Bosnia and Herzegovina Multiple Indicator Cluster Survey (MICS) 2011-2012, Final Report

Publication date: 2013

BOSNIA AND HERZEGOVINA MULTIPLE INDICATOR CLUSTER SURVEY 2011–2012 Final Report February, 2013 BOSNIA AND HERZEGOVINA MULTIPLE INDICATOR CLUSTER SURVEY 2011–2012 Publisher UNICEF Office for Bosnia and Herzegovina Authors Aida Pilav Amela Lolic Ana Abdelbasit Dajana Mitrovic Irena Jokic Miroslav Stijak Translation Almir Comor Proofreading Chris Hughes Design Sandra Ozimica Cover photo Almir Panjeta Printed by Amos graf Print run 300 Published in February, 2013 The Multiple Indicator Cluster Survey (MICS) is an international household survey programme developed by the United Nations Children’s Fund (UNICEF). MICS provides up-to-date information on the situation of children and women and measures key indicators that allow countries to monitor progress towards the Millennium Development Goals (MDGs) and other internationally agreed upon commitments. The Bosnia and Herzegovina MICS for 2011–2012 was conducted at the end of 2011 and the beginning of 2012 by the Federal Ministry of Health (FMH) together with the Institute for Public Heath of the Federation of Bosnia and Herzegovina (IPH FBiH) (as the implementing agency for the Federation of Bosnia and Herzegovina) and the Ministry for Health and Social Welfare of the Republic of Srpska (MHSW RS), in collaboration with the Agency for Statistics of Bosnia and Herzegovina (BHAS). Financial and technical support was provided by UNICEF and the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), which supported the master sample frame development activities. Additional financial support was provided by the United Nations Population Fund (UNFPA) and the United Nations High Commissioner for Refugees (UNHCR). The survey was conducted as part of the fourth global round of the MICS programme (MICS4). Additional information on the global MICS programme can be obtained from www.childinfo.org. Suggested citation The Agency for Statistics of Bosnia and Herzegovina, the Federal Ministry of Health, the Ministry of Health and Social Welfare of the Republic of Srpska and the Institute for Public Health of the Federation of Bosnia and Herzegovina. (2013). Bosnia and Herzegovina Multiple Indicator Cluster Survey (MICS) 2011–2012, Final Report. Sarajevo: UNICEF. MONITORING THE SITUATION OF CHILDREN AND WOMEN iii Summary Table of Findings1 Multiple Indicator Cluster Survey (MICS) and Millennium Development Goals (MDG) Indicators for Bosnia and Herzegovina 2011–2012 Topic MICS4 Indicator Number MDG Indicator Number Indicator Value NUTRITION Nutritional status Underweight prevalence 2.1a 1.8 Moderate and Severe (- 2 SD) 1.6 per cent 2.1b 1.8 Severe (- 3 SD) 0.9 per cent Stunting prevalence 2.2a Moderate and Severe (- 2 SD) 8.9 per cent 2.2b Severe (- 3 SD) 3.8 per cent Wasting prevalence 2.3a Moderate and Severe (- 2 SD) 2.3 per cent 2.3b Severe (- 3 SD) 1.6 per cent Breastfeeding and infant feeding 2.4 Children ever breastfed 95.3 per cent 2.5 Early initiation of breastfeeding 42.3 per cent 2.6 Exclusive breastfeeding under 6 months 18.5 per cent 2.7 Continued breastfeeding at 1 year 12.4 per cent 2.8 Continued breastfeeding at 2 years 12.2 per cent 2.9 Predominant breastfeeding under 6 months 45.8 per cent 2.10 Duration of breastfeeding 8.8 per cent 2.11 Bottle feeding 79.5 per cent 2.12 Introduction of solid, semi-solid or soft foods 71.3 per cent 2.13 Minimum meal frequency 72.2 per cent 2.14 Age-appropriate breastfeeding 18.2 per cent 2.15 Milk feeding frequency for non-breastfed children 90.7 per cent Low birth weight 2.18 Low birth weight infants 3.1 per cent 2.19 Infants weighed at birth 97.8 per cent CHILD HEALTH Vaccinations 3.1 Tuberculosis immunisation coverage 97.8 per cent 3.2 Polio immunisation coverage 85.1 per cent 3.3 Immunisation coverage for diphtheria, pertussis and tetanus (DPT) 85.5 per cent 3.4 4.3 Measles, mumps and rubella immunisation coverage 79.9 per cent 3.5 Hepatitis B immunisation coverage 83.9 per cent Care for illness 3.8 Oral rehydration therapy with continued feeding 54.6 per cent 3.9 Care-seeking for suspected pneumonia 86.9 per cent 3.10 Antibiotic treatment of suspected pneumonia 76.2 per cent Solid fuel use 3.11 Solid fuels (used as the primary source of energy for cooking) 69.5 per cent WATER AND SANITATION Water and sanitation 4.1 7.8 Use of improved drinking water sources 99.6 per cent 4.2 Water treatment 8.5 per cent 4.3 7.9 Use of improved sanitation 94.3 per cent 4.4 Safe disposal of child’s faeces 19.6 per cent 4.5 Place for hand washing 97.9 per cent 4.6 Availability of soap 98.6 per cent 1 See Appendix E for details on indicator definitions. iv MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN v Topic MICS4 Indicator Number MDG Indicator Number Indicator Value HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS knowledge and attitudes 9.1 Comprehensive knowledge about HIV prevention women aged 15-49 years 43.4 per cent men aged 15-49 years 44.9 per cent 9.2 6.3 Comprehensive knowledge about HIV prevention amongst people aged 15-24 women aged 15-24 years 47.6 per cent men aged 15-24 years 47.4 per cent 9.3 Knowledge of mother-to-child transmission of HIV women aged 15-49 years 67.4 per cent men aged 15-49 years 49.2 per cent 9.4 Accepting attitudes towards people living with HIV women aged 15-49 years 15.1 per cent men aged 15-49 years 17.5 per cent 9.5 Women who know where to be tested for HIV 65.4 per cent Men who know where to be tested for HIV 71.0 per cent 9.6 Women who have been tested for HIV and know the results 0.4 per cent Men who have been tested for HIV and know the results 0.8 per cent 9.7 Sexually active women aged 15-24 who have been tested for HIV and know the results 0.1 per cent Sexually active men aged 15-24 who have been tested for HIV and know the results 1.2 per cent 9.8 HIV counselling during antenatal care 10.2 per cent 9.9 HIV testing during antenatal care 6.1 per cent Sexual behaviour 9.10 Women aged 15-24 who have never had sex 79.4 per cent Men aged 15-24 who have never had sex 52.8 per cent 9.11 Sex before age 15 amongst people aged 15-24 women aged 15-24 years 0.1 per cent men aged 15-24 years 1.5 per cent 9.12 Age mixing amongst sexual partners women aged 15-24 years 4.1 per cent men aged 15-24 years 0.6 per cent 9.13 Sex with multiple partners women aged 15-49 years 0.9 per cent men aged 15-49 years 6.5 per cent 9.14 Condom use during sex with multiple partners women aged 15-49 years (64.4) per cent men aged 15-49 years 60.9 per cent 9.15 Sex with non-regular partners women aged 15-24 years 58.8 per cent men aged 15-24 years 93.5 per cent 9.16 6.2 Condom use with non-regular partners women aged 15-24 years 71.4 per cent men aged 15-24 years 71.0 per cent Orphaned children 9.17 Children’s living arrangements 0.4 per cent 9.18 Prevalence of children with one or both parents dead 3.0 per cent Topic MICS4 Indicator Number MDG Indicator Number Indicator Value REPRODUCTIVE HEALTH Contraception and unmet need 5.1 5.4 Adolescent birth rate (women aged 15-19 years) 8 per 1,000 5.3 5.3 Contraceptive prevalence rate 45.8 per cent 5.4 5.6 Unmet need 9.0 per cent Maternal and newborn health Antenatal care coverage 5.5a 5.5 At least once by skilled personnel 87.0 per cent 5.5b 5.5 At least four times by any provider 84.2 per cent 5.6 Content of antenatal care 85.2 per cent 5.7 5.2 Skilled attendant at delivery 99.9 per cent 5.8 Institutional deliveries 99.7 per cent 5.9 Caesarean section 13.9 per cent CHILD DEVELOPMENT Child development 6.1 Support for learning 95.1 per cent 6.2 Father’s support for learning 76.2 per cent 6.3 Learning materials: children’s books 55.8 per cent 6.4 Learning materials: playthings 56.0 per cent 6.5 Inadequate care 1.6 per cent 6.6 Early Childhood Development Index 96.4 per cent 6.7 Attendance at early childhood education 13.1 per cent EDUCATION Literacy and education 7.1 2.3 Literacy rate amongst people aged 15-24 women aged 15-24 years 99.3 per cent men aged 15-24 years 99.9 per cent 7.2 School readiness 16.3 per cent 7.3 Net intake rate for primary education 83.2 per cent 7.4 2.1 Primary school net attendance ratio (adjusted) 97.6 per cent 7.5 Secondary school net attendance ratio (adjusted) 91.8 per cent 7.6 2.2 Children reaching last grade of primary school 99.5 per cent 7.7 Primary completion rate 146.1 per cent Net primary completion rate 91.5 per cent 7.8 Transition rate to secondary school 96.9 per cent 7.9 Gender Parity Index (primary school) 0.99 ratio 7.10 Gender Parity Index (secondary school) 1.02 ratio CHILD PROTECTION Child discipline 8.5 Violent discipline 55.2 per cent Early marriage 8.6 Marriage before age 15 women aged 15-49 years 0.4 per cent men aged 15-49 years 0.1 per cent 8.7 Marriage before age 18 women aged 20-49 years 9.5 per cent men aged 20-49 years 0.6 per cent 8.8 young women aged 15-19 years currently married or in union 0.6 per cent young men aged 15-19 years currently married or in union 0.0 per cent Spousal age difference 8.10a women aged 15-19 years (*) per cent 8.10b women aged 20-24 years 8.8 per cent Domestic violence 8.14 Attitudes towards domestic violence women aged 15-49 years 4.8 per cent men aged 15-49 years 6.0 per cent vi MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 Topic MICS4 Indicator Number MDG Indicator Number Indicator Value ACCESS TO MASS MEDIA AND USE OF INFORMATION/COMMUNICATION TECHNOLOGY Access to mass media MT.1 Exposure to mass media women aged 15-49 years 44.2 per cent men aged 15-49 years 55.8 per cent Use of information/ communication technology MT.2 Use of computers women aged 15-24 years 93.2 per cent men aged 15-24 years 94.0 per cent MT.3 Use of the Internet women aged 15-24 years 91.1 per cent men aged 15-24 years 92.1 per cent SUBJECTIVE WELL-BEING Subjective well-being SW.1 Life satisfaction women aged 15-24 years 53.5 per cent men aged 15-24 years 49.5 per cent SW.2 Happiness women aged 15-24 years 90.5 per cent men aged 15-24 years 91.1 per cent SW.3 Perception of a better life women aged 15-24 years 32.7 per cent men aged 15-24 years 35.7 per cent TOBACCO AND ALCOHOL USE Tobacco use TA.1 Tobacco use women aged 15-49 years 27.3 per cent men aged 15-49 years 39.9 per cent TA.2 Smoking before age 15 women aged 15-49 years 3.2 per cent men aged 15-49 years 9.4 per cent Alcohol use TA.3 Alcohol use women aged 15-49 years 18.3 per cent men aged 15-49 years 52.7 per cent TA.4 Use of alcohol before age 15 women aged 15-49 years 1.4 per cent men aged 15-49 years 8.4 per cent ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases SUMMARY TABLE OF FINDINGS . . . . . . . . . . . . . . . . . . .iii TABLE OF CONTENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii LIST OF TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .viii LIST OF FIGURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi LIST OF ABBREVIATIONS . . . . . . . . . . . . . . . . . . . . . . . . . xii ACkNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii ExECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . .xiv I INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Survey Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 II SAMPLE AND SURVEY METHODOLOGY . . . . 3 Sample Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Training and Fieldwork . . . . . . . . . . . . . . . . . . . . . . . . 5 Data Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Report Preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 How to Read the Tables . . . . . . . . . . . . . . . . . . . . . . . 6 III SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS . . . . . . . . . . . . . . . . . . . . . . . . 7 Sample Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Characteristics of Households . . . . . . . . . . . . . . . . . 8 Characteristics of Female and Male Respondents 15-49 years of Age and Children Under-5 . . . . . . . . . . . . . . . . . . . . . . . . 11 Children’s Living Arrangements . . . . . . . . . . . . . . 14 IV NUTRITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Nutritional Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Breastfeeding and Infant and young Child Feeding . . . . . . . . . . . . . . . . . . . . . 19 Low Birth Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 V CHILD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Immunisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Oral Rehydration Treatment . . . . . . . . . . . . . . . . . . 34 Care-Seeking and Antibiotic Treatment of Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Solid Fuel Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 VI WATER AND SANITATION . . . . . . . . . . . . . . . . . . 47 Use of Improved Drinking Water Sources . . . . . 47 Use of Improved Sanitation . . . . . . . . . . . . . . . . . . 54 Hand Washing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 VII REPRODUCTIVE HEALTH . . . . . . . . . . . . . . . . . . . 63 Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Knowledge of Contraceptive Methods . . . . . . . . 63 Use of Contraceptives . . . . . . . . . . . . . . . . . . . . . . . . 65 Unmet Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Assistance at Delivery . . . . . . . . . . . . . . . . . . . . . . . . 73 Place of Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 VIII CHILD DEVELOPMENT . . . . . . . . . . . . . . . . . . . . . 76 Early Childhood Education and Learning . . . . . 76 Early Childhood Development . . . . . . . . . . . . . . . 80 Ix LITERACY AND EDUCATION . . . . . . . . . . . . . . . . 82 Literacy amongst Women and Men aged 15 to 25 years . . . . . . . . . . . . . . . . . 82 School Readiness . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Primary and Secondary School Participation . . 84 x CHILD PROTECTION . . . . . . . . . . . . . . . . . . . . . . . . 92 Child Discipline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Early Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Attitudes towards Domestic Violence . . . . . . . . . 99 xI HIV/AIDS AND SExUAL BEHAVIOUR THAT INCREASES THE RISk OF HIV TRANSMISSION . . . . . . . . . . . . . . . . . . .102 Knowledge about HIV Transmission and Misconceptions about HIV/AIDS . . . . . . . .102 Accepting Attitudes towards People Living with HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114 Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care . . . . . . . . . . . . . . . . . . . . . . .117 Sexual Behaviour Related to HIV Transmission. .122 xII ACCESS TO MASS MEDIA AND USE OF INFORMATION/COMMUNICATION TECHNOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . .130 Access to Mass Media . . . . . . . . . . . . . . . . . . . . . . .130 Use of Information/Communication Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132 xIII TOBACCO AND ALCOHOL USE . . . . . . . . . . . .135 Tobacco Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Alcohol Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139 xIV SUBjECTIVE WELL-BEING . . . . . . . . . . . . . . . . .142 APPENDIx A: Sample Design . . . . . . . . . . . . . . . . . . . .150 APPENDIx B: List of Personnel Involved in the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155 APPENDIx C: Estimates of Sampling Errors . . . . . .159 APPENDIx D: Data Quality Tables . . . . . . . . . . . . . . .174 APPENDIx E: BiH MICS4 Indicators – Numerators and Denominators . . . . . . . . . .184 APPENDIx F: BiH MICS4 Questionnaires . . . . . . . . .191 APPENDIx G: Nutritional Status of Children (NCHS/CDC/WHO standard) . . . . . . . . . . . . . . .250 APPENDIx H: Education Tables by ISCED . . . . . . . .252 Table of Contents MONITORING THE SITUATION OF CHILDREN AND WOMEN vii List of Tables MONITORING THE SITUATION OF CHILDREN AND WOMEN ixviii MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 Table HH.1: Results of the household, women’s, men’s and under-5’s interviews . . . . . . . . . . . . . . . . . . . . . 7 Table HH.2: Household age distribution by sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Table HH.3: Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Table HH.4: Women’s background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Table HH.4M: Men’s background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Table HH.5: Under-5’s background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 Table HA.6: Children’s living arrangements and orphanhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Table NU.1: Nutritional status of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Table NU.2: Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Table NU.3: Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 Table NU.4: Duration of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 Table NU.5: Age-appropriate breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 Table NU.6: Minimum meal frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 Table NU.7: Bottle feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Table NU.8: Low birth weight infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Table CH.1 (a): Vaccinations in first year of life, BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Table CH.1 (b): Vaccinations in first year of life, FBiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 Table CH.1 (c): Vaccinations in first year of life, RS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 Table CH.2: Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 Table CH.3: Oral rehydration solutions and recommended homemade fluids . . . . . . . . . . . . . . . . . . . . . .35 Table CH.4: Feeding practices during diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Table CH.5: Oral rehydration therapy with continued feeding and other treatments . . . . . . . . . . . . . . . .38 Table CH.6: Prevalence of suspected pneumonia by background characteristics . . . . . . . . . . . . . . . . . . .40 Table CH.7: Knowledge of the two danger signs of pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Table CH.8: Solid fuel use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 Table CH.9: Solid fuel use by place of cooking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 Table WS.1: Use of improved water sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48 Table WS.2: Household water treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 Table WS.3: Time to source of drinking water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52 Table WS.4: Person collecting water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 Table WS.5: Types of sanitation facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54 Table WS.6: Use and sharing of sanitation facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56 Table WS.7: Disposal of child’s faeces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 Table WS.8: Drinking water and sanitation ladders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 Table WS.9: Water and soap at place for hand washing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 Table WS.10: Availability of soap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 Table RH.1: Adolescent birth rate and total fertility rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Table RH.2: Knowledge of specific contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64 Table RH.3: Knowledge of contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 Table RH.4: Use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66 Table RH.5: Unmet need for contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69 Table RH.6: Antenatal care coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71 Table RH.7: Number of antenatal care visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72 Table RH.8: Content of antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 Table RH.9: Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74 Table RH.10: Place of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 Table CD.1: Early childhood education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76 Table CD.2: Support for learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77 Table CD.3: Learning materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78 Table CD.4: Inadequate care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79 Table CD.5: Early childhood development index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Table ED.1: Literacy amongst women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82 Table ED.1M: Literacy amongst men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83 Table ED.2: School readiness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 Table ED.3: Primary school entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85 Table ED.4: Primary school attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86 Table ED.5: Secondary school attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 Table ED.6: Children reaching last grade of primary school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Table ED.7: Primary school completion and transition to secondary school . . . . . . . . . . . . . . . . . . . . . . . .90 Table ED.8: Education gender parity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91 Table CP.1: Child discipline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 Table CP.2: Early marriage: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Table CP.2M: Early marriage: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96 Table CP.3: Trends in early marriage: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 Table CP.3M: Trends in early marriage: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 Table CP.4: Spousal age difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98 Table CP.5: Attitudes towards domestic violence: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Table CP.5M: Attitudes towards domestic violence: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Table HA.1: Knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: women aged 15-49 . . . . . . . . . 103 Table HA.1M: Knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: men aged 15-49 . . . . . . . . . . . . 104 Table HA.2: Knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: women aged 15-24 . . . . . . . . . 108 Table HA.2M: Knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: men aged 15-24 . . . . . . . . . . . . 110 Table HA.3: Knowledge of mother-to-child HIV transmission: women . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Table HA.3M: Knowledge of mother-to-child HIV transmission: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Table HA.4: Accepting attitudes towards people living with HIV/AIDS: women . . . . . . . . . . . . . . . . . . . 115 Table HA.4M: Accepting attitudes towards people living with HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . 116 Table HA.5: Knowledge of a place for HIV testing: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Table HA.5M: Knowledge of a place for HIV testing: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Table HA.6: Knowledge of a place for HIV testing amongst sexually active women aged 15-24 . . . . 119 Table HA.6M: Knowledge of a place for HIV testing amongst sexually active men aged 15-24 . . . . . . . 120 Table HA.7: HIV counselling and testing during antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Table HA.8: Sexual behaviour that increases the risk of HIV infection: women . . . . . . . . . . . . . . . . . . . . 122 Table HA.8M: Sexual behaviour that increases the risk of HIV infection: men . . . . . . . . . . . . . . . . . . . . . . . 123 Table HA.9: Sex with multiple partners: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Table HA.9M: Sex with multiple partners: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Table HA.10: Sex with multiple partners: women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Table HA.10M: Sex with multiple partners: men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Table HA.11: Sex with non-regular partners: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Table HA.11M: Sex with non-regular partners: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 List of Figures MONITORING THE SITUATION OF CHILDREN AND WOMEN xix MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 Table MT.1: Exposure to mass media: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Table MT.1M: Exposure to mass media: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Table MT.2: Use of computers and the Internet: women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Table MT.2M: Use of computers and Internet: men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Table TA.1: Current and ever use of tobacco: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Table TA.1M: Current and ever use of tobacco: men. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Table TA.2: Age at first use of cigarettes and frequency of use: women . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Table TA.2M: Age at first use of cigarettes and frequency of use: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Table TA.3: Use of alcohol: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Table TA.3M: Use of alcohol: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Table SW.1: Domains of life satisfaction: women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Table SW.1M: Domains of life satisfaction: men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Table SW.2: Life satisfaction and happiness: women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Table SW.2M: Life satisfaction and happiness: men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Table SW.3: Perception of a better life: women aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Table SW.3M: Perception of a better life: men aged 15-24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Table SD.1: Allocation of clusters (primary selection units) by stratum . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Table SD.2: Percentage of selected EAs within the sampling frame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Table SD.3: Allocation of selected EAs, updated EAs and EAs in the sample by administrative unit in BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Table SD.4: Sample allocation by administrative unit and second stage strata in BiH . . . . . . . . . . . . . 152 Table SD.5: First stage and second stage selection probabilities by strata . . . . . . . . . . . . . . . . . . . . . . . . 153 Table SD.6: Adjusted (normalised) weights by sample strata . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Table SE.1: Indicators selected for sampling error calculations, BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Table SE.2: Sampling errors: Total sample, BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Table SE.3: Sampling errors: Urban areas, BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Table SE.4: Sampling errors: Rural areas, BiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Table SE.5: Sampling errors: FBiH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Table SE.6: Sampling errors: RS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Table SE.7: Sampling errors: BD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 Table DQ.1: Age distribution of household population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 Table DQ.2: Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Table DQ.2M: Age distribution of eligible and interviewed men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Table DQ.3: Age distribution of under-5’s in household and under-5 questionnaires . . . . . . . . . . . . . . 175 Table DQ.4: Women’s completion rates by socio-economic characteristics of households . . . . . . . . . 176 Table DQ.4M: Men’s completion rates by socio-economic characteristics of households . . . . . . . . . . . . 177 Table DQ.5: Completion rates for under-5 questionnaires by socio-economic characteristics of households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Table DQ.6: Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Table DQ.7: Completeness of information for anthropometric indicators . . . . . . . . . . . . . . . . . . . . . . . . . 180 Table DQ.8: Heaping in anthropometric measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Table DQ.9: Observation of places for hand washing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Table DQ.10: Observation of vaccination cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Table DQ.11: Presence of mother in the household and the person interviewed for the under-5 questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Table DQ.12: Selection of children aged 2-14 years for the child discipline module . . . . . . . . . . . . . . . . 182 Table DQ.13: School attendance by single age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Table NU.1 (a): Nutritional status of children (NCHS/CDC/WHO standard) . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 Table ED.1 ISCED: Primary school attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Table ED.2 (a) ISCED: Lower secondary school attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254 Table ED.2 (b) ISCED: Upper secondary school attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Table ED.3 ISCED: Education gender parity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 Figure HH.1: Age and sex distribution of household population, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . 9 Figure NU.1: Percentage of children under age 5 who are underweight, stunted, wasted or overweight, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Figure NU.3: Infant feeding patterns by age, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 Figure CH.1: Percentage of children aged 18-29 months who received the recommended vaccinations by 12 months (18 months for MMR), BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . .30 Figure CH.2: Percentage of children under age 5 with diarrhoea who received ORT with continued feeding, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 Figure CH.3: Percentage of children under age 5 with diarrhoea who received ORT or increased fluids, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39 Figure WS.1: Per cent distribution of household members by source of drinking water, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48 Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Figure HA.1M: Percentage of men who have comprehensive knowledge of HIV/AIDS transmission, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Figure DQ.1: Number of household population by single ages, BiH 2011–2012 . . . . . . . . . . . . . . . . . . . . . 182 xii MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN xiii Acknowledgments The report before you is the result of a joint effort by numerous institutions and individuals that contributed through their enthusiasm and commitment to the successful implementation of MICS 2011–2012 for Bosnia and Herzegovina (BiH), as part of the fourth global round of the MICS programme (MICS4). The Federal Office of Statistics (FOS) and the Republic of Srpska Institute of Statistics (RSIS), in cooperation with the Agency for Statistics of BiH (BHAS), enabled survey implementation through the development of the MICS4 master sample frame. Survey teams and fieldwork and data entry staff played a crucial role in the implementation of the survey enabling, through their enthusiasm and commitment, the collation of the data presented in this report. We would like to thank the global MICS team from the Division of Policy and Practice at UNICEF New York, UNICEF’s Central and Eastern Europe/Commonwealth (CEE/CIS) Regional Office in Geneva, especially the regional MICS Coordinator, and the UNICEF Office for BiH whose continuous technical and logistical support was of vital importance for all phases of the survey. Survey implementation was made possible through the financial support of UNICEF, UN Women, which supported activities to update the MICS4 master sample frame, as well as UNFPA and UNHCR. Our greatest appreciation goes to all of the households and individuals for their patience and the time they set aside. Their willingness to participate reflects their awareness of the need to present their living conditions with the aim to contribute towards an improvement of living conditions for children in BiH. It is our hope that this report will contribute to the fulfilment of this goal. AIDS Acquired Immune Deficiency Syndrome BCG Bacillis-Cereus-Geuerin (Tuberculosis) BD Brcko District of Bosnia and Herzegovina BHAS Agency for Statistics of Bosnia and Herzegovina BiH Bosnia and Herzegovina CDC Centres for Disease Control and Prevention CEDAW Convention on the Elimination of All Forms of Discrimination against Women CEE Central and Eastern Europe CIS Commonwealth of Independent States CRC Convention on the Rights of the Child CSPro Census and Survey Processing System DPT Diphtheria Pertussis Tetanus EA Enumeration Area ECDI Early Childhood Development Index EPI Expanded Programme on Immunisation FBiH Federation of Bosnia and Herzegovina FMH Federal Ministry of Health FOS Federal Office of Statistics GAP Gender Action Plan of Bosnia and Herzegovina GPI Gender Parity Index Hep B Hepatitis B Hib Haemophilus influenzae type B HIV Human Immunodeficiency Virus IUD Intrauterine Device IPH FBiH Institute for Public Health of the Federation of Bosnia and Herzegovina IPV Inactive polio vaccine JMP Joint Monitoring Programme LAM Lactational Amenorrhea Method MDG Millennium Development Goals MHSW RS Ministry of Health and Social Welfare of the Republic of Srpska MICS Multiple Indicator Cluster Survey MICS4 Fourth global round of the Multiple Indicator Cluster Surveys programme MMR Measles Mumps Rubella NAR Net Attendance Ratio NCHS National Center for Health Statistics OPV Oral polio vaccine ORS Oral rehydration salts ORT Oral rehydration treatment ppm Parts per million PSU Primary Sampling Unit RS Republic of Srpska RSIS Republic of Srpska Institute of Statistics SPSS Statistical Package for Social Sciences SSU Secondary Sampling Unit STI Sexually transmitted infection TFR Total Fertility Rate UNAIDS United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session on HIV/AIDS UNHCR United Nations High Commissioner for Refugees UNICEF United Nations Children’s Fund UN Women United Nations Entity for Gender Equality and the Empowerment of Women WFFC A World Fit For Children WHO World Health Organization List of Abbreviations xiv Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen xv z About 19 per cent of children aged less than six months in BiH were exclusively breastfeed. The percentage of children aged 2-3 months being exclusively breastfed was half that of newborn children. However, every second child below six months of age was predominantly breastfed (46 per cent) and one in eight children were still being breastfed at age one. z Approximately one-fifth (18 per cent) of children aged 0-23 months were breastfed appropriately according to age. This includes exclusive breastfeeding during the initial six months and breastfeeding combined with supplemental food between six months and two years of age. Low Birth Weight Low birth weight (less than 2,500 grams) carries a range of severe health risks for children and therefore it is important for all children to be weighed at birth. z Almost all children born in the two years preceding the survey were weighed at birth (98 per cent), with 3 per cent of them weighing below 2,500 grams. Child Health Immunisation Coverage According to UNICEF and WHO guidelines children should receive the BCG vaccination, to protect against tuberculosis, three doses of DPT, to protect against diphtheria, pertussis, and tetanus, and three doses of the polio vaccine, and the measles vaccination by 12 months of age. A World Fit for Children goal is to ensure full immunisation coverage for children under one year of age at 90 per cent nationally, with at least 80 per cent coverage in every administrative unit. z Overall, at the time of the survey, vaccination cards or health booklets were available for 91 per cent of children under 5 year of age. z By the age of 12 months, 99 per cent of children had received a BCG vaccination. z Ninety-five per cent of children aged 18-29 months had received the first dose of the polio vaccine; however, coverage for the polio vaccine declined with subsequent doses to 93 per cent for the second and 85 per cent for the third dose. Similarly, 95 per cent of children had received the first dose of the DPT vaccination by the age of 12 months, yet the percentage declined to 86 per cent by the third dose. z The vaccine to protect against measles, rubella and mumps (MMR) is received by 18 months of age in BiH. The percentage of children immunised against MMR was lower than for other vaccines at 80 per cent; as a result, immunisation coverage of children aged 18-29 months by all listed vaccinations was somewhat lower at 68 per cent (this percentage includes children of this age that had received a BCG vaccine, three doses of the DPT vaccination and three doses of the polio vaccination during infancy as well as an MMR vaccine by 18 months of age). Oral Rehydration Treatment The goal of diarrhoea treatment is to help reduce the mortality rate amongst children under five by two-thirds between 1990 and 2015, while A World Fit for Children calls for a reduction in the incidence of diarrhoea by 25 per cent. z Overall 6 per cent of children under 5 years of age had had diarrhoea in the two weeks preceding the survey. z About one-third of children of that age (36 per cent) with diarrhoea had received oral rehydration salts (ORS), either as a fluid from an ORS packet or as a pre-packaged ORS fluid. One quarter (25 per cent) of children were treated with antimotility medication in the form of tablets or syrups, while about 4 per cent of children were treated with antibiotics (administered as a pill, syrup or injection). Nearly one-fifth of children with diarrhoea (19 per cent) were treated with home remedies/herbal medicine. Twenty-one per cent of children did not receive any treatment or medication. z Nearly half of the children (45 per cent) were given more than usual to drink during an episode of diarrhoea, while 6 per cent were given much less than usual to drink. In 82 per cent of cases children with diarrhoea were given the same or less to eat, while in 6 per cent of cases children were given much less than usual to eat and in 5 per cent of cases feeding was stopped. z Two-thirds of children (65 per cent) with diarrhoea received ORS or drank more than usual, while 55 per cent received oral rehydration therapy (ORT) with continued feeding. Executive Summary The BiH MICS4 2011–2012 was conducted using a representative sample in order to provide estimates for a large number of indicators on the situation of children, women and men as well as household living conditions at the level of BiH, the Federation of BiH (FBiH), the Republic of Srpska (RS) and for urban and rural areas. The survey is based on a representative sample of 6,838 households in BiH (4,107 in FBiH, 2,408 in RS and 323 in Brcko District (BD) of BiH) with an overall response rate of 91 per cent (in total, 5,778 households were interviewed). The results reflect data collected during the period November 2011 and March 2012. The survey was undertaken as part of the fourth global round of the MICS programme and implemented by the Federal Ministry of Health (FMH) and the Ministry of Health and Social Welfare of the Republic of Srpska (MHSW RS) in cooperation with the Institute for Public Health of the FBiH (IPH FBiH) and the Agency for Statistics of BiH (BHAS). Financial and technical support was provided by UNICEF with additional financial support provided by UN Women for preparing the master sample frame, as well as by UNFPA and UNHCR. The primary aim of MICS is to provide indicators for monitoring the level of progress towards the Millennium Development Goals, the Plan of Action for A World Fit for Children as well as other international and national commitments undertaken by BiH. The survey findings are presented from the equity perspective by indicating disparities in accordance with administrative units, sex, area type, the level of education of the respondent or head of the household, household wealth and other characteristics. Nutrition Nutritional Status Under MICS4 the weight and height of all children under 5 years of age were measured using anthropometric equipment recommended by UNICEF. The indicators were based on the World Health Organization (WHO) standard for the reference population of children, that in 2006 superseded the US National Center for Health Statistics, US Centers for Disease Control and Prevention and WHO (NCHS/CDC/WHO) standards that had been in use since 1978. z The most prominent problem identified in BiH in terms of nutrition was that of overweight children: one in six children under 5 years of age in BiH (FBiH and RS) was overweight. z Stunting, at 9 per cent, was the second most prevalent issue amongst children under 5 years of age, whereby 4 per cent of children this age were severely stunted, indicating chronic malnutrition (largely due to a failure to receive adequate nutrition over a long period and recurrent and chronic illness). The highest percentage of stunted children of that age was found amongst children aged 0-5 months. z The prevalence of wasting was low and present amongst 2 per cent of children under 5 years of age, whereby nearly two-thirds of these children were severely wasted. Wasting is usually the result of a recent nutritional deficiency and this indicator may exhibit significant seasonal fluctuations. The highest percentage of wasted children was found amongst children aged 0-5 months. z The prevalence of underweight children was low and present amongst 2 per cent of children under 5 years of age in BiH, whereby half of these children were severely underweight. The highest percentage of underweight children was found amongst children aged 6-11 months. Breastfeeding and Child Feeding Breastfeeding in the first few years of life protects children from infection, provides an ideal source of nutrients and is economical and safe. According to WHO and UNICEF recommendations exclusive breastfeeding is considered appropriate feeding for infants aged 0-5 months, while infants aged 6-23 months are considered to be appropriately fed if they are receiving breast milk and solid, semi-solid or soft foods. z Less than half of the youngest children in the surveyed households (42 per cent) born in the two years preceding the survey were first breastfed within one hour of birth, while a higher percentage (87 per cent) of newborns were first breastfed within one day of birth. z One-fifth of newborns received a prelacteal feed. xvi MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN xvii z Improved sources of drinking water and improved sanitation were used by 94 per cent of the population in BiH, the percentage declined with reduced household wealth. z The percentage of children aged 0-2 years whose last stools were disposed of safely was 20 per cent; for the highest proportion of children (79 per cent), their last stools were were disposed of by throwing them into the rubbish, which is not considered a safe method of disposal. Hand Washing Hand washing with water and soap is the most cost-effective health intervention to reduce the incidence of both diarrhoea and pneumonia in children under five. z Most households in BiH had a specific place for hand washing (98 per cent). In 98 per cent of cases when the place for hand washing was observed during the survey this place had both water and soap present. While there were no obvious variations by background characteristics of the households, water and soap were present in the place for hand washing by 6 percentage units less amongst the poorest compared to the richest households. Reproductive Health Fertility The total fertility rate (TFR) denotes the average number of children which a woman will have had by the end of her reproductive years, if the current fertility rates prevail. z The TFR for one year preceding the survey was 1.3 births per woman aged 15-49. The adolescent birth rate in BiH was 8 births per 1,000 women aged 15-19 for the one year period preceding the survey. knowledge of Contraceptive Methods and Use of Contraceptives Being aware of available contraceptive methods is an important step towards accessing and using a suitable method of contraception, which in turn allows choices to be made concerning family planning. z Nearly all women aged 15-49 knew at least one contraceptive method (including both modern and traditional methods). On average women knew 9.4 different contraceptive methods. z The most widely known modern method was the male condom (98 per cent). The most widely known of the traditional methods was withdrawal (93 per cent). z Contraception was currently being used by 46 per cent of married or in-union women in BiH, with traditional methods more commonly used than modern ones (34 per cent versus 12 per cent). The most popular method was withdrawal, used by one-third of married women, while the subsequent most popular method was the male condom, used by 6 per cent of women. Amongst other methods of contraception, 4 per cent of women used an intrauterine device (IUD), 4 per cent practiced periodic abstinence and 2 per cent used the pill. z More than half of women aged 15-49 in RS used a contraceptive method (54 per cent), while this percentage was somewhat lower in the FBiH (43 per cent). The contraceptive prevalence rate was similar in urban and rural areas. Contraceptive prevalence is associated with the number of births a woman has had as well as her education level. Thus, the percentage of women using any method increased from 37 per cent amongst women who had had one live birth to 53 per cent amongst women who had had four or more live births and from 45 per cent amongst women with primary education to 55 per cent amongst women with higher education. The prevalence of modern contraceptive methods rose in line with household wealth. Unmet Need for Contraception Unmet need for contraception refers to fecund women who do not use any method of contraception but who wish to postpone their next birth (spacing) or who wish to stop childbearing altogether (limiting). z The total unmet need for contraception in BiH was low: being present amongst 9 per cent of women aged 15-49. The unmet need for contraception was higher amongst women aged 20-24 (24 per cent) and women aged 25-29 (21 per cent). z One in three women had met the need for limiting, while one in nine women had met need for spacing. Care-Seeking and Antibiotic Treatment of Pneumonia A World Fit for Children goal is to reduce by one-third deaths resulting from acute respiratory infection. z About 3 per cent of children under 5 years of age were reported to have had symptoms of pneumonia during the two weeks preceding the survey. Of these children, 87 per cent were taken to an appropriate healthcare provider. Most children with suspected pneumonia were examined in public sector health facilities: nearly half of these children (48 per cent) were taken to a health centre and about one quarter to a hospital (24 per cent). Seventy-six per cent of children with suspected pneumonia in the two weeks preceding the survey were treated using antibiotics. z One in seven mothers (15 per cent) knew of two danger signs of pneumonia (fast and difficult breathing). The highest percentage of mothers (88 per cent) identified fever as a symptom for taking their child immediately to a health facility. In contrast, a lower proportion of mothers would take their children to a health facility in the event of difficult (39 per cent) or fast (20 per cent) breathing. Solid Fuel Use Cooking and heating with solid fuel in the household leads to high levels of indoor smoke, which consists of a complex mix of health-damaging pollutants. z Slightly more than two-thirds (70 per cent) of households in BiH use solid fuel for cooking, most of which use wood. The use of solid fuel for cooking was predominant in rural areas (83 per cent); however, this was not a rare occurrence in urban areas, where two-fifths of households (43 per cent) used solid fuel. Solid fuel used for cooking purposes was not common amongst the richest households, but rose with the declining wealth status and decreasing level of education of the head of the household. z More than half of the households in BiH (59 per cent) had a designated room for cooking, the lowest percentage being amongst the poorest households. Water and Sanitation One of the Millennium Development Goals is to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation between 1990 and 2015. Use of Improved Drinking Water Sources Safe drinking water is a basic necessity for good health; unsafe drinking water can be a significant carrier of numerous diseases. z Nearly the entire population in BiH uses an improved source of drinking water, including piped water (into dwellings, compounds, yards or plots or to neighbours and public taps/standpipes), tube well/boreholes, protected wells, protected springs and rainwater collection and, in certain circumstances, bottled water. z Of the 89 per cent of the household members using piped water, 4 per cent had a source of drinking water outside the dwelling. Access to piped water was somewhat less frequent in rural areas (86 per cent) compared to urban areas (93 per cent), while it was 71 per cent amongst the poorest population compared to 92 per cent amongst the richest population. z Six per cent of the population in BiH had no water source on the premises. This percentage rose with the deteriorating wealth status. Amongst the household population with no water on the premises, in nearly two-thirds of cases water was collected by an adult male (62 per cent) and to a lesser extent by an adult female (32 per cent). In 3 per cent of cases water was collected by children under 15 years of age. Use of Improved Sanitation Improved sanitation can reduce diarrheal disease by more than a third and can significantly lessen the adverse health impact of other disorders. z Improved sanitation for excreta disposal in households were used by 94 per cent of the population in BiH. This was slightly more frequent in urban (99 per cent) compared to rural areas (92 per cent). In urban areas 92 per cent of the population used flush toilets, while the population in rural areas most commonly used septic tanks (58 per cent); the population in urban areas most often used flush toilets connected to a sewer system (83 per cent). xviii MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN xix Literacy and Education Literacy amongst Women and Men aged 15-24 Youth literacy is an important MDG indicator. z The literacy rate for women and men aged 15-24 was over 99 per cent, lower only amongst women with primary education (88 per cent). School Readiness Readiness of children for primary school can be improved through attendance at early childhood education programmes or preschool attendance. z One in six children in BiH (16 per cent) who were currently attending the first grade of primary school had attended preschool during the previous year. The proportion was higher amongst females (25 per cent) than males (10 per cent) and also amongst children living in urban areas (25 per cent) compared to children in rural areas (13 per cent). Primary and Secondary School Participation Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the Millennium Development Goals and A World Fit for Children. z Of the total number of children who were of primary school entry age in BiH 83 per cent were attending the first grade: 93 per cent in RS and 80 per cent in the FBiH. Children of primary school entry age in urban areas were less likely to attend school (77 per cent) compared to children in rural areas (86 per cent). The net primary school completion rate in BiH was 92 per cent. z Nearly all children of primary school age in BiH attended school (98 per cent): 99 per cent in RS and 97 per cent in the FBiH. Most children that start grade one eventually reach the last grade of primary school. z Of the children who had attended the last grade of primary school in the previous year 97 per cent were attending the first grade of secondary school during the school year in which the survey took place. z About 92 per cent of children aged 15-18 were attending secondary school in BiH, both in the FBiH and RS. Children from the poorest households were less likely to attend secondary school or higher education (84 per cent) compared to children from the richest households. z The Gender Parity Index (GPI) in BiH was 0.99 for primary school and 1.02 for secondary school. In the FBiH the GPI was 0.99 for primary and 1.00 for secondary school, while in RS the GPI was 1.00 for primary and 1.06 for secondary school. Child Protection Child Discipline A World Fit for Children states that children must be protected against any acts of violence. The Millennium Declaration also calls for the protection of children against abuse exploitation and violence. z Every other child aged 2-14 in BiH had been subjected to psychological aggression as punishment, or physical punishment, by an adult in the household during the past month preceding the survey (55 per cent). Forty-two per cent of children had been subjected to psychological aggression as punishment and a similar proportion of children (40 per cent) had been subjected to physical punishment. One in twenty children of that age had been subjected to severe physical punishment, while one-third of children had been disciplined using only non-violent methods. z Male children were to a higher extent subjected to violent methods of discipline compared to female children (60 per cent compared to 50 per cent). Children in households where the household head had no education were five times more likely to be subjected to severe physical violence as punishment compared to children from households where the household head had primary secondary or higher education. Antenatal Care During the antenatal period pregnant women may be reached through a number of interventions that may be vital to their health and well-being and that of their infants. The WHO recommends a minimum of four antenatal visits, with specific content including blood pressure measurement, urine testing, blood testing and weight/height measurement. z Eighty-seven present of women aged 15-49 in BiH who had given birth in the two years that preceded the survey had received antenatal care from a healthcare provider. Almost all of the women had received antenatal care from a healthcare provider in RS, while in the FBiH the percentage was lower at 82 per cent. Antenatal care was provided largely by medical doctors (86 per cent). z About 84 per cent of women aged 15-49 had received antenatal care four or more times. z Three essential antenatal care services (blood pressure measurement, urine and blood testing) were provided to 85 per cent of the women aged 15-49 who had given birth in the two years preceding the survey. Assistance at Delivery and Place of Delivery Three-quarters of all maternal deaths occur during delivery and the immediate post-partum period. An important A World Fit for Children goal is to ensure that women have ready and affordable access to skilled attendance at delivery. z Almost all births in the two years preceding the survey were delivered by skilled personnel and in public sector health facilities. z One in seven women had been attended during delivery by a nurse/midwife, while the rest of the women had been assisted by a medical doctor. z One in seven women (14 per cent) gave birth by Caesarean section. The percentage of women who gave birth by Caesarean section was highest amongst women from the richest households (21 per cent). Child Development Early Childhood Education and Learning A period of rapid brain development occurs in the first 3-4 years of life and the quality of home care is the major determinant in a child’s development during this period. Therefore, engagement of adults in activities with children, the presence of children’s books in the household and the conditions of care are important indicators of the quality of home care. z For the majority of children under-five (95 per cent) an adult had engaged in four or more activities that promote learning and school readiness during the three days preceding the survey. The average number of activities was 6, while fathers engaged on average in 3 activities. z Slightly more than half of the children aged 0-59 months (56 per cent) lived in households where at least 3 children’s books and 2 or more types of playthings were present (56 per cent). z About 2 per cent of children aged 0-59 months had been left with inadequate care during the week prior to the interview, including children who were left in the care of other children under 10 years of age or left alone at home. z Thirteen per cent of children aged 36-59 months in BiH were attending an organised early childhood programme. Compared to urban areas, where one in five children was attending an organised early childhood programme, such programmes were attended by only one in thirteen children in rural areas. Children in the poorest households and children of mothers or caretakers with primary education were much less likely to attend early childhood programmes. Early Childhood Development Index Early child development is defined as an orderly predictable process along a continuous path. The Early Childhood Development Index (ECDI) is calculated as the percentage of children who are developmentally on track in at least three of the following domains: literacy and numeracy skills, physical growth, socio-emotional development and learning. z Ninety-six per cent of children aged 36-59 months in BiH were developmentally on track (96 per cent in the FBiH and 98 per cent in RS). No clear variations were observed by sex, area or other background characteristics. z More than 90 per cent of children were developmentally on track in the physical, socio-emotional and learning domains, while a