39,870 LAGHMAN 87.4 23,438 LOGAR 91.3 25,316 NANGARHAR 77.8 64,204 NIMROZ 92.9 9,046 NURISTAN 98.6 9,528 PAKTIKA 95.4 13,704 PAKTYA 91.1 18,303 PARWAN 96.3 86,155 SAMANGAN 71.1 16,502 SARI PUL 99.6 55,930 TAKHAR 99.3 79,154 URUZGAN 94.3 65,210 WARDAK 89.2 49,097 ZABUL 99.1 24,736 URBAN 65.2 308,780 RURAL 93.1 1,217,467 NATIONAL 85.7 1,526,247 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NIMROZ SARI PUL KABUL SAMANGAN NURISTAN TAKHAR KANDAHAR HERAT PAKTIKA ZABUL HERAT NANGARHAR PAKTYA NURISTAN PARWAN KHOST SAMANGAN BADAKHSHAN GHAZNI 21 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery ANTE-NATAL CONSULTATIONS NOT TAKEN FROM DOCTOR/ TRAINED BIRTH ATTENDANT DURING LAST PREGNANCY BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Ante-natal consultations not taken from doctor/ trained birth attendant during last pregnancy <70% 70% — 80% 80% — 90% >90% Ensure appropriate pre-natal and post-natal health care for mothers Article 24-d, UN Convention on the Rights of the Child. PROVINCE PERCENT NUMBER BADAKHSHAN 96.3 69,953 BADGHIS 99.2 29,672 BAGHLAN 95.8 59,182 BALKH 92.1 56,953 BAMYAN 93.1 36,347 FARAH 94.3 21,797 FARYAB 89.6 65,745 GHAZNI 85.6 73,507 GHOR 99.2 47,378 HERAT 76.1 87,999 HILMAND 94.4 56,536 JAWZJAN 89.6 22,629 KABUL 48.0 117,745 KANDAHAR 82.2 92,617 KAPISA 86.0 18,636 KHOST 85.2 31,071 KUNAR 96.9 23,190 KUNDUZ 86.5 35,945 LAGHMAN 79.7 21,388 LOGAR 73.3 20,049 NANGARHAR 76.8 62,308 NIMROZ 90.4 8,716 NURISTAN 98.0 9,528 PAKTIKA 97.4 13,870 PAKTYA 94.4 18,821 PARWAN 93.7 81,604 SAMANGAN 95.2 21,803 SARI PUL 97.7 54,175 TAKHAR 95.8 75,279 URUZGAN 98.8 67,449 WARDAK 89.7 48,712 ZABUL 99.1 24,580 URBAN 61.7 289,174 RURAL 92.0 1,186,011 NATIONAL 83.9 1,475,185 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NIMROZ GHOR KABUL LOGAR NURISTAN BADGHIS KANDAHAR HERAT PAKTIKA ZABUL HERAT NANGARHAR KAPISA URUZGAN PARWAN LAGHMAN PAKTYA NURISTAN TAKHAR 20 23 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery EVER MARRIED WOMEN UNDER 50 YEARS OF AGE NOT AWARE OF A METHOD TO DELAY PREGNANCY BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Ever married women under 50 years of age not aware of a method to delay pregnancy <40% 40%—60% 60% —80% >80% Develop preventive health care, guidance for parents and family planning education and services. Article 24-F, UN Convention on the Rights of the Child. PROVINCE PERCENT NUMBER BADAKHSHAN 96.0 118,144 BADGHIS 84.2 60,575 BAGHLAN 91.8 102,059 BALKH 73.3 87,805 BAMYAN 48.8 38,045 FARAH 42.3 18,336 FARYAB 93.5 154,633 GHAZNI 78.8 160,515 GHOR 96.2 88,489 HERAT 40.1 104,983 HILMAND 77.3 77,220 JAWZJAN 94.0 58,002 KABUL 54.8 273,107 KANDAHAR 38.1 79,273 KAPISA 71.9 29,105 KHOST 93.9 67,154 KUNAR 79.1 29,526 KUNDUZ 74.4 58,335 LAGHMAN 52.9 23,527 LOGAR 80.1 43,240 NANGARHAR 60.9 81,530 NIMROZ 60.8 10,994 NURISTAN 93.1 16,067 PAKTIKA 83.7 21,943 PAKTYA 79.9 32,752 PARWAN 88.4 140,456 SAMANGAN 94.4 40,805 SARI PUL 78.8 92,298 TAKHAR 95.8 149,728 URUZGAN 81.5 118,666 WARDAK 74.6 83,561 ZABUL 89.7 39,081 URBAN 55.4 540,747 RURAL 78.3 1,959,204 NATIONAL 71.9 2,499,951 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KANDAHAR NIMROZ GHOR KABUL HERAT NURISTAN BADAKHSHAN GHAZNI FARAH FARAH TAKHAR FARYAB BAMYAN PAKTIKA SAMANGAN TAKHAR LAGHMAN LAGHMAN JAWZJAN PARWAN 22 25 PROGRESS OF PROVINCES 2003 Pregnancy & Delivery MARRIED WOMEN UNDER 50 YEARS OF AGE CURRENTLY NOT USING A METHOD TO DELAY PREGNANCY 0 10 20 30 40 50 60 70 80 90 100 RURAL URBANNATIONAL 93.9% 79.0 % 89.7% PROVINCE PERCENT NUMBER BADAKHSHAN 97.7 120,142 BADGHIS 98.8 71,040 BAGHLAN 93.3 103,468 BALKH 91.3 108,728 BAMYAN 94.0 73,260 FARAH 75.3 32,462 FARYAB 95.2 157,789 GHAZNI 97.1 198,019 GHOR 99.2 91,254 HERAT 64.9 169,878 HILMAND 98.2 97,707 JAWZJAN 96.7 59,669 KABUL 77.7 387,175 KANDAHAR 84.1 174,561 KAPISA 88.5 35,565 KHOST 98.2 70,035 KUNAR 99.5 37,009 KUNDUZ 92.7 72,410 LAGHMAN 91.5 40,370 LOGAR 88.0 47,490 NANGARHAR 93.2 124,145 NIMROZ 85.7 15,451 NURISTAN 99.4 17,151 PAKTIKA 99.5 26,042 PAKTYA 97.3 39,866 PARWAN 93.1 148,344 SAMANGAN 96.5 41,705 SARI PUL 95.9 112,613 TAKHAR 99.3 154,986 URUZGAN 96.5 140,496 WARDAK 94.8 105,702 ZABUL 98.2 42,648 URBAN 79.0 771,922 RURAL 93.9 2,345,257 NATIONAL 89.7 3,117,179 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number HERAT NIMROZ KUNAR KABUL FARAH NURISTAN PAKTIKA GHAZNI KABUL PAKTIKA NURISTAN KANDAHAR KANDAHAR FARAH TAKHAR HERAT NIMROZ KAPISA GHOR FARYAB 24 27 PROGRESS OF PROVINCES 2003 IMMUNIZATION 26 ANALYSIS • One in two children in urban areas and three in four in rural areas were not immunized with three doses of DPT vaccine. • A wide variation was seen in the levels of coverage within the rural areas (see the list of best and worst performing provinces). • The drop out rate between the first dose and the third dose was around 20 per cent. This means that the reach of routine immunization is between 70 per cent in urban areas and 45 per cent in rural areas. The dropout rate also indicates that follow up visits are not always organized. • The campaigns (polio and measles) reach almost all households in the country and while they are able to demonstrate over 80 per cent coverage nationwide in children under-five, the coverage in young children is relatively lower. • The campaigns also show a drop out rate (for multiple dose vaccines) of between 15 per cent and 20 per cent. • Areas with high coverage with routine immunization also show a high coverage during campaigns. ACTION POINTS • Access to routine immunization services is necessary to increase the overall immunization coverage in the country. • Strengthening routine immunization services will help provide sustained high levels of immunization coverage and will help increase immunization coverage during immunization campaigns. • More attention needs to be paid to cover younger age groups during campaign activities. • Sustained awareness building campaign is necessary to increase overall immunization coverage in the country. ImmunizationPH O TO : U N IC E F A FG A /0 02 76 S /IS A A C 29 PROGRESS OF PROVINCES 2003 Immunization CHILDREN UNDER 5 YEARS OF AGE NOT RECEIVED BCG IMMUNIZATION BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <20% 20%—30% 30%—40% >40% Children under 5 years of age not received BCG immunization PROVINCE PERCENT NUMBER BADAKHSHAN 18.3 26,427 BADGHIS 79.0 50,110 BAGHLAN 79.7 104,072 BALKH 40.4 54,012 BAMYAN 56.9 50,632 FARAH 41.4 25,165 FARYAB 45.2 71,005 GHAZNI 33.7 71,257 GHOR 53.1 59,177 HERAT 28.2 78,675 HILMAND 47.3 81,948 JAWZJAN 56.4 34,420 KABUL 18.0 106,088 KANDAHAR 59.5 162,406 KAPISA 73.5 35,268 KHOST 21.1 19,419 KUNAR 18.6 10,718 KUNDUZ 59.8 54,944 LAGHMAN 14.0 9,090 LOGAR 11.5 7,114 NANGARHAR 16.9 34,014 NIMROZ 34.2 8,617 NURISTAN 50.2 9,430 PAKTIKA 29.5 10,019 PAKTYA 31.7 14,672 PARWAN 55.1 111,637 SAMANGAN 63.8 33,304 SARI PUL 53.2 67,969 TAKHAR 45.5 81,921 URUZGAN 78.4 125,662 WARDAK 14.6 17,328 ZABUL 51.0 28,845 URBAN 27.0 302,202 RURAL 45.1 1,353,164 NATIONAL 40.2 1,655,366 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number LOGAR LOGAR BAGHLAN KANDAHAR LAGHMAN NIMROZ BADGHIS URUZGAN WARDAK LAGHMAN URUZGAN PARWAN NANGARHAR NURISTAN KAPISA KABUL KABUL PAKTIKA SAMANGAN BAGHLAN 28 31 PROGRESS OF PROVINCES 2003 Immunization CHILDREN AGED 12-23 MONTHS THAT HAVE NOT RECEIVED 3 DOSES OF DPT IMMUNIZATION BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Children aged 12-23 months that have not received 3 doses of DPT immunization <40% 40% — 60% 60% — 80% >80% PROVINCE PERCENT NUMBER BADAKHSHAN 59.1 12,214 BADGHIS 95.7 8,249 BAGHLAN 92.1 21,136 BALKH 74.3 15,747 BAMYAN 98.0 13,860 FARAH 71.8 7,858 FARYAB 67.1 14,464 GHAZNI 83.3 31,878 GHOR 94.4 15,486 HERAT 48.3 24,542 HILMAND 97.9 27,973 JAWZJAN 81.4 5,717 KABUL 39.9 41,390 KANDAHAR 77.8 40,902 KAPISA 83.3 7,425 KHOST 75.6 12,028 KUNAR 34.6 3,034 KUNDUZ 83.7 14,576 LAGHMAN 47.4 4,901 LOGAR 42.9 3,880 NANGARHAR 28.8 9,796 NIMROZ 69.2 2,377 NURISTAN 78.8 2,694 PAKTIKA 88.4 4,430 PAKTYA 62.0 4,224 PARWAN 82.4 26,999 SAMANGAN 90.0 7,201 SARI PUL 84.4 16,303 TAKHAR 91.6 24,078 URUZGAN 96.4 29,946 WARDAK 78.0 18,483 ZABUL 93.9 10,701 URBAN 52.3 99,274 RURAL 76.6 385,218 NATIONAL 69.9 484,492 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number NANGARHAR NIMROZ BAMYAN KABUL KUNAR NURISTAN HILMAND KANDAHAR KABUL KUNAR URUZGAN GHAZNI LOGAR LOGAR BADGHIS URUZGAN LAGHMAN PAKTYA GHOR HILMAND 30 32 33 ImmunizationPROGRESS OF PROVINCES 2003 CHILDREN AGED 12-23 MONTHS THAT HAVE NOT RECEIVED 3+ DOSES OF POLIO IMMUNIZATION BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <30% 30%—45% 45%—60% >60% Children aged 12-23 months that have not received 3+ doses of polio immunization PROVINCE PERCENT NUMBER BADAKHSHAN 36.4 7,995 BADGHIS 66.7 6,156 BAGHLAN 70.4 16,305 BALKH 50.1 11,014 BAMYAN 71.0 10,041 FARAH 43.0 4,865 FARYAB 52.8 12,360 GHAZNI 54.9 21,002 GHOR 87.8 14,564 HERAT 34.2 17,594 HILMAND 84.2 24,230 JAWZJAN 34.9 2,620 KABUL 25.5 25,852 KANDAHAR 42.4 23,990 KAPISA 31.7 2,896 KHOST 87.4 13,907 KUNAR 24.4 2,157 KUNDUZ 68.9 12,185 LAGHMAN 46.9 5,436 LOGAR 22.0 2,217 NANGARHAR 12.0 4,077 NIMROZ 57.1 1,981 NURISTAN 53.6 1,971 PAKTIKA 74.6 3,768 PAKTYA 45.9 3,705 PARWAN 35.5 11,831 SAMANGAN 49.4 4,000 SARI PUL 55.1 10,785 TAKHAR 71.4 20,757 URUZGAN 89.6 28,827 WARDAK 48.4 11,745 ZABUL 79.3 8,917 URBAN 28.7 54,769 RURAL 56.7 294,981 NATIONAL 49.2 349,750 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number NANGARHAR NURISTAN URUZGAN URUZGAN LOGAR NIMROZ GHOR KABUL KUNAR KUNAR KHOST HILMAND KABUL LOGAR HILMAND KANDAHAR KAPISA JAWZJAN ZABUL GHAZNI 34 35 PROGRESS OF PROVINCES 2003 Immunization CHILDREN AGED 9-59 MONTHS THAT HAVE NOT RECEIVED MEASLES IMMUNIZATION BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <15% 15%—25% 25%—35% >35% Children aged 9-59 months that have not received measles immunization PROVINCE PERCENT NUMBER BADAKHSHAN 14.1 17,322 BADGHIS 42.9 21,054 BAGHLAN 50.2 55,760 BALKH 27.5 30,397 BAMYAN 32.8 23,902 FARAH 21.5 11,039 FARYAB 31.9 41,288 GHAZNI 24.7 45,379 GHOR 47.6 42,401 HERAT 18.4 42,126 HILMAND 13.6 20,881 JAWZJAN 20.3 10,243 KABUL 11.5 56,485 KANDAHAR 25.6 60,955 KAPISA 23.3 9,652 KHOST 27.4 22,301 KUNAR 8.1 3,842 KUNDUZ 56.8 43,777 LAGHMAN 15.8 9,090 LOGAR 4.7 2,495 NANGARHAR 12.2 21,220 NIMROZ 29.1 6,438 NURISTAN 31.4 5,290 PAKTIKA 19.4 5,548 PAKTYA 31.5 12,597 PARWAN 31.8 53,392 SAMANGAN 19.0 8,301 SARI PUL 16.7 19,061 TAKHAR 15.9 24,632 URUZGAN 48.5 66,610 WARDAK 21.0 21,949 ZABUL 45.1 21,789 URBAN 16.3 154,046 RURAL 26.8 683,168 NATIONAL 24.0 837,214 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number LOGAR LOGAR KUNDUZ URUZGAN KUNAR KUNAR BAGHLAN KANDAHAR KABUL NURISTAN URUZGAN KABUL NANGARHAR PAKTIKA GHOR BAGHLAN HILMAND NIMROZ ZABUL PARWAN Recognize the right of every child to a standard of living adequate for the child’s physical, mental development Article 27, UN Convention on the Rights of the Child. 36 37 PROGRESS OF PROVINCES 2003 Diarrhoea DIARRHOEA Ensure the parents and children are informed and supported in the basic knowledge of child health and hygiene Article 24, UN Convention of the Right of the Child. Support comprehensive policies for early child development and promote family and community care practices. UNICEF Medium Term Strategic Plan 2002-2006 ANALYSIS • 30 per cent of the under-five children suffered from diarrhoea in the 15 days prior to the survey. Provinces of highest prevalence are Baghlan, Badghis, Khost, Jawzjan and Kapisa. • 31 per cent of the under-five children suffered from diarrhoea did not receive Oral Rehydration Solution (ORS) or home- made fluid during the last episode. No significant gender difference is found in ORS use. • About half of the children (46 per cent) did not receive increased fluid and continued feeding during diarrhoea. • More than half (54 per cent) of all children under-five received less or no solid food during their diarrhoeal episode. The provinces of greatest need in this respect are Baghlan, Uruzgan, Sari Pul, Badghis and Badakshan. ACTION POINTS • Information on appropriate management of diarrhoea needs to be promoted through all communication channels to households and through life-skill materials, teacher-training materials and school-based learning materials. • The health worker training materials should be reinforced to communicate the importance of increased fluids and continued feeding during diarrhoea. P H O TO : U N IC E F A FG A /0 03 04 S / 38 39 PROGRESS OF PROVINCES 2003 Diarrhoea DIARRHOEA PREVALENCE IN LAST 15 DAYS (<5 YEARS CHILDREN) 0 10 5 20 15 30 25 40 35 50 45 RURALURBANNATIONAL Boys Girls 27.8 28.7 30.8 31.3 30.9 28.5 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number HILMAND NIMROZ JAWZJAN KABUL GHAZNI NURISTAN KHOST PARWAN KUNAR PAKTIKA BADGHIS KANDAHAR NIMROZ KUNAR BAGHLAN HERAT GHOR PAKTYA KAPISA NANGARHAR Note: Yellow marking indicates gender discrimination. PROVINCE BOY GIRL TOTAL GIRL/BOY PERCENT Number PERCENT Number PERCENT Number RATIO BADAKHSHAN 29.6 23,762 29.6 20,431 29.6 44,193 1.00 BADGHIS 43.9 12,928 46.0 15,759 45.1 28,687 1.05 BAGHLAN 44.8 29,188 35.7 23,552 40.2 52,741 0.80 BALKH 38.5 27,085 35.9 23,101 37.3 50,185 0.93 BAMYAN 34.6 15,557 41.1 18,244 37.8 33,802 1.19 FARAH 27.0 8,981 22.9 6,361 25.1 15,342 0.85 FARYAB 35.0 28,928 32.5 24,983 33.8 53,911 0.93 GHAZNI 13.4 13,876 12.1 13,501 12.7 27,378 0.90 GHOR 20.2 11,245 25.6 14,564 23.0 25,809 1.27 HERAT 25.5 34,991 24.0 34,534 24.7 69,525 0.94 HILMAND 6.1 6,107 10.4 7,683 7.9 13,789 1.70 JAWZJAN 52.4 15,840 45.4 14,173 48.8 30,013 0.87 KABUL 37.6 112,591 27.0 78,503 32.3 191,094 0.72 KANDAHAR 26.1 38,382 24.7 31,449 25.5 69,831 0.95 KAPISA 39.7 9,727 40.2 9,652 40.0 19,379 1.01 KHOST 46.4 22,802 49.3 22,301 47.8 45,103 1.06 KUNAR 20.7 6,269 23.2 6,337 21.9 12,606 1.12 KUNDUZ 30.3 14,288 28.9 13,335 29.6 27,623 0.95 LAGHMAN 24.2 7,931 25.3 8,288 24.8 16,219 1.05 LOGAR 31.9 10,533 34.2 10,071 33.0 20,604 1.07 NANGARHAR 35.2 36,767 32.4 31,714 33.8 68,481 0.92 NIMROZ 24.8 3,466 19.2 2,179 22.3 5,645 0.77 NURISTAN 36.5 3,680 32.1 3,088 34.3 6,768 0.88 PAKTIKA 32.2 6,045 32.7 5,175 32.4 11,220 1.02 PAKTYA 27.9 6,595 27.5 6,298 27.7 12,893 0.99 PARWAN 40.4 41,560 33.1 33,673 36.8 75,234 0.82 SAMANGAN 31.7 8,301 30.7 8,201 31.2 16,502 0.97 SARI PUL 27.7 19,563 28.6 17,306 28.1 36,869 1.03 TAKHAR 38.0 34,595 32.6 29,060 35.3 63,655 0.86 URUZGAN 28.0 25,748 28.1 19,871 28.1 45,619 1.00 WARDAK 28.4 17,906 20.4 11,745 24.6 29,651 0.72 ZABUL 27.0 8,685 29.8 7,444 28.2 16,129 1.10 URBAN 31.3 180,092 27.8 151,951 29.6 332,043 0.89 RURAL 30.8 483,831 28.7 420,627 29.8 904,458 0.93 NATIONAL 30.9 663,923 28.5 572,578 29.7 1,236,501 0.92 40 41 PROGRESS OF PROVINCES 2003 CHILDREN <5 YEARS NOT RECEIVED INCREASED FLUID OR FEEDING DURING DIARRHOEA Diarrhoea 0 10 5 20 15 30 25 40 35 50% 45 URBAN RURAL NATIONAL Boys Girls 47.4 45.2 45.8 46.5 46.1 46.2 ORS/HOME-MADE FLUID NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA 0 10 5 20 15 30 25 40 35 50% 45 URBAN RURAL NATIONAL Boys Girls 30.9 30.9 30.930.0 30.8 30.6 MORE LIQUID NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA 0 10 5 20 15 30 25 40 35 50% 45 URBAN RURAL NATIONAL Boys Girls 46.7 45.0 45.2 45.144.1 44.8 MORE/SAME SOLID FOOD NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA 10 20 15 30 25 40 35 50 55 60% 45 URBAN RURAL NATIONAL Boys Girls 52.3 54.8 54.1 55.2 54.1 54.4 BOYS GIRLS TOTAL Girl/Boy Percent Number Percent Number Percent Number RATIO URBAN 47.4 83,794 46.5 69,587 47.0 153,381 0.98 RURAL 45.2 214,991 46.1 192,035 45.6 407,026 1.02 NATIONAL 45.8 298,785 46.2 261,622 46.0 560,407 1.01 BOYS GIRLS TOTAL Girl/Boy Percent Number Percent Number Percent Number RATIO URBAN 30.9 55,680 30.0 45,588 30.5 101,269 0.97 RURAL 30.9 149,184 30.8 129,410 30.8 278,593 1.00 NATIONAL 30.9 204,864 30.6 174,998 30.8 379,862 0.99 BOYS GIRLS TOTAL Girl/Boy Percent Number Percent Number Percent Number RATIO URBAN 46.7 83,201 45.0 67,871 45.9 151,072 0.96 RURAL 44.1 210,911 45.2 188,501 44.6 399,412 1.02 NATIONAL 44.8 294,112 45.1 256,372 44.9 550,485 1.01 BOYS GIRLS TOTAL Girl/Boy Percent Number Percent Number Percent Number RATIO URBAN 52.3 92,507 55.2 82,841 53.6 175,348 1.06 RURAL 54.8 261,203 54.1 225,573 54.4 486,776 0.99 NATIONAL 54.1 353,710 54.4 308,414 54.2 662,124 1.01 Acute Respiratory InfectionPROGRESS OF PROVINCES 2003 42 43 ACUTE RESPIRATORY INFECTION ANALYSIS • 27 per cent of under-five children suffered from fever and/or cough during the 15 days prior to the survey. • 19 per cent children under-five suffered from acute respiratory infection (ARI) in the 15 days prior to the survey. The prevalence may be higher in peak season. Kabul, Kandahar and Herat had quite large numbers of cases. • Significant gender difference in prevelance was observed in Farah, Ghazni, Khost, Kunduz and Sari Pul, while, Balkh, Ghazani and Nimroz shows the difference in health- care seeking behaviour. ACTION POINTS • Access to trained health personnel needs to be significantly increased in 2004 to 2005. • Integrated Management of Childhood Illness (IMCI) training needs to be accelerated. Medium-term emphasis should be placed on enhancing local capacities, while the immediate or short-term response might be increasing the service provision by the government and local NGOs. • Another short-term measure might be to organize regular out-reach visits by trained health personnel from nearby areas. P H O TO : U N IC E F A FG A /0 01 70 S /N O O R A N I 45 Acute Respiratory InfectionPROGRESS OF PROVINCES 2003 44 BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <15% 15%—20% 20%—25% >25% Acute respiratory infection prevalence in last 15 days (<5 years children) BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number HILMAND NURISTAN BADGHIS KABUL WARDAK ZABUL BAMYAN BADAKHSHAN ZABUL NIMROZ BAGHLAN HERAT NANGARHAR HILMAND BADAKHSHAN KANDAHAR KUNDUZ PAKTIKA SAMANGAN BAGHLAN ACUTE RESPIRATORY INFECTION PREVALENCE IN LAST 15 DAYS (<5 YEARS CHILDREN) JUNE-JULY 2003 PROVINCE BOY GIRL TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO BADAKHSHAN 32.3 25,983 32.4 22,207 32.3 48,190 1.00 BADGHIS 40.5 11,820 42.2 14,282 41.4 26,102 1.04 BAGLAN 33.7 21,942 32.8 21,136 33.3 43,078 0.97 BALKH 22.7 15,885 20.1 12,581 21.5 28,465 0.89 BAMYAN 34.3 15,416 35.0 15,557 34.7 30,973 1.02 FARAH 15.8 5,145 9.7 2,619 13.1 7,765 0.61 FARYAB 24.7 20,250 24.7 18,672 24.7 38,921 1.00 GHAZNI 11.3 11,626 14.3 15752 12.9 27,378 1.27 GHOR 18.4 10,139 19.7 11,061 19.0 21,200 1.07 HERAT 15.7 21,175 17.4 24,590 16.6 45,765 1.11 HILMAND 2.8 2,758 3.8 2,758 3.2 5,516 1.36 JAWZJAN 29.1 8,575 29.5 8,933 29.3 17,508 1.01 KABUL 19.9 58,454 17.1 48,854 18.5 107,308 0.86 KANDAHAR 16.5 23,769 16.7 20,764 16.6 44,532 1.01 KAPISA 26.3 6,237 29.7 6,757 28.0 12,994 1.13 KHOST 14.7 7,141 18.2 8,144 16.4 15,285 1.24 KUNAR 14.8 4,382 14.6 3,910 14.7 8,292 0.99 KUNDUZ 14.0 6,554 10.5 4,808 12.3 11,363 0.75 LAGHMAN 20.1 6,416 15.0 4,723 17.5 11,140 0.75 LOGAR 18.5 6,006 18.2 5359 18.4 11,364 0.98 NANGARHAR 8.8 8,947 7.6 7,307 8.2 16,254 0.86 NIMROZ 19.9 2,740 17.7 1,981 18.9 4,721 0.89 NURISTAN 23.1 2,267 19.2 1,807 21.2 4,074 0.83 PAKTIKA 20.8 3,726 23.7 3,519 22.1 7,245 1.14 PAKTYA 15.5 3,631 20.0 4,520 17.7 8,151 1.29 PARWAN 23.4 23,966 19.0 19,112 21.2 43,077 0.81 SAMANGAN 30.1 7,701 31.4 8,301 30.8 16,002 1.04 SARI PUL 20.7 14,045 26.2 15,550 23.2 29,595 1.27 TAKHAR 23.0 20,757 24.4 21,034 23.7 41,791 1.06 URUZGAN 20.6 18,472 17.6 12,314 19.3 30,786 0.85 WARDAK 7.4 4,621 5.7 3,273 6.6 7,894 0.77 ZABUL 7.9 2,481 6.7 1,628 7.4 4,110 0.85 URBAN 18.7 105,841 19.1 102,527 18.9 208,368 1.02 RURAL 19.2 297,184 18.9 271,285 19.0 568,469 0.98 NATIONAL 19.1 403,025 18.9 373,812 19.0 776,837 0.99 Note: Yellow marking indicates gender discrimination. 47 PROGRESS OF PROVINCES 2003 Acute Respiratory Infection 46 ADVICE OR TREATMENT NOT SOUGHT FROM HOSPITAL/ HEALTH CENTRE DURING ARI (< 5 YEARS CHILDREN) BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <60% 60%—70% 70% — 80% >80% Advice or treatment not sought from hospital/health centre during ARI (<5 years children) BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number WARDAK NIMROZ URUZGAN KABUL JAWZJAN NURISTAN PAKTYA TAKHAR LAGHMAN HILMAND BAGHLAN NANGARHAR GHOR ZABUL TAKHAR HERAT KABUL PAKTYA LOGAR BAGHLAN PROVINCE BOY GIRL TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO BADAKHSHAN 64.6 18,654 77.4 18,210 70.3 36,864 1.20 BADGHIS 69.6 9,850 76.2 12,189 73.1 22,039 1.09 BAGHLAN 85.5 20,130 90.1 21,942 87.8 42,072 1.05 BALKH 62.7 14,459 80.3 17,148 71.2 31,607 1.28 BAMYAN 67.3 14,284 73.1 14,992 70.2 29,276 1.09 FARAH 69.7 5,800 69.6 3,648 69.7 9,449 1.00 FARYAB 67.9 14,990 64.3 14,201 66.1 29,191 0.95 GHAZNI 67.6 7,626 81.6 15,001 75.9 23,627 1.21 GHOR 55.6 3,452 58.2 7,190 56.9 13,642 1.05 HERAT 73.9 19,795 78.3 23,201 76.2 42,996 1.06 HILMAND 62.1 3,546 63.6 2,758 62.7 6,304 1.02 JAWZJAN 52.5 6,312 54.7 6,193 53.6 12,506 1.04 KABUL 62.9 63,547 58.8 49,659 61.1 113,206 0.93 KANDAHAR 64.3 20,300 66.6 18,094 65.3 38,394 1.04 KAPISA 70.7 6,088 64.7 5,717 67.7 11,806 0.92 KHOST 80.4 9,772 74.5 9,898 77.3 19,670 0.93 KUNAR 86.5 4,314 85.7 3,640 86.1 7,955 0.99 KUNDUZ 85.3 8,726 83.8 7,594 84.6 16,320 0.98 LAGHMAN 54.8 4,099 59.4 3,654 56.9 7,753 1.08 LOGAR 84.5 7,576 88.2 7,576 86.3 15,152 1.04 NANGARHAR 72.5 25,586 65.5 20,520 69.2 46,106 0.90 NIMROZ 66.7 2,443 81.9 2,245 73.2 4,688 1.23 NURISTAN 70.7 2,694 82.0 2,694 75.9 5,388 1.16 PAKTIKA 83.8 4,720 77.3 3,809 80.8 8,529 0.92 PAKTYA 92.3 3,557 86.2 4,150 88.9 7,706 0.93 PARWAN 74.5 21,235 84.6 20,022 79.1 41,257 1.14 SAMANGAN 85.4 8,201 81.7 7,601 83.6 15,802 0.96 SARI PUL 80.0 16,052 78.6 13,794 79.3 29,846 0.98 TAKHAR 91.3 23,248 83.8 22,971 87.4 46,219 0.92 URUZGAN 91.6 24,349 89.6 16,792 90.7 41,141 0.98 WARDAK 50.6 7,701 49.3 6,354 50.0 14,055 0.97 ZABUL 81.0 3,955 82.8 3,722 81.8 7,677 1.02 URBAN 68.0 110,460 68.7 104,261 68.3 214,721 1.01 RURAL 72.4 300,602 74.4 282,919 73.4 583,521 1.03 NATIONAL 71.2 411,062 72.8 387,180 71.9 798,242 1.02 Note: Yellow marking indicates gender discrimination. Breastfeeding 49 PROGRESS OF PROVINCES 2003 48 BREASTFEEDING ANALYSIS • Almost all children start breastfeeding after birth and over 90 per cent continue up to 12 months and 55 per cent up to two years. The duration of continuous breastfeeding is significantly lower for girls. • Only 29 per cent children had supplementary feeding at 6-9 months. The rate is even lower in the rural areas and the provincial towns (22-27 per cent) • More than 90 per cent could start breastfeeding within 24 hours. It was lower in Badakhshan, Baghlan, Parwan, Jawzjan and Sari Pul. ACTION POINTS • Develop database system within Ministry of Health to gather and analyze information on exclusive breastfeeding and supplementation in Afghanistan in order to plan appropriate campaigns. • Promote exclusive breastfeeding by including information in safe-motherhood campaigns at health facilities and community centres and among the community leaders. • Support and train the community leaders and imams to develop guidelines regarding appropriate practices. P H O TO : U N IC E F A FG A /0 03 30 S / CHILDREN AGED 12-15 MONTHS AND 20-23 MONTHS THAT ARE NOT BREASTFED 12-15 MONTHS BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 11.4 5132 17.0 7128 14.1 12261 1.49 RURAL 5.2 7610 8.4 11168 6.8 18778 1.62 NATIONAL 6.7 12742 10.5 18296 8.5 31039 1.57 CHILDREN AGED 0-3 MONTHS THAT DID NOT EXCLUSIVELY RECEIVE BREASTMILK DURING LAST 24 HOURS PERCENT NUMBER URBAN 3.4 2,261 RURAL 4.0 6,535 NATIONAL 3.9 8,796 Breastfeeding 51 PROGRESS OF PROVINCES 2003 50 20-23 MONTHS BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 54.6 7560 42.7 6333 48.4 13893 0.78 RURAL 40.8 15557 49.0 18583 44.8 34140 1.20 NATIONAL 44.4 23117 47.2 24917 45.8 48033 1.06 CHILDREN AGED 6-9 MONTHS THAT HAVE NO TIMELY COMPLEMENTARY FEEDING PERCENT NUMBER URBAN 66.4 57,851 RURAL 72.9 168,378 NATIONAL 71.1 226,229 CHILDREN AGED 0-23 MONTHS THAT WERE NOT BREASTFED IN FIRST 23 HOURS 0-23 MONTHS BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 9.3 20,783 7.2 14,825 8.3 35,608 0.77 RURAL 6.7 38,323 7.1 38,221 6.9 76,544 1.06 NATIONAL 7.4 59,106 7.1 53,046 7.3 112,152 0.96 MOTHERS OF CHILDREN 0-23 MONTHS WHO DISCARDED COLOSTRUM BEFORE BREASTFEEDING 0-23 MONTHS BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 42.7 94,799 41.7 84,733 42.2 179,532 0.98 RURAL 38.9 222,242 37.1 200,480 38.0 422,723 0.95 NATIONAL 39.9 317,041 38.3 285,213 39.2 602,255 0.96 Note: Yellow marking indicates gender discrimination. Note: Yellow marking indicates gender discrimination. Disability & Impairment 53 PROGRESS OF PROVINCES 2003 52 DISABILITY & IMPAIRMENT A mental or physical disabled child should enjoy a full and decent life, in conditions which ensures dignity, promote self-reliance and facilitate the child’s active participation in the community. Article 23, UN Convention on the Rights of the Child. ANALYSIS • 2.5 per cent (1-4 years) and 2.9 per cent (7-17 years) had some kind of disability or impairment. Parwan, Kabul, Bamyan, Faryab, Baghlan and Wardak had the highest percent or number of disabilities in under-fives. • Overall, in 1-4 years and 7-17 years, the provinces of greatest need are Parwan, Bamyan, Baghlan, Uruzgan and Kabul. • Gender differences were not significant. • Diagnostic and rehabilitative services are virtually absent except in a few major cities. ACTION POINTS • Encourage more preventive and rehabilitative services for children with disability. The capacity of local NGOs needs to be strengthened in this area. • Conduct blanket distribution of Vitamin-A through household immunization campaigns. • Children with disabilities (especially physical) should be identified and brought to the attention of organisations that have taken a lead role in rehabilitation for people with disabilities. Support should also be provided to national NGOs who deal with rehabilitation for children with disabilities. • Children with disabilities have abilities and should be recognized for them. This concept needs to be introduced and inculcated in the society and should be an important part of the curriculum. P H O TO : U N IC E F A FG A /0 07 58 P / CHILDREN 1-4 YEARS AND 7-17 YEARS THAT ARE DISABLED OR IMPAIRED Disability & Impairment 55 PROGRESS OF PROVINCES 2003 54 0 .8 .6 .4 .2 1.0 1.2 1.4 1.6 1.8% VISION HEARING/ SPEECH PARALYSIS AMPUTEE MENTAL VISION HEARING/ SPEECH PARALYSIS AMPUTEE MENTAL URBAN RURAL NATIONAL CHILDREN 1-4 YEARS THAT ARE DISABLED OR IMPAIRED CHILDREN 7-17 YEARS THAT ARE DISABLED OR IMPAIRED 7-17 YEARS VISION HEARING/SPEECH PARALYSIS AMPUTEE MENTAL Percent Number Percent Number Percent Number Percent Number Percent Number URBAN 0.5 27,450 1.1 54,897 0.2 11,529 0.3 16,247 0.5 24,601 RURAL 1.0 22,081 1.3 28,351 0.3 6,930 0.6 12,229 0.9 18,995 NATIONAL 0.7 49,531 1.1 83,248 0.2 18,459 0.4 28,476 0.6 43,596 1-4 YEARS VISION HEARING/SPEECH PARALYSIS AMPUTEE MENTAL Percent Number Percent Number Percent Number Percent Number Percent Number URBAN 0.4 8,779 1.1 27,052 0.3 6,792 0.2 5,025 0.3 6,651 RURAL 0.6 5,736 1.7 15,254 0.3 2,301 0.2 2,207 0.4 3,238 NATIONAL 0.4 14,515 1.3 42,306 0.3 9,093 0.2 7,232 0.3 9,889 P H O TO : U N IC E F A FG A /0 07 91 P / CHILDREN AGED 6-59 MONTHS THAT HAVE NOT RECEIVED VITAMIN-A SUPPLEMENTATION BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <10% 10%—15% 15% — 20% >20% Children aged 6-59 months that have not received Vitamin-A supplementation BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number BADAKHSHAN PAKTIKA KUNDUZ GHAZNI PAKTIKA NIMROZ GHAZNI BAGHLAN BALKH LOGAR BAGHLAN KABUL LOGAR BADGHIS NURISTAN URUZGAN BADGHIS BADAKHSHAN URUZGAN FARYAB Disability & Impairment 57 PROGRESS OF PROVINCES 2003 56 PROVINCE PERCENT NUMBER BADAKHSHAN 2.7 3,553 BADGHIS 5.4 2,955 BAGHLAN 41.3 50,325 BALKH 4.3 5,113 BAMYAN 16.2 13,012 FARAH 7.4 4,113 FARYAB 28.7 41,288 GHAZNI 42.1 78,758 GHOR 15.6 15,301 HERAT 6.6 16,398 HILMAND 8.7 14,183 JAWZJAN 6.7 3,692 KABUL 8.3 43,884 KANDAHAR 8.5 21,460 KAPISA 18.6 8,316 KHOST 22.4 19,545 KUNAR 8.6 4,449 KUNDUZ 47.4 40,014 LAGHMAN 9.3 5,704 LOGAR 4.8 2,772 NANGARHAR 7.2 13,445 NIMROZ 9.7 2,245 NURISTAN 34.9 6,210 PAKTIKA 3.9 1,201 PAKTYA 10.9 4,668 PARWAN 14.0 25,179 SAMANGAN 15.9 7,501 SARI PUL 11.1 13,293 TAKHAR 6.8 11,347 URUZGAN 29.5 43,380 WARDAK 7.6 8,279 ZABUL 18.3 9,615 URBAN 10.1 102,516 RURAL 16.0 438,683 NATIONAL 14.4 541,199 Improve diminished learning ability through use of iodized salt. A World Fit for Children. Salt Use 59 PROGRESS OF PROVINCES 2003 58 SALT USE ANALYSIS • Only 15 per cent of the households were using iodized salt. The rate was 35 per cent in the major cities, while it was only 10 per cent in all other urban and rural areas. The provinces bordering with Iran had a higher rate because of supply of Iranian iodized salt. A salt plant opened in Kabul Three months prior to the survey, which could account for a 6-fold increase in usage in comparison to a rapid survey conducted in 2002. • Locally produced salt and salt from Pakistan are mostly non-iodized. ACTION POINTS • Local capacity should be developed to iodize salt. Such iodation plants could be installed in the areas of local salt production. • Alternative means of transport are needed to ensure perennial access to areas which are very difficult to reach. P H O TO : U N IC E F A FG A /0 05 77 S /L E M O Y N E Salt Use 61 PROGRESS OF PROVINCES 2003 60 HOUSEHOLDS CONSUMING NON-IODIZED SALT BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <50% 50%—70% 70%—90% >90% Households consuming non-iodized salt BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number NIMROZ NIMROZ KUNDUZ KABUL FARAH FARAH BALKH GHAZNI HILMAND NURISTAN TAKHAR KANDAHAR HERAT PAKTIKA KUNAR PARWAN KABUL SAMANGAN JAWZJAN TAKHAR PROVINCE PERCENT NUMBER BADAKHSHAN 98.0 119,920 BADGHIS 91.5 61,314 BAGHLAN 98.8 112,527 BALKH 99.4 108,888 BAMYAN 96.3 74,392 FARAH 40.9 19,271 FARYAB 98.3 137,803 GHAZNI 98.2 188,268 GHOR 88.4 79,824 HERAT 50.3 140,869 HILMAND 43.1 44,323 JAWZJAN 99.0 57,049 KABUL 68.9 358,292 KANDAHAR 91.4 185,218 KAPISA 97.5 39,797 KHOST 95.3 56,504 KUNAR 99.1 37,885 KUNDUZ 99.4 78,306 LAGHMAN 98.9 49,282 LOGAR 96.6 47,120 NANGARHAR 98.4 123,076 NIMROZ 5.9 1,122 NURISTAN 92.9 16,362 PAKTIKA 96.7 22,108 PAKTYA 98.5 35,197 PARWAN 95.2 162,601 SAMANGAN 69.7 34,304 SARI PUL 98.3 113,366 TAKHAR 99.3 148,621 URUZGAN 98.5 147,772 WARDAK 93.3 91,455 ZABUL 98.6 39,623 URBAN 74.1 757,289 RURAL 90.2 2,175,173 NATIONAL 85.4 2,932,462 EducationPROGRESS OF PROVINCES 2003 62 EDUCATION ANALYSIS • Almost half of men and more than 85 per cent of women in Afghanistan are illiterate. • Illiteracy rates vary significantly between urban and rural areas and also between male and female. In urban areas, 40 per cent male and more than 70 per cent female were illiterate while in rural areas, illiteracy rates were more than 60 per cent for men and more than 90 per cent for women. • The roots to illiteracy and male/female differentials lie in low enrollment rates. The exclusion of girls from school by the Taliban has also helped increase gender disparities in illiteracy. • A significant push to increase enrollment in schools in 2002—2003 has increased the enrollment of boys to 67 per cent and that for girls to almost 40 per cent. However, significant disparities are seen in enrollment in urban and rural areas and between boys and girls. • In urban areas, the enrollment of boys and girls are 81 per cent and 64 per cent respectively. In the rural areas, the rates are 62 per cent for boys and 31 per cent for girls. • The enrollment rate for girls is almost half that of boys in rural areas. • The enrollment rates also vary significantly between provinces, the provinces in the south having a generally lower enrollment rate for both boys and girls than the provinces in the rest of the country. ACTION POINTS • The fastest and most sustainable way to increase the literacy rate is to get children enrolled in schools. • Access to schools is the single most important reason identified by families why children (especially girls) do not go to school. • Provision of temporary or alternative learning spaces close to home could significantly increase the enrollment of children in schools. • Availability of teachers (especially women teachers in rural areas) and teaching and learning materials will help keep those enrolled in schools. • Involvement of religious leaders and use of mosques and prayer rooms as alternative learning spaces can not only provide learning spaces close to the house but also help overcome cultural resistance seen towards education of girls seen in some parts of the country. Education is a human right and a key factor to reducing poverty and child labour and promoting democracy, peace, tolerance and development Article 38, UN Convention on the Rights of the Child. Achieve universal primary education. Ensure all boys and girls complete a full course of primary schooling Millennium Development Goals. Girls get into school, stay in school, complete their basic education and acquire the fundamental skill (Literacy, numeracy and life skills) UNICEF Medium Term Strategic Plan 2002-2006. 