smaller proportion of children aged 36-59 months were developmentally on track in literacy and numeracy skills (25 per cent). xx MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN xxi Attitudes towards People Living with HIV/AIDS The indicators on attitudes towards people living with HIV measure stigma and discrimination within a community. z In BiH 15 per cent of women and 18 per cent of men aged 15-49 had accepting attitudes for all four indicators of attitudes towards people living with HIV/AIDS. Accepting attitudes were more common amongst women in urban areas, while no difference by area was observed amongst men. Both women and men with higher education were more likely to have accepting attitudes in this respect. z The most common accepting attitudes were expressed towards members of the respondent’s family. More than 90 per cent of women and men showed a willingness to care for a family member living with HIV in their own household, while slightly less than half of the women (45 per cent) and men (49 per cent) would not want to keep the HIV status of a family member a secret. knowledge of a Place for HIV Testing and Counselling and Testing during Antenatal Care In order to protect themselves and to prevent infecting others it is important for individuals to know their HIV status. Knowledge of where to be tested for HIV and use of such services is a critical factor in the decision to seek treatment. z A higher percentage of men (71 per cent) than women (65 per cent) aged 15-49 in BiH knew of a facility where they could be tested for HIV; however, an equally low percentage of men and women had ever been tested for HIV (3 per cent of women and 5 per cent of men). A higher percentage of women (79 per cent) and men (78 per cent) aged 15- 24 who were sexually active knew where to be tested for HIV, while the percentage of those who had been tested for HIV was approximately the same as that for the population of women and men aged 15-49. A higher percentage of people aged 15-24 in RS (92 per cent of women and 88 per cent of men) knew where to be tested for HIV compared to the FBiH (72 per cent of women and 73 per cent of men). z Of the women aged 15-49 who had given birth in the two years prior to the survey only 10 per cent had received HIV counselling during antenatal care. During the antenatal period 6 per cent of women had been offered an HIV test, been tested and told the result. In RS a higher percentage of women in this population had been offered an HIV test, tested during the antenatal period and told the result (12 per cent) compared to FBiH (3 per cent). Sexual Behaviour Related to HIV Transmission In most countries over half of new HIV infections occur amongst people aged 15-24, thus a change in behaviour amongst this age group is especially important if the number of new infections is to be reduced. In this respect, using a condom every time is of particular importance. z The proportion of women and men aged 15-24 who had had sex before age 15 was very low (less than 1 per cent for women and 2 per cent for men). z Within the last 12 months 4 per cent of women aged 15-24 in BiH had had sex with a man who was older by ten years or more, while less than 1 per cent of men of the same age had had sex with a woman who was older by ten years or more. z One per cent of women and 7 per cent of men aged 15-49 in BiH had had sex with more than one partner in the last 12 months and slightly less than two-thirds of these men indicated condom use when they had sex the last time (61 per cent). z Fifty-three per cent of women aged 20-24 and 73 per cent of men of this age reported having had sex in the last 12 months, while 2 per cent of women and 17 per cent of men of this age had had sex with more than one partner in the last 12 months. About two-thirds of these men indicated condom use when they had sex the last time (66 per cent). z Seven out of ten women and men aged 15-24 in BiH had used a condom the last time they had had sex with a non- marital/non-cohabiting partner. Early Marriage The right to ‘free and full’ consent to a marriage is recognised in the Universal Declaration of Human Rights through the recognition that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. Child marriage is a violation of human rights, compromising the development of girls and often resulting in social isolation and ultimately reinforcing the gendered nature of poverty. z Early marriage is more common amongst women than men. The proportion of women and men aged 15-49 who married before 15 years of age was very low (less than 1 per cent); however, the proportion rose to 10 per cent for women aged 20-49 who married before age 18 (amongst men the proportion remained at under 1 per cent). The practice of early marriage amongst women aged 20-49 was more common in rural areas and amongst women with primary education. z Less than 1 per cent of women aged 15-19 were married or in union at the time of survey, while no such cases were observed amongst the men. z One in eleven women aged 20-24 in BiH were married to or in union with a man who was older by ten years or more, while the highest percentage of women of this age (48 per cent) were currently married to a man who was up to 4 years older. Attitudes towards Domestic Violence It is believed that women who feel that a man has the right to hit or beat his wife are frequently abused by their husbands/partners and that those men who hold the same opinion frequently abuse their wives or partners. z Five per cent of women and 6 per cent of men in BiH felt that a husband/partner has the right to hit or beat his wife/ partner for at least one of the various reasons mentioned in the survey. z Women and men most often justified a husband’s violence by instances where a woman neglects the children (4 per cent for women and 5 per cent for men). Justification of wife-beating was more present amongst the less educated women and men and amongst those living in the poorest households. HIV/AIDS and Sexual Behaviour that Increases the Risk of HIV Transmission knowledge about HIV Transmission and Misconceptions about HIV/AIDS One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. The UN General Assembly Special Session on HIV/AIDS called on governments to improve the knowledge and skills of young people on how to protect themselves against HIV. z Nearly all women and men in BiH aged 15-49 had heard of HIV/AIDS (about 99 per cent), while a lower percentage of women (82 per cent) and men (88 per cent) knew about the two main ways to prevent HIV transmission: having only one faithful uninfected partner and using a condom every time. The percentages for women and men aged 15-24 were similar. z Less than 1 half of women (43 per cent) and men (45 per cent) aged 15-49 had comprehensive knowledge of HIV prevention methods and transmission, while such knowledge was somewhat higher amongst persons aged 15-24 (48 per cent for both sexes). z Forty-eight per cent of women and men aged 15-49 rejected the two most common misconceptions regarding HIV/ AIDS, namely that HIV can be transmitted by mosquito bites and that HIV can be transmitted by sharing food with an infected person, and knew that a healthy looking person can be infected. Amongst persons aged 15-24 this percentage was somewhat higher at 54 per cent for women and 52 per cent for men. z In BiH 85 per cent of women and 75 per cent of men aged 15-49 knew that HIV can be transmitted from mother-to- child. One in eight women and one in four men did not know of any specific means of mother-to-child transmission of HIV. The percentage of women and men with knowledge on mother-to-child HIV transmission increased with their level of education and wealth. xxii Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 1 I Introduction Background This report presents findings based on the indicators taken from the BiH MICS conducted in 2011 and 2012 by the Federal Ministry of Health, the Ministry of Health and Social Welfare of RS and the Institute for Public Health of FBiH (as the implementing agency for the FBiH, under the auspices of FMH) as well as the Agency for Statistics of BiH. Technical and financial support was provided by UNICEF together with financial support from UN Women2 and UNFPA as well as UNHCR. An identical methodological approach as well as an identical approach towards fieldwork and data entry, data processing and analysis was applied in the FBiH, RS and BD. This survey provides valuable information on the situation of children, women and men in BiH and is based, to a large extent, on the need to monitor progress towards the goals and targets arising from current international agreements: the Millennium Declaration, adopted by all 191 United Nations Member States in September 2000, and the Plan of Action of A World Fit For Children, adopted by 189 Member States at the United Nations Special Session on Children in May 2002. These commitments build upon promises made by the international community at the 1990 World Summit for Children. In signing these international agreements governments have committed themselves to improve the conditions for children and to monitor progress towards that end. UNICEF has been assigned a supporting role in this task. A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the A World Fit for Children Declaration and Plan of Action also committed themselves to monitoring progress towards the goals and objectives they contained: “We will monitor regularly at the national level and, where appropriate, at the regional level and assess progress towards the goals and targets of the present Plan of Action at the national, regional and global levels. Accordingly, we will strengthen our national statistical capacity to collect, analyse and disaggregate data, including by sex, age and other relevant factors that may lead to disparities, and support a wide range of child-focused research. We will enhance international cooperation to support statistical capacity-building efforts and build community capacity for monitoring, assessment and planning.” (A World Fit for Children, paragraph 60) “…We will conduct periodic reviews at the national and subnational levels of progress in order to address obstacles more effectively and accelerate actions.…” (A World Fit for Children, paragraph 61) The Plan of Action (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “… As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with governments, relevant funds, programs and the specialised agencies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “… We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration and ask the Secretary-General to issue periodic reports for consideration by the General Assembly and as a basis for further action”. MICS4 results are of particular importance for assessing the progress made towards the 2015 goals and targets of the Millennium Declaration and the Plan of Action of A World Fit for Children and therefore they supplement available administrative data and official statistics. 2 un women supported the preparation of the Mics4 master sample frame. Access to Mass Media and Use of Information/Communication Technology MICS4 collected information on exposure of women and men aged 15-49 to newspapers/magazines, radio and television, as well as the use of computers and the Internet amongst persons aged 15-24. z Forty-four per cent of women and 56 per cent of men aged 15-49 had been exposed to all three types of media (newspaper, radio and television) on a weekly basis, while less than 1 per cent of women and men are not exposed to any type of media at least once a week. z Exposure of both sexes to television was near-universal, while exposure of both women and men aged 15-49 to the printed media rose in line with an increased level of education and or wealth and was higher amongst those living in urban areas. z Most women and men aged 15-24 had used a computer during their lifetime (97 per cent), while a lower proportion had used a computer at least once a week during the last month (84 per cent of women and 87 per cent of men). The pattern of Internet usage was similar to the pattern of computer use for both sexes. Tobacco and Alcohol Use Many studies have shown that using tobacco products is a risk factor for many deadly diseases, including cardiovascular disease and respiratory illness. Excessive and long-term alcohol use also increases the risk of cardiovascular problems, neurological impairment, liver disease and social problems. z Use of tobacco products in BiH was more common amongst men than amongst women. Two-thirds of men aged 15-49 and slightly less than half of women in this age group reported having used a tobacco product during their lifetime. z Twenty-seven per cent of women and 40 per cent of men in BiH indicated that they smoked cigarettes or had used smoke or smokeless tobacco products on one or more days during the last one month. z Seventy per cent of men that currently smoked cigarettes had smoked more than 20 cigarettes in the last 24 hours, while the highest proportion of those women that currently smoked cigarettes had smoked 10-19 cigarettes during the same period (41 per cent). z A higher percentage of men aged 15-49 (8 per cent) had had at least one drink of alcohol before age 15 compared to women (1 per cent). Alcohol consumption before age 15 for both sexes was most common in the youngest surveyed age group (15-19 years of age). z At least one drink of alcohol on one or more days during the last one month applied to a higher proportion of men (53 per cent) than women (18 per cent). Alcohol use was highest amongst women aged 20-24 (27 per cent). Alcohol use amongst women rose in line with increased wealth and level of education, while such differences were less pronounced amongst men. Subjective Well-Being Understanding the satisfaction of young women and young men in different areas of their lives and their happiness can help us to gain a comprehensive picture of young people’s life situations. z More than one half of young women (54 per cent) and half of men (50 per cent) aged 15-24 were satisfied with their life. The proportion of young persons of both sexes who were satisfied with life was higher amongst those with higher education compared to those with secondary or primary education. z In contrast to life satisfaction, happiness is a fleeting emotion that can be affected by numerous day-to-day factors. An equal percentage of young women and men indicated that they were very happy or happy (91 per cent). z About one-third of women and men aged 15-24 in BiH thought that their lives had improved during the previous year and expect that their lives would get better after one year. Such positive perceptions were more common amongst people of both sexes aged 15-24 who were currently married/in union or were ever married/in union (42 per cent of women and 64 per cent of men) compared to those who had never been married/in union (31 per cent of women and 35 per cent of men). 2 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 3 II Sample and Survey Methodology Sample Design The sample for the BiH MICS4 was designed to provide estimates for a large number of indicators on the situation of children, women and men at the level of BiH, FBiH and RS (the main geographic sampling domains)3 together with urban and rural areas. The official population estimate for BiH is 3.8 million inhabitants living in about one million households.4 The FBiH covers approximately 51 per cent of the territory of BiH and 62 per cent of the population; the RS covers approximately 49 per cent of the territory and about 36 per cent of the population; and the BD covers less than 1 per cent of the territory and approximately 2 per cent of the population. The last census in BiH was conducted in 1991 and thus the representative samples for social surveys were selected using the Master Sample methodology. The 2009 Master Sample for BiH was used to select the BiH MICS4 master sample frame, which was updated for this purpose by BHAS, FOS and RSIS in December 2010.5 The cluster sample was selected in two stages. The primary sampling units (PSUs) were the 1991 Census enumeration areas (EAs). The EAs were stratified according to the three administrative units of BiH (FBiH, RS and BD) and a sample of 500 EAs was selected to be updated for the BiH MICS46. The low birth rate, typical for the region and neighbouring countries, and small household size in BiH were the main challenges that implied the need for sample stratification in BiH. Lessons learned from the previous MICS rounds in BiH were that there is a need to oversample the population in RS and BD. A higher sampling rate was used for the EAs in RS and BD during the selection process. Within each stratum the EAs were selected with equal probability. Following the master sample frame listing it was found that there was large variability in the number of households per EA.7 The MICS4 household sample was drawn from the 22,619 households8 listed in the 484 EAs9 in which the listing was successfully implemented in BiH. In order to improve sample efficiency of indicators related to the under 5 and 5-24 age groups, the list of households was divided into three second stage strata, the list of households was divided into three second stage strata:10 households with children under 5 (type 1), households with members aged 5-24 (type 2) and all remaining households without children and youth (type 3). Firstly all households with children under 5 were selected, followed by the selection of all households with members aged 5-24 from the remaining list of households. The list of households for each second stage stratum was combined across all sampled EAs and ordered in accordance with the FBiH/RS/BD, cantons in the FBiH, municipalities and urban/rural areas to provide implicit stratification. The sample households within each second stage stratum were selected systematically with equal probability from the combined listing. In this manner, a total of 6,800 households in 474 EAs were selected at the level of BiH:11 2,441 households with children under 5, 1,788 households with members aged 5-24 and 2,571 households without children and youth. Ten EAs with only 1 household were not selected during the sample selection procedure. During fieldwork an additional 38 households12 were identified in the sampled households, resulting in a final sample of 6,838 households. The sample was stratified by type of household and is not self-weighting. Sample weights have been used for reporting the results. A more detailed description of the sample design can be found in Appendix A. 3 Due to budgetary constraints, BD is represented in the same manner as municipalities in BiH. 4 Estimate of the Agency for Statistics of BiH from 30 June 2011. 5 Ten months prior to the start of MICS4 fieldwork. 6 The listing was conducted in 490 EAs because 10 EAs were inaccessible due to flooding (five each in the FBiH and RS). An additional 6 EAs were discarded because of the poor quality of data collection (3 each in the FBiH and RS). 7 Due to the large variability in the number of listed households by sample EA the number of households selected in each EA in all three second stage strata varies considerably, based on the sampling procedures. However, this sampling strategy reduces the variability in the weights of the sample households within each of the combined first and second stage strata. 8 13,394 households in the FBiH, 8,155 in RS and 1,070 in BD. Six households were discarded from the 2010 MICS4 master sample frame (that initially comprised of 22,625 households) because of a lack of data on the ages for all household members. 9 255 EAs in the FBiH, 204 in RS and 25 in BD. 10 The EAs were not selected with probability proportional to size due to the outdated character of the census information and the changes in EA sizes since the census. 11 251 EAs in the FBiH, 198 in RS and 25 in BD. 12 Due to multiple households being found in the same dwelling unit. MICS4 is also important as a source of information for monitoring the implementation of the Convention on the Rights of the Child and the Convention on the Elimination of All Forms of Discrimination against Women and the Gender Action Plan of BiH as well as other commitments arising from the European integration processes and human rights principles contained within the Constitution of BiH, the Constitution of the FBiH and the Constitution of RS. Towards the end of 2011 and the beginning of 2012 the Ministry for Human Rights and Refugees of BiH, in cooperation with the Agency for Statistics of BiH, conducted a MICS4 survey on a sample of Roma households in BiH using the same methodology and similar survey tools. The results of the MICS4 Roma Survey in BiH will be available in a separate survey report. This report presents the results of the indicators and topics covered by the BiH MICS4 survey. Survey Objectives The 2011–2012 BiH Multiple Indicator Cluster Survey has the following as its primary objectives: z provide essential information for evaluating the situation of children, women and men in BiH; z furnish data needed for monitoring progress towards the goals established through the Millennium Declaration and other internationally agreed upon goals as a basis for future action; z contribute towards the improvement of data and monitoring systems in BiH and strengthen the technical expertise in the design, implementation and analysis of such systems; z generate data on the situation of children, women and men, including the identification of vulnerable groups and disparities, to provide information for policies and interventions within health and social care services and for the reduction of poverty. 4 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 5 z Marriage/Union z Sexual Behaviour z HIV/AIDS z Tobacco and Alcohol Use z Life Satisfaction z Health Care17 The Questionnaire for Children Under Five was administered for mothers or caretakers of children under 5 years of age18 living in the households. Normally, the questionnaire was administered for mothers of children under 5; however, in cases where the mother was not listed on the household roster a primary caretaker for the child was identified and interviewed. The questionnaire included the below modules. z Age z Early Childhood Development z Breastfeeding z Care for Illness z Immunisation z Anthropometry The questionnaires were based on the MICS4 model questionnaire.19 From the MICS4 model English version, the questionnaires were translated into local languages used in BiH. The questionnaires were pre-tested in the FBiH and RS in the City of Banja Luka and in Sarajevo Canton during September 2011. The pre-test plan provided for interviews to be conducted in 48 households in the FBiH and 24 households in RS. The households, of which 50 per cent were urban and rural households respectively, were randomly selected from the Master Sample template. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. A copy of the questionnaires used in BiH MICS4 is provided in Appendix F to this report. A separate MICS4 survey for a Roma sample was conducted by the Ministry for Human Rights and Refugees of BiH, in cooperation with the Agency for Statistics of BiH in parallel to MICS4 for a sample of the total population. The MICS4 Roma Survey used the same methodology and similar survey tools. The questionnaires provided in Appendix F of this report reflect the survey tools of both surveys (apart from the Questionnaire of Possession of Documents, which was an additional, country specific form used only within the Roma Survey). The results of the MICS4 Roma Survey will be available in a separate survey report. Training and Fieldwork Training for the fieldwork was conducted over 12 days20 during October 2011 for the survey teams in the FBiH and in November 2011 for the survey teams working in RS and BD. Training included lectures on interviewing techniques and the content of the questionnaires as well as practical work on presenting the questions. Towards the end of the training period the trainees spent two days conducting practice interviews in urban and rural areas in the City of Banja Luka and Sarajevo Canton. The fieldwork was conducted by eight teams in the FBiH and 4 teams in RS.21 These teams were generally comprised of 3 interviewers (two female and one male), one editor, one measurer and a supervisor. In some cantons in the FBiH the size of the team was determined by the number of households to be interviewed during the fieldwork. Fieldwork in the FBiH began in November 2011 and was concluded in February 2012, while fieldwork in RS began in November 2011 and was concluded in March 2012. 17 Country specific additional module that was only used within the MICS4 Roma Survey. 18 The terms ‘children under 5’, ‘children aged 0-4 years’ and ‘children aged 0-59 months’ are used interchangeably in this report. 19 The model MICS4 questionnaires can be found at <www.childininfo.org/mics4_questionnaire.html>. 20 The 12 day training included a 2 day practice pilot study. 21 One team from RS was tasked with conducting fieldwork in BD. Questionnaires Four sets of standard MICS4 questionnaires were used in the survey: 1) a household questionnaire that was used to collect information on all de jure household members,13 the household and the dwelling; 2) a women’s questionnaire administered in each household for all women aged 15-49 years, 3) a men’s questionnaire administered in each household for all men aged 15-49 years and 4) an under-5 questionnaire administered for mothers or caretakers for all children under 5 living in the household. The survey also included two country specific questionnaires that are not part of the standard MICS survey instruments: 1) Questionnaire Form for Drug Use Assessment (self-administered questionnaire for women and men age 15-49) and 2) Questionnaire Form for Defining Residency Status (asked to household questionnaire respondent or another knowledgeable adult). The findings for these questionnaires are not presented in this report and will be analysed separately. The Household Questionnaire included the below modules z Household Listing Form z Education z Water and Sanitation z Household Characteristics z Child Discipline z Hand Washing The Questionnaire for Individual Women was administered for all women living in the households aged 15-49 and included the below modules z Women’s Background z Access to Mass Media and Use of Information/Communication Technology z Child Mortality14 z Desire for Last Birth z Maternal and Newborn Health z Illness Symptoms z Contraception15 z Unmet Need z Attitudes towards Domestic Violence z Marriage/Union z Sexual Behaviour z HIV/AIDS z Tobacco and Alcohol Use z Life Satisfaction z Health Care16 The Questionnaire for Individual Men was administered for all men living in the households aged 15-49 and included the below modules z Men’s Background z Access to Mass Media and Use of Information/Communication Technology z Attitudes towards Domestic Violence 13 Persons who were usual residents in the household. 14 Only questions about the total number of live births, date of last birth and the country specific additional questions on wasted pregnancies 15 Included an additional, country specific question, on knowledge of contraceptive methods. 16 Country specific additional module that was only used within the MICS4 Roma Survey. 6 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 7 III Sample Coverage and the Characteristics of Households and Respondents Sample Coverage Of the 6,838 households in the sample 6,334 were found to be occupied; of these, 5,778 households were successfully interviewed for a household response rate of 91 per cent. In the interviewed households 4,645 women aged 15-49 were identified and 4,446 successfully interviewed, yielding a response rate of 96 per cent. In addition, 4,718 men aged 15-49 were listed in the household questionnaire as being household members. Questionnaires were completed for 4,353 eligible men, which corresponds to a response rate of 92 per cent within the interviewed households. There were 2,332 children under age five listed in the household questionnaire. Questionnaires were completed for 2,297 children, which corresponds to a response rate of 99 per cent within the interviewed households. The overall response rate for the women’s, men’s and children’s questionnaires were 87 per cent, 84 per cent, and 90 per cent, respectively (see Table HH.1). In the FBiH 3,618 households were successfully interviewed out of a total of 4,107 sampled households, which corresponds to a response rate of 93 per cent. Within the interviewed households 3,152 women and 3,133 men aged 15-49 were identified. Out of these, 3,067 women were interviewed with a response rate of 97 per cent and 2,960 men were interviewed with a response rate of 95 per cent. Questionnaires were completed for 1,518 children out of the 1,531 eligible children in the FBiH, which corresponds to a response rate of 99 per cent. In RS 1,945 households were successfully interviewed out of a total of 2,408 sampled households, which corresponds to a response rate of 90 per cent. Within the interviewed households, 1,360 women and 1,435 men aged 15-49 were identified; out of these, 1,252 women were interviewed with a response rate of 92 per cent and 1,258 men were interviewed with a response rate of 88 per cent. Of the 725 eligible children in RS questionnaires were completed for 704 children corresponding to a response rate of 97 per cent. Table HH.1: Results of the household, women’s, men’s and under-5’s interviews Number of households, women, men and children under 5 by results of the household, women’s, men’s and under-5’s interviews and the household, women’s, men’s and under-5’s response rates for, BiH 2011–2012   Area Administrative unit     Urban Rural FBiH RS BD Total Households  Sampled 2,708 4,130 4,107 2,408 323 6,838 Occupied 2,451 3,883 3,895 2,157 282 6,334 Interviewed 2,156 3,622 3,618 1,945 215 5,778 Household response rate 88.0 93.3 92.9 90.2 76.2 91.2 Women Eligible 1,649 2,996 3,152 1,360 133 4,645 Interviewed 1,576 2,870 3,067 1,252 127 4,446 Women’s response rate 95.6 95.8 97.3 92.1 95.5 95.7 Women’s overall response rate 84.1 89.4 90.4 83.0 72.8 87.3 Men Eligible 1,619 3,099 3,133 1,435 150 4,718 Interviewed 1,489 2,864 2,960 1,258 135 4,353 Men’s response rate 92.0 92.4 94.5 87.7 90.0 92.3 Men’s overall response rate 80.9 86.2 87.8 79.0 68.6 84.2 Children under 5 Eligible 812 1,520 1,531 725 76 2,332 Mothers/caretakers interviewed 802 1,495 1,518 704 75 2,297 Under-5’s response rate 98.8 98.4 99.2 97.1 98.7 98.5 Under-5’s overall response rate 86.9 91.7 92.1 87.6 75.2 89.9 Data Processing Data entry and processing was conducted separately for the FBiH, RS and BD. The data was entered using CSPro software. Data was entered into a total of 11 microcomputers by 8 data entry operators in the FBiH and 6 persons in RS; the process was supervised by data entry supervisors. Data entry commenced in the FBiH four weeks after the start of data collection (December 2011) and was concluded in April 2012. In RS data entry for the RS and BD started one week after data collection began (December 2011) and was concluded in May 2012. The data was analysed using the SPSS (Statistical Package for Social Sciences) software programme (Version 18) and the model syntax and tabulation plans developed by UNICEF were also used for this purpose. In order to ensure quality control all of the questionnaires were double entered and internal consistency checks were performed. Procedures and standard programmes developed under the global MICS4 programme and adapted to the BiH questionnaires were used throughout. Report Preparation The Constitution of BiH, which is an integral part of the Dayton Peace Agreement (Annex 4), defines the administrative structure of BiH, as a state comprised of two entities, the FBiH and RS, as well as a third administrative unit, the BD. The FBiH, RS and BD, have their own governments and all jurisdictions and responsibilities that have not been assigned through the Constitution of Bosnia and Herzegovina to its institutions. This includes legislative and executive jurisdiction over health care and social protection, which have, in the FBiH, been further assigned to 10 federal units (Cantons). The report preparation process in BiH included preparation of reports for RS, the FBiH and the BiH report. Due to the country’s administrative structure and the jurisdiction of the FBiH and RS over strategies addressing child well-being and development the data and analyses contained in the MICS4 report are presented so as to reflect data for BiH, the FBiH and RS. The relatively small sample size in BD provides too few cases to produce statistically sound estimates for all indicators for the report. Data for BD is presented in the tables in this report wherever possible. How to Read the Tables The following data, collected through this survey, has not been presented in the tables of this report: z data calculated on the basis of a small number of cases (fewer than 25 unweighted cases) for the education category ‘None’, unless it refers to the “Education level of the household head” – except in Tables HH.4, HH.4M and HH.5 (data for the education category ‘None’ is shown in tables when it refers to the “Education level of the household head”); z data disaggregated by the language of the household head; z data that is not part of the global MICS report template, except data on knowledge of contraceptive methods, (data not presented in the report, coming from country specific survey instruments, includes data on: drug use, residency status, wasted pregnancies and health care). Please note: z (M) — the letter ‘M’ after a table/figure code indicates that it refers to the male population; z (*) — an asterisk in a table indicates that a percentage or proportion has been suppressed because it is based on fewer than 25 unweighted cases; z (number) — values in parenthesis indicate that the percentage or proportion is based on only 25 to 49 unweighted cases and should be treated with caution; z age groups presented in this report also include those persons that had reached the full age indicated by the upper limit for an age group, for instance, respondents aged 15-49 include persons who had reached a full 49 years of age, while the age group of children aged 20-23 months includes those who had reached a full 23 months. 8 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 9 In the FBiH 13,374 household members were identified in the 3,618 households interviewed during the survey; of these, 6,737 were female and 6,636 male. The distribution of the surveyed population shows that the surveyed households included 19 per cent of children under 15 years of age (of which 5 per cent were children under 5 years), 72 per cent of persons aged 15-64 and 9 per cent of persons aged 65 or above. The proportion of children under 18 was 25 per cent. This distribution does not differ greatly from the estimates prepared by FOS based on the most recent surveys. In RS 6,524 household members were identified in the 2,157 households that were successfully interviewed during the survey; of these, 3,299 were female and 3,225 male. The distribution of the surveyed population shows that the surveyed households included 18 per cent of children under 15 years of age (of which 4 per cent were children under 5 years), 66 per cent of persons aged 15-64 and 16 per cent of persons aged 65 or above. The proportion of children under 18 was 22 per cent. This distribution does not differ greatly from the estimates made by RSIS based on the most recent household surveys. The overall dependency rate, namely the ratio of the inactive population (aged 0-14 and 65+) to the active population (aged 15-64), expressed as a percentage was 43 per cent, meaning that there were 43 inactive persons for each 100 active ones. Figure HH.1 shows a population pyramid with a narrow base, which indicates a low proportion of the population in the 0-4 age group and corresponds to the low birth rate. Figure HH.1: Age and sex distribution of household population, BiH 2011–2012 Tables HH.3 to HH.5 provide basic information on the households, female respondents aged 15-49, male respondents aged 15-49 and children under 5 years of age by presenting the unweighted as well as weighted figures. Information on the basic characteristics of the households, women, men and children under 5 interviewed in the survey is essential to interpret the findings presented later in the report. This information can also provide an indication of the representativeness of the survey. The remaining tables in this report are presented with weighted numbers only. See Appendix A for more details about the weighting procedures. Table HH.3 provides basic background information on the households. The sex of the household head, administrative unit (FBiH, RS and BD) area, the number of household members and education of the household head are shown in the table. These background characteristics are used in subsequent tables in this report; the figures in the table are also intended to show the numbers of observations by major categories of analysis contained in the report. Data on the background characteristics of interviewed household members in the FBiH, RS and BD is not shown in the tabular display of data within this report; however, it is presented in the reports for the FBiH and RS. As expected, the response rates for urban areas were lower than for rural areas (88 per cent compared to 93 per cent) and the rates were also lower amongst men compared to women and children in the FBiH, RS and BD and across both urban and rural areas. The response rate for households in BD (76 per cent) was additionally reduced compared to the FBiH and RS due to the inability to conduct interviews in two clusters for safety reasons. Characteristics of Households The weighted age and sex distribution of the survey population is provided in Table HH.2. The distribution was also used to produce the population pyramid in Figure HH.1. In the 5,778 households successfully interviewed during the survey 20,221 household members were listed; of these, there was an approximately equal number of males (10,036) and females (10,185). Table HH.2: Household age distribution by sex Per cent and frequency distribution of the household population by five-year age groups, dependency age groups, and by child (aged 0-17 years) and adult populations (aged 18 or above), by sex, BiH 2011–2012   Males Females Total Number Per cent Number Per cent Number Per cent Age (years) 0-4 437 4.4 454 4.5 891 4.4 5-9 706 7.0 546 5.4 1,252 6.2 10-14 871 8.7 794 7.8 1,665 8.2 15-19 817 8.1 763 7.5 1,580 7.8 20-24 895 8.9 824 8.1 1,719 8.5 25-29 644 6.4 593 5.8 1,237 6.1 30-34 559 5.6 662 6.5 1,222 6.0 35-39 710 7.1 734 7.2 1,443 7.1 40-44 740 7.4 802 7.9 1,542 7.6 45-49 856 8.5 847 8.3 1,703 8.4 50-54 814 8.1 744 7.3 1,558 7.7 55-59 637 6.3 609 6.0 1,246 6.2 60-64 427 4.3 460 4.5 887 4.4 65-69 236 2.4 376 3.7 613 3.0 70-74 323 3.2 436 4.3 759 3.8 75-79 237 2.4 325 3.2 562 2.8 80-84 91 0.9 142 1.4 233 1.2 85+ 31 0.3 68 0.7 99 0.5 Missing/DK 4 0.0 5 0.1 9 0.0 Dependency age groups 0-14 2,014 20.1 1,794 17.6 3,809 18.8 15-64 7,099 70.7 7,038 69.1 14,138 69.9 65+ 918 9.1 1,347 13.2 2,265 11.2 Missing/DK 4 0.0 5 0.1 9 0.0 Child and adult populations Children aged 0-17 years 2,522 25.1 2,333 22.9 4,855 24.0 Adults aged 18+ years 7,510 74.8 7,847 77.0 15,357 75.9 Missing/DK 4 0.0 5 0.1 9 0.0 Total 10,036 100.0 10,185 100.0 20,221 100.0 The age and sex distribution of the survey population in MICS4 does not deviate greatly from the estimates provided by the statistical institutions in BiH and reflects a distribution very similar to that obtained from other household surveys22 and MICS3. The proportion of children aged 0-14 from the total population is almost two times greater than the proportion of persons aged 65 and above of the population (19 per cent versus 11 per cent), which indicates a relatively young population. However, mean numbers of household members per household and the low proportion of children under 5 years of age confirm the current relatively negative population trends. While the sex distribution of the population does not show any clear differentials it is important to note that amongst the populations aged 5-29 and 45-59 there were a higher proportion of males compared to females. 22 2007 BiH Household Budget Survey: Final Results BHAS, FOS, RSIS, Banja Luka/Sarajevo 2008. 8 6 4 2 0 2 4 6 8 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Per cent Females Males 10 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 11 Characteristics of Female and Male Respondents 15-49 Years of Age and Children Under-5 Tables HH.4, HH.4M and HH.5 provide information on the background characteristics of female and male respondents aged 15-49 and of children under age 5. In all three tables the numbers of weighted and unweighted observations are presented. In addition, the tables also show the number of observations for each background category. These categories are used in the subsequent tabulations of this report. Table HH.4: Women’s background characteristics Per cent and frequency distribution of women aged 15-49 years by selected background characteristics, BiH 2011–2012   Weighted per cent Number of women   Weighted Unweighted Administrative unit  FBiH 71.5 3,180 3,067 RS 27.2 1,210 1,252 BD 1.3 56 127 Area Urban 34.8 1,548 1,576 Rural 65.2 2,898 2,870 Age (years) 15-19 14.4 642 424 20-24 15.2 677 632 25-29 11.2 498 881 30-34 12.8 568 860 35-39 14.5 646 643 40-44 15.5 690 494 45-49 16.3 724 512 Marital/Union status Currently married/in union 62.2 2,764 3,237 Widowed 2.6 116 83 Divorced 2.3 101 90 Separated 1.0 43 49 Never married/in union 32.0 1,422 986 Missing/DK 0.0 0 1 Motherhood status Ever gave birth 64.4 2,862 3,303 Never gave birth 35.6 1,581 1,139 Births in last two years Had a birth in last two years 6.7 298 718 Had no birth in last two years 93.3 4,148 3,728 Education None 0.4 16 20 Primary 23.9 1,064 1,044 Secondary 58.6 2,604 2,628 Higher 17.1 762 754 Wealth index quintile Poorest 14.0 620 689 Second 19.1 847 846 Middle 21.9 976 975 Fourth 22.9 1,020 929 Richest 22.1 983 1,007 Total 100.0 4,446 4,446 Table HH.3: Household composition Per cent and frequency distribution of households by selected characteristics, BiH 2011–2012   Weighted per cent Number of households   Weighted Unweighted Sex of household head  Male 81.1 4,686 4,669 Female 18.9 1,092 1,109 Administrative unit FBiH 64.2 3,710 3,618 RS 34.1 1,968 1,945 BD 1.7 100 215 Area Urban 36.7 2,118 2,156 Rural 63.3 3,660 3,622 Number of household members 1 11.5 664 760 2 17.0 982 1,078 3 20.1 1,160 1,088 4 28.0 1,618 1,367 5 13.6 784 750 6 6.5 375 459 7 2.3 134 183 8 0.6 33 54 9 0.3 19 23 10+ 0.2 9 16 Education of household head None 4.4 256 291 Primary 31.2 1,805 1,895 Secondary 53.9 3,114 2,995 Higher 10.4 601 594 Missing/DK 0.0 2 3 Total 100.0 5,778 5,778     Households with at least One child aged 0-4 years 13.2 5,778 5,778 One child aged 0-17 years 50.4 5,778 5,778 One woman aged 15-49 years 66.1 5,778 5,778 One man aged 15-49 years 66.9 5,778 5,778 Mean household size 3.5 5,778 5,778 The weighted and unweighted numbers of households are equal, since sample weights were normalised (see Appendix A). The table also shows the proportion of households with at least one child under 18, at least one child under 5, at least one woman aged 15-49 and at least one man aged 15-49. The table also shows the weighted average household size estimated by the survey. The age structure of the household heads does not differ greatly from the findings of surveys conducted by the statistical system in BiH.23 In 19 per cent of cases in this survey the household heads were women. The highest percentage of households were located in rural areas (63 per cent) and had a household head with secondary education (54 per cent). At 28 per cent, households with 4 members are the most frequent, while the proportion of households with 2 to 3 members was 37 per cent of the total household population (the estimated average household size was 3.5 members). The majority of interviewed households had at least one female member and one male member aged 15-49 (66 per cent), half of them had a child aged 0-17, while the lowest proportion of households had a child aged 0-4 (13 per cent). 23 Nearly 80 per cent of household heads in BiH were men. The 2007 BiH Household Budget Survey: Final Results BHAS, FOS, RSIS, Banja Luka/Sarajevo 2008 indicates that in 80 per cent of cases household heads were men (page 21). 12 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 13 Table HH.4M: Men’s background characteristics Per cent and frequency distribution of men aged 15-49 years by selected background characteristics, BiH 2011–2012   Weighted per cent Number of men   Weighted Unweighted Administrative unit  FBiH 69.2 3,010 2,960 RS 29.2 1,271 1,258 BD 1.6 71 135 Area Urban 32.7 1,422 1,489 Rural 67.3 2,931 2,864 Age (years) 15-19 15.7 684 442 20-24 17.1 743 465 25-29 12.3 534 700 30-34 10.5 459 837 35-39 13.7 597 809 40-44 14.2 617 577 45-49 16.5 719 523 Marital/Union status Currently married/in union 51.7 2,252 2,779 Widowed 0.1 4 4 Divorced 1.3 57 57 Separated 0.5 24 27 Never married/in union 46.3 2,017 1,486 Education None 0.2 10 10 Primary 12.5 543 584 Secondary 71.6 3,117 3,123 Higher 15.7 683 636 Wealth index quintile Poorest 15.7 685 750 Second 19.5 848 852 Middle 22.7 989 961 Fourth 20.5 893 840 Richest 21.5 938 950 Total 100.0 4,353 4,353 Similarly, Table HH.4M provides background characteristics for the male respondents aged 15-49. The table includes information on the distribution of men in the FBiH, RS and BD and their distribution by age, marital status, education and wealth (wealth index quintiles). Unlike women, the highest proportion of men in BiH and the FBiH fell within the 20-24 age group while in RS the highest percentage of men was within the 15-19 age group. As with women, the age distribution of men shows a declining trend after age 20 whereas a rising trend appears amongst women aged 30 and above and amongst men aged 35 and above. Most men (72 per cent) had secondary education, which is a higher percentage compared to the women (59 per cent). A higher percentage of men had higher education (16 per cent) than primary education (13 per cent), while a higher percentage of women had primary education (24 per cent) than higher education (17 per cent). Two-thirds of men lived in rural areas and slightly more than half of them (52 per cent) were married or in union. Slightly less than two-thirds of men (64 per cent) were in the three poorest wealth quintiles of the population. Background characteristics of children under 5 are presented in Table HH.5. These include the distribution of children by various background characteristics: FBiH, RS and BD; sex, area, age, education level of the mother or caretaker and the wealth index quintile. The overall sex distribution of children was almost even (49 per cent of boys and 51 per cent of girls). As with women and men, two-thirds of children under 5 years of age lived in rural areas. The majority of mothers with children under 5 years of age had secondary education (62 per cent), while a lower percentage had primary (23 per cent) or higher education (14 per cent). Mothers or caretakers with no education constituted less than 1 per cent of the survey population. More than half of children (58 per cent) were in the three poorest quintiles of the population. Table HH.4 provides background characteristics for female respondents aged 15-49. The table includes information on the distribution of women in the FBiH, RS and BD; their distribution by area, age, marital status, motherhood status, births in the last two years, level of education24 and wealth (wealth index quintiles25). The age distribution of women in BiH shows that the highest proportion of women of reproductive age was in the 45-49 age group. In the FBiH the highest percentage of women was also in the 45-49 age group, while in RS the highest percentage was in the 35-39 age group, followed by women aged 45-49. This data indicates clear differences by education level. Most women had secondary education (59 per cent), followed by primary education (24 per cent), while the lowest percentage of women had higher education (17 per cent). The distribution of women by marital status and motherhood status was very similar: 62 per cent of women were married or in union, while 64 per cent of women had given birth in their lifetime. Only 7 per cent of women had had a live birth in the two years preceding the survey. Almost two-thirds of women lived in rural households and slightly more than half (55 per cent) were in the three poorest wealth quintiles. 24 Unless otherwise stated, ‘education’ refers throughout this report, when it is used as a background variable, to the education level attained by the respondent. 25 Principal components analysis was performed using information on the ownership of consumer goods (assets), dwelling characteristics, water and sanitation as well as other characteristics that are related to the household’s wealth to assign weights (factor scores) to each of the household assets. Each household was then assigned a wealth score based on these weights and the assets owned by that household. The survey household population was then ranked according to the wealth score of the household they were living in and finally divided into 5 equal parts (quintiles) from lowest (poorest) to highest (richest). The assets used in these calculations are listed below. • Source of drinking water; • Type of sanitation facility; • Number of rooms used for sleeping; • Main material of dwelling floor, roof and exterior walls; • Type of fuel used for cooking; • Presence in the household of electricity, radio, a television, mobile and or non-mobile phone, refrigerator, bed, electric stove, personal computer/laptop, Internet connection, air-conditioner, digital camera, washing machine, tumble dryer, dishwasher, vacuum cleaner, DVD player, Jacuzzi and video surveillance system; • Presence in the household of a watch, bicycle, motorcycle/scooter, animal-drawn cart, car/truck, tractor; • Possession of a bank account. The wealth index is presumed to capture the underlying long-term wealth through information on the household assets and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. The wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Filmer, D. and Pritchett, L., 2001. ‘Estimating wealth effects without expenditure data – or tears: An application to educational enrolments in states of India’. Demography 38(1): 115-132. Gwatkin, D.R., Rutstein, S., Johnson, K., Pande, R. and Wagstaff. A., 2000. ‘Socio-Economic Differences in Health, Nutrition and Population’. HNP/Poverty Thematic Group, Washington, DC: World Bank and Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. 14 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 15 Ta bl e H A .6 : C hi ld re n’ s liv in g ar ra ng em en ts a nd o rp ha nh oo d Pe r c en t d is tr ib ut io n of c hi ld re n ag ed 0 -1 7 ye ar s ac co rd in g to li vi ng a rr an ge m en ts , p er ce nt ag e of c hi ld re n ag ed 0 -1 7 ye ar s in h ou se ho ld s no t l iv in g w ith a b io lo gi ca l p ar en t a nd p er ce nt ag e of ch ild re n w ho h av e on e or b ot h pa re nt s de ad , B iH 2 01 1– 20 12   Li vi ng w ith b ot h pa re nt s Li vi ng w it h ne it he r p ar en t Li vi ng w it h m ot he r on ly Li vi ng w it h fa th er o nl y Im po ss ib le to d et er m in e To ta l N ot li vi ng w ith a bi ol og ic al pa re nt 1 O ne o r bo th pa re nt s de ad 2 N um be r of c hi ld re n ag ed 0 -1 7 ye ar s O nl y m ot he r al iv e Bo th al iv e Bo th de ad Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad Se x M al e 91 .0 0. 0 0. 3 0. 3 2. 8 2. 6 1. 0 0. 6 1. 5 10 0. 0 0. 6 3. 5 2, 52 2 Fe m al e 91 .5 0. 0 0. 1 0. 0 3. 9 2. 3 0. 6 0. 2 1. 3 10 0. 0 0. 2 2. 5 2, 33 3 A dm in is tr at iv e un it FB iH 90 .8 0. 0 0. 2 0. 2 3. 7 2. 1 0. 7 0. 3 1. 9 10 0. 0 0. 4 2. 7 3, 34 5 RS 92 .2 0. 0 0. 3 0. 0 2. 5 3. 3 1. 0 0. 5 0. 2 10 0. 0 0. 3 3. 9 1, 43 3 BD 95 .9 0. 0 0. 2 0. 0 3. 3 0. 4 0. 2 0. 0 0. 0 10 0. 0 0. 2 0. 4 77 A re a U rb an 88 .7 0. 0 0. 1 0. 1 5. 4 2. 7 0. 8 0. 8 1. 4 10 0. 0 0. 3 3. 6 1, 53 6 Ru ra l 92 .4 0. 0 0. 3 0. 1 2. 4 2. 4 0. 8 0. 2 1. 4 10 0. 0 0. 4 2. 7 3, 31 9 A ge (y ea rs ) 0- 4 95 .1 0. 0 0. 0 0. 0 3. 5 0. 2 0. 7 0. 0 0. 4 10 0. 0 0. 0 0. 2 89 1 5- 9 95 .2 0. 0 0. 2 0. 0 2. 4 1. 2 0. 5 0. 0 0. 5 10 0. 0 0. 2 1. 2 1, 25 2 10 -1 4 90 .3 0. 0 0. 1 0. 1 4. 2 2. 7 1. 1 0. 8 0. 6 10 0. 0 0. 2 3. 7 1, 66 5 15 -1 7 84 .8 0. 0 0. 6 0. 5 2. 9 5. 5 0. 8 0. 5 4. 4 10 0. 0 1. 0 6. 5 1, 04 6 W ea lt h in de x qu in ti le s Po or es t 86 .0 0. 0 0. 6 0. 0 4. 4 5. 6 2. 1 0. 0 1. 3 10 0. 0 0. 6 5. 6 79 5 Se co nd 89 .4 0. 0 0. 5 0. 0 3. 8 3. 3 0. 9 0. 3 1. 7 10 0. 0 0. 5 3. 6 97 3 M id dl e 93 .1 0. 0 0. 1 0. 0 2. 3 2. 0 0. 7 0. 5 1. 4 10 0. 0 0. 1 2. 5 1, 00 6 Fo ur th 92 .7 0. 0 0. 0 0. 4 2. 9 1. 0 0. 1 0. 6 2. 3 10 0. 0 0. 4 2. 1 1, 06 8 Ri ch es t 93 .8 0. 0 0. 0 0. 2 3. 5 1. 2 0. 6 0. 5 0. 2 10 0. 0 0. 2 1. 9 1, 01 3 To ta l 91 .3 0. 0 0. 2 0. 1 3. 3 2. 5 0. 8 0. 4 1. 4 10 0. 0 0. 4 3. 0 4, 85 5 1 M IC S in di ca to r 9 .1 7 2 M IC S in di ca to r 9 .1 8 Table HH.5: Under-5’s background characteristics Per cent and frequency distribution of children under five years of age by selected characteristics, BiH 2011–2012   Weighted per cent Number of under-5 children   Weighted Unweighted Sex  Male 48.9 1,124 1,131 Female 51.1 1,173 1,166 Administrative unit   FBiH 70.1 1,611 1,518 RS 28.1 646 704 BD 1.8 40 75 Area   Urban 33.7 774 802 Rural 66.3 1,523 1,495 Age (months)   0-5 10.3 236 117 6-11 10.0 231 126 12-23 19.8 454 509 24-35 20.0 459 514 36-47 21.1 485 556 48-59 18.8 432 475 Mother’s education*   None 0.9 21 16 Primary 22.9 526 507 Secondary 62.1 1,426 1,416 Higher 14.1 324 358 Wealth index quintile   Poorest 16.9 388 398 Second 21.0 482 464 Middle 19.8 455 483 Fourth 20.4 469 427 Richest 21.9 502 525 Total 100.0 2,297 2,297 * Mother’s education refers to the educational attainment of mothers and caretakers of children under 5. Children’s Living Arrangements Children without parental care are a vulnerable group and monitoring enables the development of strategic responses and plans of action to address their needs. Table HH.6 presents information on the living arrangements of children under age 18. According to the data, 91 per cent of children aged 0-17 in BiH live with both parents (91 per cent in the FBiH and 92 per cent in RS). Seven per cent of children live with only one parent, while less than 1 per cent of children do not live with either one of their biological parents. Three per cent of children in BiH had lost one or both parents (3 per cent in the FBiH and 4 per cent in RS). A higher percentage of older children had lost one or both parents compared to younger children (7 per cent of the oldest and less than 1 per cent of the youngest children). Table HH.6 also shows that, according to the wealth index quintile, the percentage of children living with both parents was lowest in the poorest households. 16 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 17 The survey results indicate that 2 per cent of children under 5 in BiH were classified as underweight (2 per cent in FBiH and less than 1 per cent in RS), while less than 1 per cent of children were severely underweight (1 per cent in FBiH and less than 1 per cent in RS). One in eleven children of this age (9 per cent) was too short for their age (10 per cent in FBiH and 6 per cent in RS), whereby 4 per cent were severely stunted (5 per cent in FBiH and 2 per cent in RS). The data shows that wasting was present amongst 2 per cent of children (3 per cent in FBiH and 2 per cent in RS). There were no clear differences in the percentages of children who were underweight or wasted when viewed by area. The highest percentage of stunted children (16 per cent) and wasted children (9 per cent) was found amongst children aged 0-5 months, while the highest percentage of underweight children (5 per cent) was amongst children aged 6-11 months. Table NU.1 shows that nearly one in six children under 5 years of age in BiH (17 per cent) were overweight. The proportion of overweight children increased with the mother’s education level and household wealth and was highest amongst children whose mothers had higher education (22 per cent) and amongst children living in households in the two richest wealth quintiles (21 per cent each). Overweight children were present across all age groups: the percentage rose from the youngest age group and peaked amongst children aged 12-23 months (25 per cent), but was then followed by a decline in the percentage of overweight children (Figure NU.1). Figure NU.1: Percentage of children under age 5 who are underweight, stunted, wasted or overweight, BiH 2011–2012 Table NU.1 (a) was created for the purpose of comparing the nutritional status of children with the findings of the BiH MICS3 (2005–2006) and BiH MICS2 (2000) and for global reporting purposes (see Appendix G). This table shows children’s nutritional status according to the NCHS/CDC/WHO standards that have been in use since 1978 and were superseded by the new WHO standard in 2006. IV Nutrition Nutritional Status Children’s nutritional status is a reflection of their overall health. When children have access to an adequate food supply, are not exposed to repeated illness and are well cared for they reach their growth potential and are considered well nourished. The Millennium Development target is to reduce by half between 1990 and 2015 the proportion of people who suffer from hunger; this will also assist in the goal to reduce child mortality. Malnutrition is associated with more than half of all child deaths worldwide. Three-quarters of the children who die from causes related to malnutrition are only mildly or moderately malnourished and showed no outward sign of their vulnerability. In addition, undernourished children are more likely to die from common childhood ailments and more frequently suffer from faltering growth. In a well-nourished population there is a reference distribution of height and weight for children under age five. The reference population used in the 2011–2012 BiH MICS survey was based on the WHO growth standards.26 Each of the three nutritional status indicators can be expressed in standard deviation units (z-scores) from the median of the reference population. Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight-for-age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight, while those whose weight-for-age is more than three standard deviations below the median are classified as severely underweight. Height-for-age is a measure of linear growth. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered moderately or severely stunted. Children whose height-for-age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Children whose weight-for-height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted i.e., they are falling behind in developing their body weight relative to their height. Children whose weight-for-height is more than three standard deviations below the median are classified as severely wasted i.e., they are severely falling behind in developing their body weight relative to their height. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. In this survey, weights and heights of all children under 5 years of age were measured using anthropometric equipment recommended by UNICEF (www.childinfo.org). Findings in this section are based on the results of these measurements.27 Table NU.1 shows percentages of children under age 5 in relation to the three anthropometric indicators – weight- for-age, height-for-age and weight-for-height – based on anthropometric measurements taken during the fieldwork. This table also includes the percentage of overweight children i.e., children whose weight-for-height is more than two standard deviations above the median of the reference population, as well as z-scores for all three indicators. 26 http://www.who.int/childgrowth/standards/second_set/technical_report_2.pdf 27 It is a known fact that a large amount of missing data can result in biased findings. The extent of anthropometric data and data on the child’s age is of particular importance for the quality of the survey. Thus, children whose measurements are outside a plausible range and children whose full birth date (month and year) were not obtained are excluded from Table NU.1. Children are excluded from one or more of the anthropometric indicators when their weights and heights have not been measured, whichever is applicable. For example, if a child has been weighed but his/her height has not been measured then the child is included in underweight calculations but not in the calculations for stunting and wasting. Percentages of children by age and reasons for their exclusion are shown in the data quality tables DQ.6 and DQ.7. In Table DQ.6, for example, amongst the children under 5 four per cent did not have their weight as well as weight and height measured, while 6 per cent of children did not have their height measured. Table DQ.7 shows that due to incomplete dates of birth, implausible measurements and missing weight and or height 4 per cent of children were excluded from the calculations of the weight-for-age indicator, while the figures are 6 per cent for the height-for-age indicator and 9 per cent for the weight-for-height indicator. 0 5 10 15 20 25 30 0 6 12 18 24 30 36 42 48 54 60 Underweight Age (months) Per cent Stunted Wasted Overweight 18 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 19 Breastfeeding and Infant and Young Child Feeding Breastfeeding in the first few years of life protects children from infection, provides an ideal source of nutrients and is economical and safe. However, many mothers stop breastfeeding too soon and there are often pressures to switch to artificial feeding (infant formula). This can contribute to faltering growth and micronutrient malnutrition and is unsafe if clean water is not readily available. WHO/UNICEF have the below feeding recommendations z Exclusive breastfeeding for the first six months. z Continued breastfeeding for two years or more. z Safe and age-appropriate complementary foods beginning at 6 months. z Frequency of complementary feeding: 2 times per day for infants 6-8 months and 3 times per day for those of 9-11 months. z It is also recommended that breastfeeding be initiated within one hour of birth. The indicators related to recommended child feeding practices are as shown below z Early initiation of breastfeeding (within one hour of birth) z Exclusive breastfeeding rate (< 6 months) z Predominant breastfeeding (< 6 months) z Continued breastfeeding rate (at 1 year and at 2 years) z Duration of breastfeeding (exclusive, predominant and any breastfeeding) z Age-appropriate breastfeeding (0-23 months) z Introduction of solid, semi-solid and soft foods (6-8 months) z Minimum meal frequency (6-23 months) z Milk feeding frequency for non-breastfeeding children (6-23 months) z Bottle feeding (0-23 months) Table NU.2 shows the proportion of children born in the two years preceding the survey who were ever breastfed, those who were first breastfed within one hour or one day of birth and those who received a prelacteal feed. Although a very important step in the management of lactation and the establishment of a physical and emotional relationship between the baby and the mother less than half of babies in BiH (42 per cent) were breastfed for the first time within one hour of birth, while 87 per cent of newborns started breastfeeding within one day of birth (almost all deliveries took place in a public health sector facility). The percentage of children who received a prelacteal feed was 21 per cent. There were no large differences between the FBiH and RS in the percentage of children who were ever breastfed (95 per cent each) or in the percentage of children who were first breastfed within one day of birth (about 87 per cent) and children who received a prelacteal feed (about 21 per cent). Every other woman in the FBiH (52 per cent) started breastfeeding her child within one hour of birth; in RS this was done by one in five women (21 per cent) (see Figure NU.2). Table N U .1: N utritional status of children Percentage of children under age 5 by nutritional status according to three anthropom etric indices: w eight for age, height for age, and w eight for height, BiH 2011–2012   W eight for age N um ber of children under age 5 H eight for age N um ber of children under age 5 W eight for height N um ber of children under age 5 U nderw eight M ean Z-Score (SD ) Stunted M ean Z-Score (SD ) W asted O verw eight M ean Z-Score (SD ) per cent below per cent below per cent below per cent above - 2 SD 1 - 3 SD 2 - 2 SD 3 - 3 SD 4 - 2 SD 5 - 3 SD 6 + 2 SD SexMale 1.8 0.9 0.7 1,083 8.9 4.2 0.3 1,054 2.3 1.8 16.7 0.8 1,017 Fem ale 1.3 0.9 0.7 1,116 8.9 3.5 0.2 1,083 2.4 1.4 18.0 0.8 1,061 A dm inistrative unit FBiH 2.0 1.2 0.8 1,577 9.9 4.6 0.3 1,553 2.6 2.0 17.7 0.8 1,499 RS 0.4 0.1 0.6 592 6.4 1.7 0.1 554 1.7 0.6 16.4 0.8 550 BD 0.0 0.0 1.0 29 1.4 1.4 0.8 29 1.3 0.0 17.3 0.9 30 A rea U rban 1.9 0.9 0.8 734 10.8 5.8 0.2 710 1.8 0.9 21.1 0.9 675 Rural 1.4 0.9 0.7 1,465 7.9 2.9 0.3 1,427 2.6 1.9 15.6 0.7 1,403 A ge (m onths) 0-5 2.7 0.4 0.2 226 15.8 8.4 0.1 210 8.8 7.3 8.3 -0.1 207 6-11 4.7 3.9 0.8 209 9.8 2.4 0.5 201 1.7 0.0 16.8 1.0 192 12-23 1.1 0.4 1.0 438 13.8 6.1 0.2 416 1.2 0.6 24.7 1.1 398 24-35 0.4 0.0 0.8 446 7.8 3.9 0.1 439 1.4 0.7 17.9 0.9 435 36-47 0.7 0.3 0.8 468 5.0 1.6 0.4 462 1.8 0.7 18.2 0.8 454 48-59 2.1 1.9 0.6 411 5.4 2.3 0.3 409 2.2 2.2 13.5 0.6 393 M other’s education* Prim ary 1.2 0.7 0.6 514 9.4 3.6 0.1 501 2.7 1.7 15.9 0.7 498 Secondary 1.7 1.1 0.8 1,350 9.1 4.0 0.3 1,310 2.4 1.8 17.2 0.8 1,263 H igher 1.4 0.3 0.8 316 7.4 3.6 0.4 306 1.3 0.3 21.8 0.9 298 W ealth index quintile Poorest 0.9 0.2 0.5 373 10.1 2.2 0.0 361 1.9 0.9 13.6 0.8 357 Second 1.5 1.0 0.6 457 9.6 3.3 0.3 449 2.9 2.0 15.4 0.6 436 M iddle 0.7 0.2 0.8 432 6.8 2.9 0.4 421 2.6 1.8 15.7 0.7 422 Fourth 0.4 0.2 0.9 449 7.6 4.8 0.3 433 1.5 0.8 20.7 0.9 415 Richest 3.9 2.7 0.8 488 10.3 5.5 0.2 473 2.7 2.2 20.7 0.8 449 Total 1.6 0.9 0.7 2,199 8.9 3.8 0.2 2,137 2.3 1.6 17.4 0.8 2,078 1 M ICS indicator 2.1a and M D G indicator 1.8 2 M ICS indicator 2.1b 3 M ICS indicator 2.2a 4 M ICS indicator 2.2b 5 M ICS indicator 2.3a 6 M ICS indicator 2.3b * Figures for the education category “N one” are based on few er than 25 unw eighted cases and are not show n in the table. 20 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 21 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth, BiH 2011–2012 Table NU.3 shows exclusive breastfeeding28 of infants during the first six months of life as well as continued breastfeeding of children at 12-15 and 20-23 months of age. The data is based on the reports of mothers/caretakers on their children’s consumption of food and fluids during the day or night that preceded the interview. Approximately 19 per cent of children aged less than six months in BiH were exclusively breastfed, while nearly one half of these children in BiH were predominately breastfed (46 per cent). Fifteen per cent of children were exclusively breastfed in the FBiH and this percentage in RS was about 32 per cent, while the percentage of predominantly breastfed children aged less than six months was 42 per cent in the FBiH and 63 per cent in RS. About 12 per cent of children aged 12-15 months and 20-23 months continued breastfeeding. At age one there was a similar percentage of children still being breastfed in the FBiH (13 per cent) and in RS (11 per cent), while amongst children aged 20-23 months 15 per cent of children in the FBiH and 6 per cent in RS were still being breastfed. There were no large differences in the percentage of exclusive breastfeeding between girls and boys; however, there was a higher proportion of predominantly breastfed children amongst boys (61 per cent) compared to girls (33 per cent). 28 ‘Exclusively breastfed’ refers to infants who received only breast milk (and vitamins, mineral supplements or medicine as needed). ‘Predominantly breastfed’ refers to infants who received breast milk and certain other liquids (water, water-based drinks, fruit juice, oral rehydration solutions, drops, vitamins, minerals and medications) but who do not receive anything else, in particular any other milk, food-based liquids and semi-solid or solid foods. Table NU.2: Initial breastfeeding Percentage of last-born children in the 2 years preceding the survey who were ever breastfed, percentage who were breastfed within one hour of birth and within one day of birth, and percentage who received a prelacteal feed, BiH 2011–2012   Percentage who were ever breastfed1 Percentage who were first breastfed: Percentage who received a prelacteal feed Number of last-born children in the two years preceding the survey   Within one hour of birth2 Within one day of birth Administrative unit FBiH 95.2 51.5 87.3 20.5 211 RS 95.3 20.9 87.6 21.5 82 BD (97.7) (7.0) (70.9) (41.8) 6 Area Urban 94.3 36.4 85.4 19.2 94 Rural 95.7 45.0 87.8 22.0 204 Months since last birth 0-11 months 97.6 48.4 89.6 22.5 146 12-23 months 92.9 35.9 84.2 19.9 149 Assistance at delivery Skilled attendant 95.3 42.2 87.0 21.2 298 Other (*) (*) (*) (*) 0 Mother’s education* Primary 93.4 53.3 89.0 10.1 66 Secondary 95.5 39.1 86.8 23.1 187 Higher 97.0 39.8 85.3 29.2 45 Wealth index quintile Poorest 97.6 40.3 91.1 18.7 45 Second 96.6 34.3 91.5 18.5 69 Middle 94.5 37.3 81.8 27.3 58 Fourth 97.0 51.4 88.9 22.3 61 Richest 91.4 48.0 82.5 19.1 65 Total 95.3 42.3 87.1 21.1 298 1 MICS indicator 2.4 2 MICS indicator 2.5 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not The percentage of children who received a prelacteal feed increased with the mother’s education level (from 10 per cent amongst mothers with primary education to 29 per cent of mothers with higher education). It is interesting to note that slightly more than one half of mothers with primary education started breastfeeding within one hour of birth (53 per cent), while this was less common amongst mothers with secondary or higher education (about 39 per cent). 87 88 85 88 87 52 21 36 45 42 0 10 20 30 40 50 60 70 80 90 100 FBiH RS Urban Rural BiH Per cent Within one day Within one hour 22 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 23 Figure NU.3: Infant feeding patterns by age, BiH 2011–2012 Table NU.4 shows the median duration of breastfeeding amongst children at 0-35 months of age. Amongst children of this age the median duration of breastfeeding was 8.8 months (9.5 months for boys and 6.9 months for girls). The median duration of exclusive breastfeeding was 1.1 months, while the median duration of predominant breastfeeding was 3.2 months (3.6 months amongst boys and 0.7 amongst girls). The median duration of any breastfeeding was somewhat longer in the FBiH (8.6) compared to RS (7.1), while the pattern for the median duration of predominant breastfeeding was reversed (4.0 months for RS and 1.6 months for the FBiH). The median duration for any breastfeeding was shorter amongst children whose mothers had higher education (4.2 months) compared to children whose mothers had primary or secondary education (about 8 months in both cases). The median duration for predominant breastfeeding in months declined, although not uniformly, with increased wealth of the household (from 5.2 months for the poorest to 0.4 months for the richest households). Table NU.3: Breastfeeding Percentage of living children according to breastfeeding status at selected age groups, BiH 2011–2012     Children aged 0-5 months Children aged 12-15 months Children aged 20-23 months Per cent exclusively breastfed1 Per cent predominantly breastfed2 Number of children Per cent breastfed (Continued breastfeeding at 1 year)3 Number of children Per cent breastfed (Continued breastfeeding at 2 years)4 Number of children Sex   Male 18.1 60.9 110 13.0 74 15.1 74 Female 18.9 32.6 126 11.9 74 9.7 83 Administrative unit   FBiH 15.1 41.8 181 13.2 104 15.3 106 RS (31.7) (62.8) 51 (11.4) 41 6.2 50 BD (*) (*) 3 (*) 3 (*) 2 Area   Urban (7.1) (31.1) 55 5.5 57 7.0 58 Rural 22.0 50.3 180 16.8 91 15.2 100 Mother’s education*  Primary (*) (*) 50 (18.8) 21 (19.1) 34 Secondary 13.2 44.7 149 12.0 100 11.5 104 Higher (*) (*) 30 (9.1) 26 (*) 19 Wealth index   Poorest 60 per cent 25.5 52.4 149 14.7 87 15.8 86 Second 40 per cent 6.4 34.3 86 9.1 62 7.9 71 Total 18.5 45.8 236 12.4 148 12.2 157 1 MICS indicator 2.6 2 MICS indicator 2.9 3 MICS indicator 2.7 4 MICS indicator 2.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Figure NU.3 shows the detailed pattern of breastfeeding according to a child’s age in months. By 10 months of age, 67 per cent of children were weaned. Data for age groups 0-1, 2-3, 4-5, 6-7 and 8-9 months is based on 25–49 unweighted cases and should be treated with caution. Exclusively breastfed Breastfed and complimentary foods Weaned (not breastfed) 0 10 20 30 40 50 60 70 80 90 100 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 Per cent Age (months) Weaned (not breastfed) Breastfed and complimentary foods Breastfed and other milk / formula Breastfed and non-milk liquids Breastfed and plain water only Exclusively breastfed 24 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 25 Table NU.5: Age-appropriate breastfeeding percentage of children aged 0-23 months who were appropriately breastfed during the previous day, Bih 2011–2012   Children aged 0-5 months Children aged 6-23 months Children aged 0-23 months per cent exclusively breastfed1 number of children per cent currently breastfeeding and receiving solid, semi- solid or soft foods number of children per cent appropriately breastfed2 number of children Sex  Male 18.1 110 20.8 327 20.1 437 female 18.9 126 15.6 358 16.5 484 Administrative unit  fBih 15.1 181 21.6 474 19.8 655 rs (31.7) 51 10.3 195 14.8 246 Bd (*) 3 (7.3) 16 (6.0) 20 Area  urban (7.1) 55 12.3 238 11.3 294 rural 22.0 180 21.2 447 21.4 627 Mother’s education*  primary (*) 50 23.9 153 25.6 203 secondary 13.2 149 17.0 425 16.0 574 higher (*) 30 14.5 107 17.5 137 Wealth index quintile  poorest (*) 26 18.1 113 19.6 139 second (28.8) 72 20.0 142 23.0 214 Middle (*) 52 14.3 126 16.2 177 fourth (4.4) 55 24.8 135 18.9 190 richest (*) 32 13.9 169 13.2 200 Total 18.5 236 18.1 685 18.2 921 1 Mics indicator 2.6 2 Mics indicator 2.14 ( ) figures that are based on 25–49 unweighted cases (*) figures that are based on fewer than 25 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Appropriate complementary feeding of children from 6 months to two years of age is particularly important for growth and development and the prevention of undernutrition. Continued breastfeeding beyond six months should be accompanied by consumption of nutritionally adequate, safe and appropriate complementary foods that help meet nutritional requirements when breastmilk is no longer sufficient. This requires that for breastfed children, two or more meals of solid, semi-solid or soft foods are needed if they are six to eight months old, and three or more meals if they are 9-23 months of age. For children 6-23 months and older who are not breastfed, four or more meals of solid, semi-solid or soft foods or milk feeds are needed. Overall, 73 per cent of infants aged 6-8 received solid, semi-solid, or soft foods (MICS indicator 2.12). Amongst currently breastfeeding infants this percentage was 64 per cent, while it was 79 per cent amongst infants currently not breastfeeding. The percentages for children currently breastfeeding and those not currently breastfeeding were based on 25-49 unweighted cases and should be treated with caution.29 Table NU.6 presents the proportion of children aged 6-23 months who received semi-solid or soft foods the recommended minimum number of times or more during the day or night preceding the interview.30 The survey findings show that nearly three quarters of children aged 6-23 months (72 per cent) were receiving complementary foods the recommended minimum number of times (73 per cent in FBiH and 70 per cent in RS). The percentage of children who were receiving appropriate feeds the recommended minimum number of times increased with the mother’s education level (from 68 per cent for children whose mothers had primary education to 78 per cent for children whose mothers had higher education). 29 the table on introduction of solid, semi-solid or soft foods is not presented in the report since percentages for appropriate complementary feeding disaggregated by sex and area were based on fewer than 25 unweighted cases. 30 see the note in table nu.6 for a definition of the minimum number of times for the different age groups. Table NU.4: Duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding and predominant breastfeeding amongst children aged 0-35 months, Bih 2011–2012   Median duration (in months) number of children aged 0-35 monthsany breastfeeding 1 exclusive breastfeeding predominant breastfeeding Sex Male 9.5 0.6 3.6 668 female 6.9 0.5 0.7 712 Administrative unit fBih 8.6 0.5 1.6 976 rs 7.1 0.6 4.0 376 Bd (7.9) – – 28 Area urban 7.7 0.4 0.5 456 rural 8.2 0.6 2.5 924 Mother’s education* primary 7.5 1.8 3.3 300 secondary 8.0 0.5 1.1 863 higher 4.2 1.4 2.0 202 Wealth index quintile poorest 8.5 0.7 5.2 237 second 7.9 0.6 3.2 298 Middle 7.8 1.2 1.6 283 fourth 10.9 0.4 2.2 272 richest 4.8 0.4 0.4 291 Median 8.0 0.5 1.9 1,380 Mean for all children (0-35 months) 8.8 1.1 3.2 1,380 1 Mics indicator 2.10 ( ) figures that are based on 25–49 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Information on age-appropriate infant feeding for children under 24 months is provided in Table NU.5. Different criteria of feeding were used depending on the age of the child: for infants aged 0-5 months exclusive breastfeeding is considered as age-appropriate feeding, while infants aged 6-23 months are considered to be appropriately fed if they are receiving breast milk and solid, semi-solid or soft food. As a result of these feeding patterns less than one-fifth of children aged 0-5 months, children aged 6-23 months and children aged 0-23 months were being appropriately fed. The prevalence of age-appropriate breastfeeding was equal for boys and girls aged 0-5 months; it was however higher amongst children in rural areas. 26 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 27 Table NU.7: Bottle feeding Percentage of children aged 0-23 months who were fed with a bottle with a nipple during the previous day, BiH 2011–2012   Percentage of children aged 0-23 months fed with a bottle with a nipple1 Number of children aged 0-23 months Sex   Male 76.9 437 Female 81.8 484 Age (months)   0-5 60.3 236 6-11 88.6 231 12-23 84.8 454 Administrative unit   FBiH 78.8 655 RS 80.0 246 BD (94.0) 20 Area   Urban 84.8 294 Rural 77.0 627 Mother’s education*   Primary 73.6 203 Secondary 81.0 574 Higher 80.9 137 Wealth index quintile   Poorest 67.6 139 Second 76.8 214 Middle 84.8 177 Fourth 79.3 190 Richest 86.0 200 Total 79.5 921 1 MICS indicator 2.11 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Low Birth Weight Weight at birth is a good indicator not only of the mother’s health and nutritional status but also the newborn’s chances of survival, growth, long-term health and psychosocial development. Low birth weight (less than 2,500 grams) carries a range of grave health risks for children; babies who are undernourished in the womb face greatly increased risk of disease and dying during their early months and years. Low birth weight is most commonly associated with the mother’s poor health and inadequate feeding as well as cigarette smoking, especially during pregnancy. Teenagers who give birth when their own bodies have yet to finish growing run the risk of bearing underweight babies. Because many infants in the developing world are not weighed at birth and those that are weighed may provide a biased sample of all births the reported birth weights usually cannot be used to estimate the prevalence of low birth weight amongst all children. Therefore, the percentage of births weighing below 2,500 grams is estimated in MICS through two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large) and the mother’s recollection of the child’s weight or the weight as recorded on a health card if the child was weighed at birth.31 The findings of this survey, shown in Table NU.8, show that a total of 98 per cent of newborns were weighed at birth, of which only 3 per cent weighed less than 2,500 grams. The percentage of low birth weight did not vary much between the FBiH and RS, by urban and rural areas or by household wealth. 31 For a detailed description of the methodology see Boerma, J. T., Weinstein, K. I., Rutstein, S.O. and Sommerfelt, A. E., 1996. ‘Data on Birth Weight in Developing Countries: Can Surveys Help?’ Bulletin of the World Health Organization, 74(2), 209-16. Amongst those children of this age currently breastfeeding about one-third were receiving complementary foods the recommended minimum number of times (34 per cent). Amongst children of this age who were currently not breastfeeding 91 per cent had received at least 2 milk feeds during the day or night prior to the interview, while 84 per cent had received solid semi-solid or soft foods or milk feeds 4 times or more during the day or night preceding the interview. Table NU.6: Minimum meal frequency Percentage of children aged 6-23 months who received solid, semi-solid, or soft foods (and milk feeds for non-breastfeeding children) the minimum number of times or more during the previous day, according to breastfeeding status, BiH 2011–2012   Currently breastfeeding Currently not breastfeeding All   Per cent receiving solid, semi- solid and soft foods the minimum number of times Number of children aged 6-23 months Per cent receiving at least 2 milk feeds1 Per cent receiving solid, semi- solid and soft foods or milk feeds 4 times or more Number of children aged 6-23 months Per cent with minimum meal frequency2 Number of children aged 6-23 months Sex Male 29.1 97 93.4 88.1 230 70.5 327 Female 42.6 62 88.5 80.3 296 73.8 358 Age (months)   6-8 (40.6) 51 (100.0) (69.8) 51 55.2 102 9-11 (21.6) 55 (98.9) (94.0) 74 63.3 129 12-17 (41.7) 28 92.1 83.3 191 78.0 219 18-23 (40.9) 26 84.2 83.9 210 79.2 236 Administrative unit   FBiH 36.8 126 90.6 85.7 348 72.7 474 RS (23.0) 30 90.1 78.0 165 69.5 195 BD (*) 3 (*) (*) 14 (91.7) 16 Area   Urban (31.7) 39 87.8 80.7 199 72.6 238 Rural 35.2 120 92.5 85.5 327 72.0 447 Mother’s education*   Primary (15.7) 51 92.1 93.7 101 67.5 153 Secondary 46.5 90 90.1 79.4 335 72.4 425 Higher (*) 18 91.1 88.4 89 78.0 107 Wealth index quintile   Poorest (*) 35 91.9 90.1 78 67.0 113 Second (*) 35 91.8 82.5 107 71.6 142 Middle (30.3) 22 92.4 83.2 103 73.8 126 Fourth (*) 35 92.1 88.9 100 76.9 135 Richest (43.5) 31 86.9 77.7 138 71.5 169 Total 34.3 159 90.7 83.7 526 72.2 685 1 MICS indicator 2.15 2 MICS indicator 2.13 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Amongst the currently breastfeeding children aged 6-8 months the minimum meal frequency is defined as children who also receive solid, semi-solid or soft foods 2 times or more. Amongst the currently breastfeeding children aged 9-23 months receipt of solid, semi-solid or soft foods at least 3 times constitutes the minimum meal frequency. For non-breastfeeding children aged 6-23 months the minimum meal frequency is defined as children receiving solid, semi-solid or soft foods and milk feeds at least 4 times during the previous day. The continued practice of bottle-feeding is a concern due to a number of factors, including possible contamination due to unsafe water and lack of hygiene during preparation. Table NU.7 shows that a high percentage of children aged 0-23 months in BiH are fed using a bottle with a nipple (80 per cent): about the same percentage of children in FBiH (79 per cent) and the RS (80 per cent) and a higher proportion of children in urban (85 per cent) than in rural areas (77 per cent). In addition to only one-fifth of children aged 0-23 months not being fed using a bottle with a nipple, it is worrying that a bottle with a nipple was used to feed over one half of children aged 0-5 months (60 per cent). 28 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 29 V Child Health Immunisation The Millennium Development Goal (MDG) 4 is to reduce child mortality by two-thirds between 1990 and 2015. Immunisation plays a key role in this goal. Immunisation has saved the lives of millions of children in the three decades since the launch of the Expanded Programme on Immunisation (EPI) in 1974. According to UNICEF data, worldwide there are still 27 million children overlooked by routine immunisation and as a result vaccine-preventable diseases cause more than 2 million deaths every year. A World Fit for Children goal is to ensure full immunisation of children under one year of age at 90 per cent nationally, with at least 80 per cent coverage in every administrative unit. According to UNICEF and WHO guidelines a child should receive a BCG vaccination to protect against tuberculosis, three doses of DPT to protect against diphtheria, pertussis, and tetanus; three doses of the polio vaccine; three doses of the Hepatitis B (HepB) vaccine and a measles vaccination by the age of 12 months. In accordance with the UNICEF and WHO guidelines and the recommendations for immunisation against measles, rubella and mumps (MMR) outlined in the regulations on immunisation and prophylactics in the FBiH and RS, as well as for purposes of international comparison, estimates on full immunisation based on this survey refer to children aged 18-29 months that have received a BCG vaccine and three doses of DPT and the polio vaccine by 12 months of age and the MMR vaccine by 18 months.32 Information on vaccination coverage was collected for all children under five years of age. Mothers or caretakers were asked to provide vaccination cards or health booklets for all of these children. If the vaccination card for a child was available interviewers copied the vaccination information from the cards onto the questionnaire. If no vaccination card was available then the interviewer proceeded to ask the mother to recall whether or not the child had received each of the vaccinations as well as how many doses were received for polio and DPT. The final vaccination coverage estimates were based on both the information obtained from the vaccination card and the mother’s report of vaccinations received by a child. The percentage of children aged 18-29 months in BiH who received each of the specific vaccinations recommended by UNICEF and WHO is shown in Table CH.1 (a) and in Tables CH.1 (b) for the FBiH and CH.1 (c) for RS. The denominator comprised children aged 18-29 months so that only those children who were old enough to be fully vaccinated with these vaccines were taken into consideration. In the first three columns of the table the numerator includes all children who were vaccinated at any time before the survey. In the last column only those children who were vaccinated by 12 months of age, as recommended, have been included (by 18 months of age for MMR). For children without vaccination cards the proportion of vaccinations given by 12 months of age was assumed to be the same as for children with vaccination cards. Overall 91 per cent of children in BiH, including 95 per cent of children in the FBiH and 84 per cent of children in RS, had available vaccination cards or health booklets at the time of the survey (see Table CH.2). According to the data shown in Table CH.1 (a), 98 per cent of children aged 18-29 months had received a BCG vaccination by the age of 12 months and 95 per cent of children had received the first dose of the polio vaccine. The percentage decreased for subsequent doses of this vaccine to 93 per cent for the second dose and 85 per cent for the third dose, thus incurring a 10 percentage point reduction in the immunisation coverage for this vaccine. Similar to immunisation to protect against polio, a total of 95 per cent of children had received the first dose of the DPT vaccine by the age of 12 months. This percentage decreased to 86 per cent by the third dose. By the age of 12 months, the first dose of the HepB vaccine has been received by 95 per cent of children, the second by 93 per cent, and the third dose by 94 per cent of children. Immunisation coverage against measles, rubella and mumps by the age of 18 months was somewhat lower than that of other vaccines at 80 per cent. In the FBiH 99 per cent of children aged 18-29 months had received a BCG vaccination by the age of 12 months (see Table CH.1 (b)). The first dose of the polio vaccine was given to 96 per cent of children, the second dose to 93 per cent and the third dose to 83 per cent of children. In RS 94 per cent of children aged 18-29 months had received a BCG vaccination by the age of 12 months (see Table CH.1 (c)). The first dose of the polio vaccine was given to 93 per cent of children, the 32 For the purposes of comparing the percentage of children who have received the UNICEF and WHO recommended vaccines during infancy with data from the BiH MICS3 (2005–2006), data on the Hepatitis B (HepB) vaccines is not included in the calculation of full immunisation. Data on immunisation against illnesses caused by Haemophilus influenzae type B (Hib), which is a part of the immunisation calendars in the FBiH and RS, are not presented in this report. Table NU.8: Low birth weight infants Percentage of last-born children in the 2 years preceding the survey that are estimated to have weighed below 2,500 grams at birth and percentage of live births weighed at birth, BiH 2011–2012   Per cent of live births Number of last-born children in the two years preceding the surveyBelow 2,500 grams 1 Weighed at birth2 Administrative unit   FBiH 3.2 97.3 211 RS 2.8 99.4 82 BD (4.5) (97.7) 6 Area   Urban 3.4 96.2 94 Rural 3.0 98.6 204 Mother’s education*   Primary 4.2 98.6 66 Secondary 3.0 97.1 187 Higher 2.4 100.0 45 Wealth index quintile   Poorest 3.9 97.9 45 Second 3.2 99.2 69 Middle 2.8 97.2 58 Fourth 2.7 95.4 61 Richest 3.3 99.2 65 Total 3.1 97.8 298 1 MICS indicator 2.18 2 MICS indicator 2.19 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 30 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 31 BCG DPT1 DPT2 DPT3 Polio1 Polio2 Polio3 MMR All vac cinatio ns* HepB1 HepB2 HepB3 second dose to 93 per cent and the third dose to 91 per cent of children. The first dose of the DPT vaccination by the age of 12 months had been received by 97 per cent of children in the FBiH and 92 per cent in RS; by the third dose this percentage had decreased to 84 per cent in the FBiH and 90 per cent in RS (see Tables CH.1 (b) and CH.1 (c)). The first dose of the HepB vaccine had been received by 98 per cent of children in the FBiH and 86 per cent of children in RS; the second, by 94 per cent of children in the FBiH and 91 per cent in RS; while 83 per cent of children in the FBiH and 88 per cent in RS had received the third dose of the HepB vaccine by the age of 12 months. Immunisation coverage against measles, rubella and mumps by age 18 months was 79 per cent in the FBiH and 82 per cent in RS. The percentage of children in BiH who had received all of the UNICEF and WHO recommended vaccinations during infancy was 68 per cent (67 per cent in FBiH and 72 per cent in RS). This indicator includes the percentage of children who had received a BCG vaccine as well as three doses of the DPT and three doses of the polio vaccine by 12 months of age and an MMR vaccine by 18 months of age (see Figure CH.1). Data on immunisation to protect against HepB and Hib, both of which are part of the immunisation calendars in FBiH and RS, is not included in the calculation of the percentage of children with all immunisations to allow for comparison with data from previous MICS rounds in BiH. Figure CH.1: Percentage of children aged 18-29 months who received the recommended vaccinations by 12 months (18 months for MMR), BiH 2011–2012 Table CH.1 (a): Vaccinations in first year of life, BiH Percentage of children aged 18-29 months immunised against childhood diseases at any time before the survey and by 12 months of age (by 18 months for MMR), BiH 2011–2012 Vaccinated at any time before the survey according to: Vaccinated by 12 months of age (18 months for MMR)Vaccination card Mother’s report Either BCG1 89.3 10.0 99.3 97.8 Polio   1 87.9 8.2 96.0 95.1 2 86.8 8.0 94.8 92.9 32 83.7 7.5 91.2 85.1 DPT   1 88.9 8.6 97.5 95.2 2 88.0 8.4 96.4 93.1 33 84.8 7.4 92.2 85.5 MMR4 80.2 7.6 87.8 79.9     All vaccinations (BCG, Polio, DPT and MMR) 78.3 5.9 84.2 68.0 No vaccinations (BCG, Polio, DPT and MMR) 0.0 0.3 0.3 0.3     HepB   1 at birth 90.8 6.0 96.8 95.4 2 86.0 9.3 95.3 93.0 35 80.7 7.5 88.2 83.9     Number of children aged 18-29 months 463 463 463 463 1 MICS indicator 3.1 2 MICS indicator 3.2 3 MICS indicator 3.3 4 MICS indicator 3.4; MDG indicator 4.3 5 MICS indicator 3.5 Table CH.1 (b): Vaccinations in first year of life, FBiH Percentage of children aged 18-29 months immunised against childhood diseases at any time before the survey and by 12 months of age (by 18 months for MMR), FBiH 2011–2012 Vaccinated at any time before the survey according to: Vaccinated by 12 months of age (18 months for MMR) Vaccination card Mother’s report Either BCG1 93.6 5.9 99.5 99.2 Polio   1 92.0 5.0 97.0 95.7 2 90.5 4.7 95.3 92.9 32 86.4 4.2 90.6 83.2 DPT   1 91.8 5.7 97.5 96.5 2 90.6 5.4 96.0 93.9 33 86.0 4.5 90.5 84.3 MMR4 83.8 4.5 88.3 79.3     All vaccinations (BCG, Polio, DPT and MMR) 81.2 2.5 83.7 67.0 No vaccinations (BCG, Polio, DPT and MMR) 0.0 0.2 0.2 0.2     HepB   1 at birth 94.3 4.0 98.3 98.0 2 87.8 6.7 94.5 93.7 35 83.0 4.5 87.5 82.5     Number of children aged 18-29 months 327 327 327 327 1 MICS indicator 3.1 2 MICS indicator 3.2 3 MICS indicator 3.3 4 MICS indicator 3.4; MDG indicator 4.3 5 MICS indicator 3.5 Table CH.1 (c): Vaccinations in first year of life, RS Percentage of children aged 18-29 months immunised against childhood diseases at any time before the survey and by 12 months of age (by 18 months for MMR), RS 2011–2012 Vaccinated at any time before the survey according to: Vaccinated by 12 months of age (18 months for MMR) Vaccination card Mother’s report Either BCG1 79.5 19.3 98.8 93.5 Polio   1 78.1 15.2 93.3 93.3 2 78.1 15.2 93.3 92.6 32 77.5 15.2 92.7 90.5 DPT   1 82.4 15.2 97.6 91.8 2 82.4 15.2 97.6 90.3 33 82.4 15.2 97.6 89.6 MMR4 71.8 15.3 87.1 82.1     All vaccinations (BCG, Polio, DPT and MMR) 72.5 14.7 87.1 71.6 No vaccinations (BCG, Polio, DPT and MMR) 0.0 0.6 0.6 0.6     HepB   1 at birth 82.4 10.9 93.3 88.5 2 81.8 15.8 97.6 91.0 35 75.1 15.2 90.3 88.1     Number of children aged 18-29 months 128 128 128 128 1 MICS indicator 3.1 2 MICS indicator 3.2 3 MICS indicator 3.3 4 MICS indicator 3.4; MDG indicator 4.3 5 MICS indicator 3.5 98 95 93 86 95 93 85 80 68 95 93 84 0 10 20 30 40 50 60 70 80 90 100 Per cent (BCG, Polio , DPT and M MR) * The percentage for all vaccines excludes vaccines to prevent hepatitis B. 32 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 33 Table CH.2 presents immunisation coverage amongst children aged 18-29 months by background characteristics. The figures indicate children receiving the listed vaccinations at any time before the survey and are based on information from both the vaccination cards and mothers/caretakers reports. There were no large differences with respect to background characteristics. The overall percentage of children who had received all of the recommended vaccinations at any time before the survey was 84 per cent: 87 per cent in RS and 84 per cent in the FBiH. Ninety-nine per cent of children had received the BCG vaccine at any time before the survey. The third dose of the polio vaccine had been received by 91 per cent of children at any time before the survey, the third dose of the DPT vaccine had been received by 92 per cent of children, while 88 per cent of children had received the third dose of the HepB vaccine. The MMR vaccine had been received by 88 per cent of children in BiH at any time before the survey. Almost all children in the FBiH and RS had received a BCG vaccine at any time before the survey. The third dose of the polio vaccine had been received by 91 per cent of children in the FBiH and 93 per cent of children in RS, the third dose of DPT was received by 91 per cent of children in the FBiH and 98 per cent of children in RS, while 88 per cent of children in the FBiH and 90 per cent in RS received the third dose of the HepB vaccine. The MMR vaccine had been received by 88 per cent of children in the FBiH and 87 per cent of children in RS BiH at any time before the survey. Table CH.2: Vaccinations by background characteristics Percentage of children aged 18-29 months currently vaccinated against childhood diseases, BiH 2011–2012 Percentage of children who received: Percentage with vaccination card seen Number of children aged 18-29 months BCG Polio DPT MMR None of the vaccinations (BCG, Polio, DPT and MMR) All of the vaccinations (BCG, Polio, DPT and MMR) HepB 1 2 3 1 2 3 1 2 3 Sex Male 99.0 97.2 96.4 93.6 97.4 97.0 92.9 89.0 0.3 86.1 94.5 96.4 90.1 89.0 227 Female 99.7 94.9 93.2 88.9 97.6 95.9 91.6 86.6 0.3 82.4 99.0 94.3 86.3 93.7 236 Administrative unit FBiH 99.5 97.0 95.3 90.6 97.5 96.0 90.5 88.3 0.2 83.7 98.3 94.5 87.5 94.8 327 RS 98.8 93.3 93.3 92.7 97.6 97.6 97.6 87.1 0.6 87.1 93.3 97.6 90.3 83.7 128 BD (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 8 Area Urban 99.5 97.5 97.0 91.4 98.5 97.0 91.0 87.9 0.0 84.9 97.0 97.7 89.6 89.2 162 Rural 99.2 95.3 93.6 91.1 97.0 96.1 92.9 87.7 0.5 83.8 96.7 94.1 87.4 92.5 301 Mother’s education* Primary 97.7 93.7 93.7 88.5 94.5 94.5 89.3 85.3 1.5 84.2 95.3 87.2 80.9 89.6 102 Secondary 99.7 95.9 94.5 91.8 97.9 96.5 92.9 88.2 0.0 83.9 97.1 97.1 89.3 91.7 291 Higher 100.0 100.0 97.6 92.8 100.0 98.8 94.0 89.4 0.0 85.7 97.6 100.0 94.0 93.0 68 Wealth index quintile Poorest 98.1 96.2 95.3 91.4 96.2 95.3 91.4 90.0 1.0 87.2 94.4 88.3 81.6 93.5 85 Second 99.1 95.3 93.4 89.6 95.3 94.3 90.5 85.1 0.9 83.1 95.3 96.2 91.5 90.7 85 Middle 100.0 99.2 98.3 93.7 99.2 99.2 91.7 94.2 0.0 89.1 97.9 96.2 89.1 91.1 98 Fourth 99.2 98.3 95.6 93.0 98.7 95.2 93.4 89.0 0.0 85.1 97.4 97.4 93.0 91.8 93 Richest 100.0 91.5 91.5 88.3 97.7 97.7 93.8 81.1 0.0 77.2 98.5 97.7 85.6 90.2 104 Total 99.3 96.0 94.8 91.2 97.5 96.4 92.2 87.8 0.3 84.2 96.8 95.3 88.2 91.4 463 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table CH.2 presents immunisation coverage amongst children aged 18-29 months by background characteristics. The figures indicate children receiving the listed vaccinations at any time before the survey and are based on information from both the vaccination cards and mothers/caretakers reports. There were no large differences with respect to background characteristics. The overall percentage of children who had received all of the recommended vaccinations at any time before the survey was 84 per cent: 87 per cent in RS and 84 per cent in the FBiH. Ninety-nine per cent of children had received the BCG vaccine at any time before the survey. The third dose of the polio vaccine had been received by 91 per cent of children at any time before the survey, the third dose of the DPT vaccine had been received by 92 per cent of children, while 88 per cent of children had received the third dose of the HepB vaccine. The MMR vaccine had been received by 88 per cent of children in BiH at any time before the survey. Almost all children in the FBiH and RS had received a BCG vaccine at any time before the survey. The third dose of the polio vaccine had been received by 91 per cent of children in the FBiH and 93 per cent of children in RS, the third dose of DPT was received by 91 per cent of children in the FBiH and 98 per cent of children in RS, while 88 per cent of children in the FBiH and 90 per cent in RS received the third dose of the HepB vaccine. The MMR vaccine had been received by 88 per cent of children in the FBiH and 87 per cent of children in RS BiH at any time before the survey. Table CH.2: Vaccinations by background characteristics Percentage of children aged 18-29 months currently vaccinated against childhood diseases, BiH 2011–2012 Percentage of children who received: Percentage with vaccination card seen Number of children aged 18-29 months BCG Polio DPT MMR None of the vaccinations (BCG, Polio, DPT and MMR) All of the vaccinations (BCG, Polio, DPT and MMR) HepB 1 2 3 1 2 3 1 2 3 Sex Male 99.0 97.2 96.4 93.6 97.4 97.0 92.9 89.0 0.3 86.1 94.5 96.4 90.1 89.0 227 Female 99.7 94.9 93.2 88.9 97.6 95.9 91.6 86.6 0.3 82.4 99.0 94.3 86.3 93.7 236 Administrative unit FBiH 99.5 97.0 95.3 90.6 97.5 96.0 90.5 88.3 0.2 83.7 98.3 94.5 87.5 94.8 327 RS 98.8 93.3 93.3 92.7 97.6 97.6 97.6 87.1 0.6 87.1 93.3 97.6 90.3 83.7 128 BD (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 8 Area Urban 99.5 97.5 97.0 91.4 98.5 97.0 91.0 87.9 0.0 84.9 97.0 97.7 89.6 89.2 162 Rural 99.2 95.3 93.6 91.1 97.0 96.1 92.9 87.7 0.5 83.8 96.7 94.1 87.4 92.5 301 Mother’s education* Primary 97.7 93.7 93.7 88.5 94.5 94.5 89.3 85.3 1.5 84.2 95.3 87.2 80.9 89.6 102 Secondary 99.7 95.9 94.5 91.8 97.9 96.5 92.9 88.2 0.0 83.9 97.1 97.1 89.3 91.7 291 Higher 100.0 100.0 97.6 92.8 100.0 98.8 94.0 89.4 0.0 85.7 97.6 100.0 94.0 93.0 68 Wealth index quintile Poorest 98.1 96.2 95.3 91.4 96.2 95.3 91.4 90.0 1.0 87.2 94.4 88.3 81.6 93.5 85 Second 99.1 95.3 93.4 89.6 95.3 94.3 90.5 85.1 0.9 83.1 95.3 96.2 91.5 90.7 85 Middle 100.0 99.2 98.3 93.7 99.2 99.2 91.7 94.2 0.0 89.1 97.9 96.2 89.1 91.1 98 Fourth 99.2 98.3 95.6 93.0 98.7 95.2 93.4 89.0 0.0 85.1 97.4 97.4 93.0 91.8 93 Richest 100.0 91.5 91.5 88.3 97.7 97.7 93.8 81.1 0.0 77.2 98.5 97.7 85.6 90.2 104 Total 99.3 96.0 94.8 91.2 97.5 96.4 92.2 87.8 0.3 84.2 96.8 95.3 88.2 91.4 463 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 34 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 35 Oral Rehydration Treatment Diarrhoea is the second leading cause of death amongst children under five worldwide. In the treatment of diarrhoea of particular importance is increased fluid intake, continued adequate feeding of the child and use of oral rehydration salts (ORS). The goal is to reduce by two-thirds the mortality rate amongst children under five by 2015.33 In addition, A World Fit for Children calls for a reduction in the incidence of diarrhoea by 25 per cent. In MICS the prevalence of diarrhoea was estimated by asking mothers or caretakers whether their child had had an episode of diarrhoea in the two weeks prior to the survey (see Table CH.3). In cases where mothers reported that the child had suffered diarrhoea a series of questions were asked about the treatment of the illness, including what the child had to drink and eat during the episode and whether this was more or less than the child usually drank and ate. Table CH.3 also shows the percentage of children who had diarrhoea in the two weeks preceding the survey as well as the percentage of children who received various types of recommended liquids during the episode of diarrhoea. Since children may have been given more than one type of liquid the percentages do not necessarily add up to 100. Overall 6 per cent of children under five in BiH had diarrhoea in the two weeks preceding the survey (see Table CH.3. Diarrhoea prevalence was at 7 per cent amongst children in the FBiH and 4 per cent amongst children in RS. Viewed by age, the peak of diarrhoea was amongst children aged 12-23 months (8 per cent). About 36 per cent of children received fluids from ORS packets or pre-packaged ORS fluids. Children of mothers with primary education were less likely to receive ORS than children of mothers with secondary education (14 per cent compared to 37 per cent). There was no evident difference in diarrhoea prevalence amongst girls and boys or in the percentage of boys and girls who received ORS. 33 Compared to 1990 (Millennium Development Goals) Table CH.3: Oral rehydration solutions and recommended homemade fluids Percentage of children aged 0-59 months with diarrhoea in the last two weeks and treatment with oral rehydration solutions and recommended homemade fluids, BiH 2011–2012   Had diarrhoea in last two weeks Number of children aged 0-59 months Children with diarrhoea who received ORS (Fluid from ORS packet or pre-packaged ORS fluid) Number of children aged 0-59 months with diarrhoea in last two weeks Sex         Male 6.9 1,124 35.2 78 Female 5.0 1,173 37.8 58 Administrative unit   FBiH 6.7 1,611 35.7 108 RS 4.3 646 (39.1) 28 BD 1.0 40 (*) 0 Area   Urban 5.3 774 (43.5) 41 Rural 6.2 1,523 33.2 95 Age (months)   0-11 5.8 466 (*) 27 12-23 7.7 454 (47.3) 35 24-35 4.2 459 (*) 19 36-47 6.8 485 (37.9) 33 48-59 5.1 432 (*) 22 Mother’s education*   Primary 5.5 526 13.8 29 Secondary 5.8 1,426 37.1 83 Higher 7.7 324 (*) 25 Wealth index quintile   Poorest 6.9 388 (*) 27 Second 7.7 482 (36.1) 37 Middle 3.9 455 (*) 18 Fourth 6.0 469 (*) 28 Richest 5.3 502 (67.1) 27 Total 5.9 2,297 36.3 136 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 36 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 37 Table CH.4: Feeding practices during diarrhoea Per cent distribution of children aged 0-59 months with diarrhoea in the last two weeks by amount of liquids and food given during episode of diarrhoea, BiH 2011–2012   Had diarrhoea in last two weeks Number of children aged 0-59 months Drinking practices during diarrhoea Total Eating practices during diarrhoea Total Number of children aged 0-59 months with diarrhoea in last two weeks Given much less to drink Given somewhat less to drink Given about the same to drink Given more to drink Given nothing to drink Given much less to eat Given somewhat less to eat Given about the same to eat Given more to eat Stopped food Sex   Male 6.9 1,124 8.9 11.3 30.8 46.9 2.1 100.0 6.2 37.7 46.2 9.9 0.0 100.0 78 Female 5.0 1,173 1.4 9.6 33.7 43.4 11.9 100.0 6.8 19.1 60.8 1.4 11.9 100.0 58 Administrative unit   FBiH 6.7 1,611 7.2 9.7 29.3 45.9 7.9 100.0 5.2 24.4 56.8 7.2 6.4 100.0 108 RS 4.3 646 (0.0) (14.0) (41.9) (44.1) (0.0) 100.0 (11.2) (49.7) (36.3) (2.8) (0.0) 100.0 28 BD 1.0 40 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 0 Area   Urban 5.3 774 (0.0) (13.4) (20.9) (65.7) (0.0) 100.0 (11.6) (39.6) (33.9) (14.9) (0.0) 100.0 41 Rural 6.2 1,523 8.2 9.3 36.9 36.6 9.0 100.0 4.2 25.5 60.5 2.5 7.3 100.0 95 Age (months)   0-11 5.8 466 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 27 12-23 7.7 454 (2.3) (9.3) (31.7) (39.1) (17.6) 100.0 (6.8) (27.5) (43.4) (4.6) (17.6) 100.0 35 24-35 4.2 459 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 19 36-47 6.8 485 (18.6) (9.5) (21.6) (47.8) (2.4) 100.0 (2.4) (49.8) (45.4) (2.3) (0.0) 100.0 33 48-59 5.1 432 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 22 Mother’s education *  Primary 5.5 526 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 29 Secondary 5.8 1,426 8.4 10.7 25.1 46.4 9.4 100.0 9.6 32.2 47.8 2.9 7.4 100.0 83 Higher 7.7 324 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 25 Wealth index quintile   Poorest 6.9 388 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 27 Second 7.7 482 (2.2) (10.8) (23.5) (44.7) (18.8) 100.0 (6.5) (23.6) (51.1) (2.2) (16.7) 100.0 37 Middle 3.9 455 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 18 Fourth 6.0 469 (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 28 Richest 5.3 502 (3.0) (11.8) (23.6) (61.6) (0.0) 100.0 (5.9) (38.5) (32.6) (22.9) (0.0) 100.0 27 Total 5.9 2,297 5.7 10.5 32.0 45.4 6.3 100.0 6.4 29.8 52.4 6.3 5.1 100.0 136 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Fifty-five per cent of children received ORT with continued feeding, as is recommended (see Figure CH.2). Overall 65 per cent of children with diarrhoea received ORS or increased fluids (see Figure CH.3). Thirty-three per cent of children received diarrhoea antimotility medication in the form of tablets or syrup, while only 1 per cent of children received medication in the form of an injection. Diarrhoea was treated with home remedies/herbal medicine in 19 per cent of children, while 9 per cent of children were treated in some other way. Twenty-one per cent of children with diarrhoea were not given any treatment or medication. Table CH.4 shows the feeding practices of children during the episode of diarrhoea. The data show that during the episode of diarrhoea 45 per cent of children under 5 years of age drank more than usual while 43 per cent drank the same or less. With respect to food intake 82 per cent of children were given the same amount to eat or somewhat less and 6 per cent of children were given much less than usual to eat. In 5 per cent of cases children stopped food altogether. Table CH.5 shows the proportion of children aged 0-59 months with diarrhoea in the last two weeks who received oral rehydration therapy (ORT) with continued feeding and the percentage of children with diarrhoea who received other treatments. 38 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 39 Figure CH.2: Percentage of children under age 5 with diarrhoea who received ORT with continued feeding, BiH 2011–2012 * Data for RS and urban areas is based on 25-49 unweighted cases and should be interpreted with caution. Table CH.5: Oral rehydration therapy with continued feeding and other treatments Percentage of children aged 0-59 months with diarrhoea in the last two weeks who received oral rehydration therapy with continued feeding and percentage of children with diarrhoea who received other treatments, BiH 2011–2012   Children with diarrhoea who received: Other treatments: Not given any treatment or drug Number of children aged 0-59 months with diarrhoea in last two weeks ORS or increased fluids ORT with continued feeding1 Pill or syrup Injection Intravenous Home remedy, herbal medicine OtherAntibiotic Antimotility Zinc Other Unknown Antibiotic Non-antibiotic Unknown Sex   Male 65.0 59.9 4.1 24.2 0.0 2.0 2.1 1.0 0.0 0.0 0.0 9.8 8.9 21.2 78 Female 64.8 47.5 1.4 27.0 0.0 1.3 4.2 0.0 0.0 0.0 1.4 31.2 9.6 20.1 58 Administrative unit FBiH 64.8 54.6 2.2 24.8 0.0 0.7 3.7 0.0 0.0 0.0 0.7 21.4 10.2 22.5 108 RS (66.5) (55.3) (5.6) (27.9) (0.0) (5.6) (0.0) (2.8) (0.0) (0.0) (0.0) (8.4) (5.6) (14.0) 28 BD (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 0 Area   Urban (79.0) (69.4) (3.8) (24.8) (0.0) (1.9) (0.0) (1.9) (0.0) (0.0) (0.0) (28.3) (16.8) (7.7) 41 Rural 58.8 48.1 2.5 25.6 0.0 1.7 4.3 0.0 0.0 0.0 0.9 14.9 5.9 26.4 95 Age (months) 0-23 (62.2) (49.7) (2.6) (36.7) (0.0) (0.0) (1.3) (1.3) (0.0) (0.0) (0.0) (14.3) (13.9) (26.2) 62 24-59 67.2 58.7 3.2 16.0 0.0 3.2 4.3 0.0 0.0 0.0 1.1 22.8 5.3 16.1 74 Wealth index Poorest 60 per cent 57.6 45.2 2.9 27.8 0.0 1.0 5.0 1.0 0.0 0.0 1.0 21.2 4.9 24.3 81 Richest 40 per cent (75.8) (68.5) (2.9) (21.8) (0.0) (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) (15.6) (15.6) (15.4) 55 Total 64.9 54.6 2.9 25.4 0.0 1.7 3.0 0.6 0.0 0.0 0.6 19.0 9.2 20.7 136 1 MICS indicator 3.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 55 (55) (69) 48 60 47 55 0 10 20 30 40 50 60 70 80 90 100 Per cent FBiH RS Urban Rural Male Female BiH Figure CH.3: Percentage of children under age 5 with diarrhoea who received ORT or increased fluids, BiH 2011–2012 * Data for RS and urban areas is based on 25-49 unweighted cases and should be interpreted with caution. 65 (66) (79) 59 65 65 65 0 10 20 30 40 50 60 70 80 90 FBiH RS Urban Rural Male Female BiH Per cent 40 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 41 Care-Seeking and Antibiotic Treatment of Pneumonia Pneumonia is the leading cause of death in children worldwide and the use of antibiotics in under-fives with suspected pneumonia is a key intervention. A World Fit for Children goal is to reduce by one-third the deaths due to acute respiratory infection. In the BiH MICS4 the prevalence of suspected pneumonia was estimated by asking mothers or caretakers whether their child under age five had suffered an illness with a cough accompanied by rapid or difficult breathing, the symptoms of which were a problem with the chest or a problem with both the chest and a blocked nose. Table CH.6 presents the prevalence of suspected pneumonia. Survey findings indicate that, during the two weeks preceding the survey 3 per cent of children aged 0-59 months were reported to have had symptoms of pneumonia (3 per cent in the FBiH and 4 per cent in RS). Of these children, 87 per cent were taken to an appropriate service provider (MICS indicator 3.9, which is not shown in Table CH.6). The highest percentage of children were examined in public sector facilities, of which 48 per cent were taken to a health centre and 24 per cent to a hospital, while 7 per cent were examined by a visiting health worker (mobile health service). A small percentage of children were taken to a private medical practice (7 per cent) and a private pharmacy (2 per cent) – (data not shown in Table CH.6). The prevalence of suspected pneumonia amongst children under 5 did not vary much by sex. In relation to age, the prevalence of suspected pneumonia was highest amongst children aged 12-23 months (5 per cent). Overall, about three quarters (76 per cent) of children under 5 years of age with suspected pneumonia in the two weeks prior to the survey were treated with antibiotics (MICS indicator 3.10, which is not shown in Table CH.6). Table CH.6: Prevalence of suspected pneumonia by background characteristics Percentage of children aged 0-59 months with suspected pneumonia in the last two weeks, BiH 2011–2012   Had suspected pneumonia in the last two weeks Number of children aged 0-59 months Sex   Male 3.6 1,124 Female 2.8 1,173 Administrative unit FBiH 2.8 1,611 RS 4.2 646 BD 4.0 40 Area Urban 3.4 774 Rural 3.1 1,523 Age (months) 0-11 1.0 466 12-23 5.0 454 24-35 4.2 459 36-47 2.8 485 48-59 2.9 432 Mother’s education* Primary 3.8 526 Secondary 3.1 1,426 Higher 2.7 324 Wealth index quintile Poorest 5.3 388 Second 2.5 482 Middle 2.9 455 Fourth 2.8 469 Richest 2.8 502 Total 3.2 2,297 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. MICS indicator 3.9: Percentage of children aged 0-59 months with suspected pneumonia in the last two weeks who were taken to a health provider; the indicator is not shown in Table CH.6 because of the low number of unweighted cases for the background characteristics (fewer than 25 unweighted cases). MICS indicator 3.10: Percentage of children aged 0-59 with suspected pneumonia who received antibiotics in the last two weeks; the indicator is not shown in Table CH.6 because of the low number of unweighted cases for the background characteristics (fewer than 25 unweighted cases). A mother’s knowledge of the danger signs of pneumonia is an important determinant of care-seeking behaviour. Issues related to knowledge of danger signs of pneumonia are presented in Table CH.7. Overall 15 per cent of women knew of the two danger signs of pneumonia, namely fast and difficult breathing. Thirty-nine per cent of mothers identified difficult breathing and 20 per cent of mothers identified fast breathing as symptoms for taking the child immediately to a health facility. Fast breathing was recognised as a danger sign of pneumonia by an approximately equal percentage of mothers in urban and rural areas (about 20 per cent). It is interesting to note that, when viewed according to their level of education, the knowledge that fast breathing is a danger sign of pneumonia was most common amongst mothers with primary education (27 per cent) and decreased with an increase in the mother’s education level (12 per cent for higher education). A higher percentage of mothers in RS (50 per cent) than in the FBiH (34 per cent) believed that the child should immediately be taken to a health facility if experiencing difficulty in breathing. Twenty-two per cent of mothers in the FBiH and 15 per cent of mothers in RS believed that the child should immediately be taken to a health facility if experiencing fast breathing. The highest percentage of mothers believed that a child should be taken immediately to a health facility in the case of fever (88 per cent) and if the child became sicker (43 per cent). 