63 P H O TO : U N IC E F A FG A /0 02 02 S /N O O R A N I 64 65 PROGRESS OF PROVINCES 2003 Education ILLITERACY RATE (15+ YEARS) BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <60% 60%—70% 70%—80% >80% Illiteracy rate (15+ years) BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NIMROZ BADGHIS KABUL HERAT NURISTAN FARYAB HERAT NANGARHAR PAKTIKA TAKHAR GHAZNI KANDAHAR KUNAR JAWZJAN TAKHAR BALKH KAPISA SAMANGAN KANDAHAR PROVINCE MALE FEMALE TOTAL FEMALE/MALE Percent Number Percent Number Percent Number RATIO BADAKHSHAN 71.1 155,674 89.2 182,101 79.8 337,775 1.25 BADGHIS 76.2 81,136 98.3 97,634 86.8 178,771 1.29 BAGHLAN 63.4 127,020 89.3 165,670 75.8 292,690 1.41 BALKH 58.0 125,758 88.2 193,204 73.2 318,962 1.52 BAMYAN 55.8 71,563 93.3 118,801 74.5 190,364 1.67 FARAH 61.8 45,278 92.7 65,111 76.9 110,389 1.50 FARYAB 75.2 180,669 94.7 251,674 85.4 432,342 1.26 GHAZNI 55.4 196,519 91.0 322,156 73.2 518,675 1.64 GHOR 66.9 98,812 97.1 133,655 81.5 232,467 1.45 HERAT 50.6 229,076 72.6 329,118 61.6 558,194 1.43 HILMAND 80.2 130,605 96.2 144,197 87.8 274,802 1.20 JAWZJAN 70.8 82,894 96.1 117,433 83.7 200,326 1.36 KABUL 29.9 267,140 66.2 607,525 48.3 874,665 2.21 KANDAHAR 58.3 178,878 85.3 258,564 71.7 437,442 1.46 KAPISA 46.9 33,709 89.0 60,438 67.3 94,147 1.90 KHOST 63.4 76,425 97.0 101,482 79.0 177,907 1.53 KUNAR 64.5 31,751 90.8 43,413 77.5 75,164 1.41 KUNDUZ 66.8 94,036 84.8 122,939 75.9 216,975 1.27 LAGHMAN 50.2 45,717 91.2 74,680 69.6 120,398 1.82 LOGAR 45.2 41,484 82.3 73,914 63.5 115,398 1.82 NANGARHAR 43.7 107,853 81.7 207,136 63.0 314,988 1.87 NIMROZ 71.8 18,224 89.2 22,681 80.5 40,937 1.24 NURISTAN 68.6 18,925 91.8 23,229 79.7 42,155 1.34 PAKTIKA 67.4 31,300 85.0 37,551 76.0 68,851 1.26 PAKTYA 63.5 48,535 98.0 65,134 79.6 113,669 1.54 PARWAN 52.9 139,243 91.0 246,329 72.3 385,572 1.72 SAMANGAN 73.5 59,207 92.8 71,409 83.0 130,616 1.26 SARI PUL 69.7 138,196 94.9 192,621 82.4 330,817 1.36 TAKHAR 75.3 216,150 94.2 269,012 84.7 485,162 1.25 URUZGAN 67.5 174,080 94.6 214,662 80.2 388,742 1.40 WARDAK 46.1 76,437 91.1 160,767 69.3 237,204 1.98 ZABUL 67.6 53,426 94.9 71,105 80.9 124,531 1.40 URBAN 40.1 705,639 71.9 1,270,112 56.0 1,975,751 1.8 RURAL 63.9 2,670,079 91.9 3,775,232 77.8 6,445,344 1.4 NATIONAL 56.8 3,375,718 85.9 5,045,344 71.3 8,421,095 1.5 Note: Yellow marking indicates gender discrimination. 66 67 PROGRESS OF PROVINCES 2003 Education CHILDREN AGED 7-12 YEARS NOT ENROLLED IN SCHOOL - 2003 BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <40% 40%—50% 50%—60% >60% Children aged 7-12 years not enrolled in school - 2003 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NURISTAN HILMAND KANDAHAR HERAT NIMROZ URUZGAN GHAZNI BADAKHSHAN KUNAR BADGHIS KABUL BAGHLAN KAPISA ZABUL URUZGAN BALKH SAMANGAN NURISTAN HILMAND PROVINCE BOY GIRL TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO BADAKHSHAN 25.1 22,874 29.3 23,540 27.0 46,414 1.17 BADGHIS 63.4 26,471 98.5 32,011 78.8 58,482 1.55 BAGHLAN 17.1 13,890 39.3 28,987 27.7 42,877 2.30 BALKH 18.2 16,073 38.9 31,919 28.2 47,992 2.14 BAMYAN 39.8 20,932 69.0 35,923 54.3 56,855 1.73 FARAH 45.1 13,658 80.6 25,633 63.3 39,291 1.79 FARYAB 37.2 34,188 57.8 56,804 47.9 90,992 1.55 GHAZNI 46.1 65,631 72.5 101,635 59.2 167,266 1.57 GHOR 35.9 22,675 79.0 44,429 56.2 67,104 2.20 HERAT 20.4 42,607 32.4 63,041 26.2 105,648 1.59 HILMAND 74.0 64,416 90.0 65,401 81.3 129,817 1.22 JAWZJAN 32.4 12,506 73.3 23,820 51.1 36,326 2.26 KABUL 14.3 52,453 33.0 114,048 23.4 166,502 2.31 KANDAHAR 45.7 79,257 80.2 117,264 61.5 196,521 1.75 KAPISA 18.6 6,831 51.4 14,998 33.1 21,829 2.76 KHOST 37.1 21,549 86.0 36,834 57.9 58,384 2.32 KUNAR 23.0 6,809 51.0 13,213 36.1 20,021 2.22 KUNDUZ 43.0 22,402 62.6 33,520 53.0 55,921 1.46 LAGHMAN 29.2 12,120 44.9 15,774 36.4 27,894 1.54 LOGAR 28.9 11,734 75.4 29,381 51.6 41,115 2.61 NANGARHAR 31.7 31,807 60.0 55,469 45.3 87,275 1.89 NIMROZ 57.0 8,449 64.4 9,013 60.5 17,762 1.13 NURISTAN 61.5 5,980 66.9 6,046 64.1 12,025 1.09 PAKTIKA 37.9 8,984 94.3 19,169 64.0 28,153 2.49 PAKTYA 25.3 8,373 83.3 20,303 49.9 28,677 3.29 PARWAN 16.4 19,718 69.9 80,997 42.6 100,716 4.26 SAMANGAN 31.9 10,101 56.0 13,602 42.3 23,703 1.76 SARI PUL 35.9 23,325 74.8 49,159 55.5 72,484 2.08 TAKHAR 35.1 37,640 58.5 56,183 46.1 93,822 1.67 URUZGAN 74.5 81,723 89.2 82,842 81.2 164,565 1.20 WARDAK 25.3 21,757 73.7 57,183 48.2 78,940 2.91 ZABUL 45.4 14,035 98.6 21,789 67.5 35,824 2.17 URBAN 19.0 134,337 35.6 230,651 26.9 364,988 1.87 RURAL 38.4 706,929 68.8 1,149,275 52.9 1,856,204 1.79 NATIONAL 33.0 841,266 59.5 1,379,926 45.6 2,221,192 1.80 Note: Yellow marking indicates gender discrimination. 68 69 PROGRESS OF PROVINCES 2003 Education CAUSE OF NOT ENROLLING IN SCHOOL-2003 PROVINCE TOO FAR INADEQUATE NO SEPARATE DOMESTIC NOT HOUSEHOLD FACILITY SCHOOL WORK NECESSARY INCOME Percent Number Percent Number Percent Number Percent Number Percent Number Percent Number BADAKHSHAN 44.8 19,987 8.5 3,775 9.5 4,219 10.4 4,664 2.5 1,110 5.0 2,221 BADGHIS 3.8 2,216 48.8 28,318 29.5 17,114 15.7 9,111 11.9 6,895 3.8 2,216 BAGHLAN 24.3 10,266 31.4 13,286 13.8 5,838 10.5 4,429 20.0 8,455 7.6 3,221 BALKH 11.6 5,414 25.4 11,823 38.3 17,843 25.8 12,036 4.8 2,251 14.5 6,772 BAMYAN 35.7 20,083 5.0 2,829 27.1 15274 15.6 8,769 3.0 1,697 17.3 9,759 FARAH 32.0 12,536 13.6 5,332 42.5 16,652 3.3 1,310 17.2 6,736 4.5 1,777 FARYAB 51.5 46,285 17.5 15,779 11.4 10,256 31.9 28,665 11.4 10,256 25.7 23,142 GHAZNI 57.0 93,384 34.1 55,880 11.7 19,127 33.9 55,505 12.8 21,002 7.1 11,626 GHOR 25.0 16,592 0.8 553 17.8 11,798 5.0 3,318 48.1 31,893 3.9 2,581 HERAT 36.6 34,952 13.3 12,676 22.8 21,776 18.8 17,928 11.8 11,320 11.8 11,277 HILMAND 60.6 78,008 51.8 66,583 30.0 38,610 10.0 13,001 9.0 11,622 1.1 1,379 JAWZJAN 36.4 13,101 27.2 9,766 43.0 15,483 11.6 4,169 1.7 596 18.9 6,789 KABUL 44.8 72,988 27.9 45,386 10.1 16,504 12.2 19,881 22.6 36,827 9.4 15,303 KANDAHAR 34.1 66,885 18.8 36,853 22.9 44,874 9.5 18,704 18.9 36,956 2.2 4,220 KAPISA 24.7 5,272 18.8 4,009 22.3 4,752 40.8 8,687 14.6 3,118 5.6 1,188 KHOST 35.4 19,795 1.1 626 37.4 20,923 7.6 4,260 - - 4.5 2,506 KUNAR 72.3 14,224 12.0 2,359 19.2 3,775 13.4 2,629 5.1 1,011 1.7 337 KUNDUZ 48.7 26,465 7.0 3,818 20.9 11,376 5.9 3,209 2.4 1,321 6.0 3,283 LAGMAN 58.3 16,041 23.3 6,416 8.7 2,406 7.1 1,961 18.8 5,169 4.2 1,159 LOGAR 33.0 13,582 37.1 15,245 9.7 3,973 9.7 3,973 13.7 5,636 7.9 3,234 NANGARHAR 52.3 44,821 12.2 10,429 12.2 10,429 17.9 15,296 18.7 15,992 3.4 2,903 NIMROZ 25.2 4,424 23.7 4,160 7.1 1,255 11.8 2,080 8.5 1,486 2.8 495 NURISTAN 75.3 8,937 17.2 2,037 3.3 394 32.7 3,877 24.1 2,858 7.2 854 PAKTIKA 50.4 13,994 49.1 13,621 51.5 14,284 40.6 11,261 9.6 2,650 4.5 1,242 PAKTYA 21.8 6,224 9.4 2,668 47.5 13,560 23.4 6,669 2.6 741 1.0 296 PARWAN 48.2 48,234 45.8 45,808 31.8 31,853 34.8 34,887 8.8 8,797 3.0 3,034 SAMANGAN 27.3 6,301 34.2 7,901 35.1 8,101 27.7 6,401 10.0 2,300 6.5 1,500 SARIPOL 7.8 5,518 15.5 11,036 33.6 23,827 21.6 15,299 24.7 17,557 13.4 9,531 TAKHAR 35.3 32,658 9.0 8,303 8.4 7,749 22.2 20,480 30.5 28,230 8.7 8,026 URUZGAN 14.4 23,509 56.4 91,798 9.5 15,393 7.4 12,034 21.5 34,984 3.6 5,877 WARDAK 26.0 19,254 11.9 8,857 49.6 36,774 20.3 15,018 2.1 1,540 9.6 7,124 ZABUL 24.4 8,607 41.3 14,578 33.2 11,709 11.9 4,187 18.2 6,436 0.9 310 URBAN 25.5 90,914 9.6 34,304 13.6 48,296 18.7 66,428 20.1 71,574 10.1 35,923 RURAL 39.5 719,640 29.0 528,203 23.6 429,604 16.9 307,269 14.1 255,868 6.6 119,258 NATIONAL 37.2 810,553 25.8 562,506 22.0 477,900 17.2 373,696 15.0 327,442 7.1 155,181 TEACHERS EXPENSIVE FEEL ASHAMED SECURITY INADEQUATE OTHERS PROVINCE GENDER SANITATION Percent Number Percent Number Percent Number Percent Number Percent Number Percent Number - - 1.5 666 11.9 5,330 4.5 1,999 - - 2.0 888 BADAKHSHAN 0.8 492 0.2 123 0.4 246 0.2 123 0.2 123 3.2 1,847 BADGHIS 14.3 6,039 18.6 7,851 9.0 3,825 4.8 2,013 - - 24.3 10,266 BAGHLAN 23.9 11,143 3.1 1,436 7.0 3,255 7.4 3,466 0.9 424 14.6 6,819 BALKH 2.8 1,556 3.0 1,697 0.3 141 0.3 141 1.0 566 12.3 6,930 BAMYAN 3.1 1,216 0.5 187 4.8 1,871 0.5 187 0.2 94 10.7 4,210 FARAH 0.3 263 0.3 263 5.0 4,471 0.3 263 - - 12.6 11,308 FARYAB 1.6 2,625 11.7 19,127 4.1 6,751 7.1 11,626 0.2 375 21.1 34,503 GHAZNI - - - - 1.4 922 - - - - 2.5 1,659 GHOR 2.0 1,950 7.5 7,150 4.8 4,602 1.0 975 1.6 1,545 17.0 16,223 HERAT 6.9 8,865 2.3 2,955 5.2 6,698 5.8 7,486 - - 18.5 23,836 HILMAND 36.4 13,101 2.0 715 1.3 476 1.0 357 0.3 119 29.1 10,481 JAWZJAN 0.4 688 11.7 19,132 5.4 8,834 5.9 9,645 0.9 1,493 36.9 60,057 KABUL 10.9 21,393 0.2 366 0.7 1,326 0.6 1,097 0.3 582 9.5 18,601 KANDAHAR 4.9 1,039 5.6 1,188 13.6 2,896 12.5 2,673 4.9 1,039 51.6 10,989 KAPISA - - - - 1.6 877 1.8 1,002 2.0 1,128 14.8 8,269 KHOST 19.2 3,775 12.7 2,494 - - 1.7 337 0.3 67 45.5 8,966 KUNAR 1.6 856 5.2 2,834 1.6 894 0.7 405 0.6 342 28.4 15,413 KUNDUZ 4.5 1,248 1.6 446 3.6 980 18.1 4,991 - - 18.1 4,991 LAGMAN - - 0.2 92 2.5 1,016 14.6 6,006 0.9 370 3.8 1,571 LOGAR 8.0 6,865 1.8 1,551 6.0 5,156 2.7 2,309 0.1 118 34.1 29,160 NANGARHAR 0.6 99 1.7 297 0.6 99 - - - - 27.8 4,886 NIMROZ 2.8 329 24.7 2,924 2.8 329 11.4 1,347 4.2 493 26.9 3,187 NURISTAN 37.8 10,475 7.3 2,029 4.9 1,366 3.1 869 4.6 1,283 14.5 4,016 PAKTIKA 3.1 889 3.4 963 11.2 3,186 0.3 74 0.8 222 18.2 5,187 PAKTYA 12.4 12,438 5.8 5,764 2.1 2,124 6.4 6,371 0.9 910 36.7 36,707 PARWAN 0.9 200 - - 1.7 400 2.6 600 0.4 100 15.6 3,600 SAMANGAN 1.4 1,003 6.7 4,765 5.7 4,013 0.7 502 3.9 2,759 42.0 29,846 SARIPOL 3.3 3,044 11.1 10,241 15.6 14,392 1.2 1,107 0.3 277 12.3 11,347 TAKHAR 12.2 19,871 0.9 1,399 0.7 1,119 0.2 280 1.9 3,079 36.9 60,172 URUZGAN 9.1 6,739 19.7 14,633 5.2 3,851 0.8 578 3.9 2,888 12.2 9,049 WARDAK 4.8 1,706 0.2 78 13.2 4,652 28.6 10,080 6.2 2,171 12.7 4,497 ZABUL 1.8 6,450 7.8 27,811 4.2 14,908 4.2 15,104 1.9 6,614 19.9 70,936 URBAN 7.3 133,456 4.7 85,554 4.5 81,189 3.5 63,804 0.9 15,954 21.3 388,545 RURAL 6.4 139,906 5.2 113,365 4.4 96,097 3.6 78,907 1.0 22,567 21.1 459,481 NATIONAL 71 PROGRESS OF PROVINCES 2003 Child Labour CHILD LABOUR ANALYSIS • One in ten boys and one in twenty girls work for more than half a day to support the family income. • More girls and boys in rural areas work for more than half a day to support their family income. • In urban areas, three times more boys than girls and in rural areas, twice as many boys than girls work for more than half a day to support family income. • The reverse is true for household chores where three times more girls in rural areas and twice the number of girls in urban areas work for more than half a day in the house. • This interferes with the child’s ability to attend school and get education. ACTION POINTS • Providing flexible accelerated learning and vocational education support will allow these children to get their education while contributing to the household. 70 Article 31 ensures the child the right to rest and leisure, to engage in play and recreational activities Article 31, UN Convention on the Rights of the Child. Protection against abuse, exploitation and violence. Millennium Development Goals. Concentrate on the worst form of child labour. UNICEF Medium Term Strategic Plan 2002-2006. P H O TO : U N IC E F A FG A /0 07 11 P /IS A A C 72 73 Child Labour CHILDREN AGED 7-12 YEARS THAT WORKED FOR AT LEAST HALF-A-DAY (4-12 HOURS) FOR INCOME IN/OUT OF HOUSEHOLD BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 7.9 55,002 3.0 19,086 5.5 74,088 0.38 RURAL 9.4 169,657 5.1 84,353 7.3 254,010 0.54 NATIONAL 9.0 224,659 4.5 103,439 6.8 328,098 0.50 NATIONALRURALURBAN Boys Girls 1 2 3 4 5 6 7 8 9 10 11% 7.9 3.0 9.4 5.1 9.0 4.5 CHILDREN AGED 7-12 YEARS THAT DID DOMESTIC CHORES FOR AT LEAST HALF-A-DAY (4-12 HOURS) BOYS GIRLS TOTAL GIRL/BOY Percent Number Percent Number Percent Number RATIO URBAN 6.1 42,223 15.3 97,163 10.5 139,386 2.51 RURAL 12.5 224,930 22.7 372,365 17.3 597,295 1.82 NATIONAL 10.7 267,153 20.6 469,528 15.4 736,681 1.93 NATIONALRURALURBAN Boys Girls 0 3 6 9 12 15 18 21 24 27 30% 6.1 15.3 12.5 22.7 10.7 20.6 Note: Yellow marking indicates gender discrimination. Note: Yellow marking indicates gender discrimination. PROGRESS OF PROVINCES 2003 Water & Sanitation PROGRESS OF PROVINCES 2003 74 75 WATER & SANITATION ANALYSIS • Only 40 per cent of households had access to safe drinking water. Other than major cities this figure is only about 30 per cent. In some provinces it is less than 10 per cent (Bamyan, Baghlan, Sari Pul) while Kabul, Herat, Sari Pul, Takhar and Parwan had large numbers of people without access to safe water. • Among those who had access to safe water, only about 1/4 of them had a water source within their compound. • Only 3 per cent of households had flush toilet facilities for their members. These are mostly in the major cities. About two-thirds of the households had pit latrines. Ghor, Uruzgan, Baghlan, Khost, Badakhshan and Ghazni had most people in worse condition. • Except in major cities, for almost half of the children there was no fixed place for disposal of faeces. Ghor, Laghman, Farah and Uruzgan had the worst conditions, while Kabul, Baghlan and Nangarhar had the largest number. • Only 18 per cent of mothers of under-five children wash their hands with soap or ash after defecation. This is a little higher in urban areas (32 per cent). In Jawzjan, Nuristan and Ghor, it is almost zero (1-2 per cent). ACTION POINTS • Nationwide campaigns on protecting water at the storage point will help significantly increase the availability of safe water at the household level. • The focus on the provision of safe water has been predominantly on the use of ground water. Significantly, more work is needed to make surface water safe. To rapidly increase the availability of safe water to the population, the use of intermediate technologies needs to be explored. • Promotion of sanitary latrines and hygiene practices has been the most neglected aspect of water and sanitation work in Afghanistan. Significant emphasis needs to be placed on these projects in future programme activities. • Awareness campaigns are needed to increase community awareness regarding the benefits of safe drinking water. The life skills and school curriculum modules must also include this information. • Increased access to safe drinking water, closer to the households should be a high priority of the water programme. • Protecting open wells and springs can increase the access of households to safe drinking water by about 40 per cent. • Campaigns are necessary to make the mothers aware about the oral-faecal cycle of diarrhoea. P H O TO : U N IC E F A FG A /0 08 85 D /IS A A C 76 77 PROGRESS OF PROVINCES 2003 Water & Sanitation BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ <30% 30%—50% 50%—70% >70% Households with no safe drinking water from pump/protected spring BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL NIMROZ BAGHLAN HERAT KANDAHAR NURISTAN SARI PUL KABUL HILMAND PAKTIKA BAMYAN PARWAN LOGAR LOGAR SAMANGAN URUZGAN NANGARHAR PAKTYA JAWZJAN TAKHAR HOUSEHOLDS WITH NO SAFE DRINKING WATER FROM PUMP/PROTECTED SPRING PROVINCE PERCENT NUMBER BADAKHSHAN 78.6 96,158 BADGHIS 73.6 49,371 BAGHLAN 93.5 106,488 BALKH 60.4 66,283 BAMYAN 92.3 71,280 FARAH 53.4 25,165 FARYAB 83.7 117,290 GHAZNI 61.1 117,386 GHOR 83.9 75,953 HERAT 54.5 152,814 HILMAND 33.3 34,276 JAWZJAN 86.7 50,379 KABUL 26.2 140,790 KANDAHAR 26.2 53,205 KAPISA 78.4 32,150 KHOST 46.4 27,563 KUNAR 57.1 21,841 KUNDUZ 84.0 66,257 LAGHMAN 47.8 23,883 LOGAR 38.9 19,033 NANGARHAR 42.5 53,356 NIMROZ 70.6 13,503 NURISTAN 80.6 14,161 PAKTIKA 69.3 15,857 PAKTYA 58.5 20,896 PARWAN 78.5 134,389 SAMANGAN 87.8 43,205 SARI PUL 93.1 107,597 TAKHAR 81.0 121,498 URUZGAN 84.4 127,062 WARDAK 44.8 44,283 ZABUL 59.5 23,883 URBAN 39.0 405,319 RURAL 68.8 1,661,937 NATIONAL 59.8 2,067,256 78 79 PROGRESS OF PROVINCES 2003 Water & Sanitation BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Households not having a sanitary latrine <20% 20%—40% 40%—60% >60% BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KABUL LOGAR GHOR URUZGAN LOGAR NURISTAN KHOST GHOR WARDAK WARDAK URUZGAN BADAKHSHAN HERAT NIMROZ FARAH BAGHLAN KANDAHAR KABUL BADGHIS GHAZNI HOUSEHOLDS NOT HAVING A SANITARY LATRINE PROVINCE PERCENT NUMBER BADAKHSHAN 57.2 69,731 BADGHIS 72.8 48,140 BAGHLAN 59.5 67,637 BALKH 23.9 26,173 BAMYAN 70.5 54,450 FARAH 75.2 35,455 FARYAB 30.5 42,603 GHAZNI 33.6 64,506 GHOR 81.3 73,556 HERAT 8.6 24,146 HILMAND 35.2 36,246 JAWZJAN 47.1 27,393 KABUL 2.0 10,812 KANDAHAR 13.3 26,881 KAPISA 38.3 15,666 KHOST 80.4 47,734 KUNAR 63.1 23,931 KUNDUZ 43.7 34,372 LAGHMAN 45.3 22,636 LOGAR 4.2 2,033 NANGARHAR 40.9 51,241 NIMROZ 56.2 10,730 NURISTAN 36.0 6,308 PAKTIKA 58.4 13,290 PAKTYA 39.2 14,005 PARWAN 15.2 26,089 SAMANGAN 54.1 26,603 SARI PUL 27.2 31,351 TAKHAR 38.5 57,566 URUZGAN 75.8 113,908 WARDAK 8.4 8,279 ZABUL 51.4 20,548 URBAN 13.2 136,664 RURAL 41.4 997,357 NATIONAL 32.9 1,134,021 80 81 PROGRESS OF PROVINCES 2003 Water & Sanitation BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Children aged under 5 years with no fixed place for disposal of child faeces <20% 20%—40% 40%—60% >60% BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number WARDAK PAKTYA GHOR NANGARHAR KANDAHAR WARDAK LAGHMAN URUZGAN KABUL NURISTAN URUZGAN KABUL HERAT NIMROZ FARAH GHOR PAKTYA KUNAR BADGHIS BAGHLAN CHILDREN AGED UNDER 5 YEARS WITH NO FIXED PLACE FOR DISPOSAL OF FAECES PROVINCE PERCENT NUMBER BADAKHSHAN 52.9 78,614 BADGHIS 79.2 50,233 BAGHLAN 76.3 99,241 BALKH 40.3 53,544 BAMYAN 60.5 53,460 FARAH 80.1 47,710 FARYAB 49.6 77,843 GHAZNI 25.4 54,380 GHOR 97.7 109,136 HERAT 23.1 64,211 HILMAND 24.9 42,944 JAWZJAN 53.5 32,395 KABUL 21.4 126,163 KANDAHAR 12.4 32,963 KAPISA 37.8 18,265 KHOST 34.3 31,572 KUNAR 30.2 17,325 KUNDUZ 51.7 47,693 LAGHMAN 84.6 54,985 LOGAR 59.7 37,142 NANGARHAR 78.2 156,041 NIMROZ 66.1 16,606 NURISTAN 77.3 15,015 PAKTIKA 77.8 26,538 PAKTYA 23.1 10,522 PARWAN 30.8 62,189 SAMANGAN 76.1 39,905 SARI PUL 67.7 87,783 TAKHAR 50.1 88,840 URUZGAN 80.1 127,342 WARDAK 11.0 13,092 ZABUL 56.1 31,559 URBAN 28.6 319,671 RURAL 49.7 1,485,585 NATIONAL 43.9 1,805,256 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number NANGARHAR NURISTAN GHOR KABUL KABUL NIMROZ NURISTAN HERAT PAKTYA PAKTIKA JAWZJAN KANDAHAR TAKHAR PAKTYA FARYAB PARWAN KHOST KAPISA BADAKHSHAN GHAZNI MOTHERS WITH CHILDREN UNDER 5 YEARS OF AGE THAT DO NOT ALWAYS WASH THEIR OWN HANDS WITH SOAP/ASH AFTER THEIR OWN OR CHILD DEFECATION PROVINCE PERCENT NUMBER BADAKHSHAN 96.1 141,017 BADGHIS 92.9 57,743 BAGHLAN 92.8 121,384 BALKH 95.3 125,407 BAMYAN 89.2 77,928 FARAH 85.6 49,675 FARYAB 97.8 154,370 GHAZNI 80.4 163,516 GHOR 99.3 107,846 HERAT 90.3 248,037 HILMAND 92.6 157,198 JAWZJAN 98.6 58,478 KABUL 58.1 332,257 KANDAHAR 79.8 211,162 KAPISA 84.3 40,540 KHOST 68.0 63,771 KUNAR 88.1 50,019 KUNDUZ 77.0 71,228 LAGHMAN 95.8 60,422 LOGAR 83.0 51,278 NANGARHAR 58.0 112,108 NIMROZ 81.6 20,403 NURISTAN 98.8 18,695 URUZGAN 95.4 151,691 PAKTIKA 86.3 28,443 PAKTYA 62.8 29,047 PARWAN 93.4 188,387 SAMANGAN 83.8 43,605 SARI PUL 95.0 123,398 TAKHAR 63.3 111,535 WARDAK 78.3 93,765 ZABUL 95.5 53,116 URBAN 67.8 741,365 RURAL 87.0 2,576,103 NATIONAL 81.8 3,317,468 82 83 PROGRESS OF PROVINCES 2003 PROVINCE PERCENT BADAKHSHAN 96.1 BADGHIS 92.9 BAGHLAN 92.8 BALKH 95.3 BAMYAN 89.2 FARAH 85.6 FARYAB 97.8 GHAZNI 80.4 GHOR 99.3 HERAT 90.3 HILMAND 92.6 JAWZJAN 98.6 KABUL 58.1 KANDAHAR 79.8 KAPISA 84.3 KHOST 68.0 KUNAR 88.1 KUNDUZ 77.0 LAGHMAN 95.8 LOGAR 83.0 NANGARHAR 58.0 NIMROZ 81.6 NURISTAN 98.8 PAKTIKA 86.3 PAKTYA 62.8 PARWAN 93.4 SAMANGAN 83.8 SARI PUL 95.0 TAKHAR 63.3 URUZGAN 95.4 WARDAK 78.3 ZABUL 95.5 URBAN 67.8 RURAL 87.0 NATIONAL 81.8 Water & Sanitation 0 0 50 60 70 80 90 100 50 60 70 80 90 100 Access to MediaPROGRESS OF PROVINCES 2003 84 85 ACCESS TO MEDIA ANALYSIS • One in three households have access to a radio while in households where a radio is available, women are listening to it. Access is a little higher in the major cities only. 'Other urban areas' are very similar to 'rural areas' in this respect. The rate ranges from about 50 per cent to 80 per cent in different provinces. ACTION POINTS • Media messages targeted at women should be broadcast during early hours of the morning and late in the evening. P H O TO : U N IC E F A FG A /0 01 46 S /N O O R A N I 86 87 PROGRESS OF PROVINCES 2003 Access to Media BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Households without a radio <15% 15%—30% 30%—45% >45% BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KANDAHAR PAKTIKA GHOR KABUL KABUL PAKTYA SAMANGAN HERAT HILMAND ZABUL NIMROZ FARYAB ZABUL NURISTAN SARI PUL SARI PUL NANGARHAR NIMROZ NURISTAN PARWAN HOUSEHOLDS WITHOUT A RADIO PROVINCE PERCENT NUMBER BADAKHSHAN 47.1 57,517 BADGHIS 49.3 32,750 BAGHLAN 49.6 55,961 BALKH 32.5 35,515 BAMYAN 51.7 39,883 FARAH 42.6 20,020 FARYAB 50.1 69,690 GHAZNI 24.8 47,255 GHOR 57.6 52,171 HERAT 27.9 77,721 HILMAND 18.4 18,911 JAWZJAN 49.3 28,584 KABUL 18.4 98,396 KANDAHAR 12.6 25,430 KAPISA 27.8 11,360 KHOST 36.5 21,675 KUNAR 38.4 14,696 KUNDUZ 49.3 38,812 LAGHMAN 31.6 15,685 LOGAR 25.8 12,565 NANGARHAR 21.4 26,711 NIMROZ 56.6 10,697 NURISTAN 52.8 9,265 PAKTIKA 24.2 5,506 PAKTYA 22.6 8,077 PARWAN 36.5 62,189 SAMANGAN 57.6 28,303 SARI PUL 54.1 62,451 TAKHAR 40.2 60,334 URUZGAN 37.9 57,094 WARDAK 23.6 23,104 ZABUL 21.2 8,452 URBAN 25.0 258,617 RURAL 36.5 878,165 NATIONAL 33.0 1,136,782 88 89 PROGRESS OF PROVINCES 2003 Access to Media BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Households where women do not listen to radio <15% 15%—30% 30%—45% >45% BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number KANDAHAR PAKTIKA SAMANGAN KABUL HILMAND NIMROZ SARI PUL HERAT ZABUL ZABUL GHOR FARYAB KABUL PAKTYA KUNDUZ SARI PUL NANGARHAR NURISTAN FARYAB PARWAN HOUSEHOLDS WHERE WOMEN DO NOT LISTEN TO RADIO PROVINCE PERCENT NUMBER BADAKHSHAN 49.9 59,294 BADGHIS 47.9 31,888 BAGHLAN 50.4 56,565 BALKH 36.7 40,210 BAMYAN 52.9 35,923 FARAH 44.8 21,049 FARYAB 54.1 74,424 GHAZNI 25.1 43,879 GHOR 56.0 49,037 HERAT 29.1 79,652 HILMAND 18.9 19,502 JAWZJAN 53.7 30,609 KABUL 20.2 108,230 KANDAHAR 15.4 31,122 KAPISA 27.8 11,212 KHOST 35.4 20,798 KUNAR 35.9 13,145 KUNDUZ 54.5 42,501 LAGHMAN 32.8 16,219 LOGAR 30.4 14,875 NANGARHAR 21.7 26,972 NIMROZ 40.0 5,678 NURISTAN 53.2 9,298 PAKTIKA 21.8 4,803 PAKTYA 22.3 7,929 PARWAN 36.8 61,279 SAMANGAN 60.7 29,304 SARI PUL 56.2 64,959 TAKHAR 40.5 60,611 URUZGAN 35.4 50,377 WARDAK 22.7 21,179 ZABUL 19.3 7,289 URBAN 26.5 272,767 RURAL 37.4 877,046 NATIONAL 34.1 1,149,813 CHILD RIGHTS ANALYSIS • Only 6 per cent of the under-five have a Tazkera, a certificate which guarantees citizenship. The rate is a little higher in the major cities (17 per cent). There is no significant gender gap. • One in every 20 children do not live with both of their parents. • 7 per cent of girls aged 15-19 years are currently in union (married). ACTION POINTS • Conduct campaigns to register all births of under 5 year old. • Re-establish community-based birth registration. • Identify orphans and monitor living arrangements to ensure their access to basic living conditions and reduce risk of denial of their rights. Child Rights 91 PROGRESS OF PROVINCES 2003 90 P H O TO : U N IC E F A FG H A N IS TA N /C A R W A R D IN E CHILDREN NOT LIVING WITH BOTH PARENTS Child Rights 93 PROGRESS OF PROVINCES 2003 92 NATIONALRURALURBAN 6.0 5.6 5.5 5.5 5.2 5.4 0 1 2 3 4 6 5 Boys Girls BOYS GIRLS TOTAL Percent Number Percent Number Percent Number URBAN 5.6 108,259 6.0 110,125 5.8 218,384 RURAL 5.5 276,200 5.2 238,874 5.4 515,074 NATIONAL 5.5 384,459 5.4 348,999 5.5 733,458 CHILDREN AGED UNDER 5 YEARS THAT CITIZENSHIP CARD (TAZKERA) NOT SHOWN PROVINCE BOY GIRL TOTAL GIRL/BOY PERCENT Number PERCENT Number PERCENT Number RATIO BADAKHSHAN 97.8 78,170 98.4 68,399 98.1 146,569 1.01 BADGHIS 98.7 28,933 99.3 33,981 99.0 62,914 1.01 BAGHLAN 97.5 63,409 97.9 64,617 97.7 128,027 1.00 BALKH 98.5 69,487 98.9 63,393 98.7 132,880 1.00 BAMYAN 99.4 44,692 99.7 44,267 99.5 88,959 1.00 FARAH 96.6 31,900 97.6 27,129 97.1 59,030 1.01 FARYAB 99.4 81,787 98.6 75,476 99.0 157,263 0.99 GHAZNI 98.5 100,885 98.0 108,385 98.2 209,270 0.99 GHOR 99.7 55,674 99.3 56,227 99.5 111,901 1.00 HERAT 89.9 122,891 95.4 136,717 92.7 259,608 1.06 HILMAND 98.0 97,313 98.7 72,296 98.3 169,609 1.01 JAWZJAN 88.5 26,678 86.3 26,917 87.4 53,595 0.98 KABUL 76.9 230,812 81.9 239,081 79.4 469,892 1.07 KANDAHAR 98.9 144,903 98.8 125,112 98.8 270,015 1.00 KAPISA 85.8 21,012 87.6 20,938 86.7 41,950 1.02 KHOST 98.2 48,110 98.3 44,101 98.3 92,211 1.00 KUNAR 97.3 29,391 99.0 26,762 98.1 56,154 1.02 KUNDUZ 99.5 46,891 99.3 45,833 99.4 92,724 1.00 LAGHMAN 98.6 32,439 99.2 32,706 98.9 65,145 1.01 LOGAR 73.4 24,207 73.2 21,435 73.3 45,642 1.00 NANGARHAR 96.6 100,688 97.8 95,324 97.2 196,011 1.01 NIMROZ 97.2 13,635 97.7 11,027 97.4 24,661 1.01 NURISTAN 97.4 9,758 98.3 9,495 97.8 19,254 1.01 PAKTIKA 96.9 18,258 97.9 15,443 97.4 33,701 1.01 PAKTYA 83.4 19,711 87.7 20,081 85.5 39,792 1.05 PARWAN 80.4 82,211 82.9 84,031 81.7 166,242 1.03 SAMANGAN 97.7 25,503 99.6 26,603 98.7 52,106 1.02 SARI PUL 99.3 70,226 100.0 60,445 99.6 130,671 1.01 TAKHAR 99.7 90,778 98.5 88,287 99.1 179,064 0.99 URUZGAN 99.7 90,958 100.0 69,688 99.8 160,646 1.00 WARDAK 97.9 61,611 97.3 56,028 97.6 117,639 0.99 ZABUL 96.6 30,861 97.2 23,883 96.8 54,744 1.01 URBAN 87.2 503,196 89.9 492,492 88.5 995,688 1.03 RURAL 95.4 1,490,588 96.0 1,401,616 95.7 2,892,204 1.01 NATIONAL 93.2 1,993,784 94.4 1,894,108 93.7 3,887,892 1.01 BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number LOGAR NURISTAN URUZGAN KABUL KABUL NIMROZ SARI PUL KANDAHAR PARWAN PAKTIKA BAMYAN HERAT PAKTYA PAKTYA GHOR GHAZNI KAPISA KAPISA KUNDUZ NANGARHAR Child Rights 95 PROGRESS OF PROVINCES 2003 94 GIRLS 15-19 YEARS OF AGE CURRENTLY IN UNION PROVINCE PERCENT NUMBER BADAKHSHAN 9.4 14,213 BADGHIS 10.7 8,495 BAGHLAN 7.4 10,065 BALKH 5.8 6,718 BAMYAN 9.6 8,486 FARAH 12.9 6,829 FARYAB 8.1 14,727 GHAZNI 8.9 21,377 GHOR 9.0 9,771 HERAT 9.8 20,151 HILMAND 4.5 5,122 JAWZJAN 4.0 3,097 KABUL 6.7 9,856 KANDAHAR 6.7 8,888 KAPISA 5.8 2,821 KHOST 7.9 6,390 KUNAR 8.0 3,303 KUNDUZ 4.8 3,137 LAGHMAN 4.7 2,763 LOGAR 7.2 4,527 NANGARHAR 8.4 11,100 NIMROZ 7.9 1,552 NURISTAN 8.2 1,709 PAKTIKA 5.6 1,822 PAKTYA 2.6 1,260 PARWAN 5.3 9,708 SAMANGAN 4.9 2,600 SARI PUL 7.2 10,534 TAKHAR 6.7 12,731 URUZGAN 6.7 11,755 WARDAK 5.8 7,316 ZABUL 7.2 3,955 URBAN 6.1 69,305 RURAL 7.3 216,335 NATIONAL 7.0 285,640 BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Girls 15-19 years of age currently in union <5% 5%—7% 7%—10% >10% BEST 5 PROVINCES WEAKEST 5 PROVINCES By Percent By Number By Percent By Number PAKTYA PAKTYA FARAH GHAZNI JAWZJAN NIMROZ BADGHIS HERAT HILMAND NURISTAN HERAT FARYAB LAGHMAN PAKTIKA BAMYAN BADAKHSHAN KUNDUZ SAMANGAN BADAKHSHAN TAKHAR Population & DemographyPROGRESS OF PROVINCES 2003 96 97 POPULATION & DEMOGRAPHY ANALYSIS • MICS estimates the total population of Afghanistan to be 24.5 million • 57 per cent of the population is below 18 years of age. There are more men than women. • The average household size is seven, with children under 18 accounting for 4 out of 7 people in the household. • The population of Afghanistan is increasing rapidly. The total fertility rate is estimated as 6.3 per woman. The overall population growth rate over the last 24 years of conflict is estimated as 2.5 per cent per year. The limited access to health facilities means that many women are repeatedly exposed to the risk of disease, disability and death during pregnancy, labour, birth and post-natal recovery. Maternal mortality is assumed to be one of the highest in the world. • 3.3 per cent of households are headed by a female, indicating the male member might be dead or displaced. • Under-five mortality is estimated at 172 and infant mortality at 115 per 1,000 live births. This is one of the highest in the world. P H O TO : U N IC E F A FG A /0 03 89 S /T IN TS M A N POPULATION AGE DISTRIBUTION POPULATION PYRAMID 98 99 PROGRESS OF PROVINCES 2003 20 20 percent 15 1510 105 50 75+ 70—74 65—69 60—64 55—59 50—54 45—49 40—44 35—39 30—34 25—29 20—24 15—19 10—14 5—9 0—4 75+ 70—74 65—69 60—64 55—59 50—54 45—49 40—44 35—39 30—34 25—29 20—24 15—19 10—14 5—9 0—4 Male Female Population & Demography POPULATION <18 YEARS POPULATION AGE DISTRIBUTION AGE GROUP MALE FEMALE PERCENT NUMBER PERCENT NUMBER 0 3.5 423,099 3.5 407,607 1 3.2 390,156 3.1 362,888 2 3.6 441,973 3.4 400,454 3 3.7 450,477 3.8 447,557 4 3.6 441,989 3.4 402,573 0-4 17.7 2,147,694 17.3 2,021,078 5-9 18.1 2,204,060 17.8 2,086,130 10-14 15.2 1,845,461 14.2 1,660,626 15-19 10.2 1,239,337 10.6 1,236,986 20-24 6.9 838,145 8.1 946,646 25-29 5.3 649,951 6.7 785,270 30-34 4.4 539,481 5.3 617,042 35-39 4.1 498,284 5.0 589,433 40-44 4 480,977 3.9 454,300 45-49 3.2 390,966 2.5 294,142 50-54 3.0 362,765 3.9 452,003 55-59 1.8 217,186 1.5 172,296 60-64 2.6 313,336 1.6 186,287 65-69 1.2 144,160 0.5 64,105 70-74 1.4 165,927 0.6 71,881 75+ 1.0 125,071 0.5 