42 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 43 Table CH.7: knowledge of the two danger signs of pneumonia Percentage of mothers and caretakers of children aged 0-59 months by symptoms that would cause them to take the child immediately to a health facility and percentage of mothers who recognise fast and difficult breathing as signs for seeking care immediately, BiH 2011–2012   Percentage of mothers/caretakers of children aged 0-59 months who think that a child should be taken immediately to a health facility if the child: Mothers/caretakers who recognise the two danger signs of pneumonia Number of mothers/caretakers of children aged 0-59 months   Is not able to drink or breastfeed Becomes sicker Develops a fever Has fast breathing Has difficulty breathing Has blood in stool Is drinking poorly Has other symptoms Administrative unit     FBiH 16.9 41.5 85.6 21.5 33.7 24.5 7.2 42.0 16.2 459 RS 14.6 46.8 92.6 15.0 49.5 17.0 6.4 27.3 10.4 183 BD 43.0 57.0 100.0 50.4 62.0 51.6 39.3 4.9 47.9 11 Area   Urban 16.4 41.8 86.9 19.2 43.0 24.5 5.4 32.7 14.3 219 Rural 16.8 44.0 88.2 20.7 36.3 21.9 8.5 39.5 15.5 433 Mother’s education*   Primary 18.1 47.8 86.1 27.1 37.0 27.4 8.2 34.3 19.5 154 Secondary 17.0 43.5 88.4 19.6 39.9 22.5 7.8 36.5 15.1 403 Higher 13.2 34.4 87.8 11.7 35.9 17.2 5.2 45.6 8.0 93 Wealth index quintile   Poorest 20.1 40.6 88.3 21.5 41.5 22.8 11.9 35.9 17.6 107 Second 17.4 52.7 87.6 25.2 40.6 24.6 10.0 35.3 19.9 136 Middle 17.9 40.7 86.7 19.0 42.8 25.0 6.2 37.7 15.2 132 Fourth 13.7 44.7 88.3 22.9 34.8 24.9 5.3 32.9 14.4 134 Richest 15.0 37.2 88.1 13.0 34.1 17.2 5.0 43.8 9.1 144 Total 16.7 43.2 87.8 20.2 38.6 22.8 7.5 37.3 15.1 652 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 44 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 45 Solid Fuel Use More than 3 billion people around the world rely on solid fuel for their basic energy needs, including cooking and heating. Solid fuels include biomass such as wood, charcoal, crops or other agricultural residues, dung, shrubs, straw and coal. Cooking and heating with solid fuel leads to high levels of indoor smoke, which is a complex mix of health damaging pollutants. The main problem with the use of solid fuel is incomplete combustion, which produces toxic elements such as, amongst others, carbon monoxide and sulphur oxide (SO2). Use of solid fuel increases the risk of acute respiratory illness, pneumonia, chronic obstructive lung disease and cancer. The primary indicator of solid fuel use is the proportion of the population using solid fuel as their primary source of domestic energy for cooking. Table CH.8 shows that 70 per cent of households in BiH use solid fuel for cooking, while a lower percentage of households use electricity for this purpose (21 per cent). Use of solid fuel for cooking was more common in RS (74 per cent) than in the FBiH (67 per cent). There was a difference by area, with solid fuel being used for cooking in 83 per cent of rural and 43 per cent of urban households. Solid fuel use was not common amongst the richest households and increased with a decline in wealth and a decrease in the level of education of the household head. The highest percentage of households used wood for cooking (69 per cent), with a higher proportion of households in RS (73 per cent) than in the FBiH (67 per cent). The percentage of households that used charcoal and coal/lignite for cooking purposes was negligible. Table CH.8: Solid fuel use Per cent distribution of household members according to type of cooking fuel used by the household and percentage of household members living in households using solid fuels for cooking, BiH 2011–2012   Percentage of household members in households using: Number of household members   Electricity Liquefied petroleum gas (LPG) Natural gas Solid fuels No food cooked in the household Other fuel Missing Total Solid fuels for cooking1   Coal, lignite Charcoal Wood Agricultural crop residue Administrative unit   FBiH 23.5 6.7 2.3 0.1 0.7 66.5 0.1 0.0 0.0 0.1 100.0 67.4 13,374 RS 17.0 9.2 0.2 0.0 0.2 73.3 0.0 0.0 0.1 0.0 100.0 73.6 6,524 BD 23.4 4.1 0.0 3.0 1.8 67.7 0.0 0.0 0.0 0.0 100.0 72.5 323 Area 0.0   Urban 40.4 11.8 4.4 0.0 1.1 42.0 0.0 0.0 0.1 0.1 100.0 43.1 6,932 Rural 11.5 5.2 0.1 0.2 0.3 82.6 0.1 0.0 0.0 0.0 100.0 83.2 13,289 Education of household head   None 8.3 0.8 0.8 0.1 2.3 87.7 0.0 0.0 0.0 0.0 100.0 90.1 598 Primary 9.4 3.9 0.7 0.4 0.3 85.3 0.0 0.0 0.0 0.0 100.0 86.0 6,095 Secondary 24.1 8.5 1.9 0.0 0.7 64.7 0.1 0.0 0.0 0.0 100.0 65.5 11,497 Higher 45.9 14.3 3.0 0.1 0.1 36.1 0.0 0.0 0.1 0.4 100.0 36.3 2,025 Missing/DK (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 7 Wealth index quintiles   Poorest 3.4 0.6 0.0 0.1 0.6 95.0 0.0 0.1 0.0 0.2 100.0 95.7 4,043 Second 8.0 2.8 0.2 0.1 0.2 88.7 0.1 0.0 0.0 0.0 100.0 89.1 4,046 Middle 13.5 4.3 0.4 0.1 1.0 80.6 0.2 0.0 0.0 0.0 100.0 81.8 4,044 Fourth 25.8 6.2 1.0 0.3 0.5 66.1 0.0 0.0 0.1 0.0 100.0 66.9 4,044 Richest 56.4 23.5 6.3 0.0 0.7 13.1 0.0 0.0 0.0 0.0 100.0 13.8 4,044 Total 21.4 7.5 1.6 0.1 0.6 68.7 0.0 0.0 0.0 0.0 100.0 69.5 20,221 1 MICS indicator 3.11 (*) Figures that are based on fewer than 25 unweighted cases 46 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 47 VI Water and Sanitation Safe drinking water is a basic necessity for good health and unsafe drinking water can be a significant carrier of numerous diseases.34 Drinking water can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. In addition to its association with disease, access to drinking water may be particularly important for women and children, especially in rural areas, who bear the primary responsibility for carrying water, often over long distances. One of the Millennium Development Goals (7, C) is to reduce by half, between 1990 and 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. A World Fit for Children goal calls for a reduction in the proportion of households without access to hygienic sanitation facilities and affordable and safe drinking water by at least one-third.35 The below list of indicators are used in MICS Water: z Use of improved drinking water sources z Use of an adequate water treatment method z Time to source of drinking water z Person collecting drinking water Sanitation: z Use of improved sanitation z Sanitary disposal of child’s faeces MICS also collects additional information on the availability of facilities and conditions for hand washing. The below indicators are collected z Place for hand washing observed z Availability of soap Use of Improved Drinking Water Sources The distribution of the population by main source of drinking water is shown in Table WS.1 and Figure WS.1. Improved sources of drinking water include piped water (into dwellings, compounds, yards or plots and to neighbours or public taps/standpipes), tube wells/boreholes, protected wells, protected springs and rainwater collection. Bottled water is considered as an improved water source only if the household is also using an improved water source for hand washing and cooking. Almost the entire population of BiH uses an improved source of drinking water. The majority of the population in BiH uses drinking water that is piped into their dwelling or into their yard or plot (86 per cent). Piped water (including water piped to a neighbour or a public tap) was used by the highest percentage of the population in RS (90 per cent) and a smaller percentage in the FBiH (88 per cent). In urban areas 91 per cent of the population had running water in their dwelling, yard or plot, whereas the corresponding proportion in rural areas was 83 per cent. A public tap was used by 2 per cent of the population in both urban and rural areas. The next most important sources of drinking water in BiH were protected wells (4 per cent) and protected springs (3 per cent), while a somewhat lower percentage of household members used tube wells (2 per cent). Less than 1 per cent of the population in BiH used unimproved sources. While the poorest population was less likely to have running water in their dwelling (71 per cent), when compared to the richest population, a high percentage of the poorest household population did use improved sources of drinking water (99 per cent). 34 Such as dysentery, cholera and hepatitis A. 35 For more details on water and sanitation and to access some reference documents please visit the UNICEF childinfo website <http://www. childinfo.org/wes.html> The use of solid fuel is in itself a weak indicator of indoor air pollution since the concentration of pollutants varies when the same type of fuel is burned in different types of stoves or fireplaces. The use of sealed stoves with chimney flukes minimises indoor air pollution, whereas the use of open stoves or fireplaces without a chimney or smoke extractor provides no protection against the harmful effects of solid fuel combustion. Solid fuel use by place of cooking is depicted in Table CH.9. Indoor air pollution depends on cooking practices, place of cooking and the type of fuel used. The findings show that the place of cooking in 59 per cent of households in BiH was a room designated to serve only as a kitchen, while 39 per cent of households cooked somewhere else in the house (no separate room for cooking available). A designated room for cooking was present in three quarters of households in the FBiH (76 per cent) and one quarter of households in RS (26 per cent). Survey results show that the percentage of households with a room designated for cooking increased with the household’s wealth, being highest amongst the richest households (about 76 per cent). There were no clear differences with respect to the level of education of the household head. Table CH.9: Solid fuel use by place of cooking Per cent distribution of household members in households using solid fuels by place of cooking, BiH 2011–2012   Place of cooking Number of household members in households using solid fuels for cooking In a separate room used as kitchen Elsewhere in the house In a separate building At another place Missing Total Administrative unit   FBiH 75.6 23.9 0.1 0.3 0.1 100.0 9,013 RS 26.4 70.3 3.2 0.0 0.1 100.0 4,800 BD 99.8 0.2 0.0 0.0 0.0 100.0 234 Area   Urban 65.5 33.8 0.5 0.1 0.1 100.0 2,989 Rural 57.5 40.9 1.4 0.3 0.1 100.0 11,058 Education of household head   None 55.3 44.4 0.3 0.0 0.0 100.0 539 Primary 59.5 38.8 1.3 0.3 0.1 100.0 5,242 Secondary 59.9 38.6 1.2 0.2 0.1 100.0 7,529 Higher 52.0 47.7 0.3 0.0 0.0 100.0 735 Missing/DK (*) (*) (*) (*) (*) 100.0 2 Wealth index quintiles   Poorest 50.6 48.2 0.9 0.3 0.0 100.0 3,870 Second 52.5 45.6 1.6 0.1 0.2 100.0 3,604 Middle 59.7 39.4 0.8 0.0 0.0 100.0 3,309 Fourth 76.3 22.6 0.7 0.4 0.0 100.0 2,706 Richest 75.7 19.4 4.9 0.0 0.0 100.0 558 Total 59.2 39.4 1.2 0.2 0.1 100.0 14,047 (*) Figures that are based on fewer than 25 unweighted cases 48 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 49 Figure WS.1: Per cent distribution of household members by source of drinking water, BiH 2011–2012 Table WS.1: Use of improved water sources Per cent distribution of household population according to main source of drinking water and percentage of household population using improved drinking water sources, BiH 2011–2012   Main source of drinking water of drinking water Total Percentage using improved sources of drinking water1 Number of household members   Improved sources Unimproved sources   Piped water Tubewell/ borehole Protected well Protected spring Rainwater collection Bottled water* Unprotected well Unprotected spring Tanker truck Bottled water* Other   Into dwelling Into yard/ plot To neighbour Public tap/ standpipe Administrative unit   FBiH 85.7 0.7 0.2 1.8 1.0 3.7 3.4 0.8 2.3 0.0 0.1 0.0 0.1 0.2 100.0 99.6 13,374 RS 85.7 2.7 0.7 0.4 2.9 3.4 2.6 0.0 1.1 0.2 0.3 0.0 0.0 0.0 100.0 99.5 6,524 BD 15.6 3.7 0.0 54.6 4.6 12.9 0.1 0.0 8.0 0.2 0.0 0.0 0.4 0.0 100.0 99.4 323 Area   Urban 90.6 0.0 0.2 2.3 0.2 0.6 2.7 0.0 3.0 0.0 0.1 0.0 0.0 0.2 100.0 99.7 6,932 Rural 81.4 2.1 0.5 2.2 2.4 5.4 3.3 0.8 1.5 0.1 0.2 0.0 0.1 0.1 100.0 99.5 13,289 Education of household head   None 82.9 1.1 0.8 2.5 2.4 3.6 3.4 2.6 0.4 0.0 0.3 0.0 0.0 0.0 100.0 99.7 598 Primary 82.6 2.5 0.8 1.8 3.1 4.5 2.6 0.8 0.8 0.1 0.2 0.0 0.0 0.2 100.0 99.5 6,095 Secondary 85.6 1.0 0.2 2.4 1.0 3.7 3.2 0.3 2.3 0.1 0.2 0.0 0.1 0.0 100.0 99.7 11,497 Higher 85.1 0.0 0.1 2.7 1.0 2.0 3.9 0.1 4.3 0.0 0.2 0.0 0.1 0.6 100.0 99.2 2,025 Missing/DK (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 7 Wealth index quintile   Poorest 71.2 4.3 1.3 3.2 2.8 8.8 5.8 0.7 0.7 0.1 0.7 0.0 0.0 0.2 100.0 98.9 4,043 Second 83.3 1.7 0.4 3.0 1.6 3.7 3.7 0.5 1.7 0.2 0.0 0.0 0.0 0.0 100.0 99.8 4,046 Middle 86.5 0.5 0.0 3.2 2.1 3.1 2.1 1.0 1.3 0.0 0.1 0.0 0.0 0.1 100.0 99.8 4,044 Fourth 89.3 0.2 0.0 0.9 1.2 2.1 3.4 0.2 2.4 0.0 0.0 0.0 0.2 0.0 100.0 99.7 4,044 Richest 92.4 0.0 0.0 0.9 0.6 1.1 0.5 0.1 4.0 0.0 0.0 0.0 0.0 0.3 100.0 99.7 4,044 Total 84.6 1.4 0.4 2.2 1.7 3.8 3.1 0.5 2.0 0.1 0.2 0.0 0.1 0.1 100.0 99.6 20,221 1 MICS indicator 4.1; MDG indicator 7.8 (*) Figures that are based on fewer than 25 unweighted cases * Households using bottled water as the main source of drinking water are classified into improved or unimproved drinking water users according to the water source used for other purposes such as cooking and hand washing. The use of household water treatment is presented in Table WS.2. Households were asked about ways in which they might be treating water at home to make it safer to drink. Boiling water, adding bleach or chlorine, using a water filter or using solar disinfection Piped into dwelling, yard or plot, neigbour 86% Public tap/standpipe 2% Tubewell/borehole 2% Protected well or spring 7% Rainwater collection 1% Unprotected well or spring 0% Bottled water 2% Other unimproved source 0% 50 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 51 are considered as proper treatment for drinking water. The table shows water treatment by all households and the percentage of household members living in households that use unimproved water sources but use appropriate water treatment methods. About 95 per cent of household members did not use a water treatment method. Amongst the remaining household members boiling water and adding chlorine were used to an equal extent (about 2 per cent) as a water treatment method. Of the household members who were not using an improved source of drinking water, 9 per cent used an appropriate water treatment method. This means that less than 1 per cent of all household members in BiH used drinking water from an unimproved source that had not been appropriately treated. Table WS.2: Household water treatment Percentage of household population by drinking water treatment method used in the household and for household members living in households where an unimproved drinking water source is used, the percentage who are using an appropriate treatment method, BiH 2011–2012   Water treatment method used in the household Number of household members Percentage of household members in households using unimproved drinking water sources and using an appropriate water treatment method1 Number of household members in households using unimproved drinking water sourcesNone Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar disinfection Let it stand and settle Other Missing/DK Administrative unit   FBiH 94.5 2.3 2.8 0.1 0.3 0.0 0.0 0.3 0.0 13,374 0.0 53 RS 95.2 2.2 1.7 0.2 1.0 0.0 0.0 0.2 0.0 6,524 (23.8) 31 BD 94.5 3.3 0.1 0.0 1.9 0.0 0.0 0.5 0.0 323 (*) 2 Area   Urban 96.6 2.5 0.3 0.2 0.6 0.0 0.0 0.0 0.0 6,932 (*) 23 Rural 93.7 2.1 3.5 0.1 0.5 0.0 0.0 0.4 0.0 13,289 11.7 62 Main source of drinking water   Improved 94.7 2.3 2.4 0.1 0.5 0.0 0.0 0.2 0.0 20,135 N/A N/A Unimproved 91.5 1.1 7.4 0.0 0.0 0.0 0.0 7.4 0.0 85 8.5 85 Education of household head   None 97.1 0.6 2.1 0.0 0.0 0.0 0.0 0.2 0.0 598 (*) 2 Primary 95.3 1.7 2.9 0.4 0.2 0.0 0.0 0.1 0.0 6,095 (3.1) 30 Secondary 94.2 2.6 2.3 0.0 0.7 0.0 0.0 0.3 0.0 11,497 (16.7) 38 Higher 95.5 2.4 1.3 0.0 0.7 0.0 0.0 0.1 0.0 2,025 (*) 16 Missing/DK (*) (*) (*) (*) (*) (*) (*) (*) (*) 7 – 0 Wealth index quintile   Poorest 93.6 1.8 4.2 0.2 0.1 0.0 0.0 0.7 0.0 4,043 2.1 46 Second 95.6 2.3 1.6 0.0 0.3 0.0 0.0 0.5 0.0 4,046 (*) 9 Middle 94.1 2.7 2.6 0.1 0.3 0.0 0.0 0.0 0.0 4,044 (*) 7 Fourth 95.5 1.8 2.3 0.3 0.7 0.0 0.0 0.0 0.0 4,044 (*) 10 Richest 94.8 2.8 1.2 0.0 1.3 0.0 0.0 0.0 0.0 4,044 (*) 13 Total 94.7 2.3 2.4 0.1 0.5 0.0 0.0 0.2 0.0 20,221 8.5 85 1 MICS indicator 4.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases N/A: “Not applicable” 52 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 53 Ta bl e W S. 4: P er so n co lle ct in g w at er Pe rc en ta ge o f h ou se ho ld s w ith ou t d rin ki ng w at er o n th e pr em is es a nd p er c en t d is tr ib ut io n of h ou se ho ld s w ith ou t d rin ki ng w at er o n th e pr em is es a cc or di ng to th e pe rs on u su al ly c ol le ct in g dr in ki ng w at er u se d in th e ho us eh ol d, B iH 2 01 1– 20 12   Pe rc en ta ge o f h ou se ho ld s w ith ou t d rin ki ng w at er o n pr em is es N um be r o f ho us eh ol ds Pe rs on u su al ly c ol le ct in g dr in ki ng w at er N um be r o f h ou se ho ld s w ith ou t d rin ki ng w at er on p re m is es Ad ul t w om an Ad ul t m an Fe m al e ch ild un de r a ge 1 5 M al e ch ild un de r a ge 1 5 M is si ng D K To ta l A dm in is tr at iv e un it   FB iH 5. 9 3, 71 0 30 .5 63 .3 1. 2 2. 4 0. 4 2. 3 10 0. 0 21 8 RS 3. 3 1, 96 8 28 .9 65 .4 0. 0 0. 0 0. 0 5. 7 10 0. 0 64 BD 54 .7 10 0 41 .2 53 .3 0. 0 4. 9 0. 6 0. 0 10 0. 0 55 A re a   U rb an 4. 8 2, 11 8 31 .8 57 .8 0. 0 5. 2 0. 2 5. 0 10 0. 0 10 1 Ru ra l 6. 4 3, 66 0 32 .0 63 .9 1. 1 1. 1 0. 4 1. 5 10 0. 0 23 6 Ed uc at io n of h ou se ho ld h ea d   N on e 7. 8 25 6 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 20 Pr im ar y 5. 3 1, 80 5 29 .4 62 .4 2. 4 0. 0 0. 2 5. 6 10 0. 0 95 Se co nd ar y 5. 9 3, 11 4 35 .7 59 .1 0. 2 3. 4 0. 0 1. 7 10 0. 0 18 2 H ig he r 6. 6 60 1 (1 1. 6) (8 4. 9) (0 .0 ) (0 .4 ) (2 .3 ) (0 .8 ) 10 0. 0 40 M is si ng /D K – 2 – – – – – – 0. 0 0 W ea lt h in de x qu in ti le   Po or es t 8. 8 1, 51 5 36 .2 61 .1 0. 0 1. 1 0. 0 1. 5 10 0. 0 13 3 Se co nd 6. 1 1, 15 0 40 .6 47 .0 3. 7 1. 7 0. 0 7. 1 10 0. 0 71 M id dl e 6. 2 1, 06 3 24 .2 68 .6 0. 0 4. 2 1. 4 1. 7 10 0. 0 65 Fo ur th 4. 6 1, 00 6 (2 3. 9) (7 0. 6) (0 .0 ) (4 .9 ) (0 .0 ) (0 .7 ) 10 0. 0 46 Ri ch es t 2. 1 1, 04 5 (1 8. 0) (7 9. 1) (0 .0 ) (0 .7 ) (0 .7 ) (1 .4 ) 10 0. 0 22 To ta l 5. 8 5, 77 8 31 .9 62 .1 0. 8 2. 3 0. 3 2. 6 10 0. 0 33 7 ( ) F ig ur es th at a re b as ed o n 25 –4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s The amount of time it took to obtain water is presented in Table WS.3 and the person who usually collected the water in Table WS.4. Note that these results refer to one roundtrip from home to the drinking water source and that information on the number of trips made in one day was not collected in MICS4. The data shows that most household members in BiH had a drinking water source on the premises (94 per cent). For 2 per cent of the household members using improved sources of drinking water it took 30 minutes or more to go to the sources of the water, get the water and return. A negligible percentage of the population that used unimproved sources of drinking water obtained the water outside the premises. Table WS.3: Time to source of drinking water Per cent distribution of household population according to time to go to source of drinking water, get water and return for users of improved and unimproved drinking water sources, BiH 2011–2012   Time to source of drinking water Missing/ DK   Total Number of household members   Users of improved drinking water sources Users of unimproved drinking water sources Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Water on premises Less than 30 minutes 30 minutes or more Administrative unit   FBiH 94.2 3.4 2.0 0.1 0.2 0.0 0.1 0.1 100.0 13,374 RS 96.5 2.1 0.6 0.3 0.2 0.1 0.1 0.0 100.0 6,524 BD 46.1 36.9 16.2 0.2 0.5 0.0 0.0 0.1 100.0 323 Area   Urban 94.7 3.3 1.2 0.4 0.2 0.0 0.0 0.1 100.0 6,932 Rural 93.8 3.6 2.0 0.0 0.2 0.1 0.1 0.1 100.0 13,289 Education of household head   None 94.0 4.3 1.1 0.4 0.0 0.0 0.3 0.0 100.0 598 Primary 94.8 2.7 2.0 0.0 0.3 0.1 0.1 0.0 100.0 6,095 Secondary 94.1 3.9 1.5 0.1 0.1 0.0 0.1 0.1 100.0 11,497 Higher 92.5 3.3 2.7 0.8 0.6 0.1 0.0 0.0 100.0 2,025 Missing/DK (*) (*) (*) (*) (*) (*) (*) (*) 100.0 7 Wealth index quintile   Poorest 90.2 5.2 3.3 0.2 0.4 0.2 0.4 0.0 100.0 4,043 Second 93.4 4.9 1.5 0.0 0.2 0.0 0.0 0.0 100.0 4,046 Middle 93.7 3.6 2.1 0.4 0.1 0.0 0.0 0.1 100.0 4,044 Fourth 95.5 2.7 1.4 0.2 0.0 0.0 0.0 0.2 100.0 4,044 Richest 97.9 1.3 0.5 0.0 0.3 0.0 0.0 0.0 100.0 4,044 Total 94.1 3.5 1.8 0.2 0.2 0.1 0.1 0.1 100.0 20,221 (*) Figures that are based on fewer than 25 unweighted cases Table WS.4 shows that 6 per cent of households in BiH had no water sources on the premises (6 per cent in the FBiH and 3 per cent in RS) and that the percentage of households with no sources of drinking water on the premises declined with increased wealth. When the source of drinking water was not on the premises, in the majority of cases (62 per cent) an adult male collected water. Adult females collected water in 32 per cent of cases, while for the remainder of the households water was less frequently collected by female or male children under the age of 15 years. 54 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 55 Use of Improved Sanitation Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases including diarrhoeal diseases and polio. Improved sanitation can reduce diarrhoeal disease by more than a third and can significantly lessen the adverse health impact of other disorders. An improved sanitation facility is defined as one that hygienically separates human excreta from human contact. Improved sanitation facilities for excreta disposal include flush or pour flush to a piped sewer system, septic tank or pit latrine, ventilated improved pit latrine, pit latrine with slab and use of a composting toilet. Data on the use of improved sanitation facilities in BiH are presented in Table WS.5 However, sharing of sanitation facilities, even if those are improved, is assumed to compromise their safety. Therefore, ‘improved sanitation’ is used both in the context of this report and as an MDG indicator to refer to improved sanitation facilities, which are not shared. Data on improved sanitation are presented in Tables WS.6 and WS.8. Table WS.5 indicates that the most common improved sanitation facilities were flush toilets connected to a sewer system (48 per cent) or septic tank (43 per cent). The household population in rural areas most commonly used septic tanks (58 per cent), while the most common type of sanitation facility in urban areas was a flush toilet with connection to a sewer system (83 per cent). The use of improved sanitation facilities is positively associated with wealth. Table WS.5: Types of sanitation facilities Per cent distribution of household population according to type of toilet facility used by the household, BiH 2011–2012   Type of toilet facility used by household Open defecation (no facility, bush, field) Total Number of household members Improved sanitation facility Unimproved sanitation facility Flush/pour flush to: Ventilated improved pit latrine Pit latrine with slab Flush/pour flush to somewhere else Pit latrine without slab/ open pit Bucket Other MissingPiped sewer system Septic tank Pit latrine Unknown place/ not sure/DK where Administrative unit   FBiH 57.5 37.5 0.1 0.1 0.6 1.6 1.6 0.8 0.0 0.0 0.2 0.0 100.0 13,374 RS 29.4 55.1 0.5 0.1 0.1 4.4 8.2 2.1 0.0 0.0 0.0 0.0 100.0 6,524 BD 45.4 47.8 0.3 0.0 1.6 4.6 0.3 0.0 0.0 0.0 0.0 0.0 100.0 323 Area   Urban 83.3 15.3 0.0 0.0 0.3 0.3 0.5 0.1 0.0 0.0 0.2 0.0 100.0 6,932 Rural 29.9 58.0 0.3 0.2 0.5 3.8 5.4 1.8 0.0 0.0 0.1 0.0 100.0 13,289 Education of household head   None 28.7 47.7 2.4 0.2 2.4 8.1 6.7 3.2 0.3 0.0 0.1 0.2 100.0 598 Primary 36.1 49.4 0.2 0.1 0.7 4.8 6.1 2.4 0.0 0.0 0.1 0.0 100.0 6,095 Secondary 51.8 42.7 0.1 0.1 0.3 1.5 2.6 0.7 0.0 0.0 0.1 0.0 100.0 11,497 Higher 69.9 27.3 0.0 0.0 0.0 0.6 2.2 0.0 0.0 0.0 0.0 0.0 100.0 2,025 Missing/DK (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 100.0 7 Wealth index quintile   Poorest 20.6 49.9 0.9 0.1 2.1 11.0 9.2 5.9 0.0 0.0 0.1 0.1 100.0 4,043 Second 37.5 56.4 0.1 0.1 0.1 1.5 3.8 0.3 0.0 0.0 0.1 0.0 100.0 4,046 Middle 46.3 49.1 0.1 0.3 0.0 0.4 3.8 0.0 0.0 0.0 0.0 0.0 100.0 4,044 Fourth 58.5 39.8 0.0 0.0 0.0 0.0 1.7 0.0 0.0 0.0 0.0 0.0 100.0 4,044 Richest 78.0 21.5 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.2 0.0 100.0 4,044 Total 48.2 43.3 0.2 0.1 0.4 2.6 3.7 1.2 0.0 0.0 0.1 0.0 100.0 20,221 (*) Figures that are based on fewer than 25 unweighted cases 56 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 57 Ta bl e W S. 7: D is po sa l o f c hi ld ’s fa ec es pe r c en t d is tr ib ut io n of c hi ld re n ag ed 0 -2 y ea rs a cc or di ng to p la ce o f d is po sa l o f c hi ld ’s fa ec es a nd th e pe rc en ta ge o f c hi ld re n ag ed 0 -2 y ea rs w ho se s to ol s w er e di sp os ed o f s af el y th e la st ti m e th e ch ild p as se d st oo ls , B ih 2 01 1– 20 12   Pl ac e of d is po sa l o f c hi ld ’s fa ec es to ta l pe rc en ta ge of c hi ld re n w ho se la st st oo ls w er e di sp os ed of s af el y1 n um be r of c hi ld re n ag ed 0- 2 ye ar s ch ild u se d to ile t/ la tr in e pu t/ rin se d in to to ile t or la tr in e pu t/ rin se d in to d ra in or d itc h th ro w n in to ru bb is h Bu rie d le ft in th e op en o th er d K M is si ng Ty pe o f s an it at io n fa ci lit y in d w el lin g   im pr ov ed 12 .1 7. 4 0. 5 78 .7 0. 2 0. 0 0. 2 0. 1 0. 8 10 0. 0 19 .5 1, 29 1 u ni m pr ov ed 13 .6 7. 3 0. 9 78 .2 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 20 .8 85 o pe n de fe ca tio n (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) 1 A dm in is tr at iv e un it   fB ih 13 .3 5. 7 0. 6 78 .8 0. 2 0. 1 0. 2 0. 1 1. 0 10 0. 0 19 .0 97 3 rs 9. 9 11 .5 0. 4 77 .8 0. 0 0. 0 0. 2 0. 0 0. 2 10 0. 0 21 .4 37 6 Bd (4 .3 ) (1 3. 4) (0 .0 ) (8 2. 3) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 (1 7. 7) 28 A re a   u rb an 12 .6 6. 2 0. 0 79 .8 0. 4 0. 2 0. 7 0. 0 0. 2 10 0. 0 18 .8 45 6 ru ra l 12 .0 8. 1 0. 8 78 .0 0. 1 0. 0 0. 0 0. 1 1. 0 10 0. 0 20 .0 92 2 M ot he r’s e du ca ti on *   pr im ar y 11 .4 6. 6 1. 1 79 .5 0. 5 0. 0 0. 0 0. 0 0. 8 10 0. 0 18 .1 30 0 se co nd ar y 12 .4 7. 6 0. 5 78 .1 0. 1 0. 0 0. 3 0. 1 0. 9 10 0. 0 20 .0 86 1 h ig he r 10 .3 8. 3 0. 0 81 .0 0. 0 0. 0 0. 4 0. 0 0. 0 10 0. 0 18 .6 20 1 W ea lt h in de x qu in ti le   po or es t 12 .5 11 .0 1. 4 74 .5 0. 0 0. 3 0. 0 0. 0 0. 3 10 0. 0 23 .5 23 6 se co nd 13 .4 6. 5 0. 8 78 .8 0. 0 0. 0 0. 0 0. 3 0. 3 10 0. 0 19 .8 29 8 M id dl e 12 .1 8. 5 0. 0 76 .9 0. 0 0. 0 0. 3 0. 0 2. 2 10 0. 0 20 .6 28 3 fo ur th 12 .7 4. 6 0. 6 80 .3 0. 6 0. 0 0. 3 0. 0 0. 9 10 0. 0 17 .3 27 1 ri ch es t 10 .4 7. 1 0. 0 81 .7 0. 3 0. 0 0. 5 0. 0 0. 0 10 0. 0 17 .5 29 1 To ta l 12 .2 7. 4 0. 5 78 .6 0. 2 0. 1 0. 2 0. 1 0. 7 10 0. 0 19 .6 1, 37 7 1 M ic s in di ca to r 4 .4 ( ) f ig ur es th at a re b as ed o n 25 –4 9 un w ei gh te d ca se s (* ) f ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s * fi gu re s fo r t he e du ca tio n ca te go ry “n on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t s ho w n in th e ta bl e. The Millennium Development Goals and the WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation classify households as using an unimproved sanitation facility if they are using otherwise acceptable sanitation facilities but sharing a facility between two or more households or using a public toilet facility. Table WS.6 shows that 94 per cent of the population used improved sanitation that is not shared, the percentage being somewhat higher in the FBiH (97 per cent) compared to RS (89 per cent). Less than 1 per cent of the total population using improved sanitation shared a sanitation facility. Amongst the population that used unimproved sanitation facilities (5 per cent) the rural population shared sanitation facilities less frequently than the population in urban areas. There was a negative correlation between the use of unimproved sanitation facilities and the education of the household head. Table WS.6: Use and sharing of sanitation facilities per cent distribution of household population by use of private and public sanitation facilities and use of shared facilities by users of improved and unimproved sanitation facilities, Bih 2011–2012   Users of improved sanitation facilities Users of unimproved sanitation facilities open defecation (no facility, bush, field) total number of household members not shared (use of improves sanitation)1 public facility Shared by not shared Shared by 5 households or less More than 5 households 5 households or less Administrative unit   fBih 96.5 0.0 0.7 0.1 2.5 0.1 0.0 100.0 13,374 rs 89.4 0.0 0.2 0.0 10.3 0.1 0.0 100.0 6,524 Bd 99.5 0.0 0.2 0.0 0.3 0.0 0.0 100.0 323 Area   urban 98.7 0.0 0.4 0.2 0.8 0.0 0.0 100.0 6,932 rural 92.0 0.0 0.6 0.0 7.2 0.2 0.0 100.0 13,289 Education of household head   none 86.7 0.0 2.8 0.0 10.1 0.2 0.2 100.0 598 primary 90.4 0.0 0.9 0.0 8.4 0.3 0.0 100.0 6,095 secondary 96.1 0.0 0.3 0.1 3.5 0.0 0.0 100.0 11,497 higher 97.8 0.0 0.0 0.0 2.2 0.0 0.0 100.0 2,025 Missing/dK (*) (*) (*) (*) (*) (*) (*) 100.0 7 Wealth index quintile   poorest 82.3 0.0 2.3 0.0 14.8 0.5 0.1 100.0 4,043 second 95.7 0.0 0.1 0.0 4.3 0.0 0.0 100.0 4,046 Middle 95.8 0.1 0.2 0.1 3.8 0.0 0.0 100.0 4,044 fourth 98.2 0.0 0.0 0.1 1.7 0.0 0.0 100.0 4,044 richest 99.3 0.0 0.0 0.2 0.5 0.0 0.0 100.0 4,044 Total 94.3 0.0 0.5 0.1 5.0 0.1 0.0 100.0 20,221 1 Mics indicator 4.3; Mdg indicator 7.9 (*) figures that are based on fewer than 25 unweighted cases Safe disposal of a child’s faeces is disposing of the stool by the child using a toilet or by rinsing the stool into a toilet or latrine. Disposal of faeces of children aged 0-2 years is presented in Table WS.7. The percentage of children aged 0-2 years whose last stools were disposed of safely was 20 per cent: 19 per cent in the FBiH and 21 per cent in RS. For 79 per cent of children aged 0-2 years, the last stool was thrown into the rubbish. 58 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 59 Ta bl e W S. 8: D ri nk in g w at er a nd s an it at io n la dd er s Pe rc en ta ge o f h ou se ho ld p op ul at io n by d rin ki ng w at er a nd s an ita tio n la dd er s, Bi H 2 01 1– 20 12   Pe rc en ta ge o f h ou se ho ld p op ul at io n us in g: N um be r of h ou se ho ld m em be rs   Im pr ov ed d ri nk in g w at er 1 U ni m pr ov ed dr in ki ng w at er To ta l Im pr ov ed sa ni ta tio n2 U ni m pr ov ed s an it at io n To ta l Im pr ov ed dr in ki ng w at er so ur ce s an d im pr ov ed sa ni ta tio n   Pi pe d in to dw el lin g, p lo t o r ya rd O th er im pr ov ed Sh ar ed im pr ov ed fa ci lit ie s U ni m pr ov ed fa ci lit ie s O pe n de fe ca tio n A dm in is tr at iv e un it FB iH 88 .6 11 .0 0. 4 10 0. 0 96 .5 0. 8 2. 7 0. 0 10 0. 0 96 .2 13 ,3 74 RS 89 .5 10 .0 0. 5 10 0. 0 89 .4 0. 2 10 .4 0. 0 10 0. 0 89 .1 6, 52 4 BD 25 .7 73 .6 0. 6 10 0. 0 99 .5 0. 2 0. 3 0. 0 10 0. 0 98 .9 32 3 A re a U rb an 93 .6 6. 1 0. 3 10 0. 0 98 .7 0. 5 0. 8 0. 0 10 0. 0 98 .4 6, 93 2 Ru ra l 84 .9 14 .6 0. 5 10 0. 0 92 .0 0. 6 7. 4 0. 0 10 0. 0 91 .6 13 ,2 89 Ed uc at io n of h ou se ho ld h ea d N on e 84 .4 15 .4 0. 3 10 0. 0 86 .7 2. 8 10 .3 0. 2 10 0. 0 86 .7 59 8 Pr im ar y 85 .9 13 .6 0. 5 10 0. 0 90 .4 1. 0 8. 6 0. 0 10 0. 0 90 .1 6, 09 5 Se co nd ar y 88 .9 10 .8 0. 3 10 0. 0 96 .1 0. 4 3. 5 0. 0 10 0. 0 95 .8 11 ,4 97 H ig he r 89 .4 9. 8 0. 8 10 0. 0 97 .8 0. 0 2. 2 0. 0 10 0. 0 97 .0 2, 02 5 M is si ng /D K (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) 10 0. 0 (* ) 7 W ea lt h in de x qu in ti le Po or es t 76 .2 22 .7 1. 1 10 0. 0 82 .3 2. 3 15 .3 0. 1 10 0. 0 81 .7 4, 04 3 Se co nd 86 .8 13 .0 0. 2 10 0. 0 95 .7 0. 1 4. 3 0. 0 10 0. 0 95 .4 4, 04 6 M id dl e 88 .3 11 .5 0. 2 10 0. 0 95 .8 0. 4 3. 8 0. 0 10 0. 0 95 .7 4, 04 4 Fo ur th 91 .9 7. 9 0. 3 10 0. 0 98 .2 0. 1 1. 7 0. 0 10 0. 0 98 .0 4, 04 4 Ri ch es t 96 .3 3. 4 0. 3 10 0. 0 99 .3 0. 2 0. 5 0. 0 10 0. 0 99 .0 4, 04 4 To ta l 87 .9 11 .7 0. 4 10 0. 0 94 .3 0. 6 5. 1 0. 0 10 0. 0 94 .0 20 ,2 21 1 M IC S in di ca to r 4 .1 ; M D G in di ca to r 7 .8 2 M IC S in di ca to r 4 .3 ; M D G in di ca to r 7 .9 (* ) F ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation developed a new way of presenting the access figures36 by disaggregating and refining the data on drinking water and sanitation and reflecting them in a ‘ladder’ format. This ladder allows a disaggregated analysis of trends using a three rung ladder for drinking-water and a four rung ladder for sanitation. For sanitation this gives an understanding of the proportion of the population: z with no sanitation facilities at all; z percentage of those reliant on technologies defined by JMP as ‘unimproved’; z percentage of those sharing sanitation facilities of otherwise acceptable technology; z percentage of those using ‘improved’ sanitation facilities. Table WS.8 presents the percentages of the household population by drinking water and sanitation ladders. The table also shows the percentage of household members using improved sources of drinking water and sanitary means of excreta disposal. An analysis of the survey data using a three rung ladder for drinking water showed that almost all households members in BiH, the FBiH and RS were using improved sources of drinking water with about 88 per cent using water piped into their dwelling or plot/yard, while about 12 per cent had some other source of improved water. Unimproved sources of drinking water were used by less than 1 per cent of the population. An analysis of the survey data using a four rung ladder for sanitation showed that improved sanitation was used by 94 per cent of household members (97 per cent in the FBiH and 89 per cent in RS). The remaining 6 per cent of household members used unimproved sanitation, which included the use of unimproved sanitation facilities (5 per cent) and shared use of improved facilities (less than 1 per cent). Improved sources of drinking water and improved sanitation were used by 94 per cent of household members in BiH, with a somewhat higher figure in the FBiH (96 per cent) compared to RS (89 per cent). There was a positive correlation between the use of improved sources of drinking water and improved sanitation and the education level of the household head as well as household wealth. 36 WHO/UNICEF JMP (2008), MDG Assessment Report: Progress on Drinking Water and Sanitation: Special Focus on Sanitation <http://www.wssinfo.org/ fileadmin/user_upload/resources/1251794333-JMP_08_en.pdf> 60 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 61 Hand Washing Hand washing with water and soap is the most cost effective health intervention to reduce the incidence of both diarrhoea and pneumonia in children under five. It is most effective when done using water and soap after visiting a toilet or cleaning a child, before eating or handling food and before feeding a child. Monitoring correct hand washing behaviour at these critical times is challenging. This survey assessed the likelihood that correct hand washing behaviour takes place by observing if a household had a specific place where people most often washed their hands and observing if water and soap (or other local cleansing materials) were present at a specific place for hand washing. Table WS.9 shows that the place used for hand washing was observed in 98 per cent of households in BiH (99 per cent in the FBiH and 96 per cent in RS); in the remaining 2 per cent of households the place for hand washing was either not in the dwelling/plot/yard or other reasons were reported for not being able to observe the place. The observation of the place for hand washing showed that in 98 per cent of cases these places had both water and soap present. In less than 1 per cent of cases the specific place for hand washing had soap but no water or had water but no soap, while in a negligible percentage of observed places for hand washing neither water nor soap were available. While most households had both water and soap available there was a positive correlation between their availability in the observed place for hand washing and the wealth status of the household. Thus, water and soap were least likely to be available in the poorest households (94 per cent) and most likely to be available in the richest households (99 per cent). Table WS.9: Water and soap at place for hand washing Percentage of households where place for hand washing was observed and per cent distribution of households by availability of water and soap at place for hand washing, BiH 2011–2012   Percentage of households where place for hand washing was observed Percentage of households where place for hand washing was not observed Total Number of households Per cent distribution of households where place for hand washing was observed, and: Total Number of households where place for hand washing was observed   Not in dwelling/plot/yard No permission to see Other reasons Missing Water and soap are available1 Water is available, soap is not available Water is not available, soap is available Water and soap are not available Administrative unit  FBiH 99.3 0.4 0.2 0.1 0.1 100.0 3,710 98.8 0.1 1.0 0.1 100.0 3,682 RS 95.5 1.6 1.7 1.2 0.0 100.0 1,968 96.2 2.3 0.9 0.6 100.0 1,879 BD 80.3 5.9 9.3 4.5 0.0 100.0 100 100.0 0.0 0.0 0.0 100.0 80 Area Urban 98.2 0.1 1.1 0.5 0.1 100.0 2,118 99.1 0.6 0.2 0.0 100.0 2,081 Rural 97.3 1.4 0.7 0.6 0.0 100.0 3,660 97.2 1.0 1.4 0.4 100.0 3,561 Education of household head None 92.6 4.2 2.5 0.8 0.0 100.0 256 95.6 3.6 0.7 0.0 100.0 237 Primary 96.6 1.8 0.8 0.8 0.0 100.0 1,805 97.1 1.0 1.5 0.4 100.0 1,744 Secondary 98.4 0.3 0.9 0.4 0.0 100.0 3,114 98.2 0.7 0.9 0.2 100.0 3,065 Higher 98.9 0.0 0.4 0.3 0.4 100.0 601 99.8 0.2 0.0 0.0 100.0 594 Missing/DK (*) (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0 2 Wealth index quintiles Poorest 93.7 3.4 1.7 1.0 0.2 100.0 1,515 94.3 2.4 2.4 0.9 100.0 1,419 Second 98.8 0.2 0.8 0.2 0.0 100.0 1,150 99.3 0.3 0.4 0.0 100.0 1,137 Middle 99.0 0.0 0.5 0.4 0.0 100.0 1,063 98.9 0.4 0.7 0.0 100.0 1,052 Fourth 98.6 0.0 0.6 0.7 0.0 100.0 1,006 99.1 0.2 0.7 0.0 100.0 992 Richest 99.7 0.0 0.3 0.0 0.0 100.0 1,045 99.3 0.4 0.2 0.0 100.0 1,042 Total 97.6 0.9 0.9 0.5 0.0 100.0 5,778 97.9 0.9 1.0 0.2 100.0 5,642 1 MICS indicator 4.5 (*) Figures that are based on fewer than 25 unweighted cases Table WS.10 shows that, in cases where the place for hand washing was observed, soap was available in 97 per cent of households and in nearly 1 per cent of households the soap was subsequently shown to the interviewer. The percentage of households where soap was present anywhere in the dwelling was 99 per cent. There was a positive correlation between the presence of soap at the designated place for hand washing or anywhere in the household and the education of the household head and household wealth. Thus, the lowest percentage of soap available (anywhere) was found amongst households where the household head had no education and amongst the poorest households. 62 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 63 VII Reproductive Health Fertility In MICS4 the birth rates for women aged 15 to 19 and total fertility rate (TFR) were calculated by using information on the date of the last birth of each woman and were based on the one year period (1-12 months) preceding the survey. Rates were underestimated by a very small margin due to an absence of information on multiple births (twins, triplets etc.) and on women who may have had multiple deliveries during the one year period preceding the survey. The TFR was calculated by summing the age specific fertility rates calculated for each of the 5-year age groups of women, from age 15 through to age 49. The TFR denotes the average number of children to which a woman will have given birth by the end of her reproductive years if current fertility rates prevail. Table RH.1 shows that the TFR was 1.3 births per woman. The survey findings indicate that the adolescent birth rate in BiH was 8 births per 1,000 women for the one year period preceding the survey. Table RH.1: Adolescent birth rate and total fertility rate Adolescent birth rates and total fertility rates, BiH 2011–2012   Adolescent birth rate1 (Age-specific fertility rate for women age 15-19) Total Fertility Rate Administrative unit   FBiH 6 1.3 RS (*) 1.2 BD (*) (1.8) Area   Urban (21) 1.1 Rural 2 1.4 Women’s education   Primary (*) 2.3 Secondary 8 1.5 Higher (*) 1.1  Total 8 1.3 1 MICS indicator 5.1; MDG indicator 5.4 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. knowledge of Contraceptive Methods Being aware of available contraceptive methods is an important step towards accessing and using a suitable method of contraception, which in turn allows choices about family planning to be made. In the 2011–2012 BiH MICS a set of questions on knowledge of contraceptive methods were added to the questionnaire for individual women. Information was collected from all women aged 15-49 years on whether they had heard of the following family planning methods: female and male sterilisation, IUD (intrauterine device), injectables, implants, pill, male condom, female condom, diaphragm, foam/jelly, lactational amenorrhea method (LAM), periodic abstinence/the rhythm method, withdrawal and emergency/postcoital contraception. Data on LAM are not presented in Tables RH.2, RH.3 and RH.4 because there is no LAM programme in the FBiH and RS. Of these methods, periodic abstinence/the rhythm method and withdrawal were considered traditional methods while the rest were considered to be modern methods of contraception. The respondents were also asked if they had heard of any other ways or methods to avoid pregnancy, apart from those mentioned above. Table W S.10: A vailability of soap Per cent distribution of households by availability of soap in the dw elling, BiH 2011–2012   Place for hand w ashing observed Place for hand w ashing not observed Total Percentage of households w ith soap anyw here in the dw elling 1 N um ber of households   Soap observed Soap not observed at place for hand w ashing Soap show n N o soap in household N ot able/ D oes not w ant to show soap M issing   Soap show n N o soap in household N ot able/ D oes not w ant to show soap A dm inistrative unit   FBiH 99.0 0.2 0.1 0.0 0.7 0.1 0.0 0.0 100.0 99.9 3,710 RS 92.7 2.0 0.2 0.5 2.2 0.1 2.1 0.1 100.0 97.0 1,968 BD 80.3 0.0 0.0 0.0 3.9 0.0 15.7 0.0 100.0 84.3 100 A rea   U rban 97.6 0.4 0.1 0.2 0.4 0.1 1.2 0.0 100.0 98.4 2,118 Rural 96.0 1.0 0.1 0.1 1.8 0.0 0.9 0.1 100.0 98.8 3,660 Education of household head   N one 89.2 1.8 1.2 0.4 5.9 0.0 1.5 0.0 100.0 96.9 256 Prim ary 95.3 1.0 0.1 0.2 2.1 0.1 1.1 0.1 100.0 98.4 1,805 Secondary 97.5 0.7 0.1 0.1 0.6 0.0 0.9 0.0 100.0 98.9 3,114 H igher 98.7 0.2 0.0 0.0 0.1 0.4 0.6 0.0 100.0 99.0 601 M issing/D K (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 2 W ealth index quintile   Poorest 90.5 2.3 0.4 0.5 4.3 0.3 1.6 0.1 100.0 97.1 1,515 Second 98.5 0.3 0.0 0.0 0.3 0.0 0.9 0.0 100.0 99.1 1,150 M iddle 98.6 0.4 0.0 0.0 0.3 0.0 0.7 0.0 100.0 99.3 1,063 Fourth 98.4 0.1 0.1 0.0 0.1 0.0 1.3 0.0 100.0 98.6 1,006 Richest 99.3 0.2 0.0 0.2 0.1 0.0 0.2 0.0 100.0 99.6 1,045 Total 96.6 0.8 0.1 0.2 1.3 0.1 1.0 0.0 100.0 98.6 5,778 1 M ICS indicator 4.6 (*) Figures that are based on few er than 25 unw eighted cases 64 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 65 Table RH.3: knowledge of contraceptive methods Percentage of women aged 15-49 currently married or in union who have heard of at least one contraceptive method and who have heard of at least one modern method, by background characteristics, BiH 2011–2012   Any method Any modern method1 Number of women currently married or in union Administrative unit FBiH 99.6 99.3 1,944 RS 100.0 99.7 777 BD 99.4 99.4 43 Area   Urban 100.0 99.7 876 Rural 99.6 99.2 1,887 Age (years)   15-19 (*) (*) 4 20-24 99.8 99.8 150 25-29 99.7 99.7 308 30-34 99.9 99.1 484 35-39 99.3 99.3 580 40-44 99.7 99.7 613 45-49 100.0 99.2 624 Education*   Primary 99.2 98.5 933 Secondary 100.0 99.8 1,576 Higher 100.0 100.0 246 Wealth index quintile   Poorest 99.2 96.9 385 Second 99.5 99.5 542 Middle 99.6 99.6 627 Fourth 100.0 100.0 602 Richest 100.0 100.0 608 Total 99.7 99.4 2,764 1 Female sterilisation, male sterilisation, pill, IUD, injectables, implants, male condom, female condom, emergency contraception and other modern methods. (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Use of Contraceptives Appropriate family planning is important for the health of women and children through 1) the prevention of pregnancies that are too early or too late, 2) extending the period between births and 3) limiting the number of children. Access by all couples to information and services to prevent pregnancies that are too early, too closely spaced, too late or too many is critical. Table RH.4 shows that a method of contraception was being used by 46 per cent of women who were married or in union: 54 per cent in RS and 43 per cent in the FBiH and that there were no large differences by area. The most popular method used was withdrawal, which accounted for 30 per cent of cases and was at a similar level in RS (33 per cent) and the FBiH (29 per cent). The next most popular method was the male condom (6 per cent). Amongst other methods of contraception, 4 per cent of women used an IUD, 4 per cent practiced periodic abstinence and 2 per cent were on the pill. Slightly more than one-third of women aged 20-24 used a contraceptive method (36 per cent). This percentage rose by age 40-44 to 51 per cent, but was followed by a decline to 40 per cent amongst women aged 45-49. The prevalence of any contraceptive method differed in accordance with the women’s education level and was highest amongst women with higher education (55 per cent). The percentage of male condom and pill use increased with women’s education. Thus, the male condom was most commonly used by women with higher education (14 per cent) and least commonly by women with primary education (2 per cent); while for the pill the percentages were 6 per cent and less than 1 per cent respectively. There was also a positive correlation between contraceptive prevalence and the number of live births. Table RH.2 shows that nearly all women aged 15-49 knew at least one contraceptive method. Modern methods were somewhat more widely known than traditional methods: 99 per cent of all women had heard of at least one modern method while 95 per cent of women knew at least one traditional method. The most widely known modern method was the male condom (98 per cent), followed by the pill (96 per cent) and the IUD (92 per cent). Of the traditional methods, the most widely known method was withdrawal (93 per cent), as well as periodic abstinence/the rhythm method (87 per cent). Survey data indicates that the knowledge of sexually active women aged 15-49 who were not married or in union was somewhat better compared to women who were ever married or in union. A higher proportion of women who were not married knew of emergency contraception, the female condom, foam/jelly, implants, injectables and the diaphragm. On average women knew 9.4 different contraceptive methods. Table RH.2: knowledge of specific contraceptive methods Percentage of all women aged 15-49, percentage of women aged 15-49 currently married or in union and percentage of sexually active women aged 15-49 not married or in union who have heard of any contraceptive method, by specific method, BiH 2011–2012   All Currently married or in union Sexually active women that are not married or in union1 Any method 99.6 99.7 99.7     Any modern method 99.4 99.4 99.7 Female sterilisation 80.4 80.1 88.0 Male sterilisation 75.7 75.3 87.4 Pill 96.2 95.6 99.1 IUD 91.9 94.1 96.4 Injectables 55.1 53.6 61.6 Implants 36.5 34.8 51.0 Male condom 98.2 98.1 99.7 Female condom 62.3 57.8 81.9 Diaphragm 59.1 58.2 72.4 Foam/jelly 47.6 46.1 62.5 Emergency contraception 61.8 58.9 86.1     Any traditional method 94.9 96.6 99.3 Rhythm 86.8 87.6 97.6 Withdrawal 92.7 95.1 97.6 Other 2.4 2.6 2.0 Mean number of methods known by women 9.4 9.3 10.8 Number of women 4,446 2,764 346 1 Had last sexual intercourse within 30 days preceding the survey Table RH.3 presents knowledge of contraceptives for women currently married or in union by background characteristics. The data indicates that the knowledge of women who were currently married or in union did not differ greatly by background characteristics with respect to any method and modern methods. 66 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 67 Table RH.4: Use of contraception Percentage of women aged 15-49 years currently married or in union who are using (or whose partner is using) a contraceptive method, BiH 2011–2012   Not using any method Per cent of women (currently married or in union) who are using: Number of women currently married or in union Female sterilisation Male sterilisation IUD Injectables Implants Pill Male condom Female condom Diaphragm/ Foam/Jelly Periodic abstinence Withdrawal Other method Any modern method Any traditional method Any method1 Administrative unit   FBiH 56.9 0.2 0.0 2.2 0.0 0.0 1.6 5.9 0.1 0.0 3.9 29.2 0.0 10.0 33.1 43.1 1,944 RS 46.3 0.3 0.0 8.0 0.0 0.0 1.3 6.7 0.5 0.0 3.1 32.6 1.2 16.8 36.9 53.7 777 BD 75.3 0.0 0.0 0.3 0.0 0.0 7.1 7.1 0.0 0.0 2.9 7.2 0.0 14.5 10.2 24.7 43 Area   Urban 53.1 0.0 0.0 3.5 0.0 0.0 2.8 8.0 0.0 0.0 1.8 30.7 0.0 14.3 32.5 46.9 876 Rural 54.7 0.3 0.0 3.9 0.0 0.0 1.0 5.3 0.3 0.0 4.5 29.4 0.5 10.8 34.4 45.3 1,887 Age (years)   15-19 (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 4 20-24 64.4 0.0 0.0 1.1 0.0 0.0 2.6 3.4 0.0 0.0 3.9 24.7 0.0 7.0 28.6 35.6 150 25-29 55.5 0.1 0.0 2.1 0.0 0.0 2.5 8.2 0.0 0.0 3.0 28.5 0.1 12.9 31.7 44.5 308 30-34 52.4 0.5 0.0 3.1 0.0 0.1 2.4 7.4 0.4 0.1 5.1 28.5 0.1 13.9 33.7 47.6 484 35-39 51.3 0.1 0.0 5.4 0.0 0.0 1.8 7.0 0.0 0.0 4.6 29.7 0.0 14.3 34.4 48.7 580 40-44 49.2 0.0 0.0 4.9 0.0 0.0 0.9 6.7 0.0 0.0 2.4 35.4 0.5 12.5 38.3 50.8 613 45-49 60.5 0.3 0.0 3.2 0.0 0.0 0.6 3.6 0.6 0.0 3.2 27.0 0.9 8.5 31.1 39.5 624 Number of live births2   0 81.2 0.0 0.0 1.5 0.0 0.0 3.1 2.3 0.0 0.0 1.6 10.3 0.0 6.9 11.9 18.8 129 1 63.5 0.0 0.0 2.5 0.0 0.0 2.4 5.6 0.3 0.0 3.0 22.5 0.0 10.9 25.5 36.5 579 2 52.2 0.3 0.0 3.9 0.0 0.0 1.6 7.3 0.1 0.0 3.1 31.0 0.4 13.3 34.4 47.8 1,432 3 43.9 0.1 0.0 5.0 0.0 0.0 0.4 5.9 0.0 0.1 6.8 37.9 0.0 11.4 44.7 56.1 484 4+ 47.2 0.2 0.0 5.3 0.0 0.0 0.0 1.6 1.4 0.0 3.9 37.4 3.0 8.5 44.3 52.8 140 Education*  Primary 55.1 0.5 0.0 2.8 0.0 0.0 0.4 2.4 0.0 0.0 3.1 35.5 0.3 6.0 38.9 44.9 933 Secondary 55.1 0.1 0.0 4.1 0.0 0.0 1.5 7.3 0.4 0.0 4.1 27.1 0.3 13.4 31.5 44.9 1,576 Higher 44.7 0.0 0.0 5.4 0.0 0.0 6.3 13.5 0.0 0.1 3.5 26.3 0.1 25.3 30.0 55.3 246 Wealth index quintile   Poorest 58.2 0.1 0.0 3.7 0.0 0.0 0.5 2.8 0.0 0.0 2.4 30.9 1.5 7.0 34.8 41.8 385 Second 57.4 0.0 0.0 3.1 0.0 0.0 0.1 3.5 0.0 0.0 3.2 32.1 0.5 6.9 35.7 42.6 542 Middle 53.3 0.4 0.0 3.6 0.0 0.0 2.3 4.6 0.3 0.0 5.4 29.8 0.2 11.3 35.4 46.7 627 Fourth 50.4 0.3 0.0 2.3 0.0 0.0 1.6 8.5 0.0 0.0 5.0 31.8 0.0 12.7 36.9 49.6 602 Richest 53.6 0.0 0.0 6.2 0.0 0.0 2.7 10.0 0.7 0.0 1.8 25.0 0.0 19.6 26.8 46.4 608 Total 54.2 0.2 0.0 3.8 0.0 0.0 1.6 6.2 0.2 0.0 3.7 29.8 0.3 12.0 33.8 45.8 2,764 1 MICS indicator 5.3; MDG indicator 5.3 * Because the standard child mortality module was not included in the questionnaire, instead of ‘number of living children’ table RH.4 uses ‘number  of live births’ for this background characteristic. (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 68 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 69 Table RH.5: Unmet need for contraception percentage of women aged 15-49 years currently married or in union with an unmet need for family planning and percentage of demand for contraception satisfied, Bih 2011–2012   Met need for contraception Unmet need for contraception number of women currently married or in union percentage of demand for contraception satisfied number of women currently married or in union with need for contraception for spacing for limiting total for spacing for limiting total 1 Administrative unit   fBih 10.7 32.7 43.4 3.6 6.3 9.9 1,944 81.5 1,036 rs 12.6 41.5 54.1 2.6 4.1 6.7 777 88.9 473 Bd 10.1 14.7 24.7 3.4 9.7 13.1 43 65.3 16 Area   urban 12.0 34.9 46.9 3.4 6.0 9.3 876 83.4 493 rural 10.8 34.9 45.7 3.3 5.6 8.9 1,887 83.7 1,032 Age (years)   15-19 (*) (*) (*) (*) (*) (*) (*) (*) 3 20-24 30.2 6.8 37.0 19.7 4.6 24.3 150 60.3 92 25-29 29.1 16.0 45.1 10.8 10.0 20.9 308 68.3 203 30-34 20.2 28.3 48.4 3.6 8.4 12.1 484 80.1 293 35-39 7.2 42.0 49.1 1.5 7.4 8.9 580 84.6 337 40-44 4.1 46.8 50.8 0.2 3.0 3.2 613 94.0 332 45-49 1.4 38.2 39.5 0.2 2.8 3.0 624 93.0 265 Education*   primary 7.2 37.9 45.1 1.7 6.1 7.7 933 85.4 494 secondary 11.3 34.0 45.3 4.3 5.8 10.1 1,576 81.9 873 higher 26.1 29.4 55.4 3.9 3.6 7.5 246 88.1 155 Wealth index quintiles   poorest 10.8 31.1 42.0 2.9 10.3 13.3 385 76.0 212 second 11.2 31.8 43.0 4.2 5.4 9.6 542 81.8 285 Middle 11.5 35.9 47.4 3.4 5.2 8.6 627 84.6 351 fourth 11.9 38.0 50.0 3.0 4.1 7.2 602 87.4 344 richest 10.4 36.0 46.4 3.0 5.2 8.2 608 85.0 332 Total 11.2 34.9 46.1 3.3 5.7 9.0 2,764 83.6 1,525 1 Mics indicator 5.4; Mdg indicator 5.6 (*) figures that are based on fewer than 25 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Using information on contraception and unmet need the percentage of demand for contraception satisfied is also estimated using the MICS data. The percentage of demand satisfied is defined as the proportion of women currently married or in union who are currently using contraception, of the total demand for contraception. Met need for limiting includes women who are using (or whose partner is using) a contraceptive method and who do not want any more children, are using male or female sterilisation or declare themselves as infecund. Met need for spacing includes women who are using (or whose partner is using) a contraceptive method and who want to have another child or are undecided whether to have another child. The total of met need for spacing and limiting adds up to the total met need for contraception. Table RH.5 shows that the total met need for contraception in BiH was present amongst 46 per cent of women aged 15- 49: 54 per cent of women in RS and 43 per cent of women in the FBiH. There were no large differences in the percentage of total met need for contraception by area; however, with respect to education, women with higher education had a higher level of met need (55 per cent) compared to women with primary and secondary education (each 45 per cent). The total unmet need for contraception in BiH was lower than the total met need and present amongst 9 per cent of women aged 15-49 who were currently married or in union. Unmet need was present amongst 10 per cent of women in the FBiH and 7 per cent of women in RS. This need was most pronounced amongst women aged 20-24 (24 per cent) and 25-29 (21 per cent), but declined by age reaching the lowest level at age 45-49 (3 per cent). Unmet need also correlated to wealth: it was most common amongst the poorest women. Unmet Need Unmet need for contraception refers to fecund women who are not using any method of contraception, but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting). Unmet need is identified in MICS by using a set of questions related to the need for contraceptives, current use of contraception, fecundity and family planning. Table RH.5 shows the levels of met need for contraception, unmet need and the demand for contraception satisfied. Unmet need for spacing is defined as the percentage of women who are not using a method of contraception and: z are not pregnant and not postpartum amenorrheic,37 but are fecund38 and say they want to wait two or more years for their next birth; or z are not pregnant and not postpartum amenorrheic, but are fecund and unsure whether they want another child; or z are pregnant and say that the pregnancy was mistimed and would have wanted to wait; or z are postpartum amenorrheic and say that the birth was mistimed and would have wanted to wait. Unmet need for limiting is defined as the percentage of women who are not using a method of contraception and: z are not pregnant and not postpartum amenorrheic, but are fecund and say they do not want any more children; or z are pregnant and say they do not want to have a child; or z are postpartum amenorrheic and say that they did not want the birth. The total unmet need for contraception is the sum of unmet need for spacing and unmet need for limiting. 37 a woman is postpartum amenorrheic if she gave birth in the last two years, is not currently pregnant and her menstrual period has not returned since the birth of her last child. 38 a woman is considered infecund if she is neither pregnant nor postpartum amenorrheic and (1a) has not had menstruation for at least six months, (1b) never menstruated, (1c) her last menstruation occurred before her last birth or (1d) in menopause/has had a hysterectomy; or (2) she declares that she has had a hysterectomy, or she has never menstruated, or is menopausal or has been trying to get pregnant for 2 or more years without result (in response to questions as to why she thinks she is not physically able to get pregnant at the time of the survey); or (3) she declares she cannot get pregnant (when asked about her desire for future births) or (4) she has not had a birth in the preceding 5 years, is currently not using contraception and is currently married and was continuously married during the last 5 years preceding the survey. 70 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 71 Table RH.6: Antenatal care coverage Per cent distribution of women aged 15-49 who gave birth in the two years preceding the survey by type of personnel providing antenatal care during the pregnancy for the last birth, BiH 2011–2012   Person providing antenatal care No antenatal care received Total Any skilled personnel1 Number of women who gave birth in the preceding two years Medical doctor Nurse/ Midwife Other / Missing Administrative unit   FBiH 81.0 0.9 0.1 17.9 100.0 81.9 211 RS 99.7 0.0 0.0 0.3 100.0 99.7 82 BD (90.6) (0.0) (0.0) (9.4) 100.0 (90.6) 6 Area   Urban 85.3 0.0 0.0 14.7 100.0 85.3 94 Rural 86.7 1.0 0.1 12.2 100.0 87.7 204 Mother’s age at birth (years)   Less than 20 (*) (*) (*) (*) 100.0 (*) 9 20-34 86.3 0.8 0.0 12.9 100.0 87.1 260 35-49 94.3 0.0 0.9 4.7 100.0 94.3 28 Missing (*) (*) (*) (*) 100.0 (*) 1 Education*   Primary 82.9 3.0 0.4 13.6 100.0 86.0 66 Secondary 86.9 0.0 0.0 13.1 100.0 86.9 187 Higher 88.4 0.0 0.0 11.6 100.0 88.4 45 Wealth index quintiles   Poorest 93.1 0.0 0.0 6.9 100.0 93.1 45 Second 82.0 0.0 0.4 17.7 100.0 82.0 69 Middle 86.4 0.0 0.0 13.6 100.0 86.4 58 Fourth 86.7 0.0 0.0 13.3 100.0 86.7 61 Richest 85.8 3.1 0.0 11.1 100.0 88.9 65 Total 86.3 0.7 0.1 12.9 100.0 87.0 298 1 MICS indicator 5.5a; MDG indicator 5.5 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. UNICEF and the WHO recommend a minimum of four antenatal care visits during pregnancy. Table RH.7 shows the number of antenatal care visits during the last pregnancy over the two years preceding the survey, regardless of provider, by selected characteristics.40 Eighty-four per cent of mothers had received antenatal care four or more times (97 per cent in RS and 79 per cent in FBiH), while a smaller proportion of mothers had one, two or three antenatal care visits (2 per cent in total). 40 The data includes both skilled and unskilled providers. The total demand for contraception included women who currently had an unmet need (for spacing or limiting), plus those currently using contraception. The total percentage of satisfied demand for contraception in BiH was 84 per cent: 82 per cent in the FBiH and 89 per cent in RS. Met need for limiting was 35 per cent, while met need for spacing in BiH was 11 per cent. Table RH.5 shows that the total met need for contraception was higher than the total unmet need. Antenatal Care The antenatal period presents important opportunities for reaching pregnant women with a number of interventions that may prove vital for their health and well-being and that of their infants. A better understanding of foetal growth and development and its relationship to the mother’s health has resulted in increased attention to the potential of antenatal care. For example, if the antenatal period is used to inform women and families about the danger signs and symptoms and about the risks of labour and delivery it may provide a route for ensuring that pregnant women do, in practice, deliver with the assistance of a skilled healthcare provider. The antenatal period also provides an opportunity to supply information on birth spacing, which is recognised as an important factor in improving infant survival. Management of anaemia during pregnancy and the treatment of sexually transmitted infections (STIs) can significantly improve foetal outcomes and improve maternal health. Adverse outcomes such as low birth weight can be reduced through a combination of interventions to improve women’s nutritional status and prevent infection (for instance, STIs) during pregnancy. More recently, the potential of the antenatal period as an entry point for HIV prevention and care, in particular for the prevention of HIV transmission from mother-to-child, has led to renewed interest in access to and use of antenatal services. The WHO recommends a minimum of four antenatal visits, based on a review of the effectiveness of different models of antenatal care. WHO guidelines are specific on the content on antenatal care visits and include: z blood pressure measurement; z urine testing for bateriuria and proteinuria; z blood testing to detect syphilis and severe anaemia; z weight/height measurement (optional). The type of personnel providing antenatal care to women aged 15-49 years who had given birth in the two years preceding the survey is presented in Table RH.6.39 If a respondent mentioned more than one provider of antenatal care only the most qualified was considered. The findings show that 13 per cent of women in BiH did not receive antenatal care: less than 1 per cent in RS and about 18 per cent in the FBiH. Antenatal care was largely provided by professionals, most often by medical doctors (86 per cent). Almost all women in RS who had given birth in the two years prior to the survey had been provided with antenatal care by a medical doctor (nearly 100 per cent), while this figure was somewhat lower in the FBiH (81 per cent). 39 The data is only for live births. 72 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 73 Table RH.8: Content of antenatal care Percentage of women aged 15-49 years who had their blood pressure measured, urine sample and blood sample taken as part of antenatal care, BiH 2011–2012   Percentage of pregnant women who had: Number of women who had a live birth in the preceding two years Blood pressure measured Urine sample taken Blood sample taken Blood pressure measured, urine and blood sample taken1 Administrative unit   FBiH 80.7 80.1 80.1 79.8 211 RS 99.4 99.0 99.0 98.7 82 BD (90.6) (90.6) (90.6) (90.6) 6 Area   Urban 85.3 84.5 83.9 83.9 94 Rural 86.3 85.9 86.2 85.8 204 Mother’s age at birth (years)   Less than 20 (*) (*) (*) (*) 9 20-34 85.9 85.4 85.4 85.1 260 35-49 95.3 94.3 94.3 94.3 28 Missing (*) (*) (*) (*) 1 Education*   Primary 82.9 82.5 82.5 82.5 66 Secondary 86.6 85.8 85.8 85.5 187 Higher 87.9 88.4 88.4 87.9 45 Wealth index quintile   Poorest 87.4 87.4 87.4 86.8 45 Second 82.3 81.6 81.6 81.6 69 Middle 85.4 85.0 85.4 84.5 58 Fourth 86.7 86.7 86.7 86.7 61 Richest 88.9 87.6 87.2 87.2 65 Total 86.0 85.5 85.5 85.2 298 1 MICS indicator 5.6 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Assistance at Delivery Three quarters of all maternal deaths occur during delivery and the immediate post-partum period. The single most critical intervention for safe motherhood is to ensure a competent health worker with midwifery skills is present at every birth and transport to a referral facility is available for obstetric care in case of emergency. A World Fit for Children goal is to ensure that women have ready and affordable access to skilled attendance at delivery. The indicators are the proportion of births with a skilled attendant41 and proportion of institutional deliveries. The skilled attendant at delivery indicator is also used to track progress towards the Millennium Development target of reducing the maternal mortality rate by three quarters between 1990 and 2015. The MICS included a number of questions to assess the proportion of births where a skilled attendant was present. Table RH.9 shows that almost all births in the two years preceding the MICS survey were delivered by skilled personnel. 41 A skilled attendant includes a medical doctor, nurse or midwife. Table RH.7: Number of antenatal care visits Per cent distribution of women who had a live birth during the two years preceding the survey by number of antenatal care visits by any provider, BiH 2011–2012   Per cent distribution of women who had: Missing/DK Total Number of women who had a live birth in the preceding two years  No antenatal care visits One visit Two visits Three visits 4 or more visits1 Administrative unit   FBiH 17.9 0.1 0.7 1.1 79.3 0.8 100.0 211 RS 0.3 0.0 0.3 2.4 96.6 0.3 100.0 82 BD (9.4) (0.0) (0.0) (0.0) (88.3) (2.3) 100.0 6 Area   Urban 14.7 0.0 0.3 1.7 82.6 0.7 100.0 94 Rural 12.2 0.1 0.7 1.4 84.9 0.7 100.0 204 Mother’s age at birth (years)   Less than 20 (*) (*) (*) (*) (*) (*) 100.0 9 20-34 12.9 0.1 0.3 1.5 84.6 0.6 100.0 260 35-49 4.7 0.0 3.5 0.9 89.0 1.9 100.0 28 Missing (*) (*) (*) (*) (*) (*) 100.0 1 Education*   Primary 13.6 0.4 2.7 1.6 80.8 0.8 100.0 66 Secondary 13.1 0.0 0.0 1.6 84.6 0.6 100.0 187 Higher 11.6 0.0 0.0 0.6 87.3 0.6 100.0 45 Wealth index quintile   Poorest 6.9 0.6 2.8 3.9 85.2 0.6 100.0 45 Second 17.7 0.0 0.4 1.2 80.4 0.4 100.0 69 Middle 13.6 0.0 0.0 0.9 84.5 0.9 100.0 58 Fourth 13.3 0.0 0.0 0.0 86.5 0.2 100.0 61 Richest 11.1 0.0 0.4 2.1 85.1 1.2 100.0 65 Total 12.9 0.1 0.6 1.5 84.2 0.7 100.0 298 1 MICS indicator 5.5b; MDG indicator 5.5 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. The types of services pregnant women received during antenatal care are shown in Table RH.8. Amongst those women who had a live birth during the two years preceding the survey 85 per cent reported that their blood pressure had been checked and urine specimen and a blood sample taken during antenatal care visits. This figure includes a higher percentage of women in RS (99 per cent) than in the FBiH (80 per cent). 74 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 75 Place of Delivery Proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infection that can cause morbidity and mortality to either the mother or baby. Therefore, increasing the proportion of births that are delivered in health facilities is an important factor in reducing the health risks to both mother and baby. Table RH.10 presents the per cent distribution of women aged 15-49 who had a live birth in the two years preceding the survey by place of delivery and the percentage of births delivered in a health facility, according to background characteristics. Findings in this survey show that almost all deliveries in BiH occur in public sector health facilities, with a negligible number of deliveries taking place at home or another place. Table RH.10: Place of delivery Per cent distribution of women aged 15-49 who had a live birth in the two years preceding the survey by place of delivery, BiH 2011–2012   Place of delivery Total Delivered in health facility1 Number of women who had a live birth in preceding two years Public sector health facility Private sector health facility Home Other Missing / DK Administrative unit   FBiH 99.3 0.3 0.1 0.1 0.1 100.0 99.6 211 RS 100.0 0.0 0.0 0.0 0.0 100.0 100.0 82 BD (100.0) (0.0) (0.0) (0.0) (0.0) 100.0 (100.0) 6 Area   Urban 99.0 0.8 0.0 0.3 0.0 100.0 99.7 94 Rural 99.7 0.0 0.1 0.0 0.1 100.0 99.7 204 Mother’s age at birth (years)   Less than 20 (*) (*) (*) (*) (*) 100.0 (*) 9 20-34 99.7 0.0 0.1 0.1 0.1 100.0 99.7 260 35-49 97.5 2.5 0.0 0.0 0.0 100.0 100.0 28 Missing (*) (*) (*) (*) (*) 100.0 (*) 1 Number of antenatal care visits   None 100.0 0.0 0.0 0.0 0.0 100.0 100.0 39 1-3 visits (*) (*) (*) (*) (*) 100.0 (*) 6 4+ visits 99.4 0.3 0.1 0.1 0.1 100.0 99.7 251 Missing/DK (*) (*) (*) (*) (*) 100.0 (*) 2 Education*   Primary 100.0 0.0 0.0 0.0 0.0 100.0 100.0 66 Secondary 99.6 0.0 0.1 0.1 0.1 100.0 99.6 187 Higher 98.4 1.6 0.0 0.0 0.0 100.0 100.0 45 Wealth index quintiles   Poorest 100.0 0.0 0.0 0.0 0.0 100.0 100.0 45 Second 99.2 0.0 0.4 0.0 0.4 100.0 99.2 69 Middle 99.5 0.0 0.0 0.5 0.0 100.0 99.5 58 Fourth 100.0 0.0 0.0 0.0 0.0 100.0 100.0 61 Richest 98.9 1.1 0.0 0.0 0.0 100.0 100.0 65 Total 99.5 0.2 0.1 0.1 0.1 100.0 99.7 298 1 MICS indicator 5.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Doctors assisted the delivery of 86 per cent of births and nurses/midwives assisted 14 per cent, while in a negligible number of cases the delivery was assisted by a relative/friend. In RS a higher percentage of women (91 per cent) were assisted by a doctor during delivery compared to the FBiH (84 per cent), whereas the situation was reversed for deliveries assisted by a nurse/midwife. One in seven women in BiH gave birth by Caesarean section (14 per cent). Fifteen per cent of women in the FBiH and 12 per cent of women in RS gave birth by Caesarean section. There was a correlation between Caesarean section and household wealth: this type of delivery was most common amongst women living in the richest households. Table RH.9: Assistance during delivery Per cent distribution of women aged 15-49 who had a live birth in the two years preceding the survey by person assisting at delivery and percentage of births delivered by C-section, BiH 2011–2012   Person assisting at delivery Total Delivery assisted by any skilled attendant1 Per cent delivered by C-section2 Number of women who had a live birth in preceding two years Medical doctor Nurse/ Midwife Relative/ Friend Administrative unit   FBiH 84.1 15.8 0.1 100.0 99.9 14.5 211 RS 91.3 8.7 0.0 100.0 100.0 11.6 82 BD (97.7) (2.3) (0.0) 100.0 (100.0) (24.4) 6 Area   Urban 92.6 7.4 0.0 100.0 100.0 11.3 94 Rural 83.4 16.4 0.1 100.0 99.9 15.1 204 Mother’s age at birth (years)   Less than 20 (*) (*) (*) 100.0 (*) (*) 9 20-34 85.6 14.3 0.1 100.0 99.9 13.9 260 35-49 98.1 1.9 0.0 100.0 100.0 16.5 28 Missing (*) (*) (*) 100.0 (*) (*) 1 Education* Primary 86.7 13.3 0.0 100.0 100.0 12.3 66 Secondary 85.2 14.7 0.1 100.0 99.9 14.0 187 Higher 90.5 9.5 0.0 100.0 100.0 16.1 45 Wealth index quintiles   Poorest 82.1 17.9 0.0 100.0 100.0 8.3 45 Second 79.5 20.1 0.4 100.0 99.6 16.2 69 Middle 85.2 14.8 0.0 100.0 100.0 11.5 58 Fourth 90.5 9.5 0.0 100.0 100.0 10.0 61 Richest 93.6 6.4 0.0 100.0 100.0 21.2 65 Total 86.3 13.6 0.1 100.0 99.9 13.9 298 1 MICS indicator 5.7; MDG indicator 5.2 2 MICS indicator 5.9 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 76 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 77 Table CD.2 shows that for most children under five years of age (95 per cent) an adult had engaged in four or more activities that promote learning and school readiness during the 3 days preceding the survey (98 per cent in RS and 94 per cent in the FBiH). Adults engaged in 5.6 activities with children on average, which included activities with the child by any adult household member. The table also clearly shows father’s involvement in these activities. Father’s involvement in one or more activities was registered in 76 per cent of cases; on average the father engaged in 2.6 activities with the child. The percentage of children not living in the household with their biological father was 6 per cent. There were no relevant differentials by sex in terms of engagement of adults in activities with children. A larger proportion of adults in urban areas were involved in teaching and school readiness activities (98 per cent) compared to adults in rural areas (94 per cent). The percentage of children aged 36-59 months in households where adult members engaged in 4 or more activities increased with the parents’ education level and household wealth. Father’s involvement showed a similar pattern. Table CD.2: Support for learning Percentage of children aged 36-59 months with whom an adult household member engaged in activities that promote learning and school readiness during the last three days, BiH 2011–2012   Percentage of children aged 36-59 months Mean number of activities Percentage of children not living with their natural father Number of children aged 36-59 months   With whom adult household members engaged in four or more activities1 With whom the father engaged in one or more activities2 Any adult household member engaged with the child The father engaged with the child Sex   Male 94.7 74.1 5.5 2.5 8.2 456 Female 95.5 78.2 5.6 2.7 4.2 461 Administrative unit   FBiH 94.2 72.2 5.5 2.4 7.0 635 RS 98.0 85.7 5.7 3.1 4.3 270 BD (80.3) (72.3) (5.0) (2.2) (6.6) 12 Area   Urban 97.5 77.1 5.8 2.9 9.4 318 Rural 93.8 75.6 5.5 2.5 4.4 599 Age (months)   36-47 94.8 76.5 5.6 2.7 6.3 485 48-59 95.4 75.8 5.6 2.5 6.0 432 Mother’s education*   Primary 86.8 70.3 5.2 2.0 5.7 227 Secondary 98.0 75.8 5.7 2.6 7.1 563 Higher 100.0 89.2 5.8 3.8 2.9 122 Father’s education*   Primary 84.9 73.9 5.1 2.1 N/A 141 Secondary 96.6 81.0 5.6 2.8 N/A 610 Higher 99.3 91.2 5.8 3.8 N/A 109 Father not in household (97.3) (1.4) (5.7) N/A N/A 57 Wealth index quintiles   Poorest 86.5 69.0 5.0 2.0 7.3 152 Second 95.6 79.3 5.6 2.5 4.2 184 Middle 93.1 71.9 5.5 2.4 4.4 172 Fourth 98.2 77.6 5.7 2.7 11.0 197 Richest 99.6 80.7 5.9 3.2 4.0 212 Total 95.1 76.2 5.6 2.6 6.2 917 1 MICS indicator 6.1 2 MICS Indicator 6.2 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” Exposure to books in the early years not only provides a child with greater understanding of the nature of print but may also give the child opportunities to see others reading, such as older siblings doing school work. The presence of books in the household during early childhood is important for later school performance. The mothers/caretakers of all children under 5 were asked about the number of children’s books or picture books they had for the child, household objects or outside objects and homemade toys or toys that came from a shop that were available at home. VIII Child Development Early Childhood Education and Learning Readiness of children for primary school can be improved through attendance at early childhood education programmes or through preschool attendance. Early childhood education programmes include programmes for children that have organised learning components as opposed to babysitting and day care which typically do not include organised education and learning. Table CD.1 shows that 13 per cent of children aged 36-59 months were attending an organised early childhood programme, 14 per cent in the FBiH and 10 per cent in RS. There were differences between urban and rural areas, with the percentage being 23 per cent in urban areas compared to 8 per cent in rural areas. There were no substantial differentials according to a child’s age; however, differentials by the socio-economic status of the household were evident. Thirty-one per cent of children living in the richest households attended such programmes, while the figure dropped to 2 per cent for children in the poorest households. Table CD.1: Early childhood education Percentage of children aged 36-59 months who are attending an organised early childhood education programme, BiH 2011–2012 Percentage of children aged 36-59 months currently attending early childhood education1 Number of children aged 36-59 months Sex  Male 12.2 456 Female 14.0 461 Administrative unit FBiH 14.4 635 RS 10.3 270 BD (6.6) 12 Area Urban 22.8 318 Rural 7.9 599 Age of child (months)   36-47 11.4 485 48-59 15.0 432 Mother’s education* Primary 1.7 227 Secondary 13.0 563 Higher 35.0 122 Wealth index quintile   Poorest 1.6 152 Second 5.5 184 Middle 5.1 172 Fourth 16.7 197 Richest 31.1 212 Total 13.1 917 1 MICS indicator 6.7 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. It is well recognised that a period of rapid brain development occurs in the first 3-4 years of life and that the quality of home care is the major determinant of a child’s development during this period. In this context, engagement of adults in activities with children, the presence of books in the home for the child and the conditions of care are important indicators of the quality of home care. Children should be physically healthy, mentally alert, emotionally secure, socially competent and ready to learn. Information on a number of activities that support early learning was collected in the survey. These included the involvement of adults with children in the following activities: reading books or looking at picture books, telling stories, singing songs, taking children outside the home compound or yard, playing with children and spending time with children naming, counting or drawing objects. 78 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 79 Leaving children alone or in the presence of other young children is known to increase the risk of accidents. In MICS, two questions were asked to find out whether children aged 0-59 months had been left alone during the week preceding the interview and whether children were left in the care of other children under 10 years of age. Table CD.4 shows that during the week preceding the interview about 1 per cent of children aged 0-59 months were left in the care of other children under 10 years of age or were left alone at home. By combining these two care indicators it was possible to calculate that 2 per cent of children were left with inadequate care during this period. No differences were observed by administrative unit, by the sex of the child or between urban and rural areas. In RS 1 per cent of children had been left alone at home in the week preceding the interview, while the figure in the FBiH was slightly less than 1 per cent. An equal percentage of children in the FBiH and RS were left in the care of other children under 10 years of age (1 per cent). Children aged 24-59 months were more often left with inadequate care (3 per cent) than children aged 0-23 months (less than 1 per cent). Table CD.4: Inadequate care Percentage of children under age 5 left alone or left in the care of another child younger than 10 years of age for more than one hour at least once during the past week, BiH 2011–2012   Percentage of children under age 5  Number of children under age 5   Left alone in the past week Left in the care of another child younger than 10 years of age in the past week Left with inadequate care in the past week1 Sex   Male 0.8 1.2 1.8 1,124 Female 0.5 1.2 1.5 1,173 Administrative unit   FBiH 0.4 1.2 1.5 1,611 RS 1.4 1.2 2.2 646 BD 1.0 0.0 1.0 40 Area   Urban 0.4 1.0 1.3 774 Rural 0.8 1.3 1.8 1,523 Age (months)   0-23 0.2 0.3 0.3 921 24-59 1.0 1.8 2.6 1,376 Mother’s education*  Primary 1.5 2.3 3.3 526 Secondary 0.4 0.8 1.1 1,426 Higher 0.5 0.7 1.2 324 Wealth index quintiles   Poorest 1.2 2.5 2.9 388 Second 1.5 1.0 2.2 482 Middle 0.2 0.7 0.9 455 Fourth 0.0 1.0 1.0 469 Richest 0.5 1.0 1.4 502 Total 0.7 1.2 1.6 2,297 1 MICS indicator 6.5 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table CD.3 shows that slightly more than one half of children aged 0-59 months (56 per cent) lived in households where at least 3 children’s books were present. A smaller proportion of children lived in households with 10 or more books (31 per cent). In RS 66 per cent of children aged 0-59 months lived in households where at least 3 children’s books were present, while 36 per cent of children lived in households with 10 or more books. In the FBiH a somewhat lower percentage of children lived in households where at least 3 children’s books were present (51 per cent) and in households where 10 or more books were present (29 per cent). While no differentials by sex were observed, urban children appeared to have more access to children’s books than those living in rural households. In addition, the presence of children’s books positively correlated to the child’s age were reported in 75 per cent of households with children aged 24-59 months that had 3 or more children’s books, while this figure was 27 per cent for children aged 0-23 months. There was also a correlation between the presence of books in the household and the mother’s education level as well as wealth index quintile. Thus, 3 or more books were least present for those children whose mothers had just primary education (40 per cent) and children from the poorest households (39 per cent). Ten or more children’s books or picture books were less common in households where mothers had just primary education (19 per cent compared to 53 per cent for mothers with higher education) and in the poorest households (13 per cent compared to 52 per cent in the richest households). Table CD.3 also describes the types of playthings children played with and shows that more than one half of children aged 0-59 months in BiH (56 per cent) had 2 or more types of playthings in their home: 72 per cent in RS and 49 per cent in the FBiH. The types of playthings in MICS include homemade toys, toys that come from a stores and household objects (such as pots and bowls) or objects and materials found outside the home (such as sticks, rocks or pine cones). It is interesting to note that the highest percentage of children played with toys that came from a store (92 per cent) and slightly more than one half of children played with household objects and objects found outside the home (56 per cent), while the lowest proportion of children played with toys made at home (19 per cent). Differences were evident with respect to children’s ages; children aged 0-23 months had fewer toys of all types compared to children aged 24-59 months. No differentials were observed with respect to sex in terms of having a type of toy or the number of types of playthings. On the other hand, children in rural areas were less likely to play with all types of playthings compared to children in urban areas. Table CD.3: Learning materials Percentage of children under age 5 by numbers of children’s books present in the household and by playthings that children play with, BiH 2011–2012   Household has for the child: Child plays with: Two or more types of playthings2 Number of children under age 5   3 or more children’s books1 10 or more children’s books Homemade toys Toys from a shop/ manufactured toys Household objects/objects found outside Sex               Male 53.9 30.3 18.5 91.9 56.2 55.5 1,124 Female 57.7 31.8 18.4 92.7 55.8 56.5 1,173 Administrative unit   FBiH 51.3 28.8 11.1 91.9 49.7 49.1 1,611 RS 66.4 36.4 35.0 92.8 70.5 72.0 646 BD 66.7 36.9 49.0 100.0 75.7 76.6 40 Area   Urban 67.3 43.6 22.5 95.6 60.5 60.9 774 Rural 50.0 24.7 16.5 90.6 53.7 53.6 1,523 Age (months)   0-23 26.7 13.1 10.8 83.7 36.7 37.1 921 24-59 75.3 43.1 23.6 98.1 68.9 68.7 1,376 Mother’s education*   Primary 40.0 18.8 17.6 89.2 51.7 51.1 526 Secondary 58.3 31.0 18.6 93.1 57.5 57.9 1,426 Higher 73.1 53.4 19.8 95.5 56.4 57.6 324 Wealth index quintiles   Poorest 38.5 12.5 22.1 90.3 60.2 58.1 388 Second 46.8 16.7 14.4 91.1 53.9 53.9 482 Middle 52.3 28.8 18.6 91.9 53.7 54.7 455 Fourth 65.0 40.9 16.6 90.1 53.8 53.3 469 Richest 72.6 52.1 21.3 97.4 58.9 60.2 502 Total 55.8 31.1 18.5 92.3 56.0 56.0 2,297 1 MICS indicator 6.3 2 MICS indicator 6.4 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 80 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 81 Table CD.5: Early childhood development index Percentage of children aged 36-59 months who are developmentally on track in literacy-numeracy, physical, social-emotional and learning domains and the early childhood development index score, BiH 2011–2012   Percentage of children aged 36-59 months who are developmentally on track for indicated domains Early childhood development index score1 Number of children aged 36-59 months  Literacy- numeracy Physical Social- Emotional Learning Sex   Male 20.5 99.6 92.7 98.8 95.3 456 Female 29.6 99.6 97.8 99.5 97.6 461 Administrative unit   FBiH 26.7 99.5 93.9 99.1 95.6 635 RS 20.1 100.0 98.6 99.1 98.3 270 BD (49.3) (100.0) (96.7) (100.0) (100.0) 12 Area   Urban 34.6 99.7 96.7 99.0 97.7 318 Rural 20.0 99.6 94.5 99.2 95.8 599 Age (months)   36-47 17.8 99.3 94.3 99.0 95.7 485 48-59 33.2 100.0 96.3 99.3 97.3 432 Attendance at early childhood education   Attending 39.9 100.0 86.4 100.0 92.8 120 Not attending 22.8 99.6 96.6 99.0 97.0 797 Mother’s education*   Primary 19.1 99.3 97.2 99.0 96.5 227 Secondary 24.9 99.7 94.8 99.1 96.2 563 Higher 37.1 100.0 94.0 99.3 97.4 122 Wealth index quintiles   Poorest 17.6 99.5 96.3 99.0 95.2 152 Second 24.7 100.0 93.8 99.6 97.8 184 Middle 20.4 99.1 95.8 98.6 96.3 172 Fourth 29.1 99.6 98.4 99.6 98.4 197 Richest 30.9 100.0 92.5 98.9 94.4 212 Total 25.1 99.6 95.3 99.1 96.4 917 1 MICS indicator 6.6 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Early Childhood Development Early childhood development is defined as an orderly predictable process along a continuous path. During early childhood development a child learns to handle more complicated levels of moving, thinking, speaking, feeling and relating to others. Physical growth, literacy and numeracy skills, socio-emotional development and readiness to learn are vital domains in a child’s overall development, which is the basis for overall human development. A 10-item module that was developed for the MICS programme was used to calculate the Early Childhood Development Index (ECDI). The indicator is based on some benchmarks that children would be expected to have achieved if they are developing as the majority of children of that age group. Each of the 10 items is used in one of the four domains to determine if children are developmentally on track in that domain. The domains in question are shown below. z Literacy-numeracy - Children are identified as being developmentally on track based on whether they can identify/ name at least ten letters of the alphabet, whether they can read at least four simple popular words and whether they know the name and recognise the symbols of all numbers from 1 to 10. If at least two of these are true then the child is considered developmentally on track in the literacy-numeracy domain. z Physical - If the child can pick up a small object, such as a stick or a rock, with two fingers from the ground and or the mother/caretaker does not indicate that the child is sometimes too sick to play then the child is regarded as being developmentally on track in the physical domain. z Social-emotional - Children are considered to be developmentally on track if two of the following are true: if the child gets along well with other children, if the child does not kick, bite or hit other children and if the child does not get distracted easily. z Learning - If the child follows simple directions on how to do something correctly and or when given something to do is able to do it independently then the child is considered to be developmentally on track in this domain. ECDI is then calculated as the percentage of children who are developmentally on track in at least three of these four domains. ECDI is presented in Table CD.5. According to the survey findings, 96 per cent of children aged 36-59 months in BiH were developmentally on track: 98 per cent in RS and 96 per cent in the FBiH. An analysis of the four domains of childhood development shows that more than 99 per cent of children were on track in the learning domain and in the physical domain and furthermore that 95 per cent of children were on track in the socio- emotional domain; however, a great deal less children were on track in the literacy-numeracy domain (25 per cent). As expected, children aged 48-59 months were more on track in the literacy-numeracy domain compared to children aged 36-47 months (33 versus 18 per cent). Children of mothers with higher education were more on track in this domain (37 per cent) compared to children of mothers with primary education (19 per cent). 82 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 83 Table ED.1M: Literacy amongst men aged 15-24 Percentage of men aged 15-24 years who are literate, BiH 2011–2012   Percentage literate1 Percentage not known Number of men aged 15-24 years Administrative unit   FBiH 100.0 0.0 1,014 RS 100.0 0.0 393 BD (94.0) (0.0) 21 Area   Urban 100.0 0.0 485 Rural 99.9 0.0 943 Education*   Primary 97.9 0.4 67 Secondary 100.0 0.0 1,009 Higher 100.0 0.0 352 Age (years)   15-19 100.0 0.0 684 20-24 99.8 0.0 743 Wealth index quintile   Poorest 99.2 0.1 194 Second 100.0 0.0 239 Middle 100.0 0.0 337 Fourth 100.0 0.0 312 Richest 100.0 0.0 345 Total 99.9 0.0 1,428 1 MICS indicator 7.1; MDG indicator 2.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Ix Literacy and Education Literacy amongst Women and Men aged 15 to 25 years One of the A World Fit for Children goals is to assure adult literacy. Adult literacy is also a Millennium Development Goals indicator, relating to both men and women. The MICS survey provides for the assessment of literacy rates for men and women aged 15-24. Literacy was assessed on the ability of the respondent to read a short simple statement or based on school attendance. The percentage of literate women and men is presented in Tables ED.1 and ED.1M. The data indicates that the majority of women (99 per cent) and men (100 per cent) aged 15-24 in BiH are literate. Of the women that stated that primary school was their highest level of education 88 per cent were able to successfully read the statement shown to them, while this percentage was higher amongst men at 98 per cent. Table ED.1: Literacy amongst women aged 15-24 Percentage of women aged 15-24 years who are literate, BiH 2011–2012   Percentage literate1 Percentage not known Number of women aged 15-24 years Administrative unit   FBiH 99.2 0.0 989 RS 99.8 0.0 318 BD (98.9) (0.0) 12 Area   Urban 99.9 0.0 463 Rural 99.1 0.0 856 Education*   Primary 88.1 0.0 69 Secondary 100.0 0.0 869 Higher 100.0 0.0 381 Age (years)   15-19 99.1 0.0 642 20-24 99.6 0.0 677 Wealth index quintile   Poorest 98.5 0.0 177 Second 99.2 0.0 248 Middle 99.3 0.0 282 Fourth 99.4 0.0 313 Richest 100.0 0.0 299 Total 99.3 0.0 1,319 1 MICS indicator 7.1; MDG indicator 2.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 84 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 85 The indicators of school progression include: z children reaching the last grade of primary school; z primary completion rate; z transition rate to secondary school. In BiH children enter primary school at age 6 and secondary school at age 15. There are 8 or 9 grades of primary school in the FBiH and 9 grades in RS and BD. In secondary schools there are either 4 grades or 3 grades (the latter for vocational education). The school year runs from September of the current year through to June of the following year. The 9 grade primary school system was introduced for the academic year 2003/2004 in RS and BD and in 2004/2005 in the FBiH. Table ED.3 shows that out of the total number of children of primary school entry age in BiH 83 per cent were attending the first grade (93 per cent in RS and 80 per cent in the FBiH). Table ED.3: Primary school entry Percentage of children of primary school entry age entering grade 1 (net intake rate), BiH 2011–2012   Percentage of children of primary school entry age entering grade 11 Number of children of primary school entry age Sex   Male 85.7 146 Female 80.2 118 Administrative unit   FBiH 79.7 173 RS 92.9 87 BD (*) 3 Area   Urban 76.7 79 Rural 86.0 185 Mother’s education*  Primary 88.6 54 Secondary 84.1 188 Higher (70.5) 19 Wealth index quintile   Poorest (76.6) 43 Second 92.2 62 Middle 84.8 64 Fourth 91.5 45 Richest 68.4 50 Total 83.2 264 1 MICS indicator 7.3 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table ED.4 provides the percentage of children aged 6 to 14 years who were attending primary or secondary school.42 Nearly all children of primary school age in BiH were attending school (98 per cent): 99 per cent in RS and 97 per cent in the FBiH. The lowest percentage of children of primary school age who were attending school was found amongst children aged 6 years (83 per cent). This may be related to the fact that parents in BiH still enrol their children in the first grade of primary school at a later age. 42 Ratios presented in this table are ‘adjusted’ since they include not only primary school attendance but also secondary school attendance in the numerator. School Readiness Attendance at preschool education through an organised learning or child education programme is important for the readiness of children for school. Table ED.2 shows the proportion of children in the first grade of primary school who had attended preschool the previous year. Overall 16 per cent of children in BiH who were currently attending the first grade of primary school had attended preschool the previous year: 18 per cent in the FBiH and 13 per cent in RS. The proportion was higher amongst female (25 per cent) than male children (10 per cent) as well as amongst children living in urban areas (25 per cent) compared to children in rural areas (13 per cent). Table ED.2: School readiness Percentage of children attending first grade of primary school who attended preschool the previous year, BiH 2011–2012   Percentage of children attending first grade who attended preschool in previous year1 Number of children attending first grade of primary school Sex   Male 10.3 135 Female 24.9 96 Administrative unit   FBiH 18.4 139 RS 13.3 91 BD (*) 2 Area   Urban 25.3 62 Rural 13.0 169 Mother’s education*   Primary 24.3 50 Secondary 14.3 163 Higher (12.4) 18 Wealth index quintile   Poorest (6.3) 36 Second 15.3 64 Middle 6.3 58 Fourth (22.0) 37 Richest (38.6) 36 Total 16.3 231 1 MICS indicator 7.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Primary and Secondary School Participation Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the Millennium Development Goals and A World Fit for Children. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment and influencing population growth. The indicators for primary and secondary school attendance include: z net intake rate in primary education; z primary school net attendance ratio (adjusted); z secondary school net attendance ratio (adjusted); z female to male education ratio (or Gender Parity Index - GPI) in primary and secondary school. 86 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 87 Ta bl e ED .5 : S ec on da ry s ch oo l a tt en da nc e Pe rc en ta ge o f c hi ld re n of s ec on da ry s ch oo l a ge a tt en di ng s ec on da ry s ch oo l o r h ig he r ( ad ju st ed n et a tt en da nc e ra tio ) a nd p er ce nt ag e of c hi ld re n at te nd in g pr im ar y sc ho ol , B iH 2 01 1– 20 12   M al e Fe m al e To ta l N et a tt en da nc e ra tio (a dj us te d) 1 Pe r c en t at te nd in g pr im ar y sc ho ol N um be r of c hi ld re n N et a tt en da nc e ra tio (a dj us te d) 1 Pe r c en t at te nd in g pr im ar y sc ho ol N um be r of c hi ld re n N et a tt en da nc e ra tio (a dj us te d) 1 Pe r c en t at te nd in g pr im ar y sc ho ol N um be r of c hi ld re n A dm in is tr at iv e un it   FB iH 90 .4 0. 9 40 6 93 .3 1. 1 49 9 92 .0 1. 0 90 4 RS 90 .6 1. 3 20 0 92 .9 1. 6 14 9 91 .6 1. 5 34 9 BD (* ) (* ) 7 (* ) (* ) 10 (8 2. 9) (0 .0 ) 17 A re a   U rb an 90 .0 0. 2 18 8 91 .2 3. 7 21 1 90 .6 2. 0 39 9 Ru ra l 90 .6 1. 4 42 5 94 .0 0. 0 44 6 92 .3 0. 7 87 1 A ge a t b eg in ni ng o f s ch oo l y ea r   15 95 .6 3. 1 19 2 94 .7 3. 9 20 0 95 .1 3. 5 39 2 16 96 .9 0. 2 15 6 95 .1 0. 0 19 8 95 .9 0. 1 35 3 17 84 .9 0. 0 14 3 92 .7 0. 0 13 9 88 .7 0. 0 28 2 18 80 .4 0. 0 12 3 87 .8 0. 0 12 0 84 .1 0. 0 24 3 M ot he r’s e du ca ti on *  Pr im ar y 92 .0 2. 1 16 6 93 .9 0. 0 21 8 93 .1 0. 9 38 4 Se co nd ar y 96 .9 1. 1 22 3 96 .6 3. 2 23 0 96 .8 2. 2 45 3 H ig he r (* ) (* ) 22 (* ) (* ) 29 (1 00 .0 ) (0 .0 ) 51 M ot he r n ot in h ou se ho ld (9 8. 6) (0 .7 ) 44 (* ) (* ) 22 (9 4. 4) (0 .5 ) 66 Ca nn ot b e de te rm in ed 75 .6 0. 0 15 5 88 .7 0. 0 15 3 82 .1 0. 0 30 7 W ea lt h in de x qu in ti le   Po or es t 84 .5 0. 0 77 83 .3 2. 0 11 3 83 .8 1. 2 19 0 Se co nd 89 .0 0. 5 11 2 91 .3 0. 3 99 90 .1 0. 4 21 1 M id dl e 89 .0 0. 7 13 9 93 .0 1. 5 14 7 91 .0 1. 1 28 6 Fo ur th 94 .0 1. 4 16 1 97 .1 0. 0 15 7 95 .6 0. 7 31 8 Ri ch es t 92 .2 2. 0 12 4 97 .9 2. 1 14 1 95 .2 2. 0 26 4 To ta l 90 .4 1. 0 61 3 93 .1 1. 2 65 7 91 .8 1. 1 1, 27 0 1 M IC S in di ca to r 7 .5 ( ) F ig ur es th at a re b as ed o n 25 –4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s * Fi gu re s fo r t he e du ca tio n ca te go ry “N on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t s ho w n in th e ta bl e. Table ED.4: Primary school attendance Percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), BiH 2011–2012   Male Female Total Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted)1 Number of children Administrative unit   FBiH 97.4 1,007 96.9 832 97.2 1,839 RS 99.1 449 98.6 399 98.9 848 BD (86.1) 26 (96.8) 14 89.9 40 Area   Urban 97.0 435 96.6 419 96.8 855 Rural 98.0 1,046 97.9 826 98.0 1,872 Age at beginning of school year   6 85.7 146 80.2 118 83.2 264 7 100.0 138 100.0 90 100.0 228 8 99.2 157 98.1 121 98.8 278 9 100.0 150 98.0 115 99.1 264 10 98.6 168 100.0 126 99.2 294 11 98.8 195 99.4 159 99.1 354 12 100.0 165 98.6 162 99.3 328 13 98.1 155 100.0 153 99.1 308 14 97.8 208 99.9 201 98.8 409 Mother’s education*   Primary 98.0 530 99.0 431 98.4 961 Secondary 98.2 820 97.3 698 97.7 1,518 Higher 97.7 114 97.1 101 97.5 215 Mother not in household (*) 5 (*) 0 (*) 5 Wealth index quintile   Poorest 95.8 241 95.0 213 95.4 454 Second 99.5 306 98.7 261 99.1 567 Middle 97.8 307 96.8 259 97.4 567 Fourth 98.4 299 98.7 271 98.5 569 Richest 96.7 328 97.6 242 97.1 570 Total 97.7 1,482 97.5 1,245 97.6 2,727 1 MICS indicator 7.4; MDG indicator 2.1 (*) Figures that are based on fewer than 25 unweighted cases ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. The secondary school net attendance ratio is presented in Table ED.5.43 Secondary school attendance was slightly lower compared to primary school (92 per cent). One per cent of children of secondary school age were attending primary school, while 7 per cent were not attending school at all. Generally, the lower the household wealth the lower the percentage of children in secondary school: the lowest proportion of children was found amongst those from the poorest wealth quintile (84 per cent). 43 Ratios presented in this table are ‘adjusted’ since they include not only secondary school attendance but also attendance at higher levels in the numerator. 88 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 89 The percentage of children entering first grade who eventually reached the last grade of primary school is presented in Table ED.6. Of all children starting grade one almost all children in BiH eventually reached the last grade (100 per cent in RS and 99 per cent in FBiH).44 44 Since the first generation of ninth graders in RS and BD completed the final (9th) grade of primary school in the year preceding the survey a disproportionately low number of children were attending 9th grade at the time of the survey; for this reason the 8th grade was taken as the final grade in Table ED.6 for all three administrative units. The gross primary school completion rate and transition rate to secondary school are presented in Table ED.7. The gross primary completion rate is the ratio of the total number of pupils, regardless of age, entering the last grade of primary school for the first time to the number of children of primary graduation age at the beginning of the current (or most recent) school year. At the time of the survey the gross primary school completion rate was 146 per cent in BiH: 162 per cent in the FBiH and 106 per cent in RS. About 97 per cent of those children that had successfully completed the last grade of primary school during the previous year were attending the first grade of secondary school at the time of the survey. The net primary school completion rate is a more relevant indicator for BiH. The net completion rate is the ratio of the total number of pupils of primary graduation age entering the last grade of primary school for the first time to the number of children of the same age at the beginning of the current (or most recent) school year. Table ED.7 shows that the net primary school completion rate in BiH was 92 per cent: 91 per cent in both the FBiH and RS. The net primary school completion rate by area was lower amongst children living in rural areas (89 per cent) compared to children in urban areas (97 per cent). Please note: this number includes children that repeat grades and that eventually move up to reach the last grade. Table ED.6: Children reaching last grade of primary school Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), BiH 2011–2012   Per cent attending grade 1 last school year who are in grade 2 this school year Per cent attending grade 2 last school year who are attending grade 3 this school year Per cent attending grade 3 last school year who are attending grade 4 this school year Per cent attending grade 4 last school year who are attending grade 5 this school year Per cent attending grade 5 last school year who are attending grade 6 this school year Per cent attending grade 6 last school year who are attending grade 7 this school year Per cent attending grade 7 last school year who are attending grade 8 this school year Per cent who reach grade 8 of those who enter grade 11 Sex   Male 100.0 100.0 100.0 100.0 100.0 100.0 99.0 99.0 Female 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Administrative unit   FBiH 100.0 100.0 100.0 100.0 100.0 100.0 99.3 99.3 RS 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 BD (*) (*) (*) (*) (*) (*) (*) (*) Area   Urban 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Rural 100.0 100.0 100.0 100.0 100.0 100.0 99.2 99.2 Mother’s education*   Primary 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Secondary 100.0 100.0 100.0 100.0 100.0 100.0 98.9 98.9 Higher (100.0) (100.0) (*) (*) (*) (*) (100.0) 100.0 Wealth index quintile   Poorest 100.0 100.0 100.0 (100.0) (100.0) (100.0) 100.0 100.0 Second (100.0) (100.0) (100.0) 100.0 100.0 100.0 100.0 100.0 Middle 100.0 100.0 100.0 (100.0) (100.0) 100.0 100.0 100.0 Fourth 100.0 100.0 100.0 100.0 (100.0) 100.0 97.8 97.8 Richest (100.0) 100.0 (100.0) 100.0 100. 0 100.0 100.0 100.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 99.5 99.5 1 MICS indicator 7.6; MDG indicator 2.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 90 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 91 Table ED.7: Primary school completion and transition to secondary school Primary school completion rates and transition rate to secondary school, BiH 2011–2012   Primary school completion rate1 Net primary school completion rate Number of children of primary school completion age Transition rate to secondary school2 Number of children who were in the last grade of primary school the previous year Sex Male 144.2 92.7 208 98.2 209 Female 148.1 90.3 201 95.6 206 Administrative unit FBiH 162.4 91.7 290 95.9 316 RS 105.9 90.9 116 100.0 97 BD (*) (*) 3 (*) 2 Area Urban 145.5 96.5 134 96.7 149 Rural 146.4 89.1 275 97.0 265 Mother’s education* Primary 140.6 88.5 175 95.5 165 Secondary 148.0 92.8 193 97.6 212 Higher (*) (*) 36 (*) 15 Mother not in household (*) (*) 5 (*) 21 Wealth index quintile Poorest 117.8 78.6 72 (87.8) 56 Second (141.9) (96.9) 78 99.7 91 Middle 142.7 90.8 86 96.3 87 Fourth (157.5) (89.8) 89 97.6 95 Richest 165.5 100.0 85 99.6 85 Total 146.1 91.5 409 96.9 415 1 MICS indicator 7.7 2 MICS indicator 7.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. The ratio of girls to boys attending primary and secondary education is provided in Table ED.8. These ratios are better known as the Gender Parity Index (GPI). Please note: the ratios included here are obtained from net attendance ratios rather than gross attendance ratios. The ratios based on the gross attendance can provide an erroneous description of the Gender Parity Index mainly due to the fact that in most cases the majority of over-aged children attending primary education tend to be boys. In the case of BiH however, Table ED.5 shows that attendance of over-aged children at primary school is similar for boys and girls. Table ED.8 shows that gender parity for primary school in BiH was 0.99 (0.99 in FBiH and 1.00 in RS), indicating no difference in the attendance of girls and boys at primary school. For secondary school, the Gender Parity Index was 1.02 (1.00 in FBiH and 1.06 in RS). Table ED.8: Education gender parity Ratio of adjusted net attendance ratios of girls to boys in primary and secondary school, BiH 2011–2012   Primary school adjusted net attendance ratio (NAR) girls Primary school adjusted net attendance ratio (NAR) boys Gender parity index (GPI) for primary school adjusted NAR1 Secondary school adjusted net attendance ratio (NAR) girls Secondary school adjusted net attendance ratio (NAR) boys Gender parity index (GPI) for secondary school adjusted NAR2 Administrative unit   FBiH 96.4 97.4 0.99 89.6 89.3 1.00 RS 98.6 99.1 1.00 92.7 87.3 1.06 BD (96.8) (86.1) (1.12) (*) (*) (*) Area   Urban 96.6 97.0 1.00 89.0 87.5 1.02 Rural 97.4 98.0 0.99 90.8 89.0 1.02 Education of mother/caretaker*   Primary 97.9 98.0 1.00 93.9 92.0 1.02 Secondary 97.3 98.2 0.99 96.6 96.9 1.00 Higher 97.1 97.7 0.99 (*) (*) (*) Mother not in household (*) (*) (*) (*) (98.6) (*) Cannot be determined N/A N/A N/A 76.3 68.1 1.12 Wealth index quintile   Poorest 92.9 95.8 0.97 83.3 84.0 0.99 Second 98.7 99.5 0.99 91.0 85.3 1.07 Middle 96.8 97.8 0.99 88.2 88.8 0.99 Fourth 98.7 98.4 1.00 91.3 92.7 0.98 Richest 97.6 96.7 1.01 96.1 88.5 1.09 Total 97.1 97.7 0.99 90.2 88.5 1.02 1 MICS indicator 7.9; MDG indicator 3.1 2 MICS indicator 7.10; MDG indicator 3.1 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” 92 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 93 Table CP.1: Child discipline Percentage of children aged 2-14 years according to method of disciplining the child, BiH 2011–2012   Percentage of children aged 2-14 years who experienced: Number of children aged 2-14 years Respondent believes that the child needs to be physically punished Respondents to the child discipline module   Only non- violent discipline Psychological aggression Physical punishment Any violent discipline method1  Any Severe Sex   Male 30.3 47.8 44.3 4.8 60.4 1,808 16.0 1,194 Female 38.5 35.8 34.4 4.2 49.5 1,644 11.2 1,064 Administrative unit   FBiH 29.5 44.7 44.2 5.1 58.7 2,338 14.0 1,588 RS 44.2 37.0 29.6 3.2 47.9 1,056 13.2 636 BD 42.1 25.4 35.5 6.7 45.3 58 12.5 33 Area   Urban 35.8 40.8 35.7 4.9 54.3 1,088 11.9 730 Rural 33.5 42.6 41.4 4.3 55.6 2,363 14.7 1,529 Age (years)   2-4 34.2 32.5 48.4 0.9 54.6 531 11.4 359 5-9 33.8 44.1 47.0 6.9 58.9 1,252 16.8 773 10-14 34.5 43.5 31.2 3.9 52.6 1,668 12.4 1,126 Education of household head   None 33.2 51.6 46.2 23.7 56.2 60 N/A N/A Primary 29.1 45.4 39.9 4.6 57.6 944 N/A N/A Secondary 35.1 41.8 40.0 4.2 55.5 2,128 N/A N/A Higher 43.9 32.1 34.5 3.0 45.7 319 N/A N/A Missing/DK (*) (*) (*) (*) (*) 1 N/A N/A Respondent’s education*   Primary N/A N/A N/A N/A N/A N/A 14.9 718 Secondary N/A N/A N/A N/A N/A N/A 13.0 1,512 Higher N/A N/A N/A N/A N/A N/A 10.1 196 Wealth index quintile   Poorest 30.0 46.3 46.2 6.8 58.8 575 19.8 350 Second 28.9 40.7 41.5 4.9 53.6 720 17.9 459 Middle 36.3 41.7 41.4 5.8 54.4 713 11.7 467 Fourth 32.6 41.9 39.2 3.8 58.7 727 10.4 503 Richest 42.6 40.5 30.9 1.7 51.2 717 10.9 479 Total 34.2 42.1 39.6 4.5 55.2 3,451 13.8 2,258 1 MICS indicator 8.5 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” x Child Protection Child Discipline As stated in A World Fit for Children, children must be protected against any acts of violence. In addition, the Millennium Declaration calls for the protection of children against abuse, exploitation and violence. In the BiH MICS respondents were asked a series of questions on the ways adults in the household disciplined children during the past month preceding the survey.45 The two indicators below were used for the child discipline module z The number of children aged 2-14 years that had experienced psychological aggression as punishment or physical punishment. z The number of respondents who believed that in order to raise children properly, they need to be physically punished. Table CP.1 shows that in BiH more than one half of children (55 per cent) aged 2-14 years had been subjected to any method of violent discipline by their parents or other adult household members during the past month preceding the survey. In the FBiH this figure was 59 per cent and in RS 48 per cent. Forty-two per cent of children in BiH were subjected to psychological aggression (45 per cent in FBiH and 37 per cent in RS) and 40 per cent were physically punished (44 per cent in FBiH and 30 per cent in RS), of which 5 per cent experienced severe physical punishment (5 per cent in FBiH and 3 per cent in RS). When compared to the percentage of children who were actually subjected to such a practice a lower percentage of respondents (14 per cent) stated that they believe in the need for the physical punishment of children (14 per cent in FBiH and 13 per cent in the RS). Male children were subjected to physical discipline (44 per cent) to a higher extent than female children (34 per cent). Households in which the household head had no education showed a higher rate of severe physical punishment compared to households where the head had primary, secondary or higher education. 45 Please note that for the child discipline module, the questions refer to one child aged 2-14 per household who was selected randomly during fieldwork. 94 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 95 Table CP.2: Early marriage: women Percentage of women aged 15-49 years who first married or entered a marital union before their 15th birthday, percentages of women aged 20-49 years who first married or entered a marital union before their 15th and 18th birthdays and the percentage of women aged 15-19 years currently married or in union, BiH 2011–2012   Percentage married before age 151 Number of women aged 15-49 years Percentage married before age 15 Percentage married before age 182 Number of women aged 20-49 years Percentage of women 15-19 years currently married/in union3 Number of women aged 15-19 years Administrative unit   FBiH 0.4 3,180 0.5 9.9 2,686 0.8 494 RS 0.6 1,210 0.7 8.2 1,070 0.0 140 BD 0.0 56 0.0 11.3 48 (*) 8 Area   Urban 0.2 1,548 0.2 5.4 1,340 0.1 208 Rural 0.6 2,898 0.7 11.7 2,464 0.9 434 Age (years)   15-19 0.0 642 N/A N/A N/A 0.6 642 20-24 0.2 677 0.2 3.5 677 N/A N/A 25-29 1.1 498 1.1 8.6 498 N/A N/A 30-34 0.6 568 0.6 9.6 568 N/A N/A 35-39 0.6 646 0.6 13.4 646 N/A N/A 40-44 0.5 690 0.5 11.8 690 N/A N/A 45-49 0.4 724 0.4 9.8 724 N/A N/A Education*   Primary 1.2 1,064 1.3 24.0 1,040 (*) 23 Secondary 0.2 2,604 0.3 5.2 2,030 0.6 575 Higher 0.0 762 0.0 0.2 719 (0.0) 44 Wealth index quintile   Poorest 0.6 620 0.8 14.2 517 0.6 104 Second 0.3 847 0.3 12.3 736 0.5 111 Middle 1.1 976 1.3 11.3 838 2.0 137 Fourth 0.2 1,020 0.3 7.5 864 0.1 156 Richest 0.0 983 0.0 4.2 850 0.0 133 Total 0.4 4,446 0.5 9.5 3,804 0.6 642 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” Early Marriage Marriage before the age of 18 is a reality for many young girls. According to UNICEF’s worldwide estimates, over 60 million women aged 20-24 were married/in union before the age of 18. Factors that influence child marriage rates (either decreasing or increasing them) include: 1. the state of the country’s civil registration system, which provides proof of age for children; 2. the existence of an adequate legislative framework with an accompanying enforcement mechanism to address cases of child marriage; 3. the existence of customary or religious laws and practices that condone the practice. In many parts of the world parents encourage their daughters to marry while they are still children in the hope that the marriage will benefit them both financially and socially, while also relieving the financial burden on the family. In actual fact, child marriage is a violation of human rights that compromises the development of girls and often results in early pregnancy and social isolation; little education and poor vocational training reinforces the gendered nature of poverty. The right to ‘free and full’ consent to a marriage is recognised in the Universal Declaration of Human Rights through the recognition that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. Many other international documents and treaties also emphasise this issue, such as the Convention on the Elimination of all Forms of Discrimination against Women and the Convention on Consent to Marriage. Research suggests that many factors interact to place a child at risk of marriage. Poverty, protection of girls, family honour and the provision of stability during unstable social periods are considered as significant factors in determining a girl’s risk of becoming married whilst still a child. Women who marry at a young age are more likely to believe that it is sometimes acceptable for a husband to beat his wife and are more likely to experience domestic violence themselves. The age gap between partners is thought to contribute to these abusive power dynamics and also to increase the risk of untimely widowhood. Closely related to the issue of child marriage is the age at which girls become sexually active. Women who are married before the age of 18 tend to have more children than those who marry later in life. Pregnancy related deaths are known to be a leading cause of mortality for both married and unmarried girls between the ages of 15 and 19, particularly amongst the youngest of this cohort. Therefore, two significant indicators exist to estimate the percentage of women married before 15 years of age and the percentage married before 18 years of age. Table CP.2 and CP.2M show the percentage of married women and married men by age at the time of marriage. Less than 1 per cent of women aged 15-19 were currently married or in union, while no men of that age were married or in union. Such cases were not observed amongst either women or men in RS, while in the FBiH less than 1 per cent of women aged 15-19 were married or in union. Less than 1 per cent of women aged 15-49 in BiH were married before age 15. The percentage of men who married before age 15 was even lower. The proportion of women aged 20-49 in BiH who married before age 18 was 10 per cent (10 per cent in FBiH and 8 per cent in RS), while amongst men this proportion was less than 1 per cent. The proportion of women of that age who were married before age 18 was higher amongst women in rural areas (12 per cent) compared to women in urban areas (5 per cent) and was also higher amongst women with primary education (24 per cent) compared to women with secondary (5 per cent) or higher education (less than 1 per cent). The percentage of women who were first married before age 18 decreases as household wealth increased. Amongst men of that age there were no clear differences by background characteristics. 96 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 97 Ta bl e CP .3 : T re nd s in e ar ly m ar ri ag e: w om en Pe rc en ta ge o f w om en w ho w er e fir st m ar rie d or e nt er ed in to a m ar ita l u ni on b ef or e ag e 15 a nd 1 8, b y ar ea a nd a ge g ro up s, Bi H 2 01 1– 20 12   U rb an Ru ra l A ll   Pe rc en ta ge of w om en m ar rie d be fo re ag e 15 N um be r of w om en ag ed 15 -4 9 Pe rc en ta ge of w om en m ar rie d be fo re ag e 18 N um be r of w om en ag ed 20 -4 9 Pe rc en ta ge of w om en m ar rie d be fo re ag e 15 N um be r of w om en ag ed 15 -4 9 Pe rc en ta ge of w om en m ar rie d be fo re ag e 18 N um be r of w om en ag ed 20 -4 9 Pe rc en ta ge of w om en m ar rie d be fo re ag e 15 N um be r of w om en ag ed 15 -4 9 Pe rc en ta ge of w om en m ar rie d be fo re ag e 18 N um be r of w om en ag ed 2 0- 49 A ge (y ea rs )   15 -1 9 0. 0 20 8 N /A N /A 0. 0 43 4 N /A N /A 0. 0 64 2 N /A N /A 20 -2 4 0. 3 25 5 1. 3 25 5 0. 1 42 3 4. 8 42 3 0. 2 67 7 3. 5 67 7 25 -2 9 1. 1 18 7 5. 0 18 7 1. 0 31 1 10 .8 31 1 1. 1 49 8 8. 6 49 8 30 -3 4 0. 0 19 7 1. 3 19 7 0. 9 37 1 14 .0 37 1 0. 6 56 8 9. 6 56 8 35 -3 9 0. 0 20 4 12 .6 20 4 0. 9 44 3 13 .8 44 3 0. 6 64 6 13 .4 64 6 40 -4 4 0. 