50,541 MALE FEMALE TOTAL Percent Number Percent Number Percent Number Urban 55.7 1,936,241 54.9 1,865,456 55.3 3,801,697 Rural 57.9 5,027,862 55.9 4,636,170 56.9 9,664,032 National 57.3 6,964,103 55.6 6,501,626 56.5 13,465,729 Population & Demography BADAKHSHAN TAKHAR JAWZJAN BALKH KUNDUZ FARYAB SAMANGAN BAGHLAN SARI PUL NURISTAN BADGHIS PARWAN HERAT KUNAR BAMYAN GHOR LAGHMAN KAPISA KABUL WARDAK NANGARHAR URUZGAN LOGAR PAKTYA GHAZNI KHOST FARAH PAKTIKA HILMAND ZABUL KANDAHAR NIMROZ Total fertility rate data not available <6 6—7 >7 TOTAL FERTILITY RATE PROVINCE TFR BADAKHSHAN 5.97 BADGHIS 5.43 BAGHLAN 6.45 BALKH 6.21 BAMYAN 5.79 FARAH 7.03 FARYAB 5.33 GHAZNI 5.19 GOHR 7.28 HERAT 5.57 HILMAND NA JAWZJAN 5.29 KABUL 6.00 KANDAHAR 7.02 KAPISA 5.44 KHOST 6.80 KUNAR 7.88 KUNDUZ 6.42 LAGHMAN 7.86 LOGAR 6.18 NANGARHAR NA NIMROZ 6.74 NURISTAN 5.62 PAKTIKA 7.36 PAKTYA 6.48 PARWAN 6.74 SAMANGAN 7.04 SARI PUL 5.60 TAKHAR 5.98 URUZGAN 6.29 WARDAK 5.45 ZABUL 5.97 URBAN 6.00 RURAL 6.38 NATIONAL 6.26 100 101 Population & Demography PROGRESS OF PROVINCES 2003 102 FEMALE HEADED HOUSEHOLDS PERCENT NUMBER URBAN 5.0 52,029 RURAL 2.5 61,046 NATIONAL 3.3 113,075 NATIONALRURALURBAN 5.0 2.5 3.3 0 1 2 3 4 5% INFANT MORTALITY RATE 0 30 15 60 45 90 75 120 105 150 135 URBAN RURAL NATIONAL 97 121 115 de at hs p er th ou sa nd UNDER-FIVE MORTALITY RATE DEATHS PER 1000 LIVE BIRTH URBAN 97 RURAL 121 NATIONAL 115 0 40 20 80 60 120 100 160 140 200 180 URBAN RURAL NATIONAL 142 183 172 de at hs p er th ou sa nd DEATHS PER 1000 LIVE BIRTH URBAN 142 RURAL 183 NATIONAL 172 103 105 PROGRESS OF PROVINCES 2003 104 P H O TO : U N IC E F A FG A /0 03 74 S / Methodology PROGRESS OF PROVINCES 2003 106 107 METHODOLOGY SAMPLING FRAMEAvailability of a sampling frame was a major constraint in planning the survey. There were two sources of data for a sampling frame, firstly the 1979 Population Census data from the Central Statistics Office (CSO) and secondly the National Immunization Day (NID) coverage data from Ministry of Health/WHO and UNICEF. Both the sources have their own limitations and advantages. The 1979 Census data are outdated and widely affected with displacement due to war, fertility and mortality. However, the data were organized for use in any purpose. On the other hand, the NID data were based on the NID coverage and therefore could be considered as the most up to date one. But coverage data of some areas were incomplete and format of the data was not standardized for all the provinces. Standardization would need some time to make it user-friendly. Moreover, the area boundaries covered by volunteers were not well defined. A comparative analysis was carried out to address the sampling frame issue and it was apparent that despite the constraints the census data could be used. A sampling design and the related survey methodology was, henceforth, developed for MICS in Afghanistan in 2003. However, NID data and UN Habitat data were used for the major cities and Nuristan Province as the detailed breakdown of the population of these areas were not available in the 1979 census. SAMPLE SIZE Of the indicators where provincial level estimates has been provided, the indicators on coverage of immunization against different diseases have the rarest target group. The concerned target group for these indicators is 12-23 months children. It is estimated from MICS-2000 that an average of 1.3 under five children are available in one household, which translated to a figure of 0.26 for 12-23 months children. The sample size for an estimate of immunization coverage for major antigens at provincial level has been computed using the standard statistical formula. A precision level of —10% of the estimated prevalence rate was considered as reasonable at provincial level. Aggregating the sample at national level would result in a much higher precision of within —2%. The sampling error would be much lower at provincial level (within —5-6%) for the indicators for which the target groups are not very rare, e.g., diarrhoea in under-five children, enrollment among school-age children, safe water use by households, assistance in last delivery etc. However, the optimum sample size was estimated to be 138-144 children aged 12-23 months with assumed prevalence of immunization requirement. at 40-60% and a design effect of 1.5. This number translates to 553 households at provincial level as the Methodology PROGRESS OF PROVINCES 2003 108 109 SAMPLE DESIGN A two-stage cluster sampling strategy was decided for the survey where villages were treated as the primary sampling unit (PSU). The number of PSUs selected from each province was decided as 20. This again translates to a number of 27.5 households per PSU or cluster. Clusters were defined as the compact area segment of an average of 55 households in each selected PSU. The six major cities were treated as a separate domain. Hence, they were separated out from the respective provinces and 20 clusters were selected for each of these cities, except Kabul where 25 clusters were selected to account for the relatively larger population and possible heterogeneity. SELECTION OF HOUSEHOLDS Every selected village was partitioned into several equal segments of roughly 55 households each. Segments were numbered according to a prescribed fashion, starting from southeast corner and moving anti-clockwise. The random segment was selected for survey and every alternative household was interviewed, starting from the 1st or 2nd household. STRATIFICATION AND POST-STRATIFICATION Stratification for the survey was at two levels: 1. 32 provinces as both strata and study domain. The six provinces containing the major cities only covered rural areas; 2. Six major cities as strata and study domain; 3. Post-stratification was done for the 26 provinces where urban and rural areas were not separated at the time of sampling. This post stratification separated the data of the provincial urban areas (defined as district of provincial capitals from the province as a whole. As a result, estimates could be obtained for: 1. All 32 provinces (urban + rural) 2. Six rural provinces, six major cities 3. National Metro cities, other urban areas (districts of 26 provincial headquarters) and 4. National Urban, National Rural, National (Urban + Rural) However, this report provides data for 32 provinces (Urban + Rural), National Urban, National Rural and National (Urban + Rural) LIMITATIONS Insecurity and denial of access prevented visits to a few locations - about 1% of all areas and, hence, should not affect the overall data. For example, in Logar province, 19 of the sampled 20 clusters could be surveyed. It is estimated that the 1979 census village list does not contain 10% of existing villages. Assuming that the missing villages have the same characteristics as those included in the census list, this survey gives a proper representation of the country. Furthermore, since only fixed populations were included in the sample frame, nomadic and internally displaced populations (unless the settlements are long-term and recorded in 1979 census or recent NID coverage data) are not covered in this survey. IMPLEMENTATION The survey was implemented with the Central Statistics Office (CSO) of Transitional Government of Afghanistan with technical assistance from UNICEF. Different national and international NGOs provided support in the field implementation in different areas. A external group of consultants provided technical support. The different stages of the survey include: 1. Formation of a technical committee; 2. Questionnaire and manual preparation; 3. Sample village selection; 4. Training of trainers-cum-quality control officers (QCO); 5. Training of enumerators and supervisors; 6. Field data collection; 7. Data editing and coding; 8. Data entry and checking; 9. Preliminary analysis and sharing with partners; and 10. Finalization of the results. FORMATION OF A TECHNICAL COMMITTEE A technical committee was formed at the Central Statistics Office (CSO) to provide overall guidance to the project. Along with the members from CSO, members of the committee included representatives from different line ministries, development partners and Kabul University. The methodology and the questionnaire were discussed with the committee in more than one meeting before approval. Some of the representatives of the committee were also present in different stages of the training. DEVELOPING QUESTIONNAIRE AND INSTRUCTION MANUAL A household questionnaire was prepared for the survey with five parts: part-A and part-E for household information with household member listing, part-B for under-five children, part-C for 7-17 years children and part-D for ever married women. Indicator selection was based on UNICEF global list of indicators for assessing the Situation of Children and Women, Medium Term Strategic Plan (MTSP) and the Convention on Rights' of the Child (CRC). Some country specific needs were also addressed in the questionnaire along with some basic demographic and social features. Discussions were held with different UNICEF The draft questionnaire was formatted initially in English through a month-long field-testing in Bangladesh. sections and other partners in the line ministries, especially the Ministry of Health, and other development partners. Methodology PROGRESS OF PROVINCES 2003 110 111 A detailed instruction manual was prepared for all the field activities. The household listing part of the manual included all the required instructions. The data collection part included interviewing technique, indicator definitions along with the options, administering the questions, handling difficult responses, probing techniques, recording of responses, etc. for each of the questions. An event calendar mentioning major events of the country, to ensure accuracy in age reporting, was developed by merging all known event calendars from previous surveys and adding additional information in collaboration with the Central Statistics Office (CSO) and participants of the training of trainers. The draft questionnaire and the manual were discussed and field-tested in a 3-week training workshop for the trainers from each of six zones of the country. It was field tested five times in more than 150 households. A review of experiences was conducted and consensus of all 31 participants about the conceptual translation of each word (Dari and Pashtu) in the questionnaire and the manual was reached. TRAINING OF TRAINERS A total of 20 people from the Central Statistics Office (CSO), eight people from UNICEF zonal offices and three people from the Ministry of Health were selected to participate in the training of trainers (ToT). All of them had required qualifications and previous experience of fieldwork in Afghanistan. Most of them were conversant in English. The ToT was organized at UNICEF- Kabul and directly supervised by the chief consultant. The resource persons were the chief consultant and other external consultants with MICS experience. The main lectures were in English followed by the discussions in both local languages and English. The duration of the ToT was three weeks with five field tests. Attempts were made to make each participant fully conversant in the whole methodology through extensive discussions on every question, related concepts and repeated field testing. Finally the participants worked through the translation of the questionnaire and instruction manual. Based on the performance, a total of 12 people from the participants were selected as trainers-cum-QCOs (Quality Control Officers) and another eight were selected as QCOs. TRAINING OF ENUMERATORS AND SUPERVISORS Training was arranged at UNICEF's zonal level for the enumerators and supervisors. The zones are Kabul (includes Jalalabad), Mazar-e-Sharif (includes Kunduz), Herat, and Kandahar. It was arranged in two phases. In the first phase, Kabul training was organized where all the international consultants were involved. In the second phase, the external consultants were divided between the three other location to provide technical guidance and training monitoring. There were about 30-40 participants in each batch. At least four trainers were made available to run the training programme in each location. The external consultants acted as master trainers and monitored the training classes to maintain the quality and the consistency i.e., the interpretations remain same in all the classrooms for each question (verbatim training). The duration of the training was seven-eight days including two field-tests. The external consultants organized a test at the end of the training. The local trainers examined the scripts. The participants who obtained at least 75% of the scores were selected for the fieldwork. FIELD IMPLEMENTATION Field work had two components: household listing and data collection. The first part was for identification of selected villages and listing of households. The specific activities included: (i) identification of selected villages, (ii) a quick but complete count of households through discussion with different elders, (iii) completing sketch map of the village, segmentation of the village into several segments of 55 households, (iv) random selection of one segment, (v) listing all the households in the selected segment in a prescribed form, (vi) contacting and local leaders and household members for social mobilization for survey data collection. The second part was the main data collection. In each province, two teams of five members carried out both the listing of households and data collection using a prescribed listing form and data collection form or questionnaire. An average of 3.5 days were allotted to complete the task in each cluster including travel. Some extra people were trained and put on standby for any possible dropout from the teams. One UNICEF staff member at each zonal office was the focal point for the survey. FIELD TEAM There were two teams for each province or major city for data collection. Each team had one supervisor and two pairs of enumerators (male and female with some socially acceptable relationship). In each cluster, they spent one day for listing operation and two days to collect data from an average of 28 households. RECRUITMENT OF FIELD PERSONNEL UNICEF institutions, universities, schools and health centres etc. zonal offices recruited local field staff through the CSO and NGOs. They were mostly from the different national Methodology PROGRESS OF PROVINCES 2003 112 113 QUALITY CONTROL Twenty-eight national Quality Control Officers were placed across the country (nearly one per every province) to oversee provincial data collection teams. In addition, one external consultant was employed in each of six UNICEF zone offices to support the local QCOs and the UNICEF survey focal point. A standard guideline was prepared for the quality control of the field data collection and additional training was arranged for them. DATA PROCESSING Editing and coding: thirteen people were recruited for the data editing and coding and received a hands-on training. Two edit- verifiers cross-checked coded questionnaires. Two external consultants supervised the whole process and cross-checked randomly selected filled-in questionnaires. Data entry and Checking: a data entry software with in-built range checks, internal consistency/non-response checks to minimize wrong entry was developed in MS-ACCESS by the consultant group. A total of 