0 25 5 6. 2 25 5 0. 7 43 5 15 .1 43 5 0. 5 69 0 11 .8 69 0 45 -4 9 0. 0 24 2 6. 6 24 2 0. 6 48 2 11 .4 48 2 0. 4 72 4 9. 8 72 4 To ta l 0. 2 1, 54 8 5. 4 1, 34 0 0. 6 2, 89 8 11 .7 2, 46 4 0. 4 4, 44 6 9. 5 3, 80 4 N /A : “ N ot a pp lic ab le ” Ta bl e CP .3 M : T re nd s in e ar ly m ar ri ag e: m en Pe rc en ta ge o f m en w ho w er e fir st m ar rie d or e nt er ed in to a m ar ita l u ni on b ef or e ag e 15 a nd 1 8, b y ar ea a nd a ge g ro up s, Bi H 2 01 1– 20 12   U rb an Ru ra l A ll   Pe rc en ta ge of m en m ar rie d be fo re ag e 15 N um be r of m en ag ed 15 -4 9 Pe rc en ta ge of m en m ar rie d be fo re ag e 18 N um be r of m en ag ed 20 -4 9 Pe rc en ta ge of m en m ar rie d be fo re ag e 15 N um be r of m en ag ed 15 -4 9 Pe rc en ta ge of m en m ar rie d be fo re ag e 18 N um be r of m en ag ed 20 -4 9 Pe rc en ta ge of m en m ar rie d be fo re ag e 15 N um be r of m en ag ed 15 -4 9 Pe rc en ta ge of m en m ar rie d be fo re ag e 18 N um be r of m en ag ed 20 -4 9 A ge (y ea rs )   15 -1 9 0. 0 21 9 N /A N /A 0. 0 46 5 N /A N /A 0. 0 68 4 N /A N /A 20 -2 4 0. 1 26 6 0. 1 26 6 0. 0 47 8 0. 1 47 8 0. 0 74 3 0. 1 74 3 25 -2 9 1. 1 18 3 1. 3 18 3 0. 1 35 1 0. 2 35 1 0. 4 53 4 0. 6 53 4 30 -3 4 0. 0 15 0 0. 0 15 0 0. 0 30 9 0. 7 30 9 0. 0 45 9 0. 5 45 9 35 -3 9 0. 2 17 9 0. 2 17 9 0. 7 41 7 1. 7 41 7 0. 5 59 7 1. 2 59 7 40 -4 4 0. 0 18 2 0. 0 18 2 0. 0 43 5 0. 9 43 5 0. 0 61 7 0. 7 61 7 45 -4 9 0. 0 24 3 0. 0 24 3 0. 1 47 6 0. 7 47 6 0. 0 71 9 0. 5 71 9 To ta l 0. 2 1, 42 2 0. 2 1, 20 3 0. 1 2, 93 1 0. 7 2, 46 6 0. 1 4, 35 3 0. 6 3, 66 9 N /A : “ N ot a pp lic ab le ” Table CP.2M: Early marriage: men Percentage of men aged 15-49 years who first married or entered a marital union before their 15th birthday, percentages of men aged 20-49 years who first married or entered a marital union before their 15th and 18th birthdays and the percentage of men aged 15-19 years currently married or in union, BiH 2011–2012   Percentage married before age 151 Number of men aged 15-49 years Percentage married before age 15 Percentage married before age 182 Number of men aged 20-49 years Percentage of men 15-19 years currently married/ in union3 Number of men aged 15-19 years Administrative unit   FBiH 0.2 3,010 0.2 0.8 2,555 0.0 455 RS 0.0 1,271 0.0 0.1 1,049 0.0 222 BD 0.2 71 0.2 0.4 64 (*) 7 Area   Urban 0.2 1,422 0.2 0.2 1,203 0.0 219 Rural 0.1 2,931 0.1 0.7 2,466 0.0 465 Age (years)   15-19 0.0 684 N/A N/A N/A 0.0 684 20-24 0.0 743 0.0 0.1 743 N/A N/A 25-29 0.4 534 0.4 0.6 534 N/A N/A 30-34 0.0 459 0.0 0.5 459 N/A N/A 35-39 0.5 597 0.5 1.2 597 N/A N/A 40-44 0.0 617 0.0 0.7 617 N/A N/A 45-49 0.0 719 0.0 0.5 719 N/A N/A Education*   Primary 0.2 543 0.2 1.2 523 (*) 20 Secondary 0.1 3,117 0.1 0.5 2,515 0.0 602 Higher 0.0 683 0.0 0.0 621 (0.0) 62 Wealth index quintile   Poorest 0.4 685 0.5 1.3 600 0.0 86 Second 0.0 848 0.0 1.1 721 0.0 127 Middle 0.1 989 0.1 0.3 833 0.0 156 Fourth 0.0 893 0.0 0.1 722 0.0 171 Richest 0.2 938 0.3 0.3 794 0.0 144 Total 0.1 4,353 0.2 0.6 3,669 0.0 684 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” Data on marriage before age 15 and 18 allows us to see the trends in early marriage over time. Table CP.3 presents the proportion of women who were first married or entered into a marital union before age 15 and 18 by age group. The data shows that less than 1 per cent of women aged 15-49 were first married before age 15. This practice of early marriage did not differ greatly across the age groups (the proportion was highest amongst women aged 25-29 at 1 per cent, while no women who at the time of the survey were 15-19 had married before 15 years of age). One in ten women aged 20-49 married before age 18 (10 per cent): one in eight in rural areas (12 per cent) and one in twenty in urban areas (5 per cent). Younger women (ages 20-24 and 25-29) married less frequently before age 18 (4 per cent and 9 per cent respectively) than women aged 35-39 and 40-44, where the percentages were 13 and 12 per cent, respectively. Therefore it seems that there is a trend of postponing marriage until later in life especially in the rural areas where rates were higher in the past. Table CP.3M presents the proportion of men who were first married or entered into a marital union before age 15 and 18 by age group. The data shows that less than 1 per cent of men aged 15-49 married before age 15. Compared to women, a lower percentage of men aged 20-49 married before age 18 (less than 1 per cent); no differences were observed by area. 98 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 99 Attitudes towards Domestic Violence MICS4 in BiH assessed the attitudes of women and men aged 15-49 towards the violence of husbands/partners against their wives/partners in cases where certain gender roles were not fulfilled by the wife and where she had a subordinate status in society. These questions were asked in order to provide an indication of cultural beliefs that tend to be associated with the prevalence of violence against women by their husbands/partners. The main assumption here is that those women that agree with statements indicating that husbands/partners are justified in beating their wives/partners, under the situations described, tend in reality to be abused by their own husbands/partners; similarly, men who agree with such statements tend in reality to exercise violence towards their wives or partners. The responses to these questions can be found in Table CP.5 for women and Table CP.5M for men. Five per cent of women and 6 per cent of men in BiH believed that a husband/partner has a right to hit or beat his wife/ partner for at least one of the specified reasons. Five per cent of women and 6 per cent of men in the FBiH and 4 per cent of women and 7 per cent of men in RS felt that a husband/partner had the right to hit or beat his wife/partner. Women and men most often justify a husband’s violence in instances where a woman neglects the children (4 per cent for women and 5 per cent for men). A similar percentage of women (1 per cent) believed that a husband has the right to hit or beat his wife/partner if she argued with him, if she refused to have sex with him or if she demonstrated her autonomy, for instance, went out without telling her husband. Around 2 per cent of men believed that a husband has the right to hit or beat his wife/partner if she refused to have sex with him or if she argued with him. Less than 1 per cent of women and men believed that a husband has a right to hit or beat his wife/partner if she burnt the food. Justification of wife beating was more present amongst the less educated women and men and amongst those living in the poorest households. Men and women in the poorest households more often supported at least one reason justifying violence against women (13 per cent of men and 12 per cent of women), compared to men and women in the richest households (5 per cent of men and 3 per cent of women). Men and women had different attitudes towards whether a husband/partner is justified in hitting or beating his wife/ partner with respect to their marital status. A lower percentage of women who had never been married/in union believed that a husband/partner has the right to hit or beat his wife/partner in all of the instances, compared to those currently or ever-married/in union. In contrast, a higher percentage of ever-married/in union men believed that a husband/partner has the right to hit or beat his wife/partner for all of the specified reasons, compared to those who were currently or had never been married/in union. Another significant aspect of early marriage is the spousal age difference with an indicator being the percentage of married/in union women with a difference of being 10 or more years younger than their current spouse. Table CP.4 presents the results of the age difference between spouses and partners.46 The results show that 9 per cent of women aged 20-24 in BiH were currently married to a man who was older by ten years or more (12 per cent in RS and 8 per cent in the FBiH). Nearly one half of women (48 per cent) of this age group were currently married to or in union with a husband/partner who was 0-4 years older (49 per cent in RS and 47 per cent in the FBiH), while 5 per cent of women in BiH were married to or in union with a younger husband/partner (7 per cent in the FBiH and 1 per cent in RS). Table CP.4: Spousal age difference Per cent distribution of women currently married/in union aged 20-24 years according to the age difference with their husband or partner, BiH 2011–2012   Percentage of currently married/in union women aged 20-24 years whose husband or partner is: Number of women aged 20-24 years currently married/ in union   younger 0-4 years older 5-9 years older 10+ years older2 Husband/ Partner’s age unknown Total Administrative unit   FBiH 6.8 46.9 38.4 7.7 0.2 100.0 109 RS 1.3 48.5 33.0 12.2 5.0 100.0 40 BD (*) (*) (*) (*) (*) 100.0 1 Area   Urban 0.4 53.0 40.7 5.8 0.0 100.0 31 Rural 6.6 46.1 35.8 9.6 1.9 100.0 119 Age (years)   15-19 N/A N/A N/A N/A N/A N/A N/A 20-24 5.4 47.5 36.8 8.8 1.5 100.0 150 Education*   Primary 1.4 62.4 31.4 4.8 0.0 100.0 39 Secondary 7.5 36.7 42.3 11.3 2.3 100.0 98 Higher (*) (*) (*) (*) (*) 100.0 12 Wealth index quintile   Poorest 16.2 36.4 38.7 8.7 0.0 100.0 30 Second 6.0 31.5 46.0 11.7 4.7 100.0 42 Middle 1.3 58.9 36.5 2.6 0.7 100.0 41 Fourth (0.0) (61.9) (30.7) (7.4) (0.0) 100.0 18 Richest (0.0) (63.3) (18.6) (18.1) (0.0) 100.0 18 Total 5.4 47.5 36.8 8.8 1.5 100.0 150 2 MICS indicator 8.10b MICS indicator 8.10a: The percentage of currently married/in union women aged 15-19 years whose husband or partner is ten or more years older is based on fewer than 25 unweighted cases and is not presented in Table CP.4. ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” 46 The figures for currently married/in union women aged 15-19 are based on fewer than 25 unweighted cases and are not presented in Table CP.4. 100 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 101 Table CP.5M: Attitudes towards domestic violence: men Percentage of men aged 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, BiH 2011–2012   Percentage of men aged 15-49 years who believe a husband is justified in beating his wife/partner: Number of men aged 15-49 years If she goes out without telling him If she neglects the children If she argues with him If she refuses sex with him If she burns the food For any of these reasons1 Administrative unit   FBiH 1.7 3.8 2.0 2.0 0.5 5.6 3,010 RS 0.8 6.2 1.0 1.5 0.3 7.0 1,271 BD 2.1 5.8 1.6 3.4 1.6 7.4 71 Area   Urban 0.5 4.4 1.3 2.4 0.1 6.1 1,422 Rural 1.9 4.6 1.9 1.6 0.6 6.0 2,931 Age (years)   15-19 1.2 2.0 1.5 1.6 0.3 5.0 684 20-24 1.3 3.3 1.3 1.4 0.7 4.5 743 25-29 0.3 3.2 1.7 1.0 0.1 4.2 534 30-34 1.9 7.9 2.7 3.0 0.8 8.3 459 35-39 2.4 4.4 1.3 1.9 0.2 5.2 597 40-44 2.0 7.2 2.2 1.9 0.5 9.5 617 45-49 1.0 4.9 1.6 2.5 0.5 6.3 719 Marital/Union status   Currently married/in union 1.5 5.2 1.5 1.8 0.5 6.6 2,252 Formerly married/in union 5.5 15.9 7.4 10.5 0.3 16.3 84 Never married/in union 1.2 3.4 1.7 1.6 0.4 5.0 2,017 Education*   Primary 4.9 11.7 5.4 4.7 1.3 14.7 543 Secondary 1.1 4.0 1.3 1.6 0.3 5.6 3,117 Higher 0.0 0.7 0.3 0.1 0.0 0.7 683 Wealth index quintile   Poorest 3.8 10.1 4.5 3.6 1.8 12.5 685 Second 1.8 3.9 1.6 1.6 0.7 6.2 848 Middle 1.6 3.7 1.3 1.7 0.0 4.7 989 Fourth 0.3 2.9 1.4 1.3 0.1 3.8 893 Richest 0.2 3.5 0.5 1.6 0.0 4.7 938 Total 1.4 4.5 1.7 1.9 0.4 6.0 4,353 1 MICS indicator 8.14 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table CP.5: Attitudes towards domestic violence: women Percentage of women aged 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, BiH 2011–2012   Percentage of women aged 15-49 years who believe a husband is justified in beating his wife/partner: Number of women aged 15-49 years If she goes out without telling him If she neglects the children If she argues with him If she refuses sex with him If she burns the food For any of these reasons1 Administrative unit   FBiH 1.3 4.3 1.8 1.6 0.4 5.0 3,180 RS 0.6 4.1 0.4 0.2 0.0 4.3 1,210 BD 0.6 1.3 0.2 0.2 0.0 1.9 56 Area   Urban 0.5 3.8 0.8 1.1 0.1 4.1 1,548 Rural 1.3 4.5 1.7 1.2 0.4 5.1 2,898 Age (years)   15-19 0.0 1.3 0.4 0.0 0.0 1.3 642 20-24 0.4 2.6 0.3 0.9 0.1 2.8 677 25-29 0.8 3.0 1.3 1.4 0.5 4.3 498 30-34 1.4 4.2 1.4 1.0 0.0 4.4 568 35-39 2.3 7.2 3.0 2.0 1.0 8.2 646 40-44 1.3 5.8 1.6 1.6 0.4 6.4 690 45-49 1.1 5.1 1.9 1.4 0.1 5.5 724 Marital/Union status   Currently married/in union 1.7 5.7 2.1 1.7 0.4 6.4 2,764 Formerly married/in union 0.1 4.6 0.8 0.8 0.8 4.6 260 Never married/in union 0.1 1.4 0.3 0.2 0.0 1.6 1,422 Missing (*) (*) (*) (*) (*) (*) 0 Education*   Primary 3.4 9.1 4.2 2.8 0.7 10.3 1,064 Secondary 0.4 3.1 0.5 0.7 0.1 3.3 2,604 Higher 0.0 1.3 0.3 0.3 0.0 1.6 762 Wealth index quintile   Poorest 3.4 10.1 4.1 2.8 1.4 11.5 620 Second 0.6 4.5 1.5 0.9 0.2 4.6 847 Middle 1.0 2.8 1.3 1.2 0.3 3.4 976 Fourth 0.6 3.1 0.7 0.6 0.0 3.5 1,020 Richest 0.5 3.0 0.5 0.9 0.0 3.3 983 Total 1.1 4.2 1.4 1.2 0.3 4.8 4,446 1 MICS indicator 8.14 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 102 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 103 Ta bl e H A .1 : k no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep ti on s a bo ut H IV /A ID S an d co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on : w om en a ge d 15 -4 9 Pe rc en ta ge o f w om en a ge d 15 -4 9 ye ar s w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S vi ru s, pe rc en ta ge w ho re je ct co m m on m is co nc ep tio ns a nd p er ce nt ag e w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on , B iH 2 01 1– 20 12   Pe rc en ta ge w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on ca n be p re ve nt ed b y: Pe rc en ta ge o f w om en w ho kn ow b ot h w ay s Pe rc en ta ge w ho k no w th at a he al th y lo ok in g pe rs on c an h av e th e A ID S vi ru s Pe rc en ta ge w ho k no w th at H IV ca nn ot b e tr an sm it te d by : Pe rc en ta ge w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns a nd kn ow th at a h ea lth y lo ok in g pe rs on c an ha ve th e A ID S vi ru s Pe rc en ta ge w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en H av in g on ly o ne fa ith fu l u ni nf ec te d se x pa rt ne r U si ng a co nd om ev er y tim e M os qu ito bi te s Su pe rn at ur al m ea ns Sh ar in g fo od w ith s om eo ne w ith A ID S A dm in is tr at iv e un it   FB iH 97 .1 87 .8 85 .4 81 .2 76 .8 67 .7 88 .1 70 .1 49 .6 43 .9 3, 18 0 RS 99 .7 90 .4 89 .1 84 .5 72 .6 66 .5 92 .1 74 .8 45 .4 42 .3 1, 21 0 BD 96 .8 70 .5 76 .8 67 .3 63 .7 67 .3 86 .5 72 .2 44 .2 40 .0 56 A re a   U rb an 99 .9 92 .5 91 .7 87 .8 77 .7 69 .8 92 .9 78 .6 53 .4 49 .5 1, 54 8 Ru ra l 96 .7 86 .0 83 .4 78 .8 74 .3 66 .1 87 .2 67 .6 45 .7 40 .2 2, 89 8 A ge (y ea rs )   15 -2 4 98 .9 89 .6 89 .6 84 .2 80 .9 72 .6 92 .3 76 .7 54 .2 47 .6 1, 31 9 25 -2 9 99 .1 91 .9 90 .4 88 .0 81 .8 75 .2 90 .7 79 .8 61 .9 57 .8 49 8 30 -3 9 97 .0 89 .1 86 .9 82 .9 75 .2 65 .1 87 .9 71 .3 47 .6 44 .1 1, 21 4 40 -4 9 97 .0 85 .1 81 .2 76 .9 68 .4 61 .7 86 .8 63 .7 38 .9 33 .9 1, 41 4 M ar it al s ta tu s   Ev er m ar rie d/ in u ni on 97 .3 87 .3 84 .5 80 .2 72 .2 64 .1 87 .5 67 .7 43 .8 39 .1 3, 02 3 N ev er m ar rie d/ in u ni on 98 .9 90 .5 90 .1 85 .5 82 .5 74 .4 92 .8 79 .4 58 .1 52 .6 1, 42 2 M is si ng (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 0 W om en ’s ed uc at io n*   Pr im ar y 92 .4 77 .1 71 .0 66 .1 59 .7 49 .8 74 .2 47 .4 27 .5 22 .4 1, 06 4 Se co nd ar y 99 .6 90 .8 90 .0 85 .4 78 .7 70 .9 93 .2 77 .4 51 .8 46 .3 2, 60 4 H ig he r 10 0. 0 96 .2 96 .1 93 .6 87 .8 80 .5 97 .0 85 .5 66 .6 63 .8 76 2 W ea lt h in de x qu in ti le s   Po or es t 94 .7 79 .0 73 .7 69 .1 60 .4 57 .7 77 .2 56 .2 32 .4 27 .3 62 0 Se co nd 96 .9 85 .4 82 .3 77 .4 73 .8 65 .8 86 .9 66 .2 44 .7 38 .9 84 7 M id dl e 98 .0 89 .4 86 .7 82 .7 77 .0 67 .4 91 .2 73 .8 50 .6 46 .3 97 6 Fo ur th 98 .4 89 .4 89 .3 85 .0 80 .9 73 .4 91 .9 77 .3 56 .8 50 .5 1, 02 0 Ri ch es t 99 .8 94 .3 94 .0 89 .9 79 .2 68 .5 94 .0 77 .2 50 .7 47 .4 98 3 To ta l 97 .8 88 .3 86 .3 81 .9 75 .5 67 .4 89 .2 71 .4 48 .4 43 .4 4, 44 6 1 M IC S in di ca to r 9 .1 (* ) F ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s * Fi gu re s fo r t he e du ca tio n ca te go ry “N on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t s ho w n in th e ta bl e. xI HIV/AIDS and Sexual Behaviour that Increases the Risk of HIV Transmission knowledge about HIV Transmission and Misconceptions about HIV/AIDS One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step towards raising awareness and giving young people the tools to protect themselves against infection. Misconceptions about HIV are common and can hinder prevention efforts. While different regions are likely to have variations in misconceptions some appear to be universal, for example, that sharing food or mosquito bites can transmit HIV. The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect themselves against HIV. The indicators to measure this goal as well as the MDG of reducing HIV infection by half include improving the level of knowledge on HIV and its prevention and changing behaviour to prevent the further spread of the disease. One indicator which is both an MDG and UNGASS indicator is the per cent of young women who have comprehensive knowledge of HIV prevention and transmission. In Bosnia and Herzegovina all women and men aged 15-49 who had heard of AIDS were asked whether they knew the two main ways of preventing HIV transmission, namely having only one faithful uninfected partner and using a condom every time. The results are presented in Tables HA.1 and HA.1M. The data presented in Tables HA.1 and HA.1M shows that almost all women (98 per cent) and men (99 per cent) aged 15-49 in BiH had heard of HIV/AIDS. The data was similar by entity: 97 per cent of women and 99 per cent of men in the FBiH and 100 per cent of women and men in RS had heard of HIV/AIDS. Yet a lower percentage of women (82 per cent) and men (88 per cent) in BiH were aware of both main ways to prevent HIV transmission. Eighty-one per cent of women in the FBiH and 85 per cent of women in RS knew about both main ways to prevent HIV transmission, while the percentage for men was somewhat higher at 89 per cent in the FBiH and 87 per cent in RS. In addition, 88 per cent of women and 93 per cent of men aged 15-49 in BiH knew about having only one faithful uninfected partner, while 86 per cent of women and 92 per cent of men aged 15-49 knew about having only one faithful uninfected partner, while 85 per cent of women and 92 per cent of men knew that using a condom every time is one of the main ways to prevent HIV transmission. In the FBiH 88 per cent of women and 93 per cent of men aged 15-49 knew about having only one faithful uninfected partner, while 85 per cent of women and 92 per cent of men knew that using a condom every time is one of the main ways to prevent HIV transmission. In RS 90 per cent of women and 93 per cent of men aged 15-49 knew about having only one faithful uninfected partner, while 89 per cent of women and 91 per cent of men knew that using a condom every time is one of the main ways to prevent HIV transmission 104 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 105 Table HA.1M: knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: men aged 15-49 Percentage of men aged 15-49 years who know the main ways of preventing HIV transmission, percentage who know that a healthy looking person can have the AIDS virus, percentage who reject common misconceptions and percentage who have comprehensive knowledge about HIV transmission, BiH 2011–2012   Percentage who have heard of AIDS Percentage who know transmission can be prevented by: Percentage of men who know both ways Percentage who know that a healthy looking person can have the AIDS virus Percentage who know that HIV cannot be transmitted by: Percentage who reject the two most common misconceptions and know that a healthy looking person can have the AIDS virus Percentage with comprehensive knowledge1 Number of men Having only one faithful uninfected sex partner Using a condom every time Mosquito bites Supernatural means Sharing food with someone with AIDS Administrative unit   FBiH 99.1 93.1 91.9 88.8 76.8 72.3 91.9 71.7 50.4 47.5 3,010 RS 99.7 93.1 91.2 87.0 78.3 64.0 93.1 69.1 42.7 38.8 1,271 BD 96.6 89.5 92.9 87.5 78.1 69.9 86.8 58.7 46.2 46.2 71 Area   Urban 99.6 93.6 92.3 88.1 79.4 71.7 93.8 74.5 51.9 49.2 1,422 Rural 99.0 92.8 91.5 88.3 76.2 69.0 91.4 69.0 46.2 42.8 2,931 Age (years)   15-24 99.3 92.6 91.6 87.6 80.3 73.2 91.6 71.6 51.7 47.4 1,428 25-29 99.9 94.2 94.8 91.3 83.1 75.6 94.2 80.1 59.0 56.8 534 30-39 99.4 93.5 90.9 87.6 73.2 67.4 92.9 68.6 43.7 40.8 1,056 40-49 98.6 92.8 91.4 88.2 74.8 66.0 91.4 67.8 43.4 40.8 1,336 Marital status   Ever married/in union 99.1 93.3 91.0 88.1 74.8 67.9 92.2 69.5 45.3 42.6 2,336 Never married/in union 99.3 92.7 92.6 88.3 80.1 72.1 92.1 72.2 51.3 47.6 2,017 Education*   Primary 95.9 83.0 83.5 77.8 56.7 54.6 78.8 54.5 26.9 23.4 543 Secondary 99.7 93.9 92.1 88.6 78.3 70.1 93.4 70.7 47.3 44.0 3,117 Higher 100.0 97.4 97.4 95.6 89.4 81.5 97.7 84.2 69.1 66.6 683 Wealth index quintiles   Poorest 98.5 87.0 88.4 82.1 68.6 62.7 86.6 60.4 35.2 31.2 685 Second 98.9 94.1 91.9 88.7 76.6 69.9 92.7 66.4 44.5 40.6 848 Middle 99.3 94.7 91.7 89.4 78.6 69.3 92.8 71.0 48.3 46.3 989 Fourth 99.2 93.4 91.7 89.1 81.7 74.7 92.7 78.4 58.7 54.7 893 Richest 99.8 94.5 94.2 90.2 78.3 71.0 94.7 74.8 50.4 48.0 938 Total 99.2 93.0 91.7 88.2 77.2 69.9 92.2 70.8 48.1 44.9 4,353 1 MICS indicator 9.1 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. In the FBiH 68 per cent of women and 72 per cent of men aged 15-49 knew that HIV cannot be transmitted by mosquito bites and that HIV cannot be transmitted by sharing food with an infected person (70 per cent of women and 72 per cent of men), while seventy-seven per cent of women and men in the FBiH knew that a healthy looking person can be infected. Fifty per cent of women and men in the FBiH rejected the two most common misconceptions regarding HIV/ AIDS and knew that a healthy looking person can be infected. In RS 67 per cent of women and 64 per cent of men aged 15-49 knew that HIV cannot be transmitted by mosquito bites and that HIV cannot be transmitted by sharing food with an infected person (75 per cent of women and 69 per cent of men); seventy-three per cent of women and 78 per cent of men in RS also knew that a healthy looking person can be infected. Forty-five per cent of women and 43 per cent of men in RS rejected the two most common misconceptions regarding HIV/AIDS and knew that a healthy looking person can be infected. Tables HA.1, HA.2, HA.1M and HA.2M also present the percentage of women and men with comprehensive knowledge on HIV prevention and the percentages of those who can correctly identify the misconceptions concerning HIV. The indicator is based on the two most common misconceptions in BiH: HIV can be transmitted by sharing food and that HIV can be transmitted by mosquito bites. The table also provides information on whether women and men knew that HIV cannot be transmitted by supernatural means. Slightly more than two-thirds of women (67 per cent) and men (70 per cent) aged 15-49 in BiH knew that HIV cannot be transmitted by mosquito bites and that HIV cannot be transmitted by sharing food with an infected person (71 per cent for both sexes); seventy-six per cent of women and 77 per cent of men knew that a healthy looking person can be infected. Thus, 48 per cent of women and men rejected the two most common misconceptions regarding HIV/AIDS and knew that a healthy looking person can be infected. 106 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 107 Women and men who had comprehensive knowledge on HIV prevention included persons who knew of the two main means of HIV prevention (having only one faithful uninfected partner and using a condom every time), that a healthy looking person can have the AIDS virus and who rejected the two most common misconceptions. Comprehensive knowledge of HIV prevention methods and transmission was fairly low for women and men. Overall 43 per cent of women and 45 per cent of men aged 15-49 in BiH were found to have a comprehensive knowledge: 44 per cent of women and 48 per cent of men in the FBiH and 42 per cent of women and 39 per cent of men in RS. Comprehensive knowledge was somewhat higher in urban areas and amongst persons who had never been married/in union. For all of the questions the level of knowledge was higher amongst women and men with higher education and amongst persons with a higher wealth status (see figures HA.1 and HA.1M). Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, BiH 2011–2012 Know 2 ways to prevent HIV Reject 2 most common misconceptions and know that a healthy looking person can have the AIDS virus Comprehensive knowledge 78 89 96 88 27 47 69 48 23 44 67 45 0 10 20 30 40 50 60 70 80 90 100 Know 2 ways to prevent HIV Reject 2 most common misconceptions and know that a healthy looking person can have the AIDS virus Comprehensive knowledge Primary Secondary Higher BiH 66 85 94 82 28 52 67 48 22 46 64 43 0 10 20 30 40 50 60 70 80 90 100 igherPrimary Secondary H BiH er centP er centP Figure HA.1M: Percentage of men who have comprehensive knowledge of HIV/AIDS transmission, BiH 2011–2012 The findings for women and men aged 15-24 are presented separately in Tables HA.2 and HA.2M. The data shows that nearly all women and men aged 15-24 in BiH had heard of HIV/AIDS (99 per cent each), while a somewhat lower proportion of women (84 per cent) and men in this age group (88 per cent) knew about both main ways to prevent HIV transmission. Ninety-nine per cent of women and men aged 15-24 in the FBiH had heard of HIV/AIDS, while 83 per cent of women and 88 per cent of men aged 15-24 in the FBiH knew about both main ways of preventing HIV transmission; in RS, the percentages were 90 per cent for women and 85 per cent for men in this age group. Knowledge patterns amongst women and men aged 15-24 appeared similar to those of the total population of women and men aged 15-49: 54 per cent of women and 52 per cent of men aged 15-24 had comprehensive knowledge. The percentage of young women and men who knew about the ways in which HIV can be transmitted as well as HIV prevention methods was higher in the older age group 20-24 compared to those aged 15-19. For all of the questions, knowledge was higher amongst women and men who had never been married/in union compared to those who had been married/in union; knowledge improved with the level of education. 108 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 109 Table HA.2: knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: women aged 15-24 Percentage of young women aged 15-24 years who know the main ways of preventing HIV transmission, percentage who know that a healthy looking person can have the AIDS virus, percentage who reject common misconceptions and percentage who have comprehensive knowledge about HIV transmission, BiH 2011–2012   Percentage who have heard of AIDS Percentage who know transmission can be prevented by: Percentage of women who know both ways Percentage who know that a healthy looking person can have the AIDS virus Percentage who know that HIV cannot be transmitted by: Percentage who reject the two most common misconceptions and know that a healthy looking person can have the AIDS virus Percentage with comprehensive knowledge1 Number of women aged 15-24Having only one faithful uninfected sex partner Using a condom every time Mosquito bites Supernatural means Sharing food with someone with AIDS Administrative unit   FBiH 98.6 88.6 88.2 82.7 81.4 72.9 90.9 74.5 53.7 46.4 989 RS 99.9 93.7 93.6 89.5 79.5 72.3 96.7 83.4 55.7 51.8 318 BD (100.0) (65.4) (94.3) (64.2) (83.5) (55.7) (88.1) (82.3) (51.1) (41.5) 12 Area   Urban 99.9 91.0 91.6 86.3 79.9 71.5 94.5 78.8 53.8 49.7 463 Rural 98.4 88.9 88.5 83.0 81.5 73.2 91.1 75.6 54.4 46.5 856 Age (years)   15-19 98.7 87.5 87.8 80.6 78.3 70.3 91.0 74.5 50.2 42.3 642 20-24 99.2 91.6 91.2 87.5 83.5 74.7 93.5 78.8 58.0 52.7 677 Marital status   Ever married/in union 96.6 87.0 86.9 79.0 73.2 65.9 87.2 61.4 44.6 37.8 169 Never married/in union 99.3 90.0 90.0 84.9 82.1 73.6 93.0 78.9 55.6 49.1 1,150 Women’s education*   Primary 93.3 84.3 70.8 63.1 50.6 49.8 77.9 50.1 26.6 13.9 69 Secondary 99.0 87.9 88.4 82.3 80.5 70.2 91.0 74.8 51.0 43.8 869 Higher 100.0 94.5 95.8 92.4 87.5 82.2 97.8 86.0 66.4 62.6 381 Wealth index quintiles   Poorest 98.6 88.5 82.4 79.2 67.5 70.3 87.6 78.0 45.5 36.9 177 Second 98.9 90.8 91.7 86.6 85.5 71.5 93.9 75.2 56.8 50.2 248 Middle 99.1 88.2 86.1 81.0 80.2 72.0 94.7 76.0 52.7 46.7 282 Fourth 98.6 87.8 91.5 83.6 87.2 81.4 90.2 81.4 64.9 55.8 313 Richest 99.3 92.6 93.2 88.7 79.3 66.2 93.6 72.8 47.3 44.3 299 Total 98.9 89.6 89.6 84.2 80.9 72.6 92.3 76.7 54.2 47.6 1,319 1 MICS indicator 9.2; MDG indicator 6.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 110 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 111 Table HA.2M: knowledge about HIV transmission, misconceptions about HIV/AIDS and comprehensive knowledge about HIV transmission: men aged 15-24 Percentage of young men aged 15-24 years who know the main ways of preventing HIV transmission, percentage who know that a healthy looking person can have the AIDS virus, percentage who reject common misconceptions and percentage who have comprehensive knowledge about HIV transmission, BiH 2011–2012   Percentage who have heard of AIDS Percentage who know transmission can be prevented by: Percentage of men who know both ways Percentage who know that a healthy looking person can have the AIDS virus Percentage who know that HIV cannot be transmitted by: Percentage who reject the two most common misconceptions and know that a healthy looking person can have t he AIDS virus Percentage with comprehensive knowledge1 Number of men aged 15-24 Having only one faithful uninfected sex partner Using a condom every time Mosquito bites Supernatural means Sharing food with someone with AIDS Administrative unit   FBiH 99.3 93.5 91.5 88.4 80.1 75.4 91.0 71.4 53.3 49.4 1,014 RS 99.5 90.2 91.8 85.4 80.5 67.4 93.2 73.0 47.9 42.3 393 BD (94.7) (89.3) (89.3) (89.3) (85.1) (79.1) (93.4) (57.8) (45.9) (45.9) 21 Area   Urban 99.6 93.1 93.0 87.9 76.9 68.7 93.7 70.4 46.5 44.3 485 Rural 99.1 92.3 90.8 87.4 82.0 75.5 90.6 72.2 54.4 49.0 943 Age (years)   15-19 99.4 91.5 89.9 85.0 79.3 71.8 91.2 67.6 46.3 41.0 684 20-24 99.2 93.6 93.1 89.9 81.2 74.5 92.0 75.3 56.7 53.3 743 Marital status   Ever married/in union 99.4 93.7 90.5 89.3 83.0 82.4 91.9 68.1 62.1 57.7 46 Never married/in union 99.3 92.5 91.6 87.5 80.2 72.9 91.6 71.7 51.4 47.1 1,382 Education*   Primary 94.0 67.5 78.4 67.5 60.8 65.0 70.3 60.6 40.5 27.0 67 Secondary 99.4 92.1 90.4 85.9 79.0 71.2 90.9 69.1 47.4 42.8 1,009 Higher 100.0 98.5 97.3 96.1 87.6 80.6 97.6 81.0 66.1 64.4 352 Wealth index quintiles   Poorest 99.1 82.2 90.1 80.8 79.6 70.6 91.1 65.5 44.7 37.6 194 Second 99.2 94.9 92.1 88.7 84.3 73.7 89.4 68.9 50.4 43.6 239 Middle 98.8 94.5 90.0 88.3 79.5 74.6 91.3 72.6 52.7 51.4 337 Fourth 99.9 93.1 91.5 87.2 81.5 77.5 92.2 77.6 61.1 54.6 312 Richest 99.4 94.4 93.5 90.1 77.4 69.1 93.2 70.6 47.1 45.1 345 Total 99.3 92.6 91.6 87.6 80.3 73.2 91.6 71.6 51.7 47.4 1,428 1 MICS indicator 9.2; MDG indicator 6.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Eighty-nine per cent of women in the FBiH and 76 per cent of women in RS had knowledge on possible ways of mother- to-child transmission, while the figure was somewhat lower for men: 81 per cent in the FBiH and 60 per cent in RS. All three ways of mother-to-child transmission of HIV were known to 75 per cent of women in the FBiH and 49 per cent of women in RS as well as 59 per cent of men in the FBiH and 27 per cent of men in RS. Neither means of the mother-to- child transmission of HIV were known to 9 per cent of women in the FBiH and 23 per cent of women in RS as well as 18 per cent of men in the FBiH and 39 per cent of men in RS. The percentage of women and men who had this knowledge increased with the level of education and household wealth. Women and men should know that HIV can be transmitted during pregnancy, during delivery and through breastfeeding. Knowledge of the mother-to-child transmission of HIV is also an important first step for women to seek HIV testing when they are pregnant in order to avoid infection in the baby. The level of knowledge amongst women and men aged 15-49 years concerning mother-to-child transmission is presented in Tables HA.3 and HA.3M. The survey findings show that in BiH 85 per cent of women and 75 per cent of men aged 15-49 knew that HIV can be transmitted from mother-to-child, while a lower proportion of women (67 per cent) and men (49 per cent) knew all three ways of the mother-to-child transmission of HIV. One in four men (25 per cent) and one in eight women (13 per cent) did not know of any specific method of mother-to-child transmission. 112 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 113 Table HA.3: knowledge of mother-to-child HIV transmission: women Percentage of women aged 15-49 years who correctly identify means of HIV transmission from mother-to-child, BiH 2011–2012   Percentage who know HIV can be transmitted from mother-to-child Per cent who know HIV can be transmitted: Does not know any of the specific means Number of women During pregnancy During delivery By breastfeeding All three means1 Administrative unit   FBiH 88.5 86.0 82.8 78.2 75.0 8.6 3,180 RS 76.3 71.3 61.9 53.3 48.9 23.4 1,210 BD 54.4 51.2 41.8 38.9 31.7 42.4 56 Area   Urban 85.1 81.4 76.6 72.0 67.7 14.8 1,548 Rural 84.6 81.6 76.5 70.4 67.2 12.1 2,898 Age (years)   15-24 85.0 81.1 75.1 71.1 66.5 13.9 1,319 15-19 82.5 78.0 69.5 67.8 62.6 16.2 642 20-24 87.4 84.2 80.5 74.4 70.1 11.7 677 25-29 88.4 84.8 82.3 75.1 71.9 10.7 498 30-39 84.3 81.5 75.7 70.2 67.2 12.7 1,214 40-49 83.7 80.7 76.6 69.9 66.8 13.4 1,414 Marital status   Ever married/in union 84.6 81.8 77.2 71.0 67.9 12.7 3,023 Never married/in union 85.2 81.0 75.2 70.8 66.3 13.7 1,422 Missing (*) (*) (*) (*) (*) (*) 0 Education*   Primary 75.1 71.8 69.1 66.3 63.2 17.3 1,064 Secondary 87.5 84.4 78.0 72.1 68.2 12.1 2,604 Higher 90.0 86.1 83.1 74.4 71.1 10.0 762 Wealth index quintiles   Poorest 74.0 69.9 65.0 63.7 58.2 20.7 620 Second 85.9 83.7 77.5 71.8 69.0 11.0 847 Middle 84.9 81.9 77.6 72.0 69.0 13.0 976 Fourth 87.6 84.9 80.0 75.9 73.0 10.8 1,020 Richest 87.5 83.2 78.5 68.5 64.4 12.3 983 Total 84.8 81.5 76.6 70.9 67.4 13.0 4,446 1 MICS indicator 9.3 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table HA.3M: knowledge of mother-to-child HIV transmission: men Percentage of men aged 15-49 years who correctly identify means of HIV transmission from mother-to-child, BiH 2011–2012   Percentage who know HIV can be transmitted from mother-to-child Per cent who know HIV can be transmitted: Does not know any of the specific means Number of men During pregnancy During delivery By breastfeeding All three means1 Administrative unit   FBiH 80.9 75.9 69.4 64.2 58.9 18.2 3,010 RS 60.2 54.9 42.3 33.5 27.4 39.4 1,271 BD 60.1 57.7 32.1 34.2 25.0 36.5 71 Area   Urban 72.7 67.6 58.7 53.8 47.5 26.9 1,422 Rural 75.4 70.4 61.9 55.2 50.0 23.6 2,931 Age (years)   15-24 72.0 67.0 57.7 55.2 49.2 27.3 1,428 15-19 67.2 62.7 51.2 51.6 44.1 32.1 684 20-24 76.4 71.0 63.8 58.4 53.8 22.9 743 25-29 79.8 75.2 65.1 59.2 53.1 20.1 534 30-39 75.4 71.3 62.3 55.1 50.2 24.1 1,056 40-49 74.4 68.3 61.4 52.2 46.8 24.2 1,336 Marital status   Ever married/in union 76.2 70.7 63.9 55.6 50.2 22.9 2,336 Never married/in union 72.6 68.1 57.4 53.7 48.0 26.7 2,017 Education*   Primary 64.6 56.8 51.3 44.8 38.3 31.3 543 Secondary 75.1 70.0 61.1 55.3 49.5 24.6 3,117 Higher 80.2 77.7 67.6 60.3 56.3 19.8 683 Wealth index quintiles   Poorest 68.7 62.4 53.0 45.7 40.0 29.7 685 Second 73.6 69.4 60.0 54.2 49.4 25.3 848 Middle 77.1 72.0 66.4 60.5 55.6 22.3 989 Fourth 77.5 73.3 64.4 58.6 53.8 21.8 893 Richest 74.0 68.3 58.1 51.9 44.5 25.7 938 Total 74.5 69.5 60.9 54.7 49.2 24.7 4,353 1 MICS indicator 9.3 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 114 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 115 Ta bl e H A .4 : A cc ep ti ng a tt it ud es to w ar ds p eo pl e liv in g w it h H IV /A ID S: w om en Pe rc en ta ge o f w om en a ge d 15 -4 9 ye ar s w ho h av e he ar d of A ID S w ho e xp re ss a n ac ce pt in g at tit ud e to w ar ds p eo pl e liv in g w ith H IV /A ID S, B iH 2 01 1– 20 12   Pe rc en ta ge o f w om en w ho : N um be r o f w om en w ho ha ve h ea rd o f A ID S A re w ill in g to c ar e fo r a fa m ily m em be r w ith th e A ID S vi ru s in o w n ho m e W ou ld b uy fr es h ve ge ta bl es fr om a sh op ke ep er o r ve nd or w ho h as th e A ID S vi ru s Be lie ve th at a fe m al e te ac he r w ith th e A ID S vi ru s an d is n ot il l s ho ul d be a llo w ed to c on tin ue te ac hi ng W ou ld n ot w an t t o ke ep se cr et th at a fa m ily m em be r g ot in fe ct ed w ith th e A ID S vi ru s Ag re e w ith at le as t o ne ac ce pt in g at tit ud e Ex pr es s ac ce pt in g at tit ud es o n al l f ou r in di ca to rs 1 A dm in is tr at iv e un it   FB iH 92 .4 33 .1 45 .3 46 .4 97 .1 14 .3 3, 08 8 RS 86 .4 33 .2 38 .0 40 .8 89 .1 16 .6 1, 20 7 BD 83 .5 53 .7 56 .0 40 .2 91 .8 27 .1 54 A re a   U rb an 90 .9 34 .9 47 .5 46 .8 93 .6 18 .3 1, 54 7 Ru ra l 90 .4 32 .5 41 .1 43 .7 95 .4 13 .4 2, 80 2 A ge (y ea rs )   15 -2 4 91 .1 39 .7 51 .4 41 .3 95 .3 16 .9 1, 30 5 15 -1 9 90 .7 38 .1 50 .2 41 .7 94 .2 15 .3 63 3 20 -2 4 91 .4 41 .3 52 .6 40 .9 96 .3 18 .3 67 2 25 -2 9 89 .8 38 .4 47 .4 45 .0 94 .6 17 .7 49 4 30 -3 9 89 .4 32 .8 40 .5 48 .8 94 .3 15 .4 1, 17 8 40 -4 9 91 .4 26 .0 36 .8 44 .6 94 .8 12 .2 1, 37 2 M ar it al s ta tu s   Ev er m ar rie d/ in u ni on 90 .5 29 .2 38 .0 46 .2 94 .6 13 .6 2, 94 2 N ev er m ar rie d/ in u ni on 90 .8 42 .2 54 .8 41 .8 95 .1 18 .3 1, 40 7 Ed uc at io n*   Pr im ar y 91 .1 19 .0 25 .8 40 .5 95 .3 7. 4 98 3 Se co nd ar y 90 .4 34 .4 44 .2 45 .5 94 .4 15 .1 2, 59 3 H ig he r 90 .6 48 .5 63 .6 47 .8 95 .5 25 .4 76 2 W ea lt h in de x qu in ti le s   Po or es t 88 .7 25 .4 31 .2 40 .4 92 .6 9. 6 58 8 Se co nd 89 .8 31 .7 39 .2 42 .4 93 .2 14 .0 82 1 M id dl e 90 .1 29 .5 41 .3 45 .7 94 .0 13 .4 95 6 Fo ur th 89 .6 37 .5 48 .0 43 .8 95 .8 15 .7 1, 00 4 Ri ch es t 93 .8 39 .1 51 .5 49 .5 97 .2 20 .4 98 0 To ta l 90 .6 33 .4 43 .4 44 .8 94 .8 15 .1 4, 34 9 1 M IC S in di ca to r 9 .4 * Fi gu re s fo r t he e du ca tio n ca te go ry “N on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t s ho w n in th e ta bl e. Accepting Attitudes towards People Living with HIV/AIDS The indicators on attitudes towards people living with HIV measure the level of stigmatisation and discrimination within a community. Stigma and discrimination were low if respondents reported an accepting attitude for the four questions below. 1) Would you care for a family member ill with AIDS? 2) Would you buy fresh vegetables from a vendor who is HIV positive? 3) Do you think that a female teacher who is HIV positive should be allowed to teach in school? 4) Would you not want to keep the HIV status of a family member secret? Tables HA.4 and HA.4M present the attitudes of women and men towards people living with HIV/AIDS. In BiH 95 per cent of women and 98 per cent of men who had heard of HIV/AIDS agreed with at least one accepting attitude towards people living with HIV. Ninety-seven per cent of women and 98 per cent of men in the FBiH and 89 per cent of women and 96 per cent of women in RS agreed with at least one accepting attitude. The most frequent accepting attitude expressed were a willingness to care for a family member with the AIDS virus in one’s own home and not keeping the HIV status of a family member secret. A high percentage of both women and men reported a willingness to care for a family member living with HIV in their own household (91 per cent of women and 95 per cent of men), while nearly one half of women (45 per cent) and men (49 per cent) would not want to keep the HIV status of a family member secret. On the other hand, more than one half of women (57 per cent) and men (56 per cent) thought that a female teacher who was HIV positive, but is not ill, should not be allowed to continue teaching in school. In addition, about two-thirds of women and men would not buy fresh vegetables from a vendor who was HIV positive. Only 15 per cent of women and 18 per cent of men expressed accepting attitudes for all four indicators: 14 per cent of women and 18 per cent of men in the FBiH and 17 per cent of women and 16 per cent of men in RS. The proportion of both women and men with such attitudes increased with their education level and wealth status. When viewed by area, a slightly higher percentage of women in urban areas expressed accepting attitudes for all four indicators compared to women in rural areas (18 per cent versus 13 per cent); while no clear difference was observed amongst men living in urban and rural areas. There is a positive correlation between accepting attitudes for all four indicators and the level of education and household wealth. 116 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 117 knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care Another important indicator is the knowledge of where to be tested for HIV and the use of such services. In order to protect themselves as well as to prevent infecting others it is important for individuals to know their HIV status, which is also a critical factor in the decision to seek treatment. Tables HA.5 and HA.5M present data on the knowledge of a facility for HIV testing and whether women and men aged 15-49 had ever been tested for HIV. A higher percentage of men (71 per cent) than women (65 per cent) in BiH knew of a place where they could be tested for HIV, yet a very small percentage of men and women had ever been tested for HIV (3 per cent of women and 5 per cent of men). Within the 12 months preceding the survey, less than 1 per cent of women and 1 per cent of men had been tested for HIV and all of the women and almost all of the men had been told the results. In the FBiH 61 per cent of women and 71 per cent of men knew where to be tested for HIV and 3 per cent of women and 4 per cent of men had ever been tested for HIV. In RS 77 per cent of women and 71 per cent of men knew where to be tested for HIV and 2 per cent of women and 6 per cent of men had ever been tested for HIV. A larger proportion of women and men in urban areas knew where to be tested for HIV and had ever been tested when compared to rural areas; for both groups the proportion rose with the level of education and wealth. Table HA.5: knowledge of a place for HIV testing: women Percentage of women aged 15-49 years who know where to get a HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months and percentage of women who have been tested and have been told the results, BiH 2011–2012   Percentage of women who:   Number of women   Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last twelve months and have been told result2 Administrative unit FBiH 60.9 2.6 0.5 0.5 3,180 RS 77.4 2.4 0.3 0.3 1,210 BD 65.1 15.6 1.4 1.4 56 Area   Urban 76.5 4.5 0.6 0.5 1,548 Rural 59.5 1.7 0.4 0.4 2,898 Age (years)   15-24 69.6 0.9 0.0 0.0 1,319 15-19 61.0 0.3 0.0 0.0 642 20-24 77.8 1.5 0.1 0.1 677 25-29 69.3 3.8 1.1 1.1 498 30-39 64.4 4.2 0.8 0.7 1,214 40-49 61.0 2.7 0.3 0.3 1,414 Marital status   Ever married/in union 62.2 3.7 0.6 0.6 3,023 Never married/in union 72.2 0.7 0.0 0.0 1,422 Education*   Primary 41.5 1.8 0.7 0.7 1,064 Secondary 69.4 2.6 0.3 0.3 2,604 Higher 86.5 4.6 0.6 0.5 762 Wealth index quintiles   Poorest 46.7 1.2 0.3 0.3 620 Second 62.1 1.6 0.3 0.3 847 Middle 64.2 2.3 0.6 0.6 976 Fourth 68.4 2.1 0.3 0.3 1,020 Richest 78.3 5.7 0.6 0.6 983 Total 65.4 2.7 0.4 0.4 4,446 1 MICS indicator 9.5 2 MICS indicator 9.6 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table H A .4M : A ccepting attitudes tow ards people living w ith H IV /A ID S: m en Percentage of m en aged 15-49 years w ho have heard of A ID S w ho express an accepting attitude tow ards people living w ith H IV/A ID S, BiH 2011–2012   Percentage of m en w ho: N um ber of m en w ho have heard of A ID S A re w illing to care for a fam ily m em ber w ith the A ID S virus in ow n hom e W ould buy fresh vegetables from a shopkeeper or vendor w ho has the A ID S virus Believe that a fem ale teacher w ith the A ID S virus and is not ill should be allow ed to continue teaching W ould not w ant to keep secret that a fam ily m em ber got infected w ith the A ID S virus Agree w ith at least one accepting attitude Express accepting attitudes on all four indicators 1 A dm inistrative unit   FBiH 94.9 33.8 44.7 50.7 98.1 17.9 2,982 RS 94.4 32.8 41.2 46.2 96.4 15.9 1,267 BD 95.0 53.0 58.5 41.3 97.2 31.4 69 A rea   U rban 95.2 33.4 43.3 51.5 97.5 17.4 1,417 Rural 94.5 34.0 44.2 48.1 97.6 17.6 2,901 A ge (years)   15-24 94.8 35.1 50.1 46.3 97.6 17.1 1,418 15-19 94.3 31.1 44.8 44.6 97.2 14.2 680 20-24 95.3 38.7 54.9 47.8 97.9 19.8 738 25-29 95.3 43.9 47.5 51.7 98.4 23.3 533 30-39 94.5 31.6 39.0 49.5 97.4 16.7 1,050 40-49 94.7 30.1 39.6 51.2 97.4 16.3 1,317 M arital status   Ever m arried/in union 94.7 30.9 39.5 51.3 97.8 17.0 2,316 N ever m arried/in union 94.8 37.1 49.0 46.8 97.3 18.2 2,002 Education*   Prim ary 93.5 21.0 26.8 43.4 96.1 8.5 521 Secondary 94.6 32.2 41.9 49.6 97.7 17.2 3,107 H igher 96.5 51.0 66.5 52.2 98.2 26.3 683 W ealth index quintiles   Poorest 92.5 24.3 34.5 46.7 95.9 13.3 675 Second 94.3 32.2 42.9 51.2 97.1 15.1 839 M iddle 95.6 32.5 42.1 48.2 97.0 19.0 982 Fourth 94.8 37.1 48.1 49.8 98.9 19.1 886 Richest 95.9 40.3 49.5 49.9 98.7 19.9 935 Total 94.8 33.8 43.9 49.2 97.6 17.5 4,318 1 M ICS indicator 9.4 * Figures for the education category “N one” are based on few er than 25 unw eighted cases and are not show n in the table. 118 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 119 Table HA.6: knowledge of a place for HIV testing amongst sexually active women aged 15-24 Percentage of women aged 15-24 years who have had sex in the last 12 months and amongst women who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months and the percentage of women who have been tested in the last 12 months and have been told the result, BiH 2011–2012   Percentage who have had sex in the last 12 months Number of women aged 15- 24 years Percentage of women who: Number of women aged 15-24 years who have had sex in the last 12 months   Know a place to get tested Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Administrative unit   FBiH 24.8 989 71.9 0.5 0.1 0.1 245 RS 42.3 318 91.8 4.7 0.2 0.2 135 BD (33.0) 12 (*) (*) (*) (*) 4 Area   Urban 29.7 463 92.6 3.1 0.4 0.4 137 Rural 28.8 856 71.6 1.6 0.0 0.0 246 Age (years)   15-19 3.4 642 (*) (*) (*) (*) 22 20-24 53.4 677 79.1 2.2 0.1 0.1 362 Marital status   Ever married/ in union 96.3 169 61.6 3.8 0.3 0.3 163 Never married/ in union 19.2 1150 92.1 0.9 0.0 0.0 221 Education*   Primary 61.5 69 42.2 8.6 0.6 0.6 43 Secondary 21.5 869 75.3 1.1 0.1 0.1 186 Higher 40.5 381 94.1 1.5 0.0 0.0 154 Wealth index quintiles   Poorest 29.4 177 64.8 5.6 0.5 0.5 52 Second 36.2 248 75.6 1.0 0.3 0.3 90 Middle 26.8 282 70.9 1.2 0.0 0.0 76 Fourth 26.0 313 86.3 0.8 0.0 0.0 82 Richest 28.3 299 92.1 3.3 0.0 0.0 85 Total 29.1 1319 79.1 2.1 0.1 0.1 384 1 MICS indicator 9.7 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table HA.5M: knowledge of a place for HIV testing: men Percentage of men aged 15-49 years who know where to get a HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months and percentage of men who have been tested and have been told the results, BiH 2011–2012   Percentage of men who:   Number of men  Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last twelve months and have been told result2 Administrative unit   FBiH 70.9 4.3 1.1 0.9 3,010 RS 70.6 5.8 0.6 0.6 1,271 BD 78.0 4.1 1.6 1.6 71 Area   Urban 75.4 7.8 1.1 1.1 1,422 Rural 68.8 3.2 0.9 0.6 2,931 Age (years)   15-24 70.8 2.8 0.9 0.6 1,428 15-19 64.4 0.6 0.3 0.0 684 20-24 76.7 4.8 1.4 1.1 743 25-29 78.7 6.5 1.5 1.5 534 30-39 69.6 5.3 0.7 0.5 1,056 40-49 69.1 5.6 1.1 1.0 1,336 Marital status   Ever married/in union 70.3 5.5 0.8 0.7 2,336 Never married/in union 71.8 3.8 1.2 0.9 2,017 Education*   Primary 47.2 1.6 0.5 0.5 543 Secondary 71.6 4.2 0.9 0.7 3,117 Higher 87.6 9.8 1.9 1.6 683 Wealth index quintiles   Poorest 59.0 1.5 0.7 0.4 685 Second 65.5 2.7 1.0 0.9 848 Middle 74.2 3.4 0.4 0.4 989 Fourth 73.5 3.9 0.6 0.6 893 Richest 78.7 11.0 2.1 1.7 938 Total 71.0 4.7 1.0 0.8 4,353 1 MICS indicator 9.5 2 MICS indicator 9.6 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. The proportion of women and men aged 15-24 who had been tested and been told the result within the last 12 months provides a measure of the effectiveness of interventions that promote HIV counselling and testing amongst young people. This is important to know because young people may feel that there are barriers to accessing services related to sensitive issues such as sexual health. Tables HA.6 and HA.6M present the same results for sexually active women and men aged 15-24. The data shows that an approximately equal percentage of women (79 per cent) and men (78 per cent) aged 15-24 who were sexually active knew where to get tested for HIV. Seventy-two per cent of young women and 73 per cent of men in the FBiH along with 92 per cent of young women and 88 per cent of young men in RS knew where to get tested for HIV. In addition, the data indicates that only 2 per cent of sexually active women aged 15-24 and 5 per cent of men in the same age group had ever been tested for HIV. Within the 12 months preceding the survey 1 per cent of sexually active men aged 15-25 had been tested for HIV and all of them told the result. Less than 1 per cent of sexually active women aged 15-24 had been tested for HIV within the last 12 months. A somewhat higher percentage of men aged 15-24 in urban areas (8 per cent) had ever been tested for HIV compared to those in rural areas (3 per cent), while a similar percentage of women in the same age group in urban and rural areas had ever been tested for HIV. 120 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 121 Table HA.7: HIV counselling and testing during antenatal care Amongst women aged 15-49 who gave birth in the last 2 years, percentage of women who received antenatal care from a health professional during the last pregnancy, percentage who received HIV counselling, percentage who were offered and accepted an HIV test and received the results, BiH 2011–2012   Percentage of women who: Number of women who gave birth in the 2 years preceding the survey   Received antenatal care from a health care professional for last pregnancy Received HIV counselling during antenatal care1 Were offered an HIV test and were tested for HIV during antenatal care Were offered an HIV test and were tested for HIV during antenatal care and received the results2 Received HIV counselling, were offered an HIV test, accepted and received the results Administrative unit    FBiH 81.9 11.1 2.8 2.6 1.1 211 RS 99.7 7.9 12.4 12.4 1.6 82 BD (90.6) (8.0) (41.8) (41.8) (2.3) 6 Area   Urban 85.3 12.5 5.2 4.9 1.3 94 Rural 87.7 9.2 6.6 6.6 1.3 204 Age (years)   15-24 82.7 12.1 4.8 4.8 0.7 71 15-19 (*) (*) (*) (*) (*) 1 20-24 83.2 12.3 4.9 4.9 0.8 70 25-29 83.3 8.1 7.0 7.0 0.8 103 30-39 92.3 11.1 5.9 5.7 1.9 116 40-49 (*) (*) (*) (*) (*) 7 Marital status   Ever married/in union 87.0 10.2 6.2 6.1 1.3 298 Education*   Primary 86.0 6.8 5.3 5.3 0.0 66 Secondary 86.9 10.4 6.4 6.4 1.3 187 Higher 88.4 14.4 6.5 5.9 2.9 45 Wealth index quintiles   Poorest 93.1 6.9 10.2 10.2 0.0 45 Second 82.0 7.4 5.1 5.1 0.8 69 Middle 86.4 12.1 3.9 3.9 0.9 58 Fourth 86.7 11.5 3.7 3.7 1.1 61 Richest 88.9 12.4 8.9 8.5 3.2 65 Total 87.0 10.2 6.2 6.1 1.3 298 1 MICS indicator 9.8 2 MICS indicator 9.9 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table HA.6M: knowledge of a place for HIV testing amongst sexually active men aged 15-24 Percentage of men aged 15-24 years who have had sex in the last 12 months and amongst men who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months and percentage of men who have been tested in the last 12 months and have been told the result, BiH 2011–2012   Percentage who have had sex in the last 12 months Number of men aged 15-24 years Percentage of men who: Number of men aged 15-24 years who have had sex in the last 12 months   Know a place to get tested Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Administrative unit   FBiH 45.8 1014 73.4 3.7 1.4 1.4 464 RS 47.1 393 87.8 7.7 0.0 0.0 185 BD (67.8) 21 (*) (*) (*) (*) 14 Area   Urban 50.6 485 76.8 8.4 1.8 1.8 245 Rural 44.4 943 78.1 2.9 0.8 0.8 419 Age (years)   15-19 17.9 684 75.7 1.7 0.0 0.0 123 20-24 72.8 743 78.0 5.7 1.4 1.4 541 Marital status   Ever married/in union 100.0 46 80.3 18.7 0.0 0.0 46 Never married/in union 44.7 1382 77.4 3.9 1.3 1.3 618 Education*   Primary 54.5 67 (57.2) (6.3) (5.6) (5.6) 36 Secondary 39.1 1009 74.6 2.7 0.1 0.1 395 Higher 66.1 352 85.9 8.5 2.2 2.2 232 Wealth index quintiles   Poorest 40.3 194 67.9 0.3 0.0 0.0 78 Second 39.9 239 77.8 2.1 2.1 2.1 95 Middle 47.4 337 77.5 4.2 0.3 0.3 160 Fourth 44.2 312 80.7 2.9 0.0 0.0 138 Richest 55.9 345 79.3 10.2 2.7 2.7 193 Total 46.5 1428 77.6 4.9 1.2 1.2 664 1 MICS indicator 9.7 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. The percentage of women who gave birth in the two years preceding the survey and who received counselling and HIV testing during antenatal care is presented in Table HA.7. Antenatal care provided by a health worker was received by 87 per cent of women aged 15-49 who gave birth in the two years prior to the survey: 82 per cent in the FBiH and almost all women in RS. HIV counselling during antenatal care was received by only 10 per cent of these women (11 per cent in the FBiH and 8 per cent in RS). During the antenatal period 6 per cent of women were offered an HIV test, were tested and told the result (3 per cent in the FBiH and 12 per cent in RS). 122 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 123 Table HA.8M: Sexual behaviour that increases the risk of HIV infection: men Percentage of never-married young men aged 15-24 years who have never had sex, percentage of young men aged 15-24 years who have had sex before age 15, and percentage of young men aged 15-24 years who had sex with a woman 10 or more years older during the last 12 months, BiH 2011–2012   Percentage of never-married men aged 15-24 years who have never had sex1 Number of never-married men aged 15-24 years Percentage of men aged 15-24 years who had sex before age 152 Number of men aged 15-24 years Percentage of men aged 15-24 years who had sex in the last 12 months with a woman 10 or more years older3 Number of men aged 15-24 years who had sex in the 12 months preceding the survey Administrative unit   FBiH 53.5 982 1.8 1,014 0.9 464 RS 52.0 379 0.7 393 0.0 185 BD (33.0) 21 (0.0) 21 (*) 14 Area   Urban 47.6 477 2.1 485 0.0 245 Rural 55.5 905 1.2 943 1.0 419 Age (years)   15-19 80.5 684 1.8 684 1.7 123 20-24 25.6 698 1.2 743 0.4 541 Marital status   Ever married/in union N/A N/A 0.0 46 0.0 46 Never married/in union 52.8 1,382 1.5 1,382 0.7 618 Education*   Primary (45.1) 63 1.3 67 (0.0) 36 Secondary 60.7 973 2.0 1,009 1.0 395 Higher 31.9 347 0.0 352 0.0 232 Wealth index quintiles   Poorest 56.8 188 0.5 194 0.0 78 Second 60.4 231 0.0 239 0.0 95 Middle 53.0 318 2.4 337 0.0 160 Fourth 54.1 307 0.7 312 1.5 138 Richest 43.8 338 2.9 345 1.1 193 Total 52.8 1,382 1.5 1,428 0.6 664 1 MICS indicator 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” The frequency of sexual behaviour that increases the risk of HIV infection amongst women and men is presented in Tables HA.9 and HA.9M. This concerns, in particular, sexual behaviour and condom use during sex amongst women and men aged 15-49 and amongst women and men aged 15-24, especially those who have had sex with more than one partner during the last year (data on condom use amongst women aged 15-24, by background characteristics, is based on fewer than 25 unweighted cases and is not shown in Table HA.9). The survey findings show that having sex with more than one partner in the last 12 months was reported by 1 per cent of women and 7 per cent of men aged 15-49 in BiH. Men indicated condom use when they had sex the last time in 61 per cent of these cases.47 One per cent of women and 6 per cent of men in the FBiH had had sex with more than one partner. In RS these values were 1 per cent for women and 8 per cent for men. Sixty-three per cent of men with more than one sexual partner in the last 12 months in the FBiH and 55 per cent in RS indicated condom use when they had sex the last time. 47 MICS indicator 9.14 for women is not shown in table HA.9: The percentage of women aged 15-49 years who had more than one sexual partner in the last 12 months who also reported that a condom was used the last time they had sex is 64.4 per cent. This figure is based on 25-49 unweighted cases and should be treated with caution. Sexual Behaviour Related to HIV Transmission Promoting safer sexual behaviour is critical for reducing the prevalence of HIV. The use of condoms during sex, especially with non-regular partners, is particularly important for reducing the spread of HIV. In most countries over half of new HIV infections occur amongst people aged 15-24 years, thus a change in behaviour amongst this age group is especially important for reducing the rate of new infections. Risk factors for HIV include sex at an early age, sex with older partners, sex with a non-marital partner and failure to use a condom. In the BiH MICS a set of questions was administered to all women and men aged 15-24 about their sexual behaviour in order to assess the risk of their contracting the HIV infection; the findings are presented in Tables HA.8 and HA.8M. The data shows that 79 per cent of women and 53 per cent of men aged 15-24 who had never been married never had sex (85 per cent of women and 54 per cent of men in the FBiH and 62 per cent of women and 52 per cent of men in RS), while a very small proportion of women (less than 1 per cent) and men in this age group (2 per cent) had had sex before age 15. Seventy four per cent of women aged 15-24 in urban areas and 82 per cent of women in rural areas had never had sex, while amongst men in this age group, 48 per cent in urban and 56 per cent in rural areas had never had sex. Within the last 12 months, 4 per cent of women in BiH had had sex with a man who was older by ten years or more. During the same period 1 per cent of men had had sex with a woman who was older by ten years or more. Table HA.8: Sexual behaviour that increases the risk of HIV infection: women Percentage of never-married young women aged 15-24 years who have never had sex, percentage of young women aged 15-24 years who have had sex before age 15, and percentage of young women aged 15-24 years who had sex with a man 10 or more years older during the last 12 months, BiH 2011–2012   Percentage of never-married women aged 15-24 years who have never had sex1 Number of never-married women aged 15-24 years Percentage of women aged 15-24 years who had sex before age 152 Number of women aged 15-24 years Percentage of women aged 15-24 years who had sex in the last 12 months with a man 10 or more years older3 Number of women aged 15-24 years who had sex in the 12 months preceding the survey Administrative unit   FBiH 85.0 863 0.1 989 4.1 245 RS 62.1 276 0.2 318 4.4 135 BD (*) 10 (0.0) 12 (*) 4 Area   Urban 74.3 422 0.2 463 2.1 137 Rural 82.4 728 0.1 856 5.3 246 Age (years)   15-19 97.2 637 0.0 642 (*) 22 20-24 57.3 512 0.2 677 4.2 362 Marital status   Ever married/in union N/A N/A 0.9 169 9.7 163 Never married/in union 79.4 1,150 0.0 1,150 0.0 221 Education*   Primary (*) 29 1.9 69 6.2 43 Secondary 88.7 753 0.0 869 6.7 186 Higher 59.4 368 0.0 381 0.5 154 Wealth index quintiles   Poorest 86.5 144 0.3 177 6.6 52 Second 75.0 203 0.1 248 6.1 90 Middle 84.2 238 0.0 282 2.5 76 Fourth 78.3 288 0.2 313 2.0 82 Richest 76.0 277 0.1 299 4.1 85 Total 79.4 1,150 0.1 1,319 4.1 384 1 MICS indicator 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. N/A: “Not applicable” 124 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 125 Table HA.9M: Sex with multiple partners: men Percentage of men aged 15-49 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and amongst those who had sex with multiple partners the percentage who used a condom during last sex, BiH 2011–2012   Percentage of men who: Number of men aged 15-49 years Per cent of men aged 15-49 years who had more than one sexual partner in the last 12 months who also reported that a condom was used the last time they had sex2 Number of men aged 15-49 years who had more than one sexual partner in the last 12 months   Ever had sex Had sex in the last 12 months Had sex with more than one partner in the last 12 months1 Administrative unit   FBiH 81.3 79.0 5.7 3,010 62.6 173 RS 83.1 78.6 7.9 1,271 55.0 100 BD 89.9 88.3 10.9 71 (*) 8 Area   Urban 83.3 80.1 6.7 1,422 61.9 96 Rural 81.3 78.5 6.3 2,931 60.4 185 Age (years)   15-24 48.9 46.5 11.0 1,428 67.4 156 15-19 19.5 17.9 4.7 684 (*) 32 20-24 76.0 72.8 16.7 743 65.7 124 25-29 94.3 91.1 9.5 534 (64.3) 51 30-39 98.6 95.5 4.2 1,056 59.4 44 40-49 99.1 96.0 2.2 1,336 (23.5) 30 Marital status   Ever married/in union 99.9 98.6 1.3 2,336 (12.4) 31 Never married/in union 61.1 56.4 12.4 2,017 66.9 250 Education*   Primary 93.9 89.7 5.7 543 (*) 31 Secondary 79.9 77.4 6.4 3,117 61.5 198 Higher 81.9 78.4 7.6 683 (66.6) 52 Wealth index quintiles Poorest 81.5 75.6 7.8 685 (63.4) 53 Second 81.9 78.7 5.5 848 (78.0) 46 Middle 81.9 79.4 5.7 989 (48.4) 56 Fourth 80.7 78.9 5.6 893 (70.9) 50 Richest 83.5 81.7 8.0 938 51.3 75 Total 81.9 79.1 6.5 4,353 60.9 281 1 MICS indicator 9.13 2 MICS indicator 9.14 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table HA.9: Sex with multiple partners: women Percentage of women aged 15-49 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months, BiH 2011–2012   Percentage of women who: Number of women aged 15-49 years  Ever had sex Had sex in the last 12 months Had sex with more than one partner in the last 12 months1 Administrative unit   FBiH 74.2 69.2 0.9 3,180 RS 85.3 76.9 1.0 1,210 BD 86.1 80.8 2.0 56 Area Urban 77.4 69.8 1.6 1,548 Rural 77.3 72.3 0.6 2,898 Age (years) 15-24 30.8 29.1 1.4 1,319 15-19 3.4 3.4 0.6 642 20-24 56.7 53.4 2.2 677 25-29 88.1 85.2 2.2 498 30-39 98.3 92.9 0.3 1,214 40-49 99.1 87.6 0.6 1,414 Marital status Ever married/in union 100.0 92.7 0.4 3,023 Never married/in union 29.2 26.1 2.1 1,422 Missing (*) (*) (*) 0 Education* Primary 96.2 88.1 0.4 1,064 Secondary 73.3 67.8 0.7 2,604 Higher 65.1 60.7 2.4 762 Wealth index quintiles Poorest 77.1 69.4 0.8 620 Second 80.1 71.6 0.3 847 Middle 77.4 72.1 0.4 976 Fourth 76.3 70.8 1.2 1,020 Richest 76.1 72.6 1.8 983 Total 77.4 71.4 0.9 4,446 1 MICS indicator 9.13 MICS indicator 9.14: The percentage of women aged 15-49 years who had more than one sexual partner in the last 12 months who also reported that a condom was used the last time they had sex is not presented in this table. The total percentage amounts to 64.4 and is based on 25-49 unweighted cases and should be treated with caution. (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Tables HA.10 and HA.10M show that in BiH 29 per cent of women and 47 per cent of men aged 15-24 had had sex in the last 12 months, while 1 per cent of women and 11 per cent of men of that age had had sex with more than one partner in the last 12 months. Men with more than one sexual partner in the last 12 months indicated condom use when they had sex the last time in 67 per cent of cases. The percentage of men in the 20-24 age group who had sex with more than one partner was higher (17 per cent) than that of women (2 per cent). Twenty-five per cent of women and 46 per cent of men aged 15-24 in the FBiH had had sex in the last 12 months; in RS this was the case with 42 per cent of women and 47 per cent of men of this age. Sex with more than one partner in the last 12 months was reported by 1 per cent of women and 10 per cent of men in the FBiH and 2 per cent of women and 13 per cent of men in RS. 126 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 127 Table HA.10M: Sex with multiple partners: men aged 15-24 Percentage of men aged 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and amongst those who had sex with multiple partners the percentage who used a condom during last sex, BiH 2011–2012   Percentage of men aged 15-24 years who: Number of men aged 15-24 years Per cent of men aged 15-24 years who had more than one sexual partner in the last 12 months who also reported that a condom was used the last time they had sex Number of men aged 15-24 years who had more than one sexual partner in the last 12 months   Ever had sex Had sex in the last 12 months Had sex with more than one partner in last 12 months Administrative unit   FBiH 48.2 45.8 10.0 1014 67.3 101 RS 49.8 47.1 12.6 393 (63.7) 50 BD (67.8) (67.8) (27.3) 21 (*) 6 Area   Urban 53.1 50.6 13.2 485 (64.7) 64 Rural 46.8 44.4 9.8 943 69.2 92 Age (years)   15-19 19.5 17.9 4.7 684 (*) 32 20-24 76.0 72.8 16.7 743 65.7 124 Marital status   Ever married/in union 100.0 100.0 4.4 46 (*) 2 Never married/in union 47.2 44.7 11.2 1382 68.3 154 Education*   Primary 57.6 54.5 4.4 67 (*) 3 Secondary 41.5 39.1 10.9 1009 67.4 110 Higher 68.5 66.1 12.3 352 (67.1) 43 Wealth index quintiles Poorest 45.1 40.3 8.3 194 (*) 16 Second 41.6 39.9 8.0 239 (*) 19 Middle 49.9 47.4 10.5 337 (*) 35 Fourth 46.8 44.2 10.9 312 (*) 34 Richest 57.1 55.9 15.0 345 (56.4) 52 Total 48.9 46.5 11.0 1428 67.4 156 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Tables HA.11 and HA.11M present the percentage of women and men aged 15-24 years who ever had sex, the percentage who had sex in the last 12 months, the percentage who have had sex with a non-marital/non-cohabiting partner in the last 12 months and, amongst those who had sex with a non-marital/non-cohabiting partner, the percentage who used a condom the last time they had sex with such a partner. More than one half of young women had sex with a non-marital/non-cohabiting partner in the last 12 months (59 per cent), while this percentage was much higher amongst men (94 per cent). Fifty-one per cent of women and 93 per cent of men in the FBiH and 72 per cent of women and 94 per cent of men in RS had had sex with a non-marital/non-cohabiting partner. An equal percentage of young women and men in BiH used a condom the last time they had sex with a non-marital/ non-cohabiting partner (71 per cent). Seventy-three per cent of women and 74 per cent of men in the FBiH and 69 per cent of women and 62 per cent of men in RS used a condom the last time they had sex with a non-marital/non- cohabiting partner. The percentage of respondents who had sex with a non-marital/non-cohabiting partner was higher in urban than in rural areas, especially amongst women. In contrast, a smaller proportion of women aged 15-24 in urban areas (66 per cent) reported that a condom was used the last time they had sex compared to women in rural areas (76 per cent), while no such differences by area were observed amongst men. Table HA.10: Sex with multiple partners: women aged 15-24 Percentage of women aged 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months, BiH 2011–2012   Percentage of women aged 15-24 years who: Number of women aged 15-24 years  Ever had sex Had sex in the last 12 months Had sex with more than one partner in last 12 months Administrative unit   FBiH 25.8 24.8 1.3 989 RS 46.1 42.3 1.9 318 BD (33.0) (33.0) (0.0) 12 Area Urban 32.3 29.7 1.9 463 Rural 30.0 28.8 1.2 856 Age (years) 15-19 3.4 3.4 0.6 642 20-24 56.7 53.4 2.2 677 Marital status Ever married/in union 100.0 96.3 0.3 169 Never married/in union 20.6 19.2 1.6 1,150 Education* Primary 61.5 61.5 0.0 69 Secondary 23.1 21.5 1.2 869 Higher 42.6 40.5 2.2 381 Wealth index quintiles Poorest 29.4 29.4 1.1 177 Second 38.7 36.2 0.9 248 Middle 29.0 26.8 0.1 282 Fourth 28.0 26.0 3.2 313 Richest 29.7 28.3 1.4 299 Total 30.8 29.1 1.4 1,319 The percentage of women aged 15-24 years who had more than one sexual partner in the last 12 months who also reported that a condom was used the last time they had sex is based on fewer than 25 unweighted cases and is therefore not presented in the table. ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 128 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 129 Table HA.11M: Sex with non-regular partners: men Percentage of men aged 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with a non-marital/non-cohabiting partner in the last 12 months and amongst those who had sex with a non-marital/non-cohabiting partner the percentage who used a condom the last time they had sex with such a partner, BiH 2011–2012   Percentage of men aged 15-24 who: Number of men aged 15-24 years Percentage who had sex with a non- marital/non- cohabiting partner in the last 12 months1 Number of men aged 15- 24 years who had sex in the last 12 months Percentage of men aged 15-24 years who had sex with a non-marital/non-cohabiting partner in the last 12 months who also reported that a condom was used the last time they had sex with such a partner2 Number of men aged 15-24 years who had sex in last 12 months with a non- marital/non- cohabiting partner   Ever had sex Had sex in the last 12 months Administrative unit  FBiH 48.2 45.8 1,014 93.3 464 74.0 434 RS 49.8 47.1 393 93.8 185 61.7 174 BD (*) (*) 21 (*) 14 (*) 14 Area   Urban 53.1 50.6 485 97.8 245 70.2 240 Rural 46.8 44.4 943 91.0 419 71.5 381 Age (years)   15-19 19.5 17.9 684 100.0 123 78.1 123 20-24 76.0 72.8 743 92.1 541 69.2 498 Marital status   Ever married/in union 100.0 100.0 46 5.6 46 (*) 3 Never married/in union 47.2 44.7 1,382 100.0 618 71.2 618 Education*   Primary 57.6 54.5 67 (89.1) 36 (*) 32 Secondary 41.5 39.1 1,009 91.4 395 68.6 361 Higher 68.5 66.1 352 97.8 232 76.6 227 Wealth index quintiles   Poorest 45.1 40.3 194 91.7 78 (62.1) 72 Second 41.6 39.9 239 91.9 95 (77.6) 88 Middle 49.9 47.4 337 89.6 160 66.7 143 Fourth 46.8 44.2 312 96.2 138 78.2 133 Richest 57.1 55.9 345 96.4 193 69.4 186 Total 48.9 46.5 1,428 93.5 664 71.0 621 1 MICS indicator 9.15 2 MICS indicator 9.16; MDG indicator 6.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table HA.11: Sex with non-regular partners: women Percentage of women aged 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with a non-marital/non-cohabiting partner in the last 12 months and amongst those who had sex with a non-marital/ non-cohabiting partner the percentage who used a condom the last time they had sex with such a partner, BiH 2011–2012   Percentage of women aged 15-24 who: Number of women aged 15- 24 years Percentage who had sex with a non- marital/non- cohabiting partner in the last 12 months1 Number of women aged 15- 24 years who had sex in the last 12 months Percentage of women aged 15-24 years who had sex with a non-marital/non- cohabiting partner in the last 12 months who also reported that a condom was used the last time they had sex with such a partner2 Number of women aged 15-24 years who had sex in last 12 months with a non-marital/ non-cohabiting partner   Ever had sex Had sex in the last 12 months Administrative unit   FBiH 25.8 24.8 989 51.4 245 72.8 126 RS 46.1 42.3 318 71.8 135 69.1 97 BD (33.0) (33.0) 12 (*) 4 (*) 3 Area   Urban 32.3 29.7 463 74.4 137 66.0 102 Rural 30.0 28.8 856 50.0 246 75.9 123 Age (years)   15-19 3.4 3.4 642 (*) 22 (*) 18 20-24 56.7 53.4 677 57.4 362 70.0 208 Marital status   Ever married/in union 100.0 96.3 169 4.2 163 (*) 7 Never married/in union 20.6 19.2 1150 99.1 221 72.1 219 Education*   Primary 61.5 61.5 69 7.4 43 (*) 3 Secondary 23.1 21.5 869 43.0 186 84.8 80 Higher 42.6 40.5 381 92.1 154 65.1 142 Wealth index quintiles   Poorest 29.4 29.4 177 40.2 52 (*) 21 Second 38.7 36.2 248 50.2 90 (88.5) 45 Middle 29.0 26.8 282 44.7 76 (*) 34 Fourth 28.0 26.0 313 74.6 82 (72.1) 61 Richest 29.7 28.3 299 76.5 85 (65.1) 65 Total 30.8 29.1 1319 58.8 384 71.4 225 1 MICS indicator 9.15 2 MICS indicator 9.16; MDG indicator 6.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 130 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 131 Table MT.1: Exposure to mass media: women Percentage of women aged 15-49 years who are exposed to specific mass media on a weekly basis, BiH 2011–2012   Percentage of women aged 15-49 who: All three media at least once a week1 No media at least once a week Number of women aged 15-49 years   Read a newspaper at least once a week Listen to the radio at least once a week Watch television at least once a week Age (years) 15-19 63.3 76.4 98.7 53.4 0.0 642 20-24 66.7 76.5 99.4 54.9 0.3 677 25-29 60.5 80.2 99.2 50.6 0.5 498 30-34 51.7 76.2 99.2 42.6 0.3 568 35-39 44.8 76.0 99.2 35.1 0.5 646 40-44 46.5 74.7 99.2 35.3 0.1 690 45-49 49.2 71.7 98.9 39.8 0.4 724 Administrative unit   FBiH 54.9 75.0 99.2 44.8 0.4 3,180 RS 53.2 77.2 98.8 42.4 0.2 1,210 BD 55.5 84.6 99.3 51.5 0.0 56 Area   Urban 68.3 70.5 98.8 52.1 0.3 1,548 Rural 47.0 78.5 99.3 40.0 0.3 2,898 Education*   Primary 23.9 72.1 99.3 18.8 0.5 1,064 Secondary 59.5 77.9 99.3 49.0 0.1 2,604 Higher 80.6 73.8 98.7 64.4 0.6 762 Wealth index quintile   Poorest 29.5 74.2 98.4 26.0 0.9 620 Second 42.7 78.0 99.1 36.2 0.3 847 Middle 49.7 77.8 99.3 41.8 0.0 976 Fourth 63.4 76.1 98.9 50.6 0.5 1,020 Richest 75.6 72.3 99.5 58.5 0.1 983 Total 54.4 75.7 99.1 44.2 0.3 4,446 1 MICS indicator MT.1 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. After age 30 women were less exposed to all of the mentioned media types, while exposure to all the media types amongst men was lowest in the youngest age group (15-19), primarily due to low exposure to newspapers. Women and men showed different patterns of exposure to all of the media types by education and socio-economic status and there were also differences amongst women by area. This primarily concerned exposure to the print media. Women and men with higher education were more likely to be exposed to all of the media types than those with primary education. In addition, women and men in the richest households were exposed about two times more to all of the media types when compared to those in the poorest households. A higher percentage of women were exposed to all of the types of media in urban areas (52 per cent) than in rural areas (40 per cent). xII Access to Mass Media and Use of Information/Communication Technology The 2011–2012 BiH MICS collected information on the exposure to mass media and the use of computers and the Internet. Information collected concerned: z exposure of women and men aged 15-49 to newspapers/magazines, radio and television; z use of computers amongst persons aged 15-24; z use of the Internet amongst persons aged 15-24. Access to Mass Media The proportion of women and men aged 15-49 who read a newspaper, listened to the radio and watched television at least once a week is shown in Tables MT.1 and MT.1M. The survey findings show that in BiH more than one half of women read a newspaper (54 per cent), more than two- thirds listened to the radio (76 per cent) and nearly all women watched television (99 per cent) at least once a week. Men of the same age read newspapers more than women, while men and women equally frequently listened to the radio and watched television. Sixty-eight per cent of men read a newspaper, 75 per cent listened to the radio and 99 per cent watched television at least once a week. Less than 1 per cent of women and men do not have regular exposure to any of the three types of media (newspaper, radio or television), while 44 per cent of women and 56 per cent of men are exposed to all the three types of media at least on a weekly basis. Nearly all women and men in the FBiH and RS watched television at least once a week (99 per cent). In the FBiH 55 per cent of women and 70 per cent of men read a newspaper and 75 per cent of women and 74 per cent of men listened to the radio; in RS 53 per cent of women and 64 per cent of men read a newspaper and 77 per cent of women and 78 per cent of men listened to the radio at least once a week. The data also indicates that the exposure of women and men to all media types was similar in the FBiH (45 per cent of women and 56 per cent of men) and RS (42 per cent of women and 54 per cent of men). 132 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 133 Differentials in terms of background characteristics were similar for men and women aged 15-24. About two-thirds of women and men with primary education reported computer use during the year preceding the survey, while almost all of the women and men with higher education used a computer. Similarly, higher utilisation of the Internet during the year preceding the survey was observed amongst women and men aged 15-24 in urban areas (96 per cent of women and 97 per cent of men) compared to those in rural areas (88 per cent of women and 90 per cent of men). There were evident differentials by household and the wealth index quintile. During the year that preceded the survey the Internet was used by 75 per cent of women and 65 per cent of men aged 15-24 in the poorest households, compared to near-universal access to the Internet in the last 12 months amongst women and men of that age group from the richest households (99 per cent for both women and men). These differences amongst women and men were even more pronounced when computer and Internet use during the last one month was concerned. Table MT.2: Use of computers and the Internet: women aged 15-24 Percentage of young women aged 15-24 who have ever used a computer, percentage who have used a computer during the last 12 months, and frequency of use during the last one month, BiH 2011–2012   Percentage of women aged 15-24 who have: Percentage of women aged 15-24 who have: Number of women aged 15-24 years   Ever used a computer Used a computer during the last 12 months1 Used a computer at least once a week during the last one month Ever used the Internet Used the Internet during the last 12 months2 Used the Internet at least once a week during the last one month Age (years) 15-19 98.2 95.6 86.9 95.8 92.7 83.3 642 20-24 95.7 90.9 80.4 92.6 89.5 78.6 677 Administrative unit   FBiH 96.8 93.3 84.4 94.1 90.9 81.3 989 RS 97.4 93.2 81.5 94.7 92.4 80.0 318 BD (89.7) (80.0) (69.3) (89.7) (70.4) (69.3) 12 Area   Urban 98.5 96.2 92.0 97.6 96.2 91.4 463 Rural 96.1 91.6 78.9 92.3 88.3 75.2 856 Education*   Primary 68.6 63.4 41.3 61.5 55.7 29.4 69 Secondary 98.2 93.4 82.1 94.8 90.6 78.6 869 Higher 99.3 98.2 94.7 98.7 98.7 95.6 381 Wealth index quintile   Poorest 89.0 77.4 51.3 80.3 74.7 47.4 177 Second 94.5 87.6 67.0 89.9 82.1 61.6 248 Middle 97.8 96.1 88.3 95.2 93.6 85.6 282 Fourth 99.6 98.8 97.2 98.8 98.0 94.8 313 Richest 100.0 98.5 97.5 100.0 98.6 97.6 299 Total 96.9 93.2 83.5 94.2 91.1 80.9 1,319 1 MICS indicator MT.2 2 MICS indicator MT.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Table MT.1M: Exposure to mass media: men Percentage of men aged 15-49 years who are exposed to specific mass media on a weekly basis, BiH 2011–2012   Percentage of men aged 15-49 who: All three media at least once a week1 No media at least once a week Number of men aged 15-49 years   Read a newspaper at least once a week Listen to the radio at least once a week Watch television at least once a week Age (years)   15-19 60.1 69.6 98.8 49.5 0.3 684 20-24 72.4 73.3 99.1 60.3 0.6 743 25-29 74.0 78.4 98.7 59.9 0.6 534 30-34 66.2 74.9 99.6 53.2 0.0 459 35-39 63.0 76.1 99.4 52.7 0.3 597 40-44 71.9 79.5 99.4 59.2 0.1 617 45-49 68.0 76.5 98.9 55.2 0.7 719 Administrative unit   FBiH 69.5 74.1 99.2 56.1 0.4 3,010 RS 64.0 77.5 98.9 54.4 0.5 1,271 BD 71.3 86.7 99.0 65.5 0.4 71 Area   Urban 74.7 72.3 98.8 59.0 0.5 1,422 Rural 64.6 76.7 99.3 54.2 0.4 2,931 Education*   Primary 39.3 67.8 98.9 29.0 0.5 543 Secondary 69.1 76.2 99.2 57.3 0.3 3,117 Higher 86.1 77.3 99.3 70.4 0.5 683 Wealth index quintile   Poorest 42.5 72.8 97.9 36.4 1.4 685 Second 61.3 76.1 99.4 51.6 0.0 848 Middle 72.4 76.4 99.7 58.2 0.0 989 Fourth 73.6 73.1 98.9 58.0 0.7 893 Richest 82.5 77.3 99.2 69.0 0.1 938 Total 67.9 75.3 99.1 55.8 0.4 4,353 1 MICS indicator MT.1 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Use of Information/Communication Technology The questions on computer and Internet usage were only put to 15-24 year old women and men, as displayed in Tables MT.2 and MT.2M. The findings show that 97 per cent of women aged 15-24 ever used a computer, 93 per cent used a computer in the year preceding the survey and 84 per cent had used a computer at least once a week during the last one month. Overall 94 per cent of women aged 15-24 had used the Internet during their lifetime, while 91 per cent had used the Internet during the year preceding the survey. The proportion of women aged 15-25 who had used the Internet more frequently, at least once a week during the last one month, was smaller at 81 per cent. Table MT.2M shows that the pattern of computer and Internet usage was almost the same amongst men aged 15-24. Ninety-three per cent of women in the FBiH and RS had used a computer in the last 12 months, while the percentages amongst men were 95 per cent in the FBiH and 92 per cent in RS. The Internet had been used in the last 12 months by 91 per cent of women and 93 per cent of men in the FBiH and 92 per cent of women and 90 per cent of men in RS. As expected, both computer and Internet use during the last 12 months was somewhat more widespread amongst 15- 19 year old women. Use of a computer and the Internet was also positively associated with education and household wealth. In addition, a higher proportion of women and men aged 15-24 in urban areas used computers and the Internet compared to those in rural areas. 134 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 135 xIII Tobacco and Alcohol Use Many studies have shown that smoking cigarettes, pipes or cigars is a risk factor for many deadly diseases, including cardiovascular disease, respiratory illness, lung and other forms of cancer. Smokeless tobacco products are also known to have harmful effects. Excessive alcohol use also increases the risk of many harmful health conditions and in the long-term may lead to cardiovascular problems, neurological impairments, liver disease and social problems. Alcohol abuse is also associated with injuries and violence, including domestic violence.48 Information was collected on tobacco and alcohol use amongst women and men 15-49 years old regarding: z ever and current use of cigarettes and early start of cigarette smoking (before age 15); z ever and current use of smoke and smokeless tobacco products; z the intensity of use of cigarettes and smoke and smokeless tobacco products; z ever and current use of alcohol and the intensity of use. Tobacco Use Table TA.1 presents the current and ever use of tobacco products by women aged 15-49, while table TA.1M presents the corresponding information for men of the same age group. The survey findings show that the use of tobacco products in BiH is more common amongst men than women: 49 per cent of women and 63 per cent of men reported having ever used a tobacco product (48 per cent of women and 65 per cent of men in the FBiH and 51 per cent of women and 58 per cent of men in RS). Nearly one in four women (27 per cent) and two in five men (40 per cent) in BiH had smoked cigarettes or used smoke or smokeless tobacco products on one or more days during the last one month: 28 per cent of women and 42 per cent of men in the FBiH and 26 per cent of women and 34 per cent of men in RS. Fifty-two per cent of women in rural areas and 47 per cent in urban areas had never used any tobacco product, while amongst men this proportion was more or less the same in urban as in rural areas (37 per cent in both cases). Amongst current male and female tobacco users the tobacco product that was the most common was cigarettes (28 per cent of women and 39 per cent of men had smoked cigarettes in the last one month). 48 US Centers for Disease Control and Prevention <http://www.cdc.gov/> Table MT.2M: Use of computers and Internet: men aged 15-24 Percentage of young men aged 15-24 who have ever used a computer, percentage who have used a computer during the last 12 months, and frequency of use during the last one month, BiH 2011–2012   Percentage of men aged 15-24 who have: Percentage of men aged 15-24 who have: Number of men aged 15-24 years   Ever used a computer Used a computer during the last 12 months1 Used a computer at least once a week during the last one month Ever used the Internet Used the Internet during the last 12 months2 Used the Internet at least once a week during the last one month Age (years) 15-19 97.1 95.8 89.8 94.2 93.4 87.2 684 20-24 94.7 92.4 84.7 92.3 90.9 82.8 743 Administrative unit   FBiH 97.0 95.0 88.6 94.3 93.1 86.7 1,014 RS 93.3 92.0 83.4 90.7 89.9 80.2 393 BD (88.0) (86.7) (86.1) (88.0) (86.7) (84.4) 21 Area   Urban 97.6 95.9 93.1 97.1 96.6 93.1 485 Rural 94.9 93.0 84.1 91.2 89.8 80.7 943 Education*   Primary 69.6 66.1 53.4 68.4 64.9 43.9 67 Secondary 96.2 94.2 85.8 92.6 91.3 82.9 1,009 Higher 99.7 98.7 97.6 99.7 99.7 98.4 352 Wealth index quintile   Poorest 82.2 76.3 54.9 71.9 65.0 47.6 194 Second 95.5 95.4 85.4 91.4 91.4 79.5 239 Middle 97.0 94.7 88.3 94.9 94.1 87.8 337 Fourth 99.9 99.9 97.7 99.9 99.9 96.4 312 Richest 98.8 97.0 95.9 98.8 98.8 96.5 345 Total 95.8 94.0 87.2 93.2 92.1 84.9 1,428 1 MICS indicator MT.2 2 MICS indicator MT.3 ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 136 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 137 Table TA.1M: Current and ever use of tobacco: men Percentage of men aged 15-49 years by pattern of use of tobacco, BiH 2011–2012   Never smoked cigarettes or used other tobacco products Ever users Used tobacco products on one or more days during the last one month Number of men aged 15-49 years   Only cigarettes Cigarettes and other tobacco products Only other tobacco products Any tobacco product Only cigarettes Cigarettes and other tobacco products Only other tobacco products Any tobacco product1 Age (years)   15-19 71.3 22.9 4.9 0.9 28.7 10.3 1.2 2.1 13.7 684 20-24 45.6 38.5 14.3 1.6 54.4 26.4 3.4 1.2 31.1 743 25-29 35.7 51.9 11.5 0.8 64.2 44.3 0.7 0.3 45.3 534 30-34 32.2 59.2 8.1 0.2 67.5 43.0 0.7 0.0 43.7 459 35-39 22.2 69.2 7.8 0.4 77.4 49.1 0.5 0.2 49.8 597 40-44 21.7 67.1 10.0 0.2 77.3 50.2 2.2 0.0 52.4 617 45-49 23.4 69.0 7.6 0.0 76.6 48.1 0.7 0.0 48.8 719 Administrative unit   FBiH 34.4 54.9 9.6 0.9 65.4 40.0 1.5 0.8 42.4 3,010 RS 41.5 49.3 8.6 0.1 58.0 32.9 1.3 0.1 34.3 1,271 BD 50.2 47.6 2.1 0.0 49.8 37.4 0.0 0.0 37.4 71 Area   Urban 37.2 49.1 11.8 1.6 62.5 37.9 2.1 1.7 41.6 1,422 Rural 36.5 55.2 7.9 0.2 63.2 37.9 1.1 0.1 39.1 2,931 Education*   Primary 22.7 69.7 6.9 0.4 77.1 58.6 1.2 0.0 59.7 543 Secondary 36.8 54.0 8.6 0.5 63.0 37.7 1.3 0.5 39.5 3,117 Higher 47.6 36.3 14.0 1.6 51.8 22.3 2.3 1.6 26.2 683 Wealth index quintile   Poorest 30.6 62.7 6.4 0.0 69.1 46.3 1.0 0.0 47.3 685 Second 33.6 60.1 6.0 0.3 66.3 41.1 0.6 0.1 41.8 848 Middle 37.6 53.3 8.7 0.4 62.4 38.0 0.7 0.1 38.8 989 Fourth 41.8 48.6 9.0 0.3 57.9 34.9 1.5 0.3 36.7 893 Richest 38.3 44.3 14.9 1.9 61.1 31.6 3.1 2.3 37.1 938 Total 36.7 53.2 9.2 0.6 63.0 37.9 1.4 0.6 39.9 4,353 1 MICS indicator TA.1 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Tables TA.2 and TA.2M show that 3 per cent of women and 9 per cent of men aged 15-49 in BiH had smoked a whole cigarette for the first time before age 15 (4 per cent FBiH and 2 per cent RS). Nine per cent of men in the FBiH and 10 per cent in RS had smoked a whole cigarette for the first time before age 15. As displayed in Tables TA.2M and TA.2M, amongst those who currently smoked cigarettes the highest proportion of men had smoked more than 20 cigarettes in the last 24 hours; this percentage was almost three times higher compared to men who smoked 10-19 cigarettes (70 per cent versus 24 per cent). Unlike men, a smaller proportion of women had smoked more than 20 cigarettes in the last 24 hours (37 per cent), while most women had smoked 10-19 cigarettes in the last 24 hours (41 per cent). Table TA.1: Current and ever use of tobacco: women Percentage of women aged 15-49 years by pattern of use of tobacco, BiH 2011–2012   Never smoked cigarettes or used other tobacco products Ever users Used tobacco products on one or more days during the last one month Number of women aged 15-49 years   Only cigarettes Cigarettes and other tobacco products Only other tobacco products Any tobacco product Only cigarettes Cigarettes and other tobacco products Only other tobacco products Any tobacco product1 Age (years)   15-19 78.1 18.0 2.0 1.6 21.6 6.7 0.6 0.6 7.9 642 20-24 56.7 35.0 6.5 0.9 42.4 16.7 0.9 1.2 18.9 677 25-29 51.7 41.5 5.0 0.1 46.6 23.9 0.3 0.0 24.1 498 30-34 43.6 51.7 3.2 0.7 55.6 33.5 0.0 0.0 33.5 568 35-39 44.5 52.4 2.1 0.6 55.1 30.6 0.5 0.0 31.1 646 40-44 39.2 57.4 3.4 0.0 60.7 38.4 0.0 0.0 38.4 690 45-49 41.4 57.6 1.0 0.0 58.6 35.6 0.1 0.0 35.7 724 Administrative unit   FBiH 51.5 43.5 3.9 0.8 48.1 27.0 0.4 0.4 27.8 3,180 RS 48.1 49.5 1.6 0.0 51.1 26.0 0.2 0.0 26.3 1,210 BD 52.9 43.7 0.0 0.0 43.7 23.7 0.0 0.0 23.7 56 Area   Urban 47.1 45.9 5.1 1.4 52.4 29.7 0.7 0.7 31.1 1,548 Rural 52.4 44.6 2.2 0.1 47.0 25.1 0.2 0.1 25.3 2,898 Education*   Primary 49.6 48.6 1.4 0.0 50.1 29.2 0.2 0.0 29.4 1,064 Secondary 49.8 46.4 2.6 0.6 49.5 28.4 0.1 0.2 28.8 2,604 Higher 54.4 35.9 8.0 1.2 45.1 17.2 1.2 0.8 19.3 762 Maternity status   Pregnant 52.6 43.5 2.9 0.0 46.4 5.5 0.0 0.0 5.5 79 Breastfeeding (not pregnant) (*) (*) (*) (*) (*) (*) (*) (*) (*) 3 Neither 50.5 45.1 3.2 0.6 48.9 27.1 0.4 0.3 27.7 4,364 Wealth index quintile   Poorest 52.5 43.3 3.2 0.0 46.5 28.7 0.1 0.0 28.8 620 Second 54.5 43.0 2.0 0.0 45.0 24.9 0.5 0.0 25.3 847 Middle 50.7 46.9 1.8 0.0 48.8 26.2 0.1 0.0 26.3 976 Fourth 50.5 44.9 3.0 1.4 49.2 28.5 0.2 0.4 29.1 1,020 Richest 45.9 46.4 6.0 1.1 53.4 25.5 0.8 0.8 27.2 983 Total 50.6 45.1 3.2 0.6 48.9 26.7 0.4 0.3 27.3 4,446 1 MICS indicator TA.1 (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 138 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 139 Table TA.2M: Age at first use of cigarettes and frequency of use: men Percentage of men aged 15-49 years who smoked a whole cigarette before age 15 and per cent distribution of current smokers by the number of cigarettes smoked in the last 24 hours, BiH 2011–2012   Percentage of men who smoked a whole cigarette before age 15 1 Number of men aged 15-49 years Number of cigarettes in the last 24 hours Number of men aged 15-49 years who are current cigarette smokers Less than 5 5-9 10-19 20+ Missing/DK Total Age (years)   15-19 9.0 684 17.9 18.5 28.9 34.7 0.0 100.0 81 20-24 7.8 743 1.8 7.7 31.3 59.2 0.0 100.0 222 25-29 10.2 534 4.8 6.0 21.2 68.0 0.0 100.0 240 30-34 9.7 459 0.7 1.1 30.8 67.4 0.0 100.0 201 35-39 8.4 597 1.2 2.3 20.7 75.8 0.0 100.0 298 40-44 10.2 617 1.0 1.6 17.7 79.5 0.2 100.0 323 45-49 10.6 719 1.2 1.0 23.3 73.9 0.6 100.0 351 Administrative unit   FBiH 9.2 3,010 2.3 3.9 25.4 68.4 0.1 100.0 1,252 RS 9.6 1,271 3.2 3.5 18.7 74.1 0.5 100.0 437 BD 14.1 71 0.0 1.3 24.1 74.6 0.0 100.0 27 Area   Urban 8.1 1,422 1.8 5.6 27.7 64.8 0.0 100.0 569 Rural 10.0 2,931 2.8 2.8 21.7 72.5 0.2 100.0 1,147 Education*   Primary 12.6 543 1.0 1.2 23.6 74.2 0.0 100.0 326 Secondary 9.7 3,117 3.1 4.0 22.3 70.4 0.2 100.0 1,218 Higher 5.1 683 1.0 6.9 34.2 57.9 0.0 100.0 168 Wealth index quintile   Poorest 13.0 685 3.6 2.9 25.1 68.5 0.0 100.0 324 Second 8.2 848 2.6 3.2 19.2 74.8 0.2 100.0 356 Middle 8.8 989 2.3 0.8 21.1 75.9 0.0 100.0 383 Fourth 8.0 893 2.7 5.2 25.0 66.5 0.6 100.0 328 Richest 9.7 938 1.2 7.3 29.1 62.5 0.0 100.0 326 Total 9.4 4,353 2.5 3.8 23.7 69.9 0.2 100.0 1,716 1 MICS indicator TA.2 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. Alcohol Use Tables TA.3 and TA.3M show alcohol use amongst women and men aged 15-49. At least one drink of alcohol was used on one or more days during the last one month by a higher proportion of men (53 per cent) than women (18 per cent) in BiH: 46 per cent of men and 12 per cent of women in the FBiH and 34 per cent of women and 69 per cent of men in RS. With respect to education, almost three times more women with higher education (29 per cent) had consumed alcohol during the last one month compared to those with primary education (11 per cent). Alcohol consumption during the last one month was also more common amongst women in the richest households compared to those in the poorest households. However, amongst men the differentials by education and wealth were less pronounced. Table TA.2: Age at first use of cigarettes and frequency of use: women Percentage of women aged 15-49 years who smoked a whole cigarette before age 15 and per cent distribution of current smokers by the number of cigarettes smoked in the last 24 hours, BiH 2011–2012   Percentage of women who smoked a whole cigarette before age 15 1 Number of women aged 15-49 years Number of cigarettes in the last 24 hours Number of women aged 15-49 years who are current cigarette smokers Less than 5 5-9 10-19 20+ Missing/ DK Total Age (years)   15-19 4.1 642 (14.5) (26.1) (43.3) (16.0) (0.0) 100.0 47 20-24 2.6 677 7.0 14.3 48.9 29.8 0.0 100.0 120 25-29 2.9 498 15.2 6.8 41.5 36.5 0.0 100.0 121 30-34 2.9 568 10.5 5.6 46.0 36.8 1.0 100.0 191 35-39 4.0 646 12.3 7.4 45.2 35.1 0.0 100.0 201 40-44 4.0 690 9.1 10.1 40.6 39.5 0.8 100.0 265 45-49 2.3 724 10.0 14.1 30.9 45.0 0.0 100.0 260 Administrative unit   FBiH 3.9 3,180 11.3 10.7 38.9 39.0 0.2 100.0 874 RS 1.5 1,210 9.4 10.3 47.4 32.3 0.6 100.0 318 BD 2.2 56 (1.0) (6.4) (40.1) (52.5) (0.0) 100.0 13 Area   Urban 3.1 1,548 7.7 7.5 45.5 38.8 0.4 100.0 471 Rural 3.3 2,898 12.6 12.4 38.3 36.4 0.3 100.0 734 Education*   Primary 5.5 1,064 7.8 8.1 38.0 46.1 0.0 100.0 313 Secondary 2.3 2,604 12.4 11.7 42.2 33.2 0.5 100.0 746 Higher 3.0 762 8.4 10.0 42.6 39.0 0.0 100.0 141 Maternity status   Pregnant 4.8 79 (*) (*) (*) (*) (*) 100.0 4 Breastfeeding (not pregnant) (*) 3 (*) (*) (*) (*) (*) 100.0 0 Neither 3.2 4,364 10.7 10.5 41.2 37.3 0.3 100.0 1,200 Wealth index quintile   Poorest 5.0 620 11.8 10.4 40.4 37.4 0.0 100.0 179 Second 3.2 847 9.1 13.4 34.9 42.6 0.0 100.0 215 Middle 1.4 976 7.1 14.1 46.4 32.5 0.0 100.0 257 Fourth 3.8 1,020 13.3 7.3 38.7 39.4 1.4 100.0 294 Richest 3.4 983 11.7 8.3 44.4 35.5 0.0 100.0 262 Total 3.2 4,446 10.7 10.5 41.1 37.3 0.3 100.0 1,205 1 MICS indicator TA.2 ( ) Figures that are based on 25–49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 140 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 141 Table TA.3M: Use of alcohol: men Percentage of men aged 15-49 who have never had one drink of alcohol, percentage who first had one drink of alcohol before age 15 and percentage of men who have had at least one drink of alcohol on one or more days during the last one month, BiH 2011–2012   Percentage of men who: Number of men aged 15-49 years Never had one drink of alcohol Had at least one drink of alcohol before age 152 Had at least one drink of alcohol on one or more days during the last one month1 Age (years)   15-19 49.4 16.3 29.1 684 20-24 26.9 7.9 52.6 743 25-29 20.1 8.1 60.8 534 30-34 22.1 6.7 55.8 459 35-39 15.9 6.0 57.1 597 40-44 14.7 5.0 58.5 617 45-49 12.7 7.5 58.3 719 Administrative unit   FBiH 27.9 5.5 45.8 3,010 RS 13.0 15.2 68.6 1,271 BD 24.9 8.8 58.9 71 Area   Urban 21.4 7.4 54.3 1,422 Rural 24.5 8.8 51.9 2,931 Education*   Primary 21.6 8.1 53.5 543 Secondary 23.7 9.1 51.7 3,117 Higher 23.6 5.3 57.0 683 Wealth index quintile   Poorest 20.9 8.2 55.6 685 Second 22.7 8.1 51.4 848 Middle 25.9 8.5 49.5 989 Fourth 26.5 8.4 49.5 893 Richest 20.8 8.7 58.1 938 Total 23.5 8.4 52.7 4,353 1 MICS indicator TA.3 2 MICS indicator TA.4 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. More than one half of women (56 per cent) and about one quarter of men (24 per cent) never had one drink of alcohol (65 per cent of women and 28 per cent of men in the FBiH and 32 per cent of women and 13 per cent of men in RS). The highest proportion of persons of both sexes who had never consumed alcohol was found in the 15-19 age group (73 per cent of women and 49 per cent of men). Unlike men, amongst whom there were no clear differences by education and wealth, the highest proportion of women who had never had one drink of alcohol was amongst those with primary education and those in the poorest households. A higher percentage of men aged 15-49 had at least one drink of alcohol before age 15 (8 per cent) compared to women (1 per cent): 6 per cent of men and 1 per cent of women in the FBiH and 15 per cent of men and 1 per cent of women in RS. Use of alcohol by age 15 was highest amongst women and men in the youngest age group (15-19). Alcohol use before age 15 by men was lowest amongst those with higher education, while there were no clear differentials amongst women with respect to education. Table TA.3: Use of alcohol: women Percentage of women aged 15-49 who have never had one drink of alcohol, percentage who first had one drink of alcohol before age 15 and percentage of women who have had at least one drink of alcohol on one or more days during the last one month, BiH 2011–2012   Percentage of women who: Number of women aged 15-49 years Never had one drink of alcohol Had at least one drink of alcohol before age 152 Had at least one drink of alcohol on one or more days during the last one month1 Age (years)   15-19 72.6 5.4 10.7 642 20-24 45.8 1.5 26.9 677 25-29 50.4 0.5 19.5 498 30-34 49.3 0.8 19.7 568 35-39 55.4 0.4 17.7 646 40-44 56.6 0.7 16.4 690 45-49 58.4 0.0 17.4 724 Administrative unit   FBiH 65.0 1.4 12.4 3,180 RS 31.8 1.3 33.8 1,210 BD 51.9 2.7 20.6 56 Area   Urban 48.1 1.0 22.7 1,548 Rural 59.9 1.6 15.9 2,898 Education*   Primary 69.2 0.6 11.1 1,064 Secondary 53.9 1.7 18.2 2,604 Higher 42.6 1.2 29.0 762 Wealth index quintile   Poorest 61.2 2.1 14.7 620 Second 60.4 1.3 16.5 847 Middle 56.9 0.9 17.5 976 Fourth 58.0 1.3 16.7 1,020 Richest 44.9 1.4 24.6 983 Total 55.8 1.4 18.3 4,446 1 MICS indicator TA.3 2 MICS indicator TA.4 * Figures for the education category “None” are based on fewer than 25 unweighted cases and are not shown in the table. 142 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 143 Ta bl e SW .1 : D om ai ns o f l ife s at is fa ct io n: w om en a ge d 15 -2 4 pe rc en ta ge o f w om en a ge d 15 -2 4 ye ar s w ho a re v er y sa tis fie d or s at is fie d in s el ec te d do m ai ns , B ih 2 01 1– 20 12   Pe rc en ta ge o f w om en a ge d 15 -2 4 w ho a re v er y sa ti sfi ed o r s at is fie d w it h se le ct ed d om ai ns Pe rc en ta ge o f w om en ag ed 1 5- 24 w ho : n um be r of w om en ag ed 15 -2 4 ye ar s   fa m ily lif e fr ie nd sh ip s sc ho ol cu rr en t jo b h ea lth li vi ng en vi ro nm en t tr ea tm en t by o th er s th e w ay th ey lo ok cu rr en t in co m e a re n ot cu rr en tly at te nd in g sc ho ol d o no t ha ve a jo b d o no t ha ve a ny in co m e   A ge (y ea rs )   15 -1 9 95 .2 90 .1 89 .5 (* ) 96 .4 72 .3 85 .2 92 .1 70 .2 12 .3 95 .7 78 .2 64 2 20 -2 4 96 .2 90 .8 92 .2 60 .9 95 .3 70 .9 87 .4 93 .2 60 .6 54 .9 78 .2 56 .0 67 7 A dm in is tr at iv e un it   fB ih 96 .2 89 .5 91 .1 68 .2 95 .4 77 .4 87 .8 92 .9 65 .3 34 .2 85 .1 61 .7 98 9 rs 95 .2 93 .6 89 .7 (* ) 97 .1 55 .0 82 .4 92 .1 53 .2 34 .6 91 .4 81 .5 31 8 Bd (6 6. 5) (8 3. 5) (* ) (* ) (9 5. 4) (2 7. 3) (6 0. 8) (8 6. 9) (* ) (2 1. 1) (9 6. 6) (9 4. 3) 12 A re a   u rb an 96 .0 92 .3 91 .9 (6 5. 4) 94 .9 73 .4 88 .0 91 .9 59 .7 28 .7 87 .8 64 .9 46 3 ru ra l 95 .6 89 .4 89 .5 65 .1 96 .3 70 .6 85 .4 93 .0 66 .1 37 .1 86 .1 67 .8 85 6 M ar it al S ta tu s   ev er m ar rie d/ in u ni on 94 .5 86 .9 (* ) 59 .6 93 .6 66 .4 88 .6 91 .7 69 .4 91 .3 78 .7 44 .0 16 9 n ev er m ar rie d/ in u ni on 95 .9 91 .0 90 .3 66 .5 96 .1 72 .3 85 .9 92 .8 62 .2 25 .7 87 .9 70 .1 1, 15 0 Ed uc at io n*   pr im ar y 91 .4 83 .5 (* ) (* ) 86 .4 70 .0 84 .3 85 .7 (6 3. 9) 82 .9 88 .1 60 .6 69 se co nd ar y 95 .0 89 .5 89 .1 69 .8 95 .9 68 .5 84 .9 91 .9 64 .6 39 .5 85 .9 68 .2 86 9 h ig he r 98 .1 93 .8 92 .3 (* ) 97 .3 78 .8 89 .8 95 .8 61 .7 13 .0 88 .2 64 .6 38 1 W ea lt h in de x qu in ti le   po or es t 92 .8 85 .9 88 .6 (* ) 95 .5 57 .3 78 .8 90 .4 (6 1. 1) 41 .9 92 .7 74 .3 17 7 se co nd 94 .6 88 .0 85 .1 (5 6. 9) 94 .7 62 .6 85 .8 93 .0 64 .6 41 .4 87 .5 70 .3 24 8 M id dl e 93 .6 90 .9 94 .2 (5 6. 4) 97 .9 73 .7 88 .8 94 .1 69 .2 41 .1 86 .4 68 .6 28 2 fo ur th 97 .8 92 .6 89 .3 (6 9. 7) 95 .2 78 .9 87 .0 90 .4 58 .1 32 .6 81 .4 63 .4 31 3 ri ch es t 98 .3 92 .5 92 .8 (* ) 95 .6 77 .7 87 .9 94 .6 65 .4 18 .7 88 .4 61 .3 29 9 To ta l 95 .7 90 .5 90 .4 65 .2 95 .8 71 .6 86 .3 92 .6 63 .7 34 .2 86 .7 66 .8 1, 31 9 ( ) f ig ur es th at a re b as ed o n 25 –4 9 un w ei gh te d ca se s (* ) f ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s * fi gu re s fo r t he e du ca tio n ca te go ry “n on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t s ho w n in th e ta bl e. XIV Subjective Well-Being It is well known that the subjective perceptions of individuals concerning their income, health, living environment, happiness and the like play a significant role in their lives and can have an impact on their perception of well-being, irrespective of objective conditions such as actual income and physical health status. In the 2011–2012 BiH MICS a set of questions were put to women and men between 15-24 years of age to understand how satisfied this group of young people was with different areas of their lives. In addition to the set of questions on life satisfaction, the survey also asked questions about happiness and the respondents’ perceptions of a better life.49 Life satisfaction is a measure of an individual’s perceived level of well-being. Understanding young women and young men’s level of satisfaction with different areas of their lives can help us to gain a comprehensive picture of young people’s life situations. A distinction can also be made between life satisfaction and happiness. Happiness is a fleeting emotion that can be affected by numerous factors, including day-to-day factors such as the weather or a recent death in the family. It is possible for a person to be satisfied with his or her job, income, family life, friends and other aspects of his or her life but still be unhappy. Indicators related to subjective well-being: z Life satisfaction: the proportion of women and men aged 15-24 years who were very satisfied or satisfied with their family life, friendships, school, current job, health, where they lived, how they were treated by others and how they looked. z Happiness: the proportion of women and men aged 15-24 years who were very happy or happy. z Perception of a better life: the proportion of women and men aged 15-24 years who thought that their lives had improved during the last one year and who expected that their lives would be better after one year. Tables SW.1 and SW.1M show the proportion of women and men aged 15-24 years who were very satisfied or satisfied with each of the following aspects of their life: family life, friendships, school, current job, health, where they lived, how they were treated by others, how they looked and their current income. Women aged 15-24 were, in an almost equal measure, most satisfied with their health and family life (96 per cent, respectively) and how they looked (93 per cent). The results for men aged 15-24 were similar; they were the most satisfied with their health (97 per cent), their friendships (94 per cent) and how they looked (92 per cent). Women aged 15-24 in the FBiH were the most satisfied with their family life (96 per cent), followed by health (95 per cent); the pattern was similar in RS where women in this age group were the most satisfied with their health (97 per cent), followed by their family life (95 per cent). Men aged 15-24 in both the FBiH and RS were most satisfied with their health (96 per cent in the FBiH and 98 per cent in RS), followed by their friendships (93 per cent in FBiH and 97 per cent in the RS). Women and men aged 15-24 in BiH were least satisfied with their current income, with 67 per cent of young women and 69 per cent of young men in BiH not having an income at all. 49 to assist respondents in answering the set of questions on happiness and life satisfaction they were shown a card with smiling faces that corre- sponded to the response categories (see the Questionnaires in appendix f). 144 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 145 Table SW.1M: Domains of life satisfaction: men aged 15-24 percentage of men aged 15-24 years who are very or somewhat satisfied in selected domains, Bih 2011–2012   Percentage of men aged 15-24 who are very or somewhat satisfied with selected domains Percentage of men aged 15-24 who: number of men aged 15-24 years   family life friendships school current job health living environment treatment by others the way they look current income are not currently attending school do not have a job do not have any income   Age (years) 15-19 92.2 94.8 83.4 (*) 96.7 71.2 84.7 93.2 73.8 17.2 96.0 82.4 684 20-24 91.4 93.0 78.0 58.5 96.4 70.7 86.0 91.4 50.7 64.9 73.1 55.8 743 Administrative unit   fBih 92.1 92.7 81.9 62.5 96.0 77.5 84.5 91.9 60.2 43.8 84.2 66.8 1,014 rs 91.4 96.6 80.3 (54.6) 97.6 55.1 88.6 93.0 47.4 37.5 83.3 71.7 393 Bd (82.1) (99.3) (*) (*) (100.0) (51.2) (70.8) (100.0) (*) (38.2) (94.0) (94.0) 21 Area   urban 88.3 92.6 78.4 (56.1) 95.2 77.0 81.7 89.5 50.5 36.5 85.1 65.7 485 rural 93.6 94.5 83.6 61.6 97.2 67.8 87.3 93.7 60.6 44.9 83.5 70.0 943 Marital Status   ever married/in union 93.8 80.7 (*) (47.7) 99.4 77.1 83.3 98.8 (50.4) 94.3 36.9 34.6 46 never married/in union 91.7 94.3 81.7 61.6 96.4 70.8 85.5 92.1 57.3 40.3 85.6 69.7 1,382 Education*   primary 84.5 95.7 (*) (*) 92.3 61.6 80.9 89.1 (*) 87.4 76.1 60.1 67 secondary 91.1 93.1 83.9 59.2 96.4 68.8 83.6 92.5 56.0 49.4 82.9 70.1 1,009 higher 95.1 95.7 79.2 (*) 97.7 79.0 91.4 92.2 61.3 12.1 88.9 65.7 352 Wealth index quintile   poorest 87.5 92.7 75.9 (*) 98.2 53.6 76.7 90.9 (44.5) 59.6 89.1 80.1 194 second 93.8 95.2 87.5 (*) 98.3 63.4 90.3 92.9 (52.7) 46.6 84.9 76.6 239 Middle 93.9 92.5 89.8 (65.9) 97.8 77.1 84.3 96.1 60.2 45.6 81.2 69.9 337 fourth 90.2 93.1 83.1 (52.3) 94.8 72.3 84.2 94.0 63.9 32.7 86.1 67.1 312 richest 92.1 95.6 72.6 (63.4) 94.7 78.8 89.1 87.4 54.5 33.8 81.6 56.4 345 Total 91.8 93.9 81.7 59.9 96.5 71.0 85.4 92.3 56.9 42.0 84.1 68.5 1,428 ( ) figures that are based on 25–49 unweighted cases (*) figures that are based on fewer than 25 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Data was also obtained on the proportion of women and men aged 15-24 who were very or somewhat happy, with an equal percentage of women and men in BiH (91 per cent) indicating this. Ninety-four per cent of women and 89 per cent of men in RS, and 90 per cent of women and 92 per cent in the FBiH were happy or somewhat happy. Comparing 15-19 year old women to 20-24 year old women the proportion of women who were very or somewhat happy was the same (91 per cent) for both age groups. Yet amongst men slightly happier were those in the younger age group (93 per cent of those aged 15-19 compared to 89 per cent of those aged 20-24). Similar to the life satisfaction indicator, young people of both sexes with higher education were happier than those with primary education as were young people in the richest households compared to those in the poorest households. Table SW.2 shows the proportion of women aged 15-24 years with life satisfaction and Table SW.2M presents the same indicator for men. ‘Life satisfaction’ as a summary indicator was defined as being very or somewhat satisfied with all of the following aspects of their lives: one’s family life, friendships, school, current job, health, where a person lives, how they are treated by others and how they look. The survey findings show that about one half of women (54 per cent) and men (50 per cent) aged 15-24 were satisfied with life (56 per cent of women and 53 per cent of men in the FBiH and 46 per cent of women and 42 per cent of men in RS). Women and men aged 15-24 with higher education were more satisfied with life compared to those with primary education; in respect to wealth, young people in the poorest households were least satisfied with life. The average life satisfaction score is the arithmetic mean of responses to questions included in the calculation of life satisfaction (on a scale of 1 to 5) with lower scores indicating higher satisfaction levels. The survey results indicate an identical average life satisfaction score amongst women and men (1.9). 146 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 147 Table SW.2: Life satisfaction and happiness: women aged 15-24 percentage of women aged 15-24 years who are very satisfied or satisfied with their family life, friendships, school, current job, health, living environment, treatment by others and the way they look; the average life satisfaction score, percentage of women with life satisfaction who are also very satisfied or satisfied with their income and percentage of women aged 15-24 years who are very happy or happy, Bih 2011–2012   percentage of women with life satisfaction1 average life satisfaction score Missing / cannot be calculated women with life satisfaction who are very satisfied or satisfied with their income no income / cannot be calculated percentage who are very happy or happy2 number of women aged 15-24 years Age (years)   15-19 54.5 1.9 0.0 47.8 78.2 90.1 642 20-24 52.6 1.9 0.5 32.7 56.5 90.8 677 Administrative unit   fBih 56.3 1.9 0.1 37.5 61.8 89.5 989 rs 46.2 1.9 1.0 38.5 82.4 93.6 318 Bd (14.6) (2.1) (2.3) (*) (96.6) (83.5) 12 Area   urban 57.3 1.9 0.2 44.4 65.1 92.3 463 rural 51.5 1.9 0.4 33.5 68.1 89.4 856 Marital Status   ever married/in union 49.7 2.0 2.3 40.7 46.2 86.9 169 never married/in union 54.1 1.9 0.0 36.8 70.1 91.0 1,150 Education*   primary 47.8 2.0 3.8 (20.7) 64.4 83.5 69 secondary 50.3 1.9 0.1 35.8 68.3 89.5 869 higher 61.9 1.9 0.1 44.3 64.7 93.8 381 Wealth index quintile   poorest 40.5 2.0 1.5 (30.4) 75.8 85.9 177 second 42.7 2.0 0.1 28.2 70.4 88.0 248 Middle 60.3 1.9 0.1 45.9 68.7 90.9 282 fourth 55.5 1.9 0.1 32.5 63.4 92.6 313 richest 61.7 1.9 0.1 44.9 61.4 92.5 299 Total 53.5 1.9 0.3 37.6 67.1 90.5 1,319 1 Mics indicator sw.1 2 Mics indicator sw.2 ( ) figures that are based on 25–49 unweighted cases (*) figures that are based on fewer than 25 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Table SW.2M: Life satisfaction and happiness: men aged 15-24 percentage of men aged 15-24 years who are very satisfied or satisfied with their family life, friendships, school, current job, health, living environment, treatment by others and the way they look; the average life satisfaction score, percentage of men with life satisfaction who are also very satisfied or satisfied with their income and percentage of men aged 15-24 years who are very happy or happy, Bih 2011–2012   percentage of men with life satisfaction1 average life satisfaction score Missing / cannot be calculated Men with life satisfaction who are very satisfied or satisfied with their income no income / cannot be calculated percentage who are very happy or happy2 number of men aged 15-24 years Age (years)   15-19 48.9 1.8 0.3 41.3 82.7 93.3 684 20-24 50.1 1.9 0.3 34.6 55.8 89.0 743 Administrative unit   fBih 52.8 1.8 0.4 34.8 67.0 92.2 1,014 rs 42.3 1.8 0.0 41.7 71.7 88.9 393 Bd (28.6) (1.9) (0.0) (*) (94.0) (75.1) 21 Area   urban 46.2 1.9 0.8 25.6 66.1 88.5 485 rural 51.2 1.8 0.0 42.7 70.0 92.4 943 Marital Status   ever married/in union 47.3 1.8 0.0 (25.9) 34.6 93.8 46 never married/in union 49.6 1.9 0.3 37.1 69.8 91.0 1,382 Education*   primary 37.1 2.0 0.0 (*) 60.1 72.1 67 secondary 49.0 1.9 0.4 37.2 70.3 90.7 1,009 higher 53.4 1.8 0.0 40.9 65.7 95.6 352 Wealth index quintile   poorest 37.3 2.0 0.0 (*) 80.1 80.9 194 second 50.3 1.9 0.0 (37.2) 76.6 91.5 239 Middle 56.1 1.8 0.0 38.8 69.9 94.1 337 fourth 47.6 1.8 0.7 34.3 67.8 91.8 312 richest 51.2 1.8 0.6 35.1 56.4 92.8 345 Total 49.5 1.9 0.3 36.4 68.7 91.1 1,428 1 Mics indicator sw.1 2 Mics indicator sw.2 ( ) figures that are based on 25–49 unweighted cases (*) figures that are based on fewer than 25 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Women’s perceptions of a better life are shown in Table SW.3, while the corresponding indicator for men is shown in Table SW.3M. Thirty-six per cent of young women and 40 per cent of young men (39 per cent of women and 46 per cent of men in the FBiH and 27 per cent of women and men in RS) thought that their lives had improved during the last year. In contrast, a higher proportion of women (79 per cent) and men (75 per cent) expected that their lives would get better after one year (85 per cent of women and 79 per cent of men in the FBiH and 61 per cent of women and 66 per cent of men in RS). About one-third of women and men aged 15-24 in BiH, the FBiH and RS, had positive perceptions with respect to both of the previous statements, believing that their lives had improved during the last year and expecting that their lives would get better after one year. Such positive perceptions were more common amongst young people of both sexes who were currently married/in union or were ever married/in union (42 per cent of women and 64 per cent of men) compared to those who had never been married/in union (31 per cent of women and 35 per cent of men). Men aged 15-24 in rural areas and those with higher education were more likely to express positive perceptions for both statements compared to those in urban areas and with primary education. Amongst women, positive perceptions were also higher amongst those with higher education, yet no clear differences were observed between women in urban and rural areas. 148 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 149 Table SW.3M: Perception of a better life: men aged 15-24 percentage of men aged 15-24 years who think that their lives improved during the last one year and those who expect that their lives will get better after one year, Bih 2011–2012   Percentage of men who think that their life: number of men aged 15-24 years  improved during the last one year will get better after one year Both 1 Age (years)   15-19 42.1 73.1 36.3 684 20-24 38.7 76.2 35.2 743 Administrative unit   fBih 46.1 79.2 41.3 1,014 rs 26.5 65.6 22.8 393 Bd (21.3) (27.3) (10.7) 21 Area   urban 34.2 73.6 29.3 485 rural 43.5 75.3 39.1 943 Marital Status   ever married/in union 68.7 78.3 63.7 46 never married/in union 39.4 74.6 34.8 1,382 Education*   primary 19.4 68.4 17.7 67 secondary 40.6 72.7 35.5 1,009 higher 43.7 81.6 39.8 352 Wealth index quintile   poorest 29.1 68.7 27.5 194 second 31.4 66.2 27.2 239 Middle 49.0 81.2 42.8 337 fourth 51.2 75.0 44.0 312 richest 34.7 77.4 32.0 345 Total 40.4 74.7 35.7 1,428 1 Mics indicator sw.3 ( ) figures that are based on 25–49 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. Table SW.3: Perception of a better life: women aged 15-24 percentage of women aged 15-24 years who think that their lives improved during the last one year and those who expect that their lives will get better after one year, Bih 2011–2012   Percentage of women who think that their life: number of women aged 15-24 years  improved during the last one year will get better after one year Both 1 Age (years)   15-19 34.6 78.8 31.4 642 20-24 37.2 79.5 34.0 677 Administrative unit   fBih 39.0 85.3 35.4 989 rs 27.1 61.1 25.0 318 Bd (14.2) (53.9) (13.1) 12 Area   urban 33.3 79.8 31.5 463 rural 37.3 78.8 33.4 856 Marital Status   ever married/in union 46.2 78.1 42.4 169 never married/in union 34.4 79.3 31.3 1,150 Education*   primary 23.6 72.6 23.6 69 secondary 35.1 78.3 31.5 869 higher 40.1 82.4 37.2 381 Wealth index quintile   poorest 28.6 77.2 24.0 177 second 37.0 76.8 35.1 248 Middle 38.2 76.8 35.2 282 fourth 37.0 81.1 33.8 313 richest 36.0 82.5 32.5 299 Total 35.9 79.2 32.7 1,319 1 Mics indicator sw.3 ( ) figures that are based on 25–49 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. 