19 people were recruited for the data entry in Kabul. Seventeen computers and a power generator were installed for the purpose at CSO. Two external data entry supervisors supervised the work and also randomly cross-checked the entered data in order to estimate the extent of entry error, which was found to be 2-3%. After completion of data entry, a number of logical and range checks were performed to screen out the mismatched answers, and fixed by checking the questionnaires. After thorough cleaning of data it was ready for analysis. DATA ANALYSIS Data were analyzed by the chief consultant and his group using different software, mainly SPSS. Analysis focused on provincial estimations disaggregated by gender and socioeconomic classes as suggested by the technical committee. The analysis also included the calculation of confidence intervals (CIs) using an appropriate statistical method for cluster sampling. A separate software was developed for the purpose. NON-RESPONSE Non-response rate differs for different questions due to factors such as memory lapse, counting problems and understanding of the questions. However, the rate of non-response, including inconsistent response, which was also treated as non-response during the editing operation, was generally around 2-3%. TIME-FRAME ACTIVITY DATE Survey Design, Sampling, Questionnaire Preparation Mar 2003 to May 2003 Training of Trainers and Field Staff May 2003 to Jun 2003 Field Household Listing and Data Collection Jun 2003 to Jul 2003 Data Entry, Coding and Editing Jul 2003 to Sep 2003 Analysis and Report Preparation Oct 2003 to Apr 2004 Annexeures—Number of households covered by provinces and citiesPROGRESS OF PROVINCES 2003 114 115 NUMBER OF HOUSEHOLDS COVERED BY PROVINCES AND CITIES PROVINCE / CITY HOUSEHOLD BADAKHSHAN 551 BADGHIS 545 BAGHLAN 566 BALKH 520 MAZAR CITY 530 BAMYAN 546 FARAH 504 FARYAB 533 GHAZNI 515 GHOR 491 HERAT 533 HERAT CITY 555 HILMAND 523 JAWZJAN 488 KABUL 568 KABUL CITY 817 KANDAHAR 542 KANDAHAR CITY 577 KAPISA 552 KHOST 479 KUNAR 567 KUNDUZ 564 KUNDUZ CITY 623 LAGHMAN 562 LOGAR 530 NANGARHAR 601 JALALABAD CITY 638 NIMROZ 579 NURISTAN 537 PAKTIKA 557 PAKTYA 482 PARWAN 564 SAMANGAN 492 SARI PUL 461 TAKHAR 542 URUZGAN 538 WARDAK 516 ZABUL 518 Total Household: 20,806 ANNEXEURES Annexeures—Confidence IntervalsPROGRESS OF PROVINCES 2003 116 Mothers’ last delivery taken place at home (in last two years) Last delivery of mother assisted by unskilled birth attendant (in last two years) Ante-natal consultations not taken from doctor /trained birth attendent during last pregnancy Ever married women under 50 years of age not aware of a method to delay pregnancy Married women under 50 years of age currently not using a method to delay pregnancy Children under 5 years of age not received BCG immunization Children aged 12-23 months that have not received 3 doses of DPT Immunization CONFIDENCE INTERVALS Both Sexes Both Sexes NATIONAL URBAN 4.7 4.3 3.6 5.2 3.2 2.4 6.0 4.6 RURAL 0.8 1.0 1.2 1.8 0.8 2.5 2.4 2.9 NATIONAL 1.4 1.4 1.3 1.9 1.0 1.9 2.4 2.4 PROVINCIAL BADAKHSHAN 0.8 1.5 3.7 2.4 1.7 6.5 13.4 12.5 BADHGIS NAV 8.2 3.8 10.7 1.3 9.4 16.8 15.8 BAGHLAN 1.7 2.8 3.3 3.8 3.0 8.9 6.6 8.1 BALKH 2.1 2.8 3.9 9.6 3.3 9.3 11.3 13.0 BAMYAN 2.1 3.8 4.6 7.7 2.9 10.4 3.6 12.5 FARAH 2.7 4.8 3.2 14.3 6.3 13.2 14.9 17.5 FARYAB 1.8 1.9 4.7 2.7 2.1 17.3 15.7 17.9 GHAZNI 3.0 3.6 5.8 4.9 1.9 9.3 7.4 13.5 GHOR 1.5 6.1 1.3 2.8 1.8 13.9 6.8 9.6 HERAT 3.6 6.7 6.4 9.0 5.9 9.3 10.5 10.0 HILMAND 2.3 2.3 3.9 9.4 1.5 13.0 4.2 16.0 JAWZJAN 5.0 4.9 4.5 4.0 2.4 8.6 16.6 16.9 KABUL 7.6 7.3 6.0 9.4 5.4 3.6 9.7 7.9 KANDAHAR 4.7 4.3 3.5 7.3 4.2 6.7 5.4 8.2 KAPISA 1.8 7.7 7.8 6.7 4.5 11.4 8.5 12.4 KHOST 8.8 8.8 8.1 2.4 1.0 9.3 9.8 8.6 KUNAR 1.8 2.5 2.4 13.1 0.9 7.2 15.1 14.8 KUNDUZ 1.3 2.6 3.8 7.6 4.0 9.4 5.9 5.4 LAGHMAN 4.3 3.9 7.5 12.9 3.1 8.4 14.8 14.2 LOGAR 4.3 3.7 6.8 7.9 4.8 5.2 11.3 11.9 NANGARHAR 4.3 4.6 9.1 8.8 3.5 5.6 9.4 6.1 NIMROZ 4.4 5.3 7.8 12.2 5.4 13.1 14.1 14.3 NURISTAN NAV 1.8 2.1 7.6 0.6 13.1 11.4 12.8 PAKTIKA 0.9 2.0 1.7 4.9 0.6 6.6 5.4 9.2 PAKTYA 3.0 6.4 5.0 6.0 1.8 9.0 15.2 12.4 PARWAN 2.1 2.9 4.2 5.0 4.3 10.9 13.0 10.3 SAMANGAN 3.2 8.0 4.3 3.8 2.9 12.6 6.0 17.3 SARI PUL NAV 1.4 2.5 10.1 1.9 12.4 12.1 17.3 TAKHAR 1.0 0.7 4.1 2.5 0.6 15.3 13.0 14.3 URUZGAN 0.6 3.8 1.6 8.2 2.3 10.1 3.9 8.4 WARDAK 2.8 4.0 3.8 10.5 2.8 4.7 12.1 14.0 ZABUL NAV 1.1 1.5 3.2 1.5 14.3 4.5 7.7 AVERAGE CI PER PROVINCE MEAN 3.8 4.9 5.3 8.1 3.6 9.6 10.6 11.8 MEDIAN 2.9 4.2 4.4 8.1 3.2 9.3 11.3 12.4 Children aged 9-59 months that have not received measles immunization Diarrhoea prevalence in last 15 days (<5 years children) Children <5 years not received increased fluid or feeding during diarrhoea ORS/home-made fluid not given to <5 years children during diarrhoea More liquid not given to <5 years children during diarrhoea Children aged 12-23 months that have not received 3+ doses of polio immunization Both Sexes Both Sexes Boy Girl Both Sexes Boy Girl Both Sexes Boy Girl Both Sexes Boy GirlBoth Sexes 117NAV = NOT AVAILABLE 2.1 2.7 3.0 3.1 5.8 6.2 6.5 4.2 4.7 6.2 5.8 6.1 6.5 2.4 1.4 1.6 1.7 2.8 3.3 3.6 2.5 2.8 3.2 2.8 3.3 3.6 1.8 1.3 1.4 1.5 2.6 3.0 3.2 2.2 2.4 2.9 2.6 3.0 3.1 7.4 6.8 7.6 7.3 18.3 18.4 18.1 14.3 15.6 14.6 18.3 18.3 18.7 11.9 6.0 7.6 7.1 9.1 14.5 11.1 9.3 12.1 9.5 10.1 15.2 12.2 12.9 6.4 9.0 6.4 12.3 13.6 14.2 10.9 11.7 12.7 12.4 13.7 13.7 8.4 6.7 6.0 8.9 6.6 8.2 11.0 8.4 10.9 12.9 6.2 7.6 11.5 8.7 4.4 5.7 6.2 10.0 15.1 12.7 6.6 13.9 8.3 10.6 14.8 12.7 8.6 3.8 5.2 6.5 10.0 12.0 12.0 6.8 14.4 10.3 11.0 13.2 12.0 16.4 7.6 8.7 8.3 15.7 17.9 16.5 8.0 10.9 10.9 15.4 17.6 16.5 9.3 2.7 4.4 3.2 14.5 18.3 18.7 15.9 14.5 18.5 14.5 18.3 18.7 15.1 4.7 6.0 5.8 7.9 13.7 11.3 9.0 16.3 13.1 8.5 13.9 13.4 7.3 3.2 4.3 4.2 9.7 11.7 13.3 8.9 10.1 12.2 9.6 11.7 13.0 8.4 5.3 3.9 7.8 20.2 24.4 25.2 18.1 19.0 24.9 19.8 24.4 24.6 7.5 6.6 9.0 9.0 7.2 8.0 10.2 8.6 10.7 10.6 6.6 8.0 9.8 3.4 4.9 5.4 5.3 9.5 9.8 11.1 6.4 7.3 9.8 9.5 9.7 11.0 7.2 6.5 7.0 6.9 10.0 11.7 11.6 8.5 10.5 11.0 10.0 11.7 11.7 9.6 4.5 7.9 7.2 10.3 13.3 10.8 6.4 9.3 8.2 10.3 13.3 10.8 11.2 6.3 6.6 8.0 13.2 13.6 15.2 5.0 6.1 8.3 13.5 13.6 15.7 5.0 4.5 5.2 6.1 11.0 10.6 13.2 4.2 5.2 4.0 11.1 10.9 13.2 7.8 5.3 5.2 7.5 10.2 9.7 13.8 9.2 11.6 12.4 10.8 9.9 14.4 7.0 4.2 7.4 6.5 11.1 12.2 12.4 4.2 5.4 6.8 11.1 12.2 12.4 2.2 7.8 8.4 8.4 10.5 14.3 11.2 9.5 11.3 12.9 11.4 16.1 11.2 4.5 6.1 6.7 6.2 9.8 11.9 10.2 4.6 4.7 5.7 9.9 11.9 10.4 13.9 6.5 8.9 5.6 11.3 14.2 15.2 14.8 15.2 15.7 9.7 11.5 15.4 15.8 9.5 10.1 10.0 6.6 9.4 8.6 16.4 14.7 19.9 6.6 9.4 8.6 5.9 4.5 4.7 7.1 7.6 7.3 15.5 6.1 8.1 10.0 7.6 7.3 15.5 7.3 4.1 5.5 6.0 10.0 14.5 11.3 7.7 13.0 11.1 10.0 14.5 11.3 11.1 7.0 8.0 7.7 10.5 13.0 12.9 9.5 11.4 9.9 10.3 12.6 12.9 7.9 7.1 7.3 9.0 11.9 12.5 17.3 12.5 13.4 17.8 10.7 12.2 15.7 8.3 6.4 7.0 8.2 11.0 15.9 11.9 13.0 16.8 15.7 11.2 16.0 11.9 8.3 7.4 8.3 10.0 10.3 12.5 10.7 10.6 9.4 13.2 10.3 12.9 11.0 15.4 9.0 9.1 10.9 16.8 17.2 21.2 13.1 13.6 19.1 17.0 17.4 21.6 7.2 7.6 8.2 7.6 11.0 10.8 15.8 15.3 13.8 20.2 11.0 10.8 15.8 14.5 4.1 4.9 4.8 8.8 13.0 14.3 6.1 8.1 6.8 8.8 13.0 14.3 8.8 5.9 6.9 7.2 11.3 13.4 14.2 9.5 11.3 12.5 11.4 13.4 14.3 8.4 6.2 7.0 7.1 10.5 13.3 13.2 9.0 11.4 12.3 10.9 13.2 13.4 NATIONAL URBAN RURAL NATIONAL PROVINCIAL BADAKHSHAN BADHGIS BAGHLAN BALKH BAMYAN FARAH FARYAB GHAZNI GHOR HERAT HILMAND JAWZJAN KABUL KANDAHAR KAPISA KHOST KUNAR KUNDUZ LAGHMAN LOGAR NANGARHAR NIMROZ NURISTAN PAKTIKA PAKTYA PARWAN SAMANGAN SARI PUL TAKHAR URUZGAN WARDAK ZABUL AVERAGE CI PER PROVINCE MEAN MEDIAN Annexeures—Confidence IntervalsPROGRESS OF PROVINCES 2003 118 More/same solid food not given to <5 years children during diarrhoea Acute respiratory infection prevalence in last 15 days (<5 years children): June-July 2003 Advice or treatment not sought from hospital/health centre during acute respiratory infection (<5 years children) Children aged 0-23 months that were not breastfed in first 23 hours Mothers of children 0-23 months who discarded colostrum before breastfeeding CONFIDENCE INTERVALS (continued) Children aged 6-59 months that have not received vitamin-A supplimentation Households consuming non-iodized salt Children aged 7-12 years not enrolled in school-2003 Children aged 7-12 years that worked for at least half-a-day (4-12 hours) for income Children aged 7-12 years that did domestic chores for at least half-a-day (4-12 hours) Children aged 1-4 years and 7-17 years that are disabled or impaired Both SexesBoth Sexes Boy GirlBoth Sexes Boy GirlBoth Sexes Boy GirlBoth Sexes Boy GirlBoth Sexes Boy GirlBoth Sexes Boy Girl Both Sexes Boy GirlBoth Sexes Boy GirlBoth Sexes Boy Girl1-4 Years 7-17 Years NAV = NOT AVAILABLE 119 0.7 0.6 1.5 2.6 2.7 2.4 3.5 1.6 1.9 1.7 1.5 1.6 2.2 0.4 0.3 1.8 1.3 2.3 2.4 2.8 0.7 1.0 0.9 1.2 1.2 1.5 0.4 0.3 1.4 1.2 1.8 1.9 2.2 0.7 0.9 0.8 0.9 1.0 1.2 1.2 1.1 3.3 1.4 9.3 8.8 11.9 1.2 2.3 NAV 2.4 2.2 3.6 2.4 1.7 2.9 6.9 8.8 15.0 4.7 3.4 5.0 4.3 6.3 6.4 8.3 2.4 1.6 13.7 1.8 10.2 9.8 12.7 2.8 4.3 2.2 3.7 4.6 5.0 1.5 1.1 3.3 0.4 10.0 7.9 14.0 3.5 5.1 4.3 5.2 5.2 5.9 2.6 1.9 7.2 3.1 13.9 14.3 15.3 7.0 9.1 8.1 3.5 2.3 5.7 2.2 1.6 2.7 14.3 13.3 15.2 14.3 1.5 2.7 1.1 4.3 5.3 4.3 3.3 0.8 16.5 2.4 12.1 12.2 15.7 4.7 5.1 6.8 6.4 7.1 6.2 1.2 1.1 8.4 1.4 11.2 11.9 12.8 2.5 4.2 2.0 4.9 6.0 5.9 1.0 0.6 8.3 7.0 10.8 11.5 12.8 1.3 2.0 1.0 2.3 3.0 2.9 0.7 0.8 2.3 7.3 6.8 4.8 10.8 2.2 2.4 3.2 4.7 4.4 6.1 1.6 0.3 8.4 10.1 8.2 11.3 5.7 4.7 6.1 3.2 4.3 5.5 8.8 2.0 1.1 4.0 1.2 11.1 9.5 15.8 4.2 4.5 5.4 4.3 5.4 5.2 1.2 1.0 2.2 4.6 4.8 4.6 5.6 2.7 3.1 2.7 2.6 2.3 3.7 0.8 0.4 3.2 5.3 6.3 8.9 4.6 2.1 2.8 2.2 4.5 4.1 5.4 0.8 1.0 6.9 2.1 10.0 7.4 15.4 2.7 3.0 2.8 3.8 3.5 4.7 0.8 0.5 9.8 4.3 11.7 14.5 11.4 3.9 5.4 4.3 3.7 4.2 5.2 1.4 1.3 4.7 0.8 9.2 8.9 12.9 0.6 1.1 0.7 2.5 2.0 5.6 0.6 0.6 10.0 0.6 9.3 9.3 11.0 2.2 3.8 1.4 2.9 3.2 3.6 2.4 0.7 5.6 0.9 10.7 10.9 12.4 4.0 4.1 4.2 3.9 1.9 8.2 1.4 1.0 2.2 4.4 10.6 10.9 12.7 3.8 5.9 4.2 5.7 5.5 7.8 0.6 0.5 1.6 0.8 7.7 8.1 8.8 2.0 2.7 1.9 2.8 3.1 4.5 1.1 1.0 5.2 5.0 13.6 14.4 14.2 2.2 3.6 1.3 4.6 2.9 8.0 2.6 1.6 15.1 6.2 15.1 17.4 13.3 2.5 3.6 1.4 6.1 7.8 7.8 0.6 0.5 2.2 2.6 6.9 11.8 2.9 2.4 3.5 1.3 2.6 3.6 4.6 1.5 1.0 5.9 1.2 7.8 7.8 10.1 1.1 1.7 0.8 3.3 4.0 5.2 2.9 1.4 4.6 2.1 9.8 9.3 12.3 2.1 2.6 2.6 4.6 4.4 5.9 1.8 0.9 7.4 25.7 13.8 13.6 17.0 8.9 10.9 7.9 1.4 2.0 3.4 1.3 1.4 6.0 1.6 8.0 8.9 12.1 3.8 5.1 4.3 6.4 7.1 6.9 0.7 0.9 5.6 1.1 11.1 10.0 12.9 3.7 5.9 2.5 6.7 7.5 7.7 2.5 2.6 11.3 1.7 11.3 13.0 9.9 3.6 6.3 3.1 5.2 4.7 7.3 2.3 1.7 3.3 4.2 7.2 6.6 10.0 3.3 5.5 1.1 7.1 6.9 8.1 1.4 0.5 8.1 1.6 8.3 13.3 1.9 2.6 3.0 4.1 10.1 9.7 12.1 1.5 1.1 5.8 4.2 9.6 10.1 11.0 3.0 4.2 3.0 4.6 4.7 6.2 1.4 1.0 4.6 2.4 9.8 9.7 12.0 2.7 3.9 2.6 4.3 4.2 5.8 NATIONAL URBAN 4.3 5.4 5.7 2.1 2.5 2.5 5.5 6.2 6.6 1.8 2.5 3.1 3.9 4.9 5.4 RURAL 2.7 3.3 3.5 1.3 1.5 1.4 3.0 3.5 3.4 1.2 1.4 1.7 2.3 2.7 2.7 NATIONAL 2.3 2.8 3.0 1.1 1.3 1.2 2.6 3.0 3.1 1.0 1.2 1.5 2.0 2.4 2.5 PROVINCIAL BADAKHSHAN 9.7 12.6 12.8 5.2 5.4 8.0 13.2 13.8 14.8 11.4 11.3 13.2 12.9 12.7 15.9 BADHGIS 8.0 8.9 11.2 5.9 7.6 7.1 10.0 13.3 11.9 4.3 5.4 5.9 10.4 14.6 10.3 BAGHLAN 9.4 11.4 11.4 4.9 6.3 6.6 6.0 7.3 6.2 9.3 12.7 12.2 8.8 12.8 10.8 BALKH 8.6 8.6 13.4 7.1 7.7 7.4 11.6 13.0 11.4 2.8 1.5 5.7 9.4 10.1 10.2 BAMYAN 9.9 13.8 10.3 4.4 5.4 6.0 14.4 15.0 14.4 5.0 8.8 7.1 10.3 12.9 12.5 FARAH 8.5 13.1 13.2 2.8 4.1 3.7 13.9 13.8 15.4 4.7 4.4 8.7 10.6 11.7 11.8 FARYAB 15.3 17.4 16.3 7.9 9.9 7.7 16.8 19.4 16.0 0.8 1.4 NAV 8.9 10.0 12.5 GHAZNI 14.7 20.3 20.0 3.5 6.1 4.2 12.5 21.8 10.1 5.3 4.5 7.0 10.3 12.0 13.8 GHOR 10.1 10.7 13.6 4.8 5.4 5.5 19.1 21.8 18.3 2.6 3.6 1.7 7.8 10.5 8.3 HERAT 8.0 10.9 12.4 3.6 4.5 3.7 12.3 12.6 13.8 3.7 4.9 3.8 6.4 9.7 6.5 HILMAND 9.3 20.8 19.8 2.6 2.4 4.1 22.0 23.8 29.8 1.9 1.8 2.1 21.0 21.1 22.1 JAWZJAN 9.3 14.7 12.0 9.7 11.5 11.0 13.2 15.5 14.2 9.0 10.8 11.6 5.6 13.8 10.0 KABUL 7.4 8.9 9.7 3.6 4.1 4.3 9.6 10.3 11.5 2.8 3.7 3.2 5.9 7.6 8.7 KANDAHAR 8.7 10.8 11.8 5.2 5.5 5.5 9.4 11.2 12.1 2.3 2.0 3.2 9.6 10.4 10.3 KAPISA 5.6 8.4 8.9 5.8 5.3 8.5 11.8 12.3 14.8 2.6 5.2 2.6 7.1 8.7 9.2 KHOST 3.6 5.5 6.7 3.6 4.3 6.4 10.0 10.2 12.3 5.2 5.0 10.1 7.0 10.6 9.8 KUNAR 10.7 9.9 12.2 6.1 5.6 7.0 14.1 15.6 17.1 1.1 6.4 1.5 12.4 12.6 15.5 KUNDUZ 10.8 11.4 14.1 2.9 3.2 3.6 6.3 7.6 8.1 5.1 6.5 7.5 7.5 9.4 8.8 LAGHMAN 11.1 11.7 16.0 4.7 4.8 5.4 11.8 14.8 15.6 3.2 6.1 4.2 7.2 10.4 12.2 LOGAR 9.6 12.5 12.0 6.7 8.2 7.2 8.0 9.4 8.4 2.4 3.3 2.0 6.7 11.3 8.1 NANGARHAR 8.2 8.8 9.9 1.8 2.3 2.0 10.3 10.2 13.6 4.2 2.8 5.8 8.0 9.7 7.8 NIMROZ 10.2 12.8 13.0 7.4 8.1 10.3 10.3 12.4 16.3 3.2 2.3 13.4 14.1 15.1 16.4 NURISTAN 15.0 15.2 16.8 8.5 9.4 8.0 13.5 19.0 15.4 3.7 6.2 3.1 13.4 16.1 15.5 PAKTIKA 9.5 13.1 12.6 4.3 5.4 6.1 5.1 9.7 8.0 NAV NAV NAV 5.4 7.5 9.0 PAKTYA 10.1 15.2 11.9 4.5 6.2 6.0 7.0 8.7 8.5 NAV NAV NAV 2.9 4.9 3.0 PARWAN 8.4 10.1 10.6 6.8 7.7 7.2 13.6 13.8 16.8 5.2 5.6 11.6 8.1 10.3 13.3 SAMANGAN 14.6 15.4 16.9 9.4 10.4 10.1 13.0 13.3 15.0 4.4 2.2 9.5 6.5 8.7 10.5 SARI PUL 9.0 10.5 13.2 6.6 6.9 8.1 6.9 10.8 11.4 7.5 12.9 11.8 9.7 11.1 10.5 TAKHAR 13.6 14.9 16.5 5.4 6.0 6.6 8.8 12.5 12.7 2.0 NAV 3.1 12.7 16.2 14.3 URUZGAN 18.7 21.6 20.2 7.8 10.4 7.3 6.8 8.0 8.0 6.1 5.5 10.7 12.5 13.1 14.2 WARDAK 10.6 11.2 15.6 3.6 4.2 3.4 14.1 17.9 18.2 2.2 4.0 2.3 9.4 10.3 11.7 ZABUL 14.7 16.8 15.7 4.0 4.5 3.5 6.3 10.0 8.4 0.4 0.8 NAV 7.7 9.2 11.0 AVERAGE CI PER PROVINCE MEAN 10.6 13.0 13.8 5.2 6.1 6.1 11.4 13.5 13.7 4.2 5.0 6.4 9.5 11.7 11.4 MEDIAN 10.0 12.6 13.2 4.8 5.5 6.0 11.6 12.9 13.9 3.7 4.8 5.6 9.0 11.2 10.9 NATIONAL URBAN RURAL NATIONAL PROVINCIAL BADAKHSHAN BADHGIS BAGHLAN BALKH BAMYAN FARAH FARYAB GHAZNI GHOR HERAT HILMAND JAWZJAN KABUL KANDAHAR KAPISA KHOST KUNAR KUNDUZ LAGHMAN LOGAR NANGARHAR NIMROZ NURISTAN PAKTIKA PAKTYA PARWAN SAMANGAN SARI PUL TAKHAR URUZGAN WARDAK ZABUL AVERAGE CI PER PROVINCE MEAN MEDIAN Annexeures-Definitions PROGRESS OF PROVINCES 2003 120 121 Households with no safe drinking water from pump/protected spring Households not having a sanitary latrine Children aged under 5 years with no fixed place for disposal of faeces Mothers with children under 5 years of age that do not always wash their own hands with soap/ash after their own or child defecation House- holds without a radio Households where women do not listen to radio Children not living with both parents CONFIDENCE INTERVALS (continued) Both Sexes Boy GirlBoth Sexes Boy Girl DEFINITIONS PREGNANCY AND DELIVERY MOTHERS' LAST DELIVERY TAKEN PLACE AT HOME (IN LAST TWO YEARS) Percentage of deliveries of mothers during last two years, if any, that took place at home i.e., not in a health facility LAST DELIVERY OF MOTHER ASSISTED BY UNSKILLED BIRTH ATTENDANT (IN LAST TWO YEARS) Percentage of deliveres during last two years that were assisted by 'Traditional Birth Attendant', 'Family members' or 'Others' ANTE-NATAL CONSULTATIONS NOT TAKEN FROM DOCTOR/TRAINED BIRTH ATTENDANT DURING LAST PREGNANCY Percentage of last pregnancies during last two years that did not take any advice/service from 'Doctor/ Nurse / Midwife' other than tetanus toxoid (TT) vaccination EVER MARRIED WOMEN UNDER 50 YEARS OF AGE NOT AWARE OF A METHOD TO DELAY PREGNANCY Percentage of ever married women aged less than 50 years who had never heard of any method for delaying or avoiding pregnancy MARRIED WOMEN UNDER 50 YEARS OF AGE CURRENTLY NOT USING A METHOD TO DELAY PREGNANCY Percentage of currently married women aged less than 50 years currently not using any method for delaying or avoiding pregnancy IMMUNIZATION CHILDREN UNDER 5 YEARS OF AGE NOT RECEIVED BCG IMMUNIZATION Percentage of children aged 0-59 months not immunized against tuberculosis (did not receive BCG) CHILDREN AGED 12-23 MONTHS THAT HAVE NOT RECEIVED 3 DOSES OF DPT IMMUNIZATION Percentage of children aged 12-23 months that did not receive three doses of DPT vaccine CHILDREN AGED 12-23 MONTHS THAT HAVE NOT RECEIVED 3+ DOSES OF POLIO IMMUNIZATION Percentage of children aged 12-23 months that did not receive three or more doses of polio vaccine CHILDREN AGED 9-59 MONTHS THAT HAVE NOT RECEIVED MEASLES IMMUNIZATION Percentage of children aged 9-59 months that were not vaccinated against measles within last 6 months NATIONAL URBAN 5.2 2.5 3.3 3.2 3.6 5.1 2.4 2.6 0.9 1.0 1.0 RURAL 3.2 2.7 2.5 2.6 2.5 1.6 1.7 1.7 0.5 0.6 0.6 NATIONAL 2.7 2.1 2.0 2.1 2.1 1.8 1.4 1.4 0.5 0.5 0.5 PROVINCIAL BADAKHSHAN 14.3 17.3 16.4 16.9 16.3 2.9 8.5 7.7 3.6 3.4 4.6 BADHGIS 18.7 13.0 9.1 9.3 10.1 5.0 8.7 8.5 3.8 4.0 4.0 BAGHLAN 7.9 16.7 10.5 12.3 10.0 4.7 9.3 9.0 1.9 2.3 1.8 BALKH 13.9 11.6 12.8 13.3 13.0 1.5 7.4 7.2 1.8 1.6 2.3 BAMYAN 9.2 15.9 7.9 8.9 8.3 5.9 9.2 8.9 5.3 6.0 4.7 FARAH 15.0 7.5 5.8 6.4 7.2 3.8 5.9 7.0 1.7 2.0 1.8 FARYAB 13.0 12.1 11.0 13.0 10.5 2.1 9.6 8.8 3.9 4.6 3.8 GHAZNI 14.0 12.2 10.3 11.7 9.5 8.4 7.3 6.4 2.5 2.4 2.8 GHOR 11.2 10.6 2.2 2.6 1.9 1.1 7.6 8.0 2.2 2.3 2.4 HERAT 12.0 6.8 9.4 9.6 9.8 3.8 5.9 7.2 1.8 1.9 2.3 HILMAND 16.7 16.4 14.5 14.7 14.9 2.5 10.6 10.9 1.4 1.6 1.2 JAWZJAN 10.9 12.6 9.9 11.1 10.6 0.9 7.8 9.0 1.9 2.8 2.3 KABUL 9.4 1.5 5.2 4.9 6.1 9.1 3.4 3.8 1.4 1.7 1.5 KANDAHAR 9.2 5.1 3.2 3.4 3.8 5.6 4.5 4.3 1.3 1.5 1.4 KAPISA 13.6 17.3 17.1 16.8 17.8 5.9 5.3 5.2 1.5 1.8 1.6 KHOST 15.8 9.4 11.0 10.6 12.3 9.3 8.7 8.7 1.0 1.5 0.9 KUNAR 17.2 13.9 10.7 13.2 10.5 4.4 8.3 8.6 1.6 1.8 1.8 KUNDUZ 7.8 10.4 10.4 10.7 10.6 5.4 7.3 7.3 1.6 1.7 2.0 LAGHMAN 13.7 14.1 6.4 8.1 5.6 2.9 6.1 6.1 1.6 1.3 2.1 LOGAR 15.6 5.6 11.8 12.8 11.4 8.5 6.1 6.5 1.9 1.9 2.3 NANGARHAR 12.5 9.0 4.5 4.4 5.0 15.3 3.8 4.0 1.2 1.3 1.2 NIMROZ 12.1 12.9 7.7 7.7 8.2 12.1 11.8 9.2 2.0 2.4 1.9 NURISTAN 13.9 14.3 11.1 11.8 10.8 1.0 11.6 11.9 2.8 3.7 2.7 PAKTIKA 10.1 9.9 6.0 6.1 6.9 2.5 7.5 6.6 1.1 1.0 1.8 PAKTYA 16.0 13.2 10.5 10.8 11.5 7.7 5.6 5.7 2.8 2.1 3.8 PARWAN 14.1 10.4 15.8 16.2 15.4 4.9 7.1 7.1 2.1 2.1 2.5 SAMANGAN 11.9 16.4 10.5 11.2 10.1 6.3 13.2 13.0 4.4 4.1 4.9 SARI PUL 26.7 15.2 10.2 10.3 11.1 0.9 8.1 7.9 2.0 2.2 2.3 TAKHAR 16.3 12.6 12.3 12.9 11.9 12.9 8.9 9.1 2.6 2.6 3.2 URUZGAN 8.2 12.8 7.4 7.3 9.5 2.9 6.3 7.3 2.5 2.7 2.7 WARDAK 13.6 4.8 10.5 10.8 10.6 8.8 6.6 7.5 2.3 2.1 3.1 ZABUL 13.7 15.1 13.9 15.7 13.2 4.5 4.0 4.9 1.4 1.7 1.8 AVERAGE CI PER PROVINCE MEAN 13.3 10.6 9.5 10.0 9.9 6.3 7.2 7.4 2.2 2.3 2.5 MEDIAN 13.7 11.7 10.4 10.7 10.3 5.5 7.3 7.2 2.0 2.1 2.3 NAV = NOT AVAILABLE Annexeures-Definitions PROGRESS OF PROVINCES 2003 122 123 DIARRHOEA DIARRHOEA PREVALENCE IN LAST 15 DAYS (<5 YEARS CHILDREN) Percentage of children aged under five years who had three or more episodes of loose or watery stools with or without blood in stool per day in 15 days preceding the date of interview CHILDREN <5 YEARS NOT RECEIVED INCREASED FLUID OR FEEDING DURING DIARRHOEA Percentage of all cases of diarrhoea episodes, in the last 15 days, that received 'Same', 'Less' or 'No' liquid and 'No' solid food during this episode. ORS/HOME-MADE FLUID NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA Percentage of diarrhoea episodes in under-five age group not treated with 'Oral Rehydration Salt (ORS)', 'Sugar-Salt Solution' and/or any 'Other' recommended home fluids MORE LIQUID NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA Percentage of all cases of diarrhoea episodes, in the last 15 days, that received 'Same', 'Less' or 'No' liquid during this episode MORE/SAME SOLID FOOD NOT GIVEN TO <5 YEARS CHILDREN DURING DIARRHOEA Percentage of all cases of diarrhoea among under-five years children in last 15 days, that received 'Less' or 'No' solid food during this episode. ACUTE RESPIRATORY INFECTION (ARI) ACUTE RESPIRATORY INFECTION PREVALENCE IN LAST 15 DAYS (<5 YEARS CHILDREN): JUNE-JULY 2003 Percentage of children aged under five years who had acute respiratory infection (ARI) along with cough and/or cold in the last 15 days proceeding the interview in June-July, 2003. The rate might be little higher in October-November. ADVICE OR TREATMENT NOT SOUGHT FROM HOSPITAL/HEALTH CENTRE DURING ARI (<5 YEARS CHILDREN) Percentage of all cases of ARI episodes, in the last 15 days, that were treated either by 'Village Practitioner', 'Self /Family' or 'Other' (other than hospital/health centre) BREASTFEEDING CHILDREN AGED 12-15 MONTHS THAT ARE NOT BREASTFED Percentage of children aged 12 -15 months who were not breastfed with or without supplementation on the day of interview. CHILDREN AGED 20-23 MONTHS THAT ARE NOT BREASTFED Percentage of children aged 20-23 months who were not breastfed with or without supplementation on the day of interview. CHILDREN AGED 0-3 MONTHS THAT DID NOT EXCLUSIVELY RECEIVE BREASTMILK DURING LAST 24 HOURS Percentage of children aged 0-3 months who were not breastfed exclusively during last 24 hours of interview, i.e. did not receive breastmilk and/or medicine only CHILDREN AGED 6-9 MONTHS THAT HAVE NO TIMELY COMPLEMENTARY FEEDING Percentage of children aged 6-9 months who had not received solid food along with breastmilk during last 24 hours of interview CHILDREN AGED 0-23 MONTHS THAT WERE NOT BREASTFED IN FIRST 23 HOURS Percentage of children aged 0-23 months whose interval between birth and first breastfeeding was more than 23 hours MOTHERS OF CHILDREN 0-23 MONTHS WHO DISCARDED COLOSTRUM BEFORE BREASTFEEDING Percentage of children aged 0-23 months whose mothers discarded some breastmilk before initiation of breastfeeding the child for the first time after birth. DISABILITY AND IMPAIRMENT CHILDREN AGED 1-4 YEARS AND 7-17 YEARS THAT ARE DISABLED OR IMPAIRED Percentage of children aged 1-4 years and 7-17 years with 'Hearing / Vision' impairment, 'Hand / Leg' disability, 'Speaking' or 'Mental retardation' CHILDREN AGED 6-59 MONTHS THAT HAVE NOT RECEIVED VITAMIN-A SUPPLEMENTATION Percentage of children 6-59 months that did not receive vitamin-A within last 6 months of interview SALT USE HOUSEHOLDS CONSUMING NON-IODIZED SALT Percentage of households using non-iodated salt as assessed by starch solution EDUCATION ILLITERACY RATE (15+ YEARS) Population aged 15 years and above that can not read or write at least one language. CHILDREN AGED 7-12 YEARS NOT ENROLLED IN SCHOOL-2003 Percentage of children aged 7-12 years not registered in any school in 1382 Dari calendar year (i.e. 2003 AD). Annexeures-Definitions PROGRESS OF PROVINCES 2003 124 125 CHILD LABOUR CHILDREN AGED 7-12 YEARS THAT WORKED FOR AT LEAST HALF-A-DAY (4-12 HOURS) FOR INCOME Percentage of children aged 7-12 years who were engaged in work for money/income within/outside of the household for at least half-a-day, on an average, during last one week preceding the interview. CHILDREN AGED 7-12 YEARS THAT DID DOMESTIC CHORES FOR AT LEAST HALF-A-DAY (4-12 HOURS) Percentage of children aged 7-12 years who were engaged in domestic chores for at least half-a-day, on an average, during last one week preceding the interview. WATER AND SANITATION HOUSEHOLDS WITH NO SAFE DRINKING WATER FROM PUMP/PROTECTED SPRING Percentage of households collecting drinking water from either 'Unprotected well/spring/pond', 'River/canal/stream' or 'Other' unprotected sources. It does not consider the amount or quality of water collected, the time taken for water collection, nor the distance of the water source from the house. HOUSEHOLDS NOT HAVING A SANITARY LATRINE Percentage of households 'not' with sanitary latrines denotes those households where none of the members use either a water seal or an open pit latrine or traditional pit latrine. Water seal or pit latrines connected by pipe to an open place or water body was treated as unsanitary. CHILDREN AGED UNDER 5 YEARS WITH NO FIXED PLACE FOR DISPOSAL OF FAECES Percentage of children aged under five years who were not using a latrine or whose faeces were not disposed in latrine, fixed hole or other fixed places MOTHERS WITH CHILDREN UNDER 5 YEARS OF AGE THAT DO NOT ALWAYS WASH THEIR OWN HANDS WITH SOAP/ASH AFTER THEIR OWN OR CHILD DEFECATION Percentage of mothers of the children aged under five years either do not wash their hands or wash with water only or with soil and water after defecating themselves or after cleaning the bottom of their child following defecation ACCESS TO MEDIA HOUSEHOLDS WITHOUT A RADIO Percentage of households with no working radio as reported by the respondent HOUSEHOLDS WHERE WOMEN DO NOT LISTEN TO RADIO Percentage of households where the women do not listen to a radio either inside or outside their own house. CHILD RIGHTS CHILDREN NOT LIVING WITH BOTH PARENTS Percentage of children aged 0-17 years who were not living with both of their biological father and mother on the day of interview. The biological father or mother or both of them either died or lived elsewhere (not in the same household) CHILDREN AGED UNDER 5 YEARS THAT CITIZENSHIP CARD (TAJKERA) NOT SHOWN Percentage of children aged under 5 years for whom the caretakers could not show the citizenship or identification card (Tajkera) during interview. GIRLS 15-19 YEARS OF AGE CURRENTLY IN UNION Percentage of girls aged 15-19 years who were currently in union by their marriage. In Afghan culture, no union is possible without marriage. POPULATION AND DEMOGRAPHY HOUSEHOLD AND HOUSEHOLD MEMBERS In this survey, household indicates generally some people (both men and women and may or may not be related with blood) usually taking their meals from same cooking pot, sharing household assets and accumulating their earnings to procure the cooking and other household materials. Persons staying in the household for last six months were treated as members, while persons staying outside of the households for at least six months were excluded. TOTAL FERTILITY RATE (TFR) The number of children that would be born per woman if she were to live to the end of her child-bearing years and bear children at each age in accordance with prevailing age-specific fertility rates (The age-specific fertility rate is the number of births per year per 1,000 women of a specified age). INFANT MORTALITY RATE (IMR) Probability of dying between birth and exactly one year of age expressed per 1,000 live births. UNDER-FIVE MORTALITY RATE (U5MR) Probability of dying between birth and exactly five years of age expressed per 1,000 live births. FEMALE HEADED HOUSEHOLDS Households takes the major decisions of the household and other members recognize that person as the head of the household. where a female member is the head of the household. Head of the household is a member of the household who Annexeures-Questionnaire 127 PROGRESS OF PROVINCES 2003 126 STRICTLY CONFIDENTIAL CENTRAL STATISTICS OFFICE TRANSITIONAL ISLAMIC GOVERNMENT OF AFGHANISTAN Monitoring the Situation of Children and Women Project DATA COLLECTION FORM Multiple Indicator Cluster Survey-2003 CONVERTED NO: (For office use only) ("We are from the government's Central Statistics Office. We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about 60 minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with all mothers with children aged below 18 years or others who take care of children in the household".) Stratum: Urban — 1 Rural — 2 Additional form used : Yes/No Province: ________________________ (Name)________________________ (Code) District: ________________________ (Name)________________________(Code) Village: ________________________(Name) Cluster No.____________(Code) Name of household head: ________________________(Name) Household No. ____________(Code) Family Type: Nuclear ------------------ 1, Joint ------------------ 2, Extended ------------------ 3, Others ____________(Specify) 4 DATE OF INTERVIEW Interviewer (Signature)______________________________________________________________(Code) Supervisor (Signature)______________________________________________________________(Code) Quality Control Officer (Signature) ___________________________________________________ Coordinator (Signature) ______________________________________________________________ Edit Verifier: ______________________________________(Code) Coder: ___________________________(Code) Entrier: __________________________________________ (Code) QUESTIONNAIRE Annexeures-Questionnaire 129 PROGRESS OF PROVINCES 2003 128 (FOR CHILDREN UNDER AGE 18 YEARS ASK Q9 TO Q13) Q9. Who is the mother/caretaker of 'Name'? (Record line number) A9. Line no.: _____________ Q10. Is the mother of 'Name' alive? (If No/DK, go to Q.12) A10. 1-Yes 2-No 3-DK Q11. Does Name's mother live in this household? A11. 1-Yes 2-No Q12. Is the Father of 'Name' alive? (if No/DK, go to next member) A12. 1-Yes 2-No 3-DK Q13. Does Name's Father live in this household? A13. 1-Yes 2-No Q14. Total number of persons eligible for interview in the household _____________0-59 months children (to be filled in part —B) _____________7-17 years children (to be filled in part —C) _____________Ever married women (to be filled in part —D) [ARE THERE ANY OTHER CHILDREN LIVING HERE — EVEN IF THEY ARE NOT MEMBERS OF YOUR FAMILY OR DO NOT HAVE PARENTS LIVING IN THIS HOUSEHOLD INCLUDING CHILDREN AT WORK OR AT SCHOOL? If yes, insert child's information and complete form.] PART— B: FOR 0—59 MONTH CHILDREN Serial Number: _____________________________________________ Child's Name: _____________________________________________ Child's Line No.: _____________________________________________ Mother's/Caretaker's Line No.: ____________________________________ Q01. Sex of 'Name'. A01. 1-Boy 2-Girl Q02. Age of 'Name' (Record in months). A02. _____________Months PART — A: HOUSEHOLD MEMBER LISTING HOUSEHOLD MEMBER LISTING FORM FIRST, PLEASE TELL ME THE NAME OF EACH PERSON WHO USUALLY LIVES HERE, STARTING WITH THE HEAD OF THE HH. (Use survey definition of HH member). List the first name in line 01. List information of HH head first, then his spouse and children from the youngest. Then ask: 'ARE THERE ANY OTHERS WHO LIVE HERE, EVEN IF THEY ARE NOT AT HOME NOW?' (THESE MAY INCLUDE CHILDREN IN SCHOOL OR AT WORK). If yes, complete listing. Then, ask and record answers to questions as described in Instructions for Interviewers. If there is not enough room on this page, fill in the left page. If there are even more members, use additional questionnaire. In that case tick [ˆ] on cover page marking Additional form used. Q1. Line no.: _____________ Q2. Name: _______________ Q3. Is 'Name' Male or Female A3. 1-Male 2-Female Q4. Relation with the household head A4. 01-Household head 02-Spouse 03-Son/Daughter 04-In-law 05-Grand son/grand daughter 06-Brother/Sister 07-Father/Mother 08-Nephew/neice 09-Other relative 10-Non relative Q5. How old is 'Name'? [Record in Complete Years for person aged 5 years and above. For children aged Under-five years record in months 97=DK( For age 65 years and above)] A5. _____________ Year _____________Month Q6. Occupation A6. 01-Farmer 02-Housewife 03-Small Business 04-Business 05-Skill labour 06-Unskill Labour 07-Service 08-Student 09-Jobless 10-Others 11-Housework 12-Non-student 88 (for <7 Children) (FOR PERSONS AGE 10 YEARS OR OVER ASK Q7 AND Q8) Q7. Highest education grades s/he completed? (If not attended school, can s/he read or sign) can read only=96 can read & write=97 A7. _____________ Q8. Marital Status of 'Name'? A8. 1-Currently Married 2-Widowed 3-Divorced 4-Living away 5-Never Married Annexeures-Questionnaire 131 PROGRESS OF PROVINCES 2003 130 Q13. During this episode, did 'Name' drink any of the mentioned items? (Prompt each item) A13. 01-Breast milk 02-Gruel 03-Home Fluid 04-ORS 05-Formula milk 06-Water+others 07-Water only 08-Coke/Fanta 09-None Q14. Compared to normal, how much liquid did 'Name' drink during this episode? (Including breast milk) A14. 1-More 2-Same 3-Less 4-None Q15. Compared to normal, how much usual food was given to 'Name'? (Including breast milk) A15. 1-More 2-Same 3-Less 4-None Q16. Did 'Name' have cough and/or fever in last two weeks? (If No, go to Q19) A16. 1-Yes 2-No Q17. When 'Name' suffered from cough and/or fever, did s/he breath faster than usual with short, quick breathing or breathing difficulty? A17. 1-Yes 2-No 3-DK Q18. Did you seek advice or treatment for this episode of cough/fever of 'Name'? If yes, where from did you seek care? (Do not prompt) A18. 1- Hospital 2- health centre/MCH clinic/Mobile outreach clinic 3- Dispensary/pharmacy/drug seller 4- community health worker 5- Private practitioner/traditional healer 6- Relative/ other 7-None/DK Q19. Has 'Name' ever been breastfed? (if No, go to Q24) A19. 1-Yes 2-No Q20. Is 'Name' still being breastfed? A20. 1-Yes 2-No FOLLOWING QUESTIONS (Q21 TO Q25) TO BE ASKED FOR 0-23 MONTHS OLD CHILDREN Q21. How soon after 'Name' was born did you start to breastfed him/her? A21. 1-Within 6 hours 2-6 to 23 hours 3-24 to 48 hours 4-48+ hours 5-DK Q22. Did you expel some of the breastmilk before giving it to 'Name' for the first time? A22. 1-Yes 2-No 3-DK Q23. At what age you start giving 'Name' to drink something other than breastmilk? Never=96 A23. _____________Month Q03. Does 'Name' have any Tazkera (Birth certificate)? A03. 1-Yes 2-No Q04. Did 'Name' have immunization card? If yes, could you show it to me? A04. 1-Yes (seen) 2-Yes (not seen) 3-Do not have Q05. Has 'Name' ever been given BCG vaccination against tuberculosis — i.e. an injection in the left shoulder that caused a scar? (Check for scar mark) A05. 1-Yes 2-No 3-DK FOLLOWING QUESTIONS (Q6 TO Q9) HAS TO BE ASKED FOR 12-23 MONTHS OLD CHILDREN Q06. Has 'Name' ever been given any 'vaccination drops in the mouth' to protect him/her from getting polio? (If No/ DK go to Q08) A06. 1-Yes 2-No 3-DK Q07. How many times 'Name' has been given these drops? A07. _____________ Times Q08. Has 'Name' ever been given 'vaccination injections' — i.e. an injection in the mid-outer surface of thigh to prevent him/her from getting DPT (tetanus, whooping cough, diphtheria)? (If No/DK go to Q10) A08. 1-Yes 2-No 3-DK Q09. How many times 'Name' has been given DPT vaccine? A09. _____________ Times FOLLOWING QUESTIONS (Q10 TO Q20) TO BE ASKED FOR 0-59 MONTHS OLD CHILDREN Q10. Has 'Name' ever been given 'vaccination injections' — i.e. a shot in the lateral (outer) part of upper right arm at the age of 6 months or older to prevent him/her from getting measles within last one year? A10. 1-Yes 2-No 3-DK Q11. Has 'Name' received Vitamin-A capsule within last six months? (Show red/green vitamin-A capsule) A11. 1-Yes 2-No 3-DK Q12. Did 'Name' have diarrhoea in last two weeks? (If no go to Q16) A12. 1-Yes 2-No Annexeures-Questionnaire 133 PROGRESS OF PROVINCES 2003 132 Q06. Is it an all boys' school or all girls' school or both boys and girls' school? A06. 1-Boy's 2-Girl's 3-Boy+Girl Q07. Class/grade in which 'Name' reads or is admitted (in 1382)? A07. _____________ Class 77-Madrasa 80-Vocational Q08. How many days 'Name' attended the school during last 3 school days? A08. _____________ Days Q09. Did 'Name' went to school or madrasa last year (in 1381)? (If No, go to Q11) A09. 1-Yes 2-No Q10. Class/grade in which 'Name' read last year (in 1381)? A10. _____________ Class Q11. Why 'Name' is not admitted to school? (For children who are not attending school currently) A11. 01-Expensive 02-Too far 03-No adequate facility 04-No separate school 05-Security 06-Domestic work 07-HH income 08-Not necessary 09-No adequate sanitation 10-Teacher's gender 11-Feel ashamed 12-Other Q12. During the past week, whether 'Name' did household works (which brings money)? (If No, go to Q14) A12. 1-Yes 2-No Q13. If yes, how many hours on an average per day? A13. _____________ Hours Q14. During the past week, whether 'Name' worked outside the household? If yes, how 'Name' was remunerated? (If No, go to Q16) A14. 1-Unpaid 2-Paid cash 3-Paid kind 4-Cash+kind 5-No work Q15. If yes, how many hours on an average per day? A15. _____________ Hours Q16. During the past week, whether 'Name' did domestic chores for the household? (If No, go to Q18) A16. 1-Yes 2-No Q17. If yes, how many hours on an average per day? A17. _____________ Hours Q24. Since this time yesterday till now, did 'Name' receive any of the following items? (Prompt each item) (If medicine/ liquid food, skip to Q-26) A24. 1- Vitamin/Medicine/ORS 2- Solid food 3- Liquid food 4- Breastmilk only Q25. If solid food is given to 'Name' since this time yesterday how many times it was given? A25. _____________Times 97-DK Q26. (FOR 0-59 MONTHS OLD CHILDREN) Where do you dispose faeces of 'Name'? A26. 1-Latrine 2-Fixed hole 3-Other fixed place 4-No fixed place Q27. (FOR 12-59 MONTHS OLD CHILDREN) Does 'Name' have any mental or physical difficulty? If yes, what type of difficulty does s/he have? (Prompt each item) A27. 1-Vision 2-Hearing/speech 3-Paralysis 4-Amputee 5-Mental 7-Healthy PART — C : FOR CHILDREN AGED 7-17 YEARS Serial Number: _____________________________________________ Child's Name: _____________________________________________ Child's Line No.: _____________________________________________ Mother's/Caretaker's Line No.: __________________________________ Q01. Sex of 'Name'. A01. 1-Boy 2-Girl Q02. Age of 'Name' (Record in years). A02. _____________ Years Q03. Does 'Name' go to/is admitted to school or madrasa (in 1382)? (If No, go to Q09) A03. 1-Yes 2-No Q04. Is 'Name' admitted in government or NGO School this year (1382)? A04. 1-Government 2-NGO 3-Mosque Based Madrasa Q05. Which type of school 'Name' is admitted this year (1382)? A05. 1-General 2-Madrasa 3-Homebased 4-Vocational Annexeures-Questionnaire 135 PROGRESS OF PROVINCES 2003 134 Q09. Just to make sure I am right, you have had 'Number' births in your lifetime? (Write total number of live births in whole life including those of Q-04, Q-05, Q-06, Q-07, Q-08a and Q-08b except current pregnancy, if any) A09. _____________ Numbers Q10. Are you pregnant? A10. 1-Yes 2-No 3-DK Q11. Did you ever heard of any method of delaying or avoiding pregnancy? (if No, go to Q14) A11. 1-Yes 2-No Q12. If yes, are you currently using it? (if No, go to Q14) A12. 1-Yes 2-No Q13. If yes, which method are you using currently? A13. 1-Pill 2-Condom 3-Injection 4-Sterilization 5-Traditional Q14. Pregnancy History of the respondent woman (if no child ever born, skip to Q21) (start enquiring from the eldest child) Child Serial No.: _____________________________________________ Child Line No.: _____________________________________________ Mother's Line No.:_____________________________________________ Col.1. Child's name:_____________________________________________ Col.2. Was this delivery twin? A.2. 1-Single 2-Twin Col.3. Is the child boy or girl? A.3. 1-Boy 2-Girl Col.4. Date of Birth A.4. ____________month____________year Col.5. Is 'Name' presently alive? (If No, go to Q8) A.5. 1-Yes 2-No Col.6. Age of 'Name' now? (Age in months for under five children) A.6. ____________month____________year Q18. Does 'Name' have any mental or physical difficulty? If yes, what type of difficulty does s/he have? (Prompt each item) A18. 1-Vision 2-Hearing/speech 3-Paralysis 4-Amputee 5-Mental 7-Healthy PART — D: EVER MARRIED WOMEN UP TO 49 YEARS AGE Serial Number: _____________ Woman's Line No.: _____________ Woman's Name: _____________ NOW I WOULD LIKE TO ASK ABOUT ALL THE BIRTHS YOU HAVE HAD DURING YOUR LIFE. Q01. Have you ever given a birth that has shown any sign of life? (if No, go to Q10) A01. 1-Yes 2-No Q02. At what age you had your first marriage? A02. _____________Years Q03. If yes to Q-01, how many years ago did you have your first birth? A03. _____________Years Q04. Do you have any sons to whom you have given birth and are living with you? If yes, how many? A04. _____________Son (if No, write '0') Q05. Do you have any daughters to whom you have given birth and are living with you? If yes, how many? A05. _____________Daughter (if No, write '0') Q06. Does your any son not living with you now? If yes, how many? A06. _____________Son (if No, write '0') Q07. Do you have any daughters who are not living with you? If yes, how many? A07. _____________Daughter (if No, write '0') Q08. Did you ever give birth to a child who was born alive but died later (in your whole life)? If no, check was there any child who cried or a sign of life was noticed at him/her after s/he had been born but died soon after few hours or days? A08a. _____________Boys (Write '0' if no such a child was born) A08b. _____________Girls (Write '0' if no such a child was born) Annexeures-Questionnaire 137 PROGRESS OF PROVINCES 2003 136 PART — E : HOUSEHOLD INFORMATION Q01. What is the usual source of drinking water? A01. 1-Piped water 2-Bored well/protected dugwell with pump 3-Slow-sand filtration 4-Protected spring 5-Unprotected well 6-Unprotected spring/pond 7-River/canal/stream 8-Others (specify) Q02. Is the usual water source located within the compound? A02. 1-Yes 2-No 8-NA Q03. Type of latrine the household members using? (Interviewer to please physically see and code) A03. 1-Flush to sewage 2-Traditional latrine pit/vault 3-Open pit 4-None/bush/field 5-other Q04. Is the Latrine located within the compound of the household? (If No/NA, skip to Q06) A04. 1-Yes 2-No 8-NA Q05. If both water source and latrine are within compound, what is the distance between them? (Interviewer to check by walking from one to other) A05. ____________Steps NA--88 Q06. Is there any working radio in the household? A06. 1-Yes 2-No Q07. Do you listen to radio? (if No, skip to Q09) A07. 1-Yes 2-No Q08. Since this time yesterday till now what are the times did you listen to a radio? A08. 1-Early morning 2-Morning 3-Noon 4-Afternoon 5-Evening 6-Night Q09. Test the salt consumed in the household? (Use testing kit) A09. 1-Iodized 2-Non iodized 3-Both 4-No salt Col.7. Does 'Name' live with you? (If Yes, collect information of next child) A7. 1-Yes 2-No Col.8. If died, what was age at death? ( Month for <2 years, Year for 2+ years) A8. ____________month____________year Q15. Did you have any delivery during last two years? (please check with Pregnancy History) A15. 1-Yes 2-No Q16. What was the place of your that delivery? A16. 1-Govt.Hospital/Health Centre 2-Private/ NGO Health Centre 3- Home Delivery/Neighbour/Relative Q17. Who assisted with the delivery of your last child? A17. 1-Doctor/Nurse/Midwife 2-Traditional Birth Attendant 3-Relative/friend/other Q18. How many doses of injection (TT) have you taken in the arm to prevent your newborn of being affected from tetanus? A18. ____________Doses (if No, write '0') Q19. Did you see anyone for taking advice during this pregnancy other than TT? If yes, whom did you see? A19. 1-Doctor/Nurse/Midwife 2-Traditional Birth Attendant 3-Relative/friend/other 4-None (IF THE WOMAN HAD 0-59 MONTHS CHILDREN) Q20. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? (Do not prompt) A20. 0-Cough/running nose 1-Fever 2-Difficult/Fast Breath 3-Convulsion 4-Unable to drink/suck 5-Watery/Bloody diarrhoea 6-Other 7-Don't Know/none Q21. How do you usually wash hands after own or child's defecation? (Probe for more than one answer) A21. 1-Only water 2-Water & Soil 3-Water & Ash 4-Water & Soap 5-Not at all 6-Other Q22. If using water after defecation, how do you use water? A22. 1-Pouring from pot 2-In bowl Annexeures—Acknowledgements 139 PROGRESS OF PROVINCES 2003 138 NON-RESPONSE BY EACH QUESTION PART B Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 0 (0.0) 0 (0.0) 94 (0.4) 207 (0.8) 319 (1.2) 104 (2.2) 213 (5.1) 121 (2.6) 156 (5.6) 218 (0.8) 247 (1.0) 31 (0.1) 27 (0.3) 99 (1.3) Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 120 (1.5) 93 (0.4) 193 (2.8) 136 (1.9) 50 (0.2) 259 (1.0) 94 (1.0) 116 (1.2) 421 (4.3) 317 (3.3) 598 (14.6) 346 (1.3) 138 (0.7) PART A Col3 Col4 Col5Y Col5M Col6 Col7 Col8 Col9 Col10 Col11 Col12 Col13 2 (0.0) 17 (0.0) 71 (0.1) 0 (0.0) 907 (0.8) 2569 (2.8) 743 (0.8) 26 (0.0) 67 (0.1) 48 (0.1) 104 (0.1) 108 (0.1) PART C Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 0 (0.0) 0 (0.0) 117 (0.3) 383 (1.8) 246 (1.2) 283 (1.3) 301 (1.4) 562 (2.6) 692 (1.5) 944 (5.2) 571 (2.4) 873 (1.9) 952 (13.0) 3487 (7.7) PART D Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08a Q08b Q09 Q10 Q11 Q12 Q13 11 (0.1) 1032 (4.7) 34 (0.2) 14 (0.1) 15 (0.1) 21 (0.1) 23 (0.1) 21 (0.1) 21 (0.1) 14 (0.1) 268 (1.2) 669 (3.1) 713 (10.9) 741 (28.1) Q14Col2 Q14Col3 Q14Col4M Q14Col4Y Q14Col5 Q14Col6M Q14Col6Y Q14Col7 Q14Col8M Q14Col8Y Q15 Q16 Q17 Q18 18 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 11 (0.0) 13 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 13 (0.1) 228 (2.0) 221 (2.0) 519 (4.6) Q19 Q20 Q21 Q22 352 (3.1) 785 (5.0) 597 (2.7) 648 (3.0) PART E EQ01 EQ02 EQ03 EQ04 EQ05 EQ06 EQ07 EQ08 EQ09 22 (0.1) 249 (1.2) 70 (0.3) 274 (1.4) 768 (17.4) 107 (0.5) 591 (2.8) 645 (4.7) 89 (0.4) Note: Figures in the parentheses indicates percentage Q15 Q16 Q17 Q18 Q19 3782 (40.4) 855 (1.9) 994 (3.7) 548 (1.2) TECHNICAL CO-ORDINATION Mohammad Ali Watanyar, Asmatullah Ramzi, Abdul Rashid Fakhri (Central Statistics Office) TECHNICAL COMMITTEE Central Statistics Office, Ministry of Health, Ministry of Women's Affairs, Ministry of Labour and Social Affairs, Ministry of Planning, Ministry of Education, Ministry of Rural Rehabilitation and Development, Kabul University, MSH, WHO, UNESCO, UNICEF SURVEY PLANNING, IMPLEMENTATION AND REVIEW Jonathan Cauldwell (UNICEF) SENIOR TECHNICAL ADVISOR Muhammad Shuaib (SURCH, Bangladesh) TECHNICAL ADVISOR Mokhlesur Rahman (SURCH, Bangladesh) SURVEY STAFF TRAINING AND FIELD COORDINATION Abdullah-Al-Harun (SCF-UK Bangladesh) MATERIAL AND SOFTWARE DEVELOPMENT, FIELD TRAINING AND TESTING, FIELD QUALITY, DATA CODING EDITING CHECKING ENTRY, TRAINING, REPORT PREPARATION Md. Rezaul Hoque, Mohammed Shakwat Hossain Khan, Mohammad Sadeq, Md. Akter Hossain, Md. Ziaul Hasan Sikder, Younus Ali Fakir, Md. Ashraful Alam, A.T.M. Anwar Hossain, Kazi Burhan Uddin, Shahid Alam, Md. Monirul Islam Zahid, Md. Samsul Haque, Mohammad Sufian, Muhammad Rashed, Md. Nahid Ahmad (SURCH, Bangladesh) MORTALITY AND FERTILITY ESTIMATIONS Md. Zakir Hossain, Kazi Md. Abul Kalam Azad (SURCH, Bangladesh) SURVEY STAFF Central Statistics Office, Ministry of Women's Affairs and NGOs UNICEF TECHNICAL GUIDANCE Sharad Sapra, Reza Hossaini, Peter Salama, Nadia Behboodi and Programme Sections FIELD ADMINISTRATION Huma Jaghori, Farzana Wahab, Rahmatullah Quraishi, Abdul Latif, Mizan Rahman Yusufzai, Khaled Sadiq, Najibullah Hameem ACKNOWLEDGEMENTS PROGRESS OF PROVINCES 2003 140 P H O TO : U N IC E F A FG A /0 01 60 S /N O O R A N I United Nations Children's Fund Afghanistan Country Office PO Box 54 Pul-i-Charki Industrial Area Kabul-Jalalabad Road Kabul Afghanistan Telephone: +93 (0)702 22995 Facsimile: +873 761 924 996 email: kabul@unicef.org C O V E R P H O TO S : U N IC E F A FG H A N IS TA N / K AT A R IN A P R E M FO R S

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