150 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 151 In the calculation of the sample size of stratum 1, needed for a stratified sample design, ‘r’ (children immunised by all vaccines) was assumed to be 61.2 per cent. The value of deff (design effect) was taken as 3, based on the estimate from the previous survey, ‘p’ (percentage of children under 5 years in the total population of households with children under 5) was taken as 5.1 per cent, ñ (average size of households with children under 5) was taken as 4.6 members and the response rate assumed to be 90 per cent. The indicator for children (aged 18-29 months) immunised by all vaccines required 2,494 households with children under 5, which was very close to the available 2,441 households. Using a non-stratified design the same indicator would have required 10,236 households, which was much further from the available 6,800 households. In the calculation of the sample size of stratum 2, needed for a stratified sample design, ‘r’ (net secondary school attendance ratio) was assumed to be 79.3 per cent. The value of deff (design effect) was taken as 1.53 based on the estimate from the previous survey, while ‘p’ (percentage of children aged 5-24 years in the total population of households with members aged 5-24 years) was taken as 2.2 per cent; ñ (average size of households with children aged 5-24 years) was taken as 3.4 members and the response rate was assumed to be 90 per cent. The sample was selected at the level of BiH and the main geographic domains (administrative units: the FBiH, RS and BD) were not equally represented in the sample. Table SD.1 presents the allocation of clusters (enumeration areas (EAs)) for the sampling domains. Table SD.1: Allocation of clusters (primary selection units) by stratum Administrative unit Number of households 1 (2009 Master Sample) Number of EAs (2009 Master Sample) Number of clusters in the MICS4 Master Sample Frame (2010) FBiH 48,853 840 263 RS 26,994 587 212 BD 4,222 72 25 Total 80,069 1,499 500 1 Households that are considered to be present in BiH Sampling Frame and Selection of Clusters Since the last census in BiH was conducted in 1991 the selection of primary sampling units (PSUs) required the development of a relevant master sample frame. Census 1991 EAs were defined as PSUs and the Master Sample was used for this purpose. The Master Sample was updated in 2009 and consisted of 1,449 EAs that were selected systematically with equal probability from about 20,000 census 1991 EAs, covering the entire territory of BiH. Lessons learned from the previous MICS rounds were that there is a need to oversample the population in RS and BD. The master sample frame of EAs was stratified by the administrative units in BiH, namely the FBiH, RS and BD. Oversampling of the population in RS and BD was conducted during the selection of the EAs for the master sample frame. Five-hundred EAs were systematically selected with equal probability from the Master Sample. EAs represent clusters in the survey. Table SD.2 compares the distribution of households in BiH with the distribution of sampled EAs. Table SD.2: Percentage of selected EAs within the sampling frame Administrative unit Percentage of selected EAs Percentage of households in BiH FBiH 52.7 61.8 RS 42.1 36.3 BD 5.2 1.8 Total 100.0 100.0 Appendix A: Sample Design The major features of the sample design are described in this appendix. Sample design features include the target sample size, sample allocation, sampling frame and listing, choice of domains, sampling stages, stratification and the calculation of sample weights. The primary objective of the sample design for the BiH Multiple Indicator Cluster Survey was to produce statistically reliable estimates of most indicators at the BiH, FBiH and RS level and for urban and rural areas.50 A two stage stratified sampling approach was used for the selection of the cluster sample. Sample Universe The official population estimate for BiH is 3.8 million inhabitants living in about one million households.51 However, some sampling frame exercises conducted due to the lack of an official Census since 1991 estimate this number at approximately 3.3 million. As stated previously, BiH is composed of three administrative units: two entities, the FBiH and RS and a third administrative unit, BD. The FBiH covers approximately 51 per cent of the territory of BiH and 62 per cent of the population. RS covers approximately 49 per cent of the territory and about 36 per cent of the population and BD covers less than 1 per cent of the territory and approximately 2 per cent of the population. Sample Size and Sample Allocation The target sample size was 6,80052 households, which was determined based on lessons learned through the previous round of MICS as well as by budgetary limitations. The standard sample design used in most of the countries participating in the MICS programme needed to be adapted for BiH due to the low birth rate; therefore, it was necessary to target (oversample) households with children under 5 and members aged 5-24. Accordingly, the sample was stratified by households with children under 5 (type 1), households with children aged 5-24 (type 2) and all other households (type 3). In addition, the size of the three strata could not jeopardise the indicator estimates for the other target populations, such as the indicators that referred to fertile women. As the sample size was defined as 6,800 households it was necessary to calculate the size of stratum 1 and stratum 2. The size of stratum 3 was obtained as the difference between the total sample size and the sum of the size of strata 1 and 2. In the calculation of the sample size for stratum 1 the key indicator used was immunisation coverage by all vaccines amongst children aged 18-29 months. In the calculation for the sample size for stratum 2 the key indicator used was the net secondary school attendance ratio. The below formula was used to estimate the required sample size for this indicator. Wherein: z n is the required sample size, expressed as the number of households; z 4 is a factor to achieve the required 95 per cent level of confidence; z r is the predicted or anticipated value of the indicator, expressed in the form of a proportion; z 1.1 is the factor necessary to raise the sample size by 10 per cent for the expected non-response; z f is the shortened symbol for deff (design effect); z 0.12r is the margin of error to be tolerated at the 95 per cent level of confidence, defined as 12 per cent of ‘r’ (relative margin of error of r); z p is the proportion of the total population upon which the indicator ‘r’ is based; z ñ is the average household size (number of persons per household). 50 Rural settlements in BiH include all EAs that are not classified as urban within the statistical system and are classified as settlements of the type ‘other’. 51 Estimate of the Agency for Statistics of BiH from 30 June 2011. 52 The planned sample of 6,000 households was increased by 800. 152 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 153 effect due to clustering. However, even if the sampling strategy had been changed to select a more constant number of sample households per cluster it would not have decreased this first stage component of the variance. The inefficiency of the BiH sample design came from the first sampling stage, which could not be changed. This illustrates the importance of having a new census and sampling frame for BiH. Calculation of Sample Weights The BiH Multiple Indicator Cluster Survey sample is not self-weighting. Essentially, by allocating households in all three strata different sampling fractions were obtained by strata due to the variability in size of strata. The weights calculated were used in the subsequent analyses of the survey data. Since the PSUs were selected with equal probability in each stratum during the first stage and that all listed households in each second stage stratum were combined across sampled clusters the weights were calculated using a combination of the first and second stage strata (for a total of 9 groups). In order to calculate first stage selection probabilities the number of sampled EAs (PSUs) in each stratum was divided by the total number of EAs from the 2009 Master Sample.57 The second stage selection probability was obtained by dividing the number of valid households (secondary sampling units (SSUs)) selected in each second stage stratum by the total number of households listed in the stratum. Table SD.5 shows the first stage selection probabilities of PSUs by stratum and the second stage probability of SSUs in each stratum. Table SD.5: First stage and second stage selection probabilities by strata Administ- rative unit Stratum code Stratum type Number of EAs (PSUs) in the master sample frame for each stratum Number of EAs (PSUs) in the MICS sample First stage probability of selection of PSUs Number of households (SSUs) listed in the stratum Number of valid households (SSUs) selected in the stratum Second stage probability of selection of SSUs in the stratum Sampling fraction (PSU*SSU) FBiH 1 Type 1 11,213 255 0.02274146 1,526 1,468 0.961992136 0.021877106 FBiH 2 Type 2 11,213 255 0.02274146 8,374 1,101 0.131478385 0.002990011 FBiH 3 Type 3 11,213 255 0.02274146 3,500 1,326 0.378857143 0.008615765 RS 4 Type 1 7,819 204 0.02609029 797 739 0.927227102 0.024191627 RS 5 Type 2 7,819 204 0.02609029 4,201 535 0.127350631 0.003322615 RS 6 Type 3 7,819 204 0.02609029 3,157 883 0.279695914 0.007297348 BD 7 Type 1 371 25 0.06738544 118 106 0.898305085 0.060532688 BD 8 Type 2 371 25 0.06738544 548 59 0.107664234 0.007255002 BD 9 Type 3 371 25 0.06738544 404 117 0.28960396 0.019515092 Weights were calculated for the 9 strata groups using the following formula: z is the weight z is the selection probability z k is the administrative unit (FBiH, RS and BD) z i is the stratum z j is the household identifier within the stratum A second component in the calculation of sample weights took into account the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RRh = Number of interviewed households in stratum h Number of occupied households listed in stratum h Listing Activities Since the most recent Master Sample for BiH was prepared in 2009 it was necessary to update the list of households in the selected EAs prior to the selection of households. The Agency for Statistics of BiH, the Federal Office of Statistics and the Republic of Srpska Institute of Statistics conducted the listing activities in December 2010. Listing was conducted in 484 EAs out of the 500 sampled census 1991 EAs, because 10 EAs were inaccessible due to flooding and six were discarded because of the poor quality of data collection (see Table SD.3). Table SD.3: Allocation of selected EAs, updated EAs and EAs in the sample by administrative unit in BiH Administrative unit Number of sampled EAs Number of sampled EAs in which listing was conducted54 Number of EAs where the MICS4 survey was actually implemented FBiH 263 255 250 RS 212 204 199 BD 25 25 25 Total 500 484 474 In 484 EAs in the master sample frame, 22,619 households were listed.55 Following the listing, it was determined that there is a large variability in the number of households by EA. Selection of Households Following the listing in 484 EAs, the households were divided into three second stage strata.56 (1) Households with children under 5 (2,441 households) (2) Households with members aged 5-24, (8,265 households) (3) All of the remaining households without children (11,913 households) The list of households for each second stage stratum was combined across all sample EAs, ordered by entity/district, cantons (in the FBiH), municipalities and urban/rural area so as to provide implicit stratification. The sample households within each second stage stratum were selected systematically with equal probability from the combined listing (see Table SD.4). During the selection procedure, 10 EAs with only 1 household were not selected. Table SD.4: Sample allocation by administrative unit and second stage strata in BiH Administrative unit Households with children under 5 Households with members aged 5-24 All remaining households Total FBiH 1,526 1,125 1,439 4,090 RS 797 592 998 2,387 BD 118 71 134 323 Total 2,441 1,788 2,571 6,800 Due to the large variability in the number of listed households by sample EA the number of households selected in each EA (cluster) in all three second stage strata varied considerably by cluster, based on these sampling procedures. However, this sampling strategy reduced the variability in the weights of the sample households within each of the combined first and second stage strata (9 groups). In order to reduce the variability in the number of sample households per EA it would have been necessary to select the households separately for each second stage stratum within each sample EA instead of combining the listing across all sample EAs; however, this would have increased the variability in the weights considerably. The main consequence of the first stage selection of the sample EAs, with equal probability within each stratum and the large variability in the size of the EAs, was that the design effects and sampling errors for the estimates of survey indicators were expected to be relatively high. The first stage component of the variance was large because of the variability in the size of the EAs. The large number of households selected in some sample clusters also contributed to a higher design 54 16 EAs (clusters) were not included in the sample 55 11 households were excluded as they had been resident outside BiH for more than one year and 6 households were excluded because there was no data on age for any of the household members. 56 The listing questionnaire included a question on age for all household members. This enabled the identification of households with children under 5 and members aged 5-24. 57 Sub-sample of EAs from the 1991 census. wherein: 154 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 155 Appendix B: List of Personnel Involved in the Survey58 Steering Committee Danijela Alijagic, UNFPA BiH Gordana Stojnic, UNHCR BiH Milan Latinovic, MHSW RS Selma Kazic, UNICEF BiH Zdenko Milinovic, BHAS Zlatko Cardaklija, FMH Zeljko Ler, IPH FBiH Survey Coordinators Aida Pilav, Survey Coordinator for FBiH, FMH Amela Lolic, Survey Coordinator for RS, MHSW RS Dajana Mitrovic, Household Survey Specialist, BHAS Dzenis Midzic, Data Processing Coordinator for FBiH Irena Jokic, Survey Coordinator for FBiH, IPH FBiH Miroslav Stijak, Survey Coordinator and Data Processing Coordinator for RS Sample Design59 Fahrudin Memic, Sampling Specialist, UNICEF BiH Consultant Jasna Hadzic, Sampling Specialist, BHAS Fieldwork Supervisors Federation of BiH Alma Gusinac-Skopo Amra Zivanovic Enida Imamovic Hajrija Primeca Jasna Suljic Marija Zeljko Nermina Mehinovic Suad Sivic Republic of Srpska and Brcko District of BiH Marijana Acimovac Slobodanka Despotovic Vanja Ilic Zoran Sopka Fieldwork Editors Federation of BiH Admir Cavkic Adnana Maksumic Endi Mehic Iskra Vucina Lazar Djurdjevic Nermina Culov Tanja Kadic Republic of Srpska and Brcko District of BiH Boro Knezevic Jadranka Radman Milos Acimovac Sladjana Sopka After the completion of the fieldwork response rates were calculated for each sampling stratum. These were then used to adjust the sample weights calculated for each cluster. Response rates in the BiH Multiple Indicator Cluster Survey are shown in Table HH.1 in this report. Similarly, the adjustment for non-response at the individual level (women, men and under-5 children) for each stratum is equal to the inverse value of: RRh = Completed women’s (or under-5’s or men’s) questionnaires in stratum h Eligible women (or under-5’s or men) in stratum h The non-response adjustment factors for women’s, men’s and under-5’s questionnaires were applied to the adjusted household weights. Numbers of eligible women, men and under-5 children were obtained from the roster of household members in the Household Questionnaire for households where interviews were completed. The design weights for the households were calculated by multiplying the above factors in each stratum. These weights were then standardised (or normalised), one purpose of which was to make the weighted sum of the interviewed sample units equal the total sample size at the level of BiH. Normalisation was achieved by dividing the full sample weights (adjusted for non-response) by the average of these weights across all households at the level of BiH. This was performed by multiplying the sample weights by a constant factor equal to the unweighted number of households at the level of BiH divided by the weighted total number of households (using the full sample weights adjusted for non-response). A similar standardisation procedure was followed in obtaining standardised weights for the women’s, men’s and under-5’s questionnaires. Adjusted (normalised) weights varied between 0.133556 and 6.154462 in the 474 sample EAs (clusters). (See Table SD.6) Table SD.6: Adjusted (normalised) weights by sample strata Administrative unit Stratum code Stratum type Weights for: Households Women Men Children under-5 FBiH 1 Type 1 0.311575 0.268180 0.272558 0.808227 FBiH 2 Type 2 2.277474 2.003164 2.032286 6.154462 FBiH 3 Type 3 0.778961 0.714424 0.685939 2.055654 RS 4 Type 1 0.292752 0.262388 0.277591 0.774720 RS 5 Type 2 2.112122 1.981994 2.025059 5.444200 RS 6 Type 3 0.942911 0.952377 0.889894 2.951255 BD 7 Type 1 0.153133 0.133556 0.138936 0.400521 BD 8 Type 2 1.190783 1.119869 1.134607 3.069358 BD 9 Type 3 0.377487 0.321197 0.349687 0.973009 Sample weights were appended to all data sets and analyses were performed by weighting each household, woman, man or under-5 with these sample weights. 58 Names are listed in alphabetical order. 59 The sample was reviewed and approval was given by the Republic of Srpska Institute of Statistics 156 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 157 Trainers Federation of BiH Aida Filipovic-Hadziomeragic Aida Pilav Aida Ramic-Catak Alma Gusinac-Skopo Amra Junuzovic Enida Imamovic Dajana Mitrovic Irena Jokic Marija Zeljko Mirsada Mulaomerovic Republic of Srpska and Brcko District of BiH Amela Lolic Ana Abdelbasit Marijana Kasapovic Miroslav Stijak Nevenka Latinovic Sladjana Sopka Slobodanka Despotovic Vanja Ilic Financial and legal processing and technical support Federation of BiH Admir Korman Aida Kurtovic Asmira Kadric Edina Halilovic Mira Bicakcic Mirsad Krupic Republic of Srpska and Brcko District of BiH Nevenka Latinovic UNICEF Geneva and New York Attila Hancioglu, Senior Adviser and MICS Global Coordinator, UNICEF New York Ivana Bjelic, Statistics Specialist, UNICEF New York Siraj Mahmudlu, Monitoring and Evaluation Specialist/Regional MICS Coordinator, UNICEF Regional Office for CEE/CIS Turgay Unalan, Statistics Specialist (Household Surveys), UNICEF New York Yadigar Coşkun, Statistics and Monitoring Specialist, UNICEF New York Consultants Aleksandar Zoric, Data Processing Specialist, Regional Consultant, UNICEF Ana Abdelbasit, Survey Coordinator, UNICEF BiH Consultant Bo Pedersen, Household Survey Specialist, Global MICS Consultant, UNICEF David Megill, Sampling Specialist, Global MICS Consultant, UNICEF Dzejlana Sutkovic, Interpreter Emma Holmberg, Household Survey Specialist, Regional Consultant, UNICEF Fahrudin Memic, Sampling Specialist, UNICEF BiH Consultant Pierre Martel, Household Survey Specialist, Regional Consultant, UNICEF Shane M. Khan, Household Survey Specialist, Global Consultant, UNICEF Sinan Turkyilmaz, Sampling Specialist, Regional MICS Consultant, UNICEF Interviewers Federation of BiH Alen Sucurovic Amel Kalco Amela Osmic Amna Dedajic Arijana Nuhanovic Arijana Suman Asim Spahic Azemina Besic Azra Primeca Edin Beganovic Edin Kabaklic Edina Halilagic Elvedin Tuzlak Daniel Maestro Dario Dakovic Dinka Smajlovic Gabrijela Guzina Jasmina Muhamedagic Lejla Felic Majda Limic Mirela Livnjak Muamer Hodzic Nela Sehic Sabiha Fajic Samir Alic Samra Teskeredzic Sonja Jokic Stipe Madzar Zeljko Kolano Republic of Srpska and Brcko District of BiH Branko Markovic Danko Brkic Dijana Todorovic Dragana Ratkovic Dusica Majkic Goran Ilic Gorica Popovic Jana Ilic Jovica Markovic Ljubinka Vukasinovic Maja Sekulic Milja Brkic Ratko Todorovic Sanja Seranic Measurers Federation of BiH Aida Hadzic Tuzlak Alem Kudin Amir Secerbegovic Ana Zeljko Elma Skalonja Nejra Avdagic Sanel Goran Republic of Srpska and Brcko District of BiH Dalibor Miljevic Dario Pericevic Igor Ninkovic Radovan Ratkovic Data entry Federation of BiH Amela Cato Azra Spahic Irma Krupic Mirsada Gusinac Neira Cengic Sanela Pleho Sanela Tukulija Zumreta Dedajic Republic of Srpska and Brcko District of BiH Boris Milanovic Marko Granulic MONITORING THE SITUATION OF CHILDREN AND WOMEN 159 Appendix C: Estimates of Sampling Errors The sample of respondents selected for the BiH MICS was only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would have yielded results that differed somewhat from the results of the actual selected sample. Sampling errors are a measure of the variability between the estimates from all possible samples. The extent of variability is not known exactly but can be estimated statistically from the survey data. The sampling error measures below are presented in this appendix for each of the selected indicators. z Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance of the estimate. The Taylor Linearization method was used for the estimation of standard errors. z Coefficient of variation (se/r): is the ratio of the standard error to the value of the indicator and is a measure of the relative sampling error. z Design effect (deff): is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design in relation to the precision. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates an increase in the standard error due to the use of a more complex sample design. z Confidence limits: are calculated to show the interval within which the true value for the population can be reasonably assumed to fall with a specified level of confidence. For any given statistic calculated from the survey the value of that statistic will fall within a range of plus or minus two times the standard error (r + 2.se or r – 2.se) of the statistic in 95 per cent of all possible samples of identical size and design. The SPSS Version 18 Complex Samples Module was used for the calculation of sampling errors within the MICS data. The results are shown in the tables that follow. In addition to the sampling error, the measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Sampling errors were calculated for indicators of primary interest, for the BiH, FBiH, RS and BD level and for urban and rural areas. Five of the selected indicators were based on household members, 17 were based on women, 9 were based on men and 16 were based on children under 5. All indicators presented here are in the form of proportions. Table SE.1 shows the list of indicators for which sampling errors were calculated, including the base population (denominator) for each indicator. Tables SE.2 to SE.7 show the calculated sampling errors for selected domains. 160 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 161 Table SE.1: Indicators selected for sampling error calculations, BiH List of indicators selected for sampling error calculations and base populations (denominators) for each indicator, BiH 2011–2012  MICS4 Indicator Base Population HOUSEHOLD MEMBERS 4.1 Use of improved drinking water sources All household members 4.3 Use of improved sanitation All household members 7.5 Secondary school net attendance ratio (adjusted) Children of secondary school age 9.18 Prevalence of children with one or both parents dead Children aged 0-17 years 8.5 Violent discipline Children aged 2-14 years WOMEN – Pregnant women Women aged 15-49 years 5.3 Contraceptive prevalence rate Women aged 15-49 years who are currently married or in union 5.4 Unmet need Women aged 15-49 years who are currently married or in union 5.5a Antenatal care coverage – at least once by skilled personnel Women aged 15-49 years with a live birth in the 2 years preceding the survey 5.5b Antenatal care coverage – at least four times by any provider Women aged 15-49 years with a live birth in the 2 years preceding the survey 5.7 Skilled attendant at delivery Women age 15-49 years with a live birth in the 2 years preceding the survey 5.8 Institutional deliveries Women age 15-49 years with a live birth in the 2 years preceding the survey 5.9 Caesarean section Women aged 15-49 years with a live birth in the 2 years preceding the survey 7.1 Literacy rate amongst women aged 15-24 Women aged 15-24 years 8.7 Marriage before age 18 Women aged 20-49 years 9.2 Comprehensive knowledge about HIV prevention amongst women aged 15-24 Women aged 15-24 years 9.3 Knowledge of mother-to-child transmission of HIV Women aged 15-49 years 9.4 Accepting attitudes towards people living with HIV Women aged 15-49 years who have heard of HIV 9.6 Women who have been tested for HIV and know the results Women aged 15-49 years 9.7 Sexually active women aged 15-24 who have been tested for HIV and know the results Women aged 15-24 years who have had sex in the 12 months preceding the survey 9.11 Sex before age 15 amongst women aged 15-24 Women aged 15-24 years 9.16 Condom use with non-regular partners Women aged 15-24 years who had a non-marital, non-cohabiting partner in the 12 months preceding the survey MEN 7.1 Literacy rate amongst men aged 15-24 Men aged 15-24 years 8.7 Marriage before age 18 Men aged 20-49 years 9.2 Comprehensive knowledge about HIV prevention amongst men aged 15-24 Men aged 15-24 years 9.3 Knowledge of mother-to-child transmission of HIV Men aged 15-49 years 9.4 Accepting attitudes towards people living with HIV Men aged 15-49 years who have heard of HIV 9.6 Men who have been tested for HIV and know the results Men aged 15-49 years 9.7 Sexually active men aged 15-24 who have been tested for HIV and know the results Men aged 15-24 years who have had sex in the 12 months preceding the survey 9.11 Sex before age 15 amongst men aged 15-24 Men aged 15-24 years 9.16 Condom use with non-regular partners Men aged 15-24 years who had a non-marital/non-cohabiting partner in the 12 months preceding the survey MICS4 Indicator Base Population UNDER-5’s 2.1a Underweight prevalence Children under age 5 2.2a Stunting prevalence Children under age 5 2.3a Wasting prevalence Children under age 5 2.6 Exclusive breastfeeding under 6 months Total number of infants under 6 months of age 2.14 Age-appropriate breastfeeding Children aged 0-23 months – Received tuberculosis immunisation Children aged 18-29 months  – Received polio immunisation Children aged 18-29 months  – Received DPT immunisation Children aged 18-29 months  – Received measles immunisation Children aged 18-29 months  – Received Hepatitis B immunisation Children aged 18-29 months  – Diarrhoea in the previous 2 weeks Children under age 5 – Illness with a cough in the previous 2 weeks Children under age 5 3.8 Oral rehydration therapy with continued feeding Children under age 5 with diarrhoea in the previous 2 weeks 3.10 Antibiotic treatment of suspected pneumonia Children under age 5 with suspected pneumonia in the previous 2 weeks 6.1 Support for learning Children aged 36-59 months 6.7 Attendance at early childhood education Children aged 36-59 months 162 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 163 Table SE.2: Sampling errors: Total sample, BiH Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9958 0.00113 0.001 1.740 1.319 20,221 5,778 0.994 0.998 Use of improved sanitation 4.3 0.9428 0.00631 0.007 4.265 2.065 20,221 5,778 0.930 0.955 Secondary school net attendance ratio (adjusted) 7.5 0.9180 0.01169 0.013 1.382 1.176 1,270 762 0.895 0.941 Prevalence of children with one or both parents dead 9.18 0.0302 0.00415 0.137 3.302 1.817 4,855 5,621 0.022 0.038 Violent discipline 8.5 0.5520 0.01504 0.027 2.359 1.536 3,451 2,582 0.522 0.582 WOMEN Pregnant women – 0.0178 0.00212 0.119 1.139 1.067 4,446 4,446 0.014 0.022 Contraceptive prevalence rate 5.3 0.4577 0.01634 0.036 3.480 1.865 2,764 3,237 0.425 0.490 Unmet need 5.4 0.0904 0.00629 0.070 1.558 1.248 2,764 3,237 0.078 0.103 Antenatal care coverage – at least once by skilled personnel 5.5a 0.8696 0.01701 0.020 1.829 1.353 298 718 0.836 0.904 Antenatal care coverage – at least four times by any provider 5.5b 0.8421 0.01770 0.021 1.689 1.300 298 718 0.807 0.878 Skilled attendant at delivery 5.7 0.9991 0.00089 0.001 0.637 0.798 298 718 0.997 1.000 Institutional deliveries 5.8 0.9973 0.00154 0.002 0.630 0.793 298 718 0.994 1.000 Caesarean section 5.9 0.1390 0.01554 0.112 1.448 1.203 298 718 0.108 0.170 Literacy rate amongst women aged 15-24 7.1 0.9934 0.00607 0.006 5.954 2.440 1,319 1,056 0.981 1.000 Marriage before age 18 8.7 0.0947 0.00675 0.071 2.135 1.461 3,804 4,022 0.081 0.108 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 0.4764 0.01998 0.042 1.688 1.299 1,319 1,056 0.436 0.516 Knowledge of mother-to- child transmission of HIV 9.3 0.6738 0.01312 0.019 3.482 1.866 4,446 4,446 0.648 0.700 Accepting attitudes towards people living with HIV 9.4 0.1511 0.00881 0.058 2.625 1.620 4,349 4,342 0.134 0.169 Women who have been tested for HIV and know the results 9.6 0.0043 0.00121 0.280 1.509 1.228 4,446 4,446 0.002 0.007 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 0.0007 0.00070 1.002 0.323 0.568 384 461 0.000 0.002 Sex before age 15 amongst women aged 15-24 9.11 0.0012 0.00045 0.375 0.179 0.423 1,319 1,056 0.000 0.002 Condom use with non- regular partners 9.16 0.7141 0.02657 0.037 0.508 0.713 225 148 0.661 0.767   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 0.9989 0.00072 0.001 0.437 0.661 1,428 907 0.997 1.000 Marriage before age 18 8.7 0.0057 0.00148 0.260 1.508 1.228 3,669 3,911 0.003 0.009 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 0.4739 0.01535 0.032 0.857 0.926 1,428 907 0.443 0.505 Knowledge of mother-to- child transmission of HIV 9.3 0.4918 0.01418 0.029 3.499 1.871 4,353 4,353 0.463 0.520 Accepting attitudes towards people living with HIV 9.4 0.1755 0.00974 0.056 2.830 1.682 4,318 4,316 0.156 0.195 Men who have been tested for HIV and know the results 9.6 0.0080 0.00184 0.229 1.851 1.360 4,353 4,353 0.004 0.012 Sexually active men aged 15- 24 who have been tested for HIV and know the results 9.7 0.0117 0.00316 0.269 0.358 0.598 664 417 0.005 0.018 Sex before age 15 amongst men aged 15-24 9.11 0.0149 0.00387 0.261 0.928 0.963 1,428 907 0.007 0.023 Condom use with non- regular partners 9.16 0.7096 0.01921 0.027 0.652 0.808 621 365 0.671 0.748 UNDER-5’s Underweight prevalence 2.1a 0.0155 0.00409 0.264 2.411 1.553 2,199 2,201 0.007 0.024 Stunting prevalence 2.2a 0.0889 0.01018 0.115 2.751 1.659 2,137 2,150 0.069 0.109 Wasting prevalence 2.3a 0.0235 0.00493 0.210 2.221 1.490 2,078 2,093 0.014 0.033 Exclusive breastfeeding under 6 months 2.6 0.1853 0.02668 0.144 0.547 0.740 236 117 0.132 0.239 Age-appropriate breastfeeding 2.14 0.1820 0.01644 0.090 1.363 1.168 921 752 0.149 0.215 Received tuberculosis immunisation – 0.9932 0.00298 0.003 0.676 0.822 463 516 0.987 0.999 Received polio immunisation – 0.9119 0.00866 0.009 0.476 0.690 459 511 0.895 0.929 Received DPT immunisation – 0.9224 0.00826 0.009 0.488 0.699 462 514 0.906 0.939 Received measles immunisation – 0.8778 0.01086 0.012 0.556 0.746 457 507 0.856 0.900 Received Hepatitis B immunisation – 0.8817 0.01516 0.017 1.116 1.057 458 508 0.851 0.912 Diarrhoea in the previous 2 weeks – 0.0593 0.00761 0.128 2.384 1.544 2,297 2,297 0.044 0.075 Illness with a cough in the previous 2 weeks – 0.0318 0.00348 0.109 0.902 0.950 2,297 2,297 0.025 0.039 Oral rehydration therapy with continued feeding 3.8 0.5458 0.04050 0.074 0.787 0.887 136 120 0.465 0.627 Antibiotic treatment of suspected pneumonia 3.10 0.7616 0.03149 0.041 0.492 0.701 73 91 0.699 0.825 Support for learning 6.1 0.9512 0.01004 0.011 2.236 1.495 917 1,031 0.931 0.971 Attendance at early childhood education 6.7 0.1308 0.01806 0.138 2.955 1.719 917 1,031 0.095 0.167 164 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 165 Table SE.3: Sampling errors: Urban areas, BiH Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9966 0.00032 0.000 0.066 0.257 6,932 2,156 0.996 0.997 Use of improved sanitation 4.3 0.9869 0.00301 0.003 1.512 1.230 6,932 2,156 0.981 0.993 Secondary school net attendance ratio (adjusted) 7.5 0.9065 0.01455 0.016 0.602 0.776 399 242 0.877 0.936 Prevalence of children with one or both parents dead 9.18 0.0363 0.00545 0.150 1.600 1.265 1,536 1,883 0.025 0.047 Violent discipline 8.5 0.5433 0.02061 0.038 1.527 1.236 1,088 893 0.502 0.585 WOMEN Pregnant women – 0.0183 0.00305 0.166 0.814 0.902 1,548 1,576 0.012 0.024 Contraceptive prevalence rate 5.3 0.4689 0.01595 0.034 1.114 1.056 876 1,091 0.437 0.501 Unmet need 5.4 0.0931 0.00908 0.097 1.064 1.032 876 1,091 0.075 0.111 Antenatal care coverage – at least once by skilled personnel 5.5a 0.8534 0.02292 0.027 1.016 1.008 94 243 0.808 0.899 Antenatal care coverage – at least four times by any provider 5.5b 0.8264 0.02580 0.031 1.123 1.060 94 243 0.775 0.878 Skilled attendant at delivery 5.7 1.0000 0.00000 0.000 N/A N/A 94 243 1.000 1.000 Institutional deliveries 5.8 0.9971 0.00284 0.003 0.687 0.829 94 243 0.991 1.000 Caesarean section 5.9 0.1132 0.00939 0.083 0.213 0.461 94 243 0.094 0.132 Literacy rate amongst women aged 15-24 7.1 0.9986 0.00057 0.001 0.076 0.276 463 333 0.997 1.000 Marriage before age 18 8.7 0.0543 0.00507 0.093 0.719 0.848 1,340 1,441 0.044 0.064 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 0.4968 0.02564 0.052 0.873 0.934 463 333 0.446 0.548 Knowledge of mother-to- child transmission of HIV 9.3 0.6772 0.01521 0.022 1.667 1.291 1,548 1,576 0.647 0.708 Accepting attitudes towards people living with HIV 9.4 0.1828 0.00894 0.049 0.841 0.917 1,547 1,571 0.165 0.201 Women who have been tested for HIV and know the results 9.6 0.0054 0.00134 0.247 0.523 0.724 1,548 1,576 0.003 0.008 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 0.0020 0.00196 1.004 0.256 0.506 137 131 0.000 0.006 Sex before age 15 amongst women aged 15-24 9.11 0.0017 0.00080 0.463 0.124 0.352 463 333 0.000 0.003 Condom use with non- regular partners 9.16 0.6597 0.03468 0.053 0.343 0.585 102 65 0.590 0.729   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 0.9997 0.00001 0.000 0.000 0.013 485 306 1.000 1.000 Marriage before age 18 8.7 0.0024 0.00172 0.725 1.674 1.294 1,203 1,340 0.000 0.006 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 0.4433 0.01596 0.036 0.315 0.561 485 306 0.411 0.475 Knowledge of mother-to- child transmission of HIV 9.3 0.4748 0.01497 0.032 1.337 1.156 1,422 1,489 0.445 0.505 Accepting attitudes towards people living with HIV 9.4 0.1742 0.01052 0.060 1.142 1.068 1,417 1,484 0.153 0.195 Men who have been tested for HIV and know the results 9.6 0.0114 0.00255 0.223 0.858 0.926 1,422 1,489 0.006 0.017 Sexually active men aged 15-24 who have been tested for HIV and know the results 9.7 0.0177 0.00831 0.470 0.597 0.773 245 151 0.001 0.034 Sex before age 15 amongst men aged 15-24 9.11 0.0209 0.00587 0.280 0.513 0.716 485 306 0.009 0.033 Condom use with non-regular partners 9.16 0.7015 0.02631 0.037 0.459 0.678 240 140 0.649 0.754 UNDER-5’s Underweight prevalence 2.1a 0.0188 0.00834 0.444 2.893 1.701 734 767 0.002 0.035 Stunting prevalence 2.2a 0.1078 0.01836 0.170 2.597 1.612 710 742 0.071 0.145 Wasting prevalence 2.3a 0.0184 0.00260 0.142 0.268 0.518 675 715 0.013 0.024 Exclusive breastfeeding under 6 months 2.6 * * * * * 55 32 * * Age-appropriate breastfeeding 2.14 0.1131 0.02127 0.188 1.159 1.077 294 258 0.071 0.156 Received tuberculosis immunisation – 0.9952 0.00016 0.000 0.001 0.032 162 190 0.995 0.996 Received polio immunisation – 0.9139 0.01115 0.012 0.292 0.540 159 186 0.892 0.936 Received DPT immunisation – 0.9097 0.00952 0.010 0.206 0.454 160 188 0.891 0.929 Received measles immunisation – 0.8792 0.00833 0.009 0.121 0.348 159 186 0.862 0.896 Received Hepatitis B immunisation – 0.8960 0.01328 0.015 0.348 0.590 158 185 0.869 0.923 Diarrhoea in the previous 2 weeks – 0.0534 0.00920 0.172 1.340 1.158 774 802 0.035 0.072 Illness with a cough in the previous 2 weeks – 0.0335 0.00378 0.113 0.352 0.594 774 802 0.026 0.041 Oral rehydration therapy with continued feeding 3.8 * * * * * 41 36 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 26 33 * * Support for learning 6.1 0.9752 0.00570 0.006 0.470 0.686 318 352 0.964 0.987 Attendance at early childhood education 6.7 0.2282 0.01468 0.064 0.429 0.655 318 352 0.199 0.258 (*) The number of unweighted cases is fewer than 50 N/A: “Not applicable” 166 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 167 Table SE.4: Sampling errors: Rural areas, BiH Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9953 0.00141 0.001 1.543 1.242 13,289 3,622 0.992 0.998 Use of improved sanitation 4.3 0.9197 0.00726 0.008 2.587 1.608 13,289 3,622 0.905 0.934 Secondary school net attendance ratio (adjusted) 7.5 0.9232 0.01237 0.013 1.120 1.058 871 520 0.899 0.948 Prevalence of children with one or both parents dead 9.18 0.0273 0.00424 0.155 2.532 1.591 3,319 3,738 0.019 0.036 Violent discipline 8.5 0.5560 0.01738 0.031 2.064 1.437 2,363 1,689 0.521 0.591 WOMEN Pregnant women – 0.0175 0.00236 0.135 0.930 0.965 2,898 2,870 0.013 0.022 Contraceptive prevalence rate 5.3 0.4525 0.01882 0.042 3.065 1.751 1,887 2,146 0.415 0.490 Unmet need 5.4 0.0892 0.00614 0.069 0.997 0.999 1,887 2,146 0.077 0.101 Antenatal care coverage – at least once by skilled personnel 5.5a 0.8771 0.01575 0.018 1.091 1.044 204 475 0.846 0.909 Antenatal care coverage – at least four times by any provider 5.5b 0.8494 0.01665 0.020 1.027 1.014 204 475 0.816 0.883 Skilled attendant at delivery 5.7 0.9987 0.00130 0.001 0.611 0.781 204 475 0.996 1.000 Institutional deliveries 5.8 0.9974 0.00182 0.002 0.600 0.774 204 475 0.994 1.000 Caesarean section 5.9 0.1509 0.02007 0.133 1.490 1.221 204 475 0.111 0.191 Literacy rate amongst women aged 15-24 7.1 0.9906 0.00933 0.009 6.780 2.604 856 723 0.972 1.000 Marriage before age 18 8.7 0.1166 0.00798 0.068 1.597 1.264 2,464 2,581 0.101 0.133 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 0.4653 0.02193 0.047 1.395 1.181 856 723 0.421 0.509 Knowledge of mother-to-child transmission of HIV 9.3 0.6720 0.01520 0.023 3.009 1.735 2,898 2,870 0.642 0.702 Accepting attitudes towards people living with HIV 9.4 0.1336 0.01053 0.079 2.654 1.629 2,802 2,771 0.113 0.155 Women who have been tested for HIV and know the results 9.6 0.0037 0.00093 0.249 0.666 0.816 2,898 2,870 0.002 0.006 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 0.0000 0.00000 0.000 N/A N/A 246 330 0.000 0.000 Sex before age 15 amongst women aged 15-24 9.11 0.0009 0.00031 0.337 0.075 0.274 856 723 0.000 0.002 Condom use with non-regular partners 9.16 0.7594 0.02184 0.029 0.214 0.463 123 83 0.716 0.803   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 0.9985 0.00007 0.000 0.002 0.042 943 601 0.998 0.999 Marriage before age 18 8.7 0.0073 0.00201 0.275 1.428 1.195 2,466 2,571 0.003 0.011 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 0.4897 0.01577 0.032 0.597 0.773 943 601 0.458 0.521 Knowledge of mother-to-child transmission of HIV 9.3 0.5000 0.01704 0.034 3.324 1.823 2,931 2,864 0.466 0.534 Accepting attitudes towards people living with HIV 9.4 0.1761 0.01130 0.064 2.492 1.579 2,901 2,832 0.153 0.199 Men who have been tested for HIV and know the results 9.6 0.0064 0.00099 0.156 0.446 0.668 2,931 2,864 0.004 0.008 Sexually active men aged 15-24 who have been tested for HIV and know the results 9.7 0.0082 0.00077 0.094 0.019 0.139 419 266 0.007 0.010 Sex before age 15 amongst men aged 15-24 9.11 0.0117 0.00300 0.256 0.465 0.682 943 601 0.006 0.018 Condom use with non-regular partners 9.16 0.7147 0.02361 0.033 0.613 0.783 381 225 0.667 0.762 UNDER-5’s Underweight prevalence 2.1a 0.0139 0.00434 0.313 1.972 1.404 1,465 1,434 0.005 0.023 Stunting prevalence 2.2a 0.0794 0.00981 0.123 1.851 1.360 1,427 1,408 0.060 0.099 Wasting prevalence 2.3a 0.0260 0.00658 0.254 2.358 1.535 1,403 1,378 0.013 0.039 Exclusive breastfeeding under 6 months 2.6 0.2202 0.03467 0.157 0.588 0.767 180 85 0.151 0.290 Age-appropriate breastfeeding 2.14 0.2143 0.02002 0.093 1.174 1.084 627 494 0.174 0.254 Received tuberculosis immunisation – 0.9921 0.00459 0.005 0.870 0.933 301 326 0.983 1.000 Received polio immunisation – 0.9109 0.00980 0.011 0.383 0.619 301 325 0.891 0.930 Received DPT immunisation – 0.9291 0.00962 0.010 0.457 0.676 301 326 0.910 0.948 Received measles immunisation – 0.8771 0.01477 0.017 0.648 0.805 298 321 0.848 0.907 Received Hepatitis B immunisation – 0.8741 0.02045 0.023 1.223 1.106 299 323 0.833 0.915 Diarrhoea in the previous 2 weeks – 0.0623 0.00733 0.118 1.375 1.173 1,523 1,495 0.048 0.077 Illness with a cough in the previous 2 weeks – 0.0309 0.00441 0.143 0.970 0.985 1,523 1,495 0.022 0.040 Oral rehydration therapy with continued feeding 3.8 0.4813 0.01723 0.036 0.099 0.314 95 84 0.447 0.516 Antibiotic treatment of suspected pneumonia 3.10 0.7732 0.03045 0.039 0.301 0.549 47 58 0.712 0.834 Support for learning 6.1 0.9385 0.01314 0.014 2.026 1.423 599 679 0.912 0.965 Attendance at early childhood education 6.7 0.0791 0.01570 0.199 2.296 1.515 599 679 0.048 0.110 N/A: “Not applicable” 168 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 169 Table SE.5: Sampling errors: FBiH Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9960 0.00138 0.001 1.751 1.323 13,374 3,618 0.993 0.999 Use of improved sanitation 4.3 0.9652 0.00664 0.007 4.752 2.180 13,374 3,618 0.952 0.978 Secondary school net attendance ratio (adjusted) 7.5 0.9204 0.01492 0.016 1.562 1.250 904 515 0.891 0.950 Prevalence of children with one or both parents dead 9.18 0.0270 0.00478 0.177 3.216 1.793 3,345 3,693 0.017 0.037 Violent discipline 8.5 0.5872 0.01708 0.029 2.074 1.440 2,338 1,725 0.553 0.621 WOMEN Pregnant women – 0.0147 0.00243 0.165 1.247 1.117 3,180 3,067 0.010 0.020 Contraceptive prevalence rate 5.3 0.4307 0.01896 0.044 3.237 1.799 1,944 2,208 0.393 0.469 Unmet need 5.4 0.0988 0.00821 0.083 1.672 1.293 1,944 2,208 0.082 0.115 Antenatal care coverage – at least once by skilled personnel 5.5a 0.8193 0.02371 0.029 1.823 1.350 211 481 0.772 0.867 Antenatal care coverage – at least four times by any provider 5.5b 0.7930 0.02438 0.031 1.739 1.319 211 481 0.744 0.842 Skilled attendant at delivery 5.7 0.9987 0.00126 0.001 0.600 0.775 211 481 0.996 1.000 Institutional deliveries 5.8 0.9962 0.00216 0.002 0.591 0.769 211 481 0.992 1.000 Caesarean section 5.9 0.1450 0.01857 0.128 1.335 1.156 211 481 0.108 0.182 Literacy rate amongst women aged 15-24 7.1 0.9919 0.00808 0.008 6.255 2.501 989 770 0.976 1.000 Marriage before age 18 8.7 0.0995 0.00862 0.087 2.284 1.511 2,686 2,753 0.082 0.117 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 0.4638 0.02502 0.054 1.936 1.391 989 770 0.414 0.514 Knowledge of mother-to- child transmission of HIV 9.3 0.7503 0.01468 0.020 3.526 1.878 3,180 3,067 0.721 0.780 Accepting attitudes towards people living with HIV 9.4 0.1431 0.00920 0.064 2.052 1.433 3,088 2,973 0.125 0.161 Women who have been tested for HIV and know the results 9.6 0.0047 0.00153 0.328 1.550 1.245 3,180 3,067 0.002 0.008 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 0.0011 0.00110 1.002 0.338 0.581 245 308 0.000 0.003 Sex before age 15 amongst women aged 15-24 9.11 0.0008 0.00047 0.578 0.209 0.457 989 770 0.000 0.002 Condom use with non-regular partners 9.16 0.7281 0.03748 0.051 0.546 0.739 126 78 0.653 0.803   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 0.9997 0.00027 0.000 0.171 0.413 1,014 638 0.999 1.000 Marriage before age 18 8.7 0.0076 0.00211 0.278 1.583 1.258 2,555 2,670 0.003 0.012 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 0.4940 0.01963 0.040 0.982 0.991 1,014 638 0.455 0.533 Knowledge of mother-to- child transmission of HIV 9.3 0.5893 0.01909 0.032 4.458 2.111 3,010 2,960 0.551 0.628 Accepting attitudes towards people living with HIV 9.4 0.1792 0.01235 0.069 3.036 1.742 2,982 2,931 0.155 0.204 Men who have been tested for HIV and know the results 9.6 0.0085 0.00214 0.251 1.608 1.268 3,010 2,960 0.004 0.013 Sexually active men aged 15-24 who have been tested for HIV and know the results 9.7 0.0143 0.00452 0.316 0.421 0.649 464 291 0.005 0.023 Sex before age 15 amongst men aged 15-24 9.11 0.0180 0.00508 0.282 0.928 0.963 1,014 638 0.008 0.028 Condom use with non- regular partners 9.16 0.7402 0.02240 0.030 0.658 0.811 434 253 0.695 0.785 UNDER-5’s Underweight prevalence 2.1a 0.0201 0.00557 0.276 2.329 1.526 1,577 1,485 0.009 0.031 Stunting prevalence 2.2a 0.0992 0.01327 0.134 2.892 1.700 1,553 1,468 0.073 0.126 Wasting prevalence 2.3a 0.0261 0.00657 0.252 2.407 1.551 1,499 1,416 0.013 0.039 Exclusive breastfeeding under 6 months 2.6 0.1513 0.01896 0.125 0.215 0.464 181 78 0.113 0.189 Age-appropriate breastfeeding 2.14 0.1985 0.02030 0.102 1.298 1.139 655 502 0.158 0.239 Received tuberculosis immunisation – 0.9951 0.00349 0.004 0.873 0.934 327 353 0.988 1.000 Received polio immunisation – 0.9064 0.01100 0.012 0.496 0.704 324 349 0.884 0.928 Received DPT immunisation – 0.9046 0.01093 0.012 0.486 0.697 327 352 0.883 0.926 Received measles immunisation – 0.8828 0.01329 0.015 0.594 0.771 324 349 0.856 0.909 Received Hepatitis B immunisation – 0.8746 0.02006 0.023 1.273 1.128 323 348 0.835 0.915 Diarrhoea in the previous 2 weeks – 0.0672 0.01056 0.157 2.702 1.644 1,611 1,518 0.046 0.088 Illness with a cough in the previous 2 weeks – 0.0276 0.00405 0.147 0.926 0.962 1,611 1,518 0.020 0.036 Oral rehydration therapy with continued feeding 3.8 0.5460 0.04956 0.091 0.842 0.918 108 86 0.447 0.645 Antibiotic treatment of suspected pneumonia 3.10 0.8182 0.04082 0.050 0.605 0.778 44 55 0.737 0.900 Support for learning 6.1 0.9418 0.01368 0.015 2.298 1.516 635 674 0.914 0.969 Attendance at early childhood education 6.7 0.1439 0.02470 0.172 3.332 1.825 635 674 0.095 0.193 170 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 171 Table SE.6: Sampling errors: RS Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9953 0.00204 0.002 1.730 1.315 6,524 1,945 0.991 0.999 Use of improved sanitation 4.3 0.8942 0.01337 0.015 3.674 1.917 6,524 1,945 0.867 0.921 Secondary school net attendance ratio (adjusted) 7.5 0.9161 0.01748 0.019 0.874 0.935 349 221 0.881 0.951 Prevalence of children with one or both parents dead 9.18 0.0389 0.00844 0.217 3.310 1.819 1,433 1,741 0.022 0.056 Violent discipline 8.5 0.4795 0.03032 0.063 2.865 1.693 1,056 779 0.419 0.540 WOMEN Pregnant women – 0.0260 0.00437 0.168 0.946 0.972 1,210 1,252 0.017 0.035 Contraceptive prevalence rate 5.3 0.5369 0.03499 0.065 4.559 2.135 777 927 0.467 0.607 Unmet need 5.4 0.0674 0.00860 0.128 1.090 1.044 777 927 0.050 0.085 Antenatal care coverage – at least once by skilled personnel 5.5a 0.9968 0.00024 0.000 0.004 0.063 82 212 0.996 0.997 Antenatal care coverage – at least four times by any provider 5.5b 0.9659 0.01348 0.014 1.165 1.079 82 212 0.939 0.993 Skilled attendant at delivery 5.7 1.0000 0.00000 0.000 N/A N/A 82 212 1.000 1.000 Institutional deliveries 5.8 1.0000 0.00000 0.000 N/A N/A 82 212 1.000 1.000 Caesarean section 5.9 0.1161 0.02779 0.239 1.589 1.260 82 212 0.061 0.172 Literacy rate amongst women aged 15-24 7.1 0.9984 0.00117 0.001 0.212 0.460 318 258 0.996 1.000 Marriage before age 18 8.7 0.0818 0.01031 0.126 1.636 1.279 1,070 1,158 0.061 0.102 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 0.5178 0.02815 0.054 0.816 0.903 318 258 0.461 0.574 Knowledge of mother-to- child transmission of HIV 9.3 0.4895 0.02231 0.046 2.493 1.579 1,210 1,252 0.445 0.534 Accepting attitudes towards people living with HIV 9.4 0.1663 0.02096 0.126 3.951 1.988 1,207 1,248 0.124 0.208 Women who have been tested for HIV and know the results 9.6 0.0029 0.00177 0.604 1.343 1.159 1,210 1,252 0.000 0.006 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 0.0000 0.00000 0.000 N/A N/A 135 139 0.000 0.000 Sex before age 15 amongst women aged 15-24 9.11 0.0025 0.00117 0.472 0.142 0.376 318 258 0.000 0.005 Condom use with non-regular partners 9.16 0.6909 0.03736 0.054 0.418 0.647 97 65 0.616 0.766   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 1.0000 0.00000 0.000 N/A N/A 393 239 1.000 1.000 Marriage before age 18 8.7 0.0011 0.00028 0.254 0.080 0.283 1,049 1,118 0.001 0.002 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 0.4229 0.02109 0.050 0.434 0.659 393 239 0.381 0.465 Knowledge of mother-to- child transmission of HIV 9.3 0.2743 0.01852 0.068 2.167 1.472 1,271 1,258 0.237 0.311 Accepting attitudes towards people living with HIV 9.4 0.1591 0.01567 0.098 2.297 1.515 1,267 1,253 0.128 0.190 Men who have been tested for HIV and know the results 9.6 0.0064 0.00363 0.571 2.622 1.619 1,271 1,258 0.000 0.014 Sexually active men aged 15-24 who have been tested for HIV and know the results 9.7 0.0000 0.00000 0.000 N/A N/A 185 108 0.000 0.000 Sex before age 15 amongst men aged 15-24 9.11 0.0074 0.00501 0.675 0.812 0.901 393 239 0.000 0.017 Condom use with non- regular partners 9.16 0.6165 0.03737 0.061 0.573 0.757 174 98 0.542 0.691 UNDER-5’s Underweight prevalence 2.1a 0.0039 0.00230 0.585 0.882 0.939 592 655 0.000 0.009 Stunting prevalence 2.2a 0.0638 0.01175 0.184 1.434 1.197 554 621 0.040 0.087 Wasting prevalence 2.3a 0.0169 0.00499 0.295 0.920 0.959 550 615 0.007 0.027 Exclusive breastfeeding under 6 months 2.6 * * * * * 51 37 * * Age-appropriate breastfeeding 2.14 0.1481 0.03012 0.203 1.595 1.263 246 223 0.088 0.208 Received tuberculosis immunisation – 0.9879 0.00608 0.006 0.446 0.668 128 145 0.976 1.000 Received polio immunisation – 0.9269 0.01385 0.015 0.405 0.636 127 144 0.899 0.955 Received DPT immunisation – 0.9757 0.01087 0.011 0.712 0.844 127 144 0.954 0.997 Received measles immunisation – 0.8714 0.01851 0.021 0.434 0.659 127 143 0.834 0.908 Received Hepatitis B immunisation – 0.9026 0.01741 0.019 0.493 0.702 127 144 0.868 0.937 Diarrhoea in the previous 2 weeks – 0.0430 0.00591 0.138 0.597 0.772 646 704 0.031 0.055 Illness with a cough in the previous 2 weeks – 0.0418 0.00697 0.167 0.855 0.924 646 704 0.028 0.056 Oral rehydration therapy with continued feeding 3.8 * * * * * 28 33 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 27 32 * * Support for learning 6.1 0.9799 0.00931 0.010 1.441 1.200 270 328 0.961 0.999 Attendance at early childhood education 6.7 0.1028 0.02031 0.198 1.464 1.210 270 328 0.062 0.143 (*) The number of unweighted cases is fewer than 50 N/A: “Not applicable” 172 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 173 Table SE.7: Sampling errors: BD Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLD MEMBERS Use of improved drinking water sources 4.1 0.9939 0.00302 0.003 0.321 0.567 323 215 0.988 1.000 Use of improved sanitation 4.3 0.9950 0.00369 0.004 0.589 0.768 323 215 0.988 1.000 Secondary school net attendance ratio (adjusted) 7.5 * * * * * 17 26 * * Prevalence of children with one or both parents dead 9.18 0.0040 0.00327 0.824 0.503 0.710 77 187 0.000 0.011 Violent discipline 8.5 0.4533 0.06316 0.139 1.239 1.113 58 78 0.327 0.580 WOMEN Pregnant women – 0.0176 0.00789 0.448 0.453 0.673 56 127 0.002 0.033 Contraceptive prevalence rate 5.3 0.2472 0.07617 0.308 3.149 1.774 43 102 0.095 0.400 Unmet need 5.4 0.1313 0.01899 0.145 0.320 0.565 43 102 0.093 0.169 Antenatal care coverage – at least once by skilled personnel 5.5a * * * * * 6 25 * * Antenatal care coverage – at least four times by any provider 5.5b * * * * * 6 25 * * Skilled attendant at delivery 5.7 * * * * * 6 25 * * Institutional deliveries 5.8 * * * * * 6 25 * * Caesarean section 5.9 * * * * * 6 25 * * Literacy rate amongst women aged 15-24 7.1 * * * * * 12 28 * * Marriage before age 18 8.7 0.1127 0.03646 0.324 1.462 1.209 48 111 0.040 0.186 Comprehensive knowledge about HIV prevention amongst women aged 15-24 9.2 * * * * * 12 28 * * Knowledge of mother-to- child transmission of HIV 9.3 0.3171 0.04695 0.148 1.283 1.133 56 127 0.223 0.411 Accepting attitudes towards people living with HIV 9.4 0.2706 0.07094 0.262 3.060 1.749 54 121 0.129 0.412 Women who have been tested for HIV and know the results 9.6 0.0138 0.00847 0.613 0.663 0.814 56 127 0.000 0.031 Sexually active women aged 15-24 who have been tested for HIV and know the results 9.7 * * * * * 4 14 * * Sex before age 15 amongst women aged 15-24 9.11 * * * * * 12 28 * * Condom use with non-regular partners 9.16 * * * * * 3 5 * *   MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se MEN Literacy rate amongst men aged 15-24 7.1 * * * * * 21 30 * * Marriage before age 18 8.7 0.0043 0.00458 1.063 0.597 0.773 64 123 0.000 0.013 Comprehensive knowledge about HIV prevention amongst men aged 15-24 9.2 * * * * * 21 30 * * Knowledge of mother-to- child transmission of HIV 9.3 0.2497 0.05639 0.226 2.275 1.508 71 135 0.137 0.362 Accepting attitudes towards people living with HIV 9.4 0.3144 0.05588 0.178 1.898 1.378 69 132 0.203 0.426 Men who have been tested for HIV and know the results 9.6 0.0159 0.01466 0.922 1.841 1.357 71 135 0.000 0.045 Sexually active men aged 15-24 who have been tested for HIV and know the results 9.7 * * * * * 14 18 * * Sex before age 15 amongst men aged 15-24 9.11 * * * * * 21 30 * * Condom use with non-regular partners 9.16 * * * * * 14 14 * * UNDER-5’s Underweight prevalence 2.1a 0.0000 0.00000 0.000 N/A N/A 29 61 0.000 0.000 Stunting prevalence 2.2a 0.0136 0.01387 1.018 0.858 0.926 29 61 0.000 0.041 Wasting prevalence 2.3a 0.0134 0.01421 1.057 0.929 0.964 30 62 0.000 0.042 Exclusive breastfeeding under 6 months 2.6 * * * * * 3 2 * * Age-appropriate breastfeeding 2.14 * * * * * 20 27 * * Received tuberculosis immunisation – * * * * * 8 18 * * Received polio immunisation – * * * * * 8 18 * * Received DPT immunisation – * * * * * 8 18 * * Received measles immunisation – * * * * * 7 15 * * Received Hepatitis B immunisation – * * * * * 7 16 * * Diarrhoea in the previous 2 weeks – 0.0099 0.00966 0.973 0.703 0.839 40 75 0.000 0.029 Illness with a cough in the previous 2 weeks – 0.0397 0.02160 0.544 0.905 0.952 40 75 0.000 0.083 Oral rehydration therapy with continued feeding 3.8 * * * * * 0 1 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 2 4 * * Support for learning 6.1 * * * * * 12 29 * * Attendance at early childhood education 6.7 * * * * * 12 29 * * (*) The number of unweighted cases is fewer than 50 N/A: “Not applicable” 174 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 175 Appendix D: Data Quality Tables Table DQ.1: Age distribution of household population Single year age distribution of household population by sex, BiH 2011–2012     Males Females Males Females Number Per cent Number Per cent Number Per cent Number Per cent 0 87 0.9 93 0.9 45 163 1.6 188 1.8 1 82 0.8 95 0.9 46 194 1.9 156 1.5 2 89 0.9 87 0.9 47 169 1.7 187 1.8 3 101 1.0 89 0.9 48 136 1.4 158 1.5 4 78 0.8 90 0.9 49 193 1.9 159 1.6 5 125 1.2 109 1.1 50 159 1.6 172 1.7 6 129 1.3 114 1.1 51 161 1.6 168 1.7 7 149 1.5 90 0.9 52 178 1.8 142 1.4 8 148 1.5 122 1.2 53 164 1.6 134 1.3 9 156 1.6 111 1.1 54 152 1.5 127 1.2 10 169 1.7 124 1.2 55 153 1.5 116 1.1 11 185 1.8 166 1.6 56 134 1.3 137 1.3 12 176 1.8 139 1.4 57 129 1.3 128 1.3 13 150 1.5 171 1.7 58 122 1.2 121 1.2 14 193 1.9 192 1.9 59 99 1.0 108 1.1 15 203 2.0 188 1.8 60 107 1.1 99 1.0 16 165 1.6 215 2.1 61 98 1.0 107 1.1 17 140 1.4 136 1.3 62 80 0.8 96 0.9 18 130 1.3 122 1.2 63 72 0.7 99 1.0 19 180 1.8 102 1.0 64 72 0.7 58 0.6 20 203 2.0 196 1.9 65 61 0.6 90 0.9 21 200 2.0 168 1.6 66 45 0.5 68 0.7 22 178 1.8 146 1.4 67 48 0.5 77 0.8 23 150 1.5 177 1.7 68 33 0.3 68 0.7 24 163 1.6 137 1.3 69 50 0.5 73 0.7 25 144 1.4 118 1.2 70 69 0.7 84 0.8 26 125 1.2 129 1.3 71 61 0.6 95 0.9 27 144 1.4 121 1.2 72 69 0.7 88 0.9 28 122 1.2 97 0.9 73 61 0.6 93 0.9 29 109 1.1 129 1.3 74 63 0.6 76 0.7 30 121 1.2 112 1.1 75 55 0.5 93 0.9 31 96 1.0 148 1.5 76 40 0.4 59 0.6 32 111 1.1 126 1.2 77 42 0.4 48 0.5 33 109 1.1 145 1.4 78 50 0.5 67 0.7 34 122 1.2 131 1.3 79 50 0.5 58 0.6 35 130 1.3 154 1.5 80 24 0.2 39 0.4 36 156 1.6 140 1.4 81 16 0.2 32 0.3 37 156 1.6 151 1.5 82 21 0.2 33 0.3 38 132 1.3 151 1.5 83 18 0.2 19 0.2 39 135 1.3 136 1.3 84 12 0.1 19 0.2 40 152 1.5 161 1.6 85+ 31 0.3 68 0.7 41 126 1.3 166 1.6   42 145 1.4 130 1.3 DK/Missing 4 0.0 5 0.1 43 134 1.3 170 1.7   44 183 1.8 175 1.7 Total 10,036 100.0 10,185 100.0 Table DQ.2: Age distribution of eligible and interviewed women Household population of women aged 10-54, interviewed women aged 15-49 and percentage of eligible women who were interviewed, by five-year age groups, BiH 2011–2012   Household population of women aged 10-54 years Interviewed women aged 15-49 years Percentage of eligible women interviewed (Completion rate)Number Number Per cent Age (years)   10-14 794 N/A N/A N/A 15-19 763 719 14.5 94.3 20-24 824 758 15.3 92.1 25-29 593 557 11.2 93.9 30-34 662 634 12.8 95.7 35-39 734 720 14.5 98.1 40-44 802 771 15.5 96.2 45-49 847 804 16.2 94.9 50-54 744 N/A N/A N/A Total (15-49) 5,225 4,963 100.0 95.0     Ratio of 50-54 to 45-49     0.88 N/A: “Not applicable” Table DQ.2M: Age distribution of eligible and interviewed men Household population of men aged 10-54, interviewed men aged 15-49 and percentage of eligible men who were interviewed, by five-year age groups, BiH 2011–2012   Household population of men aged 10-54 years Interviewed men aged 15-49 years Percentage of eligible men interviewed (Completion rate)Number Number Per cent Age (years)   10-14 871 N/A N/A N/A 15-19 817 750 15.6 91.7 20-24 895 820 17.1 91.6 25-29 644 590 12.3 91.6 30-34 559 507 10.6 90.7 35-39 710 657 13.7 92.6 40-44 740 678 14.1 91.7 45-49 856 792 16.5 92.5 50-54 814 N/A N/A N/A Total (15-49) 5,221 4,793 100.0 91.8     Ratio of 50-54 to 45-49     0.95 N/A: “Not applicable” Table DQ.3: Age distribution of under-5’s in household and under-5 questionnaires Household population of children aged 0-7, children aged 0-4 whose mothers/caretakers were interviewed and percentage of under-5 children whose mothers/caretakers were interviewed, by single ages, BiH 2011–2012   Household population of children 0-7 years Interviewed under-5 children Percentage of eligible under-5’s interviewed (Completion rate)  Number Number Per cent Age (years)   0 180 174 19.9 96.6 1 177 174 20.0 98.3 2 176 174 19.9 99.0 3 190 186 21.3 97.7 4 168 165 18.9 98.1 5 235 N/A N/A N/A 6 242 N/A N/A N/A 7 239 N/A N/A N/A Total (0-4) 891 872 100.0 97.9     Ratio of 5 to 4       1.40 N/A: “Not applicable” 176 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 177 Table DQ.4: Women’s completion rates by socio-economic characteristics of households Household population of women aged 15-49, interviewed women aged 15-49 and percentage of eligible women who were interviewed, by selected social and economic characteristics of the household, BiH 2011–2012   Household population of women aged 15-49 years Interviewed women aged 15-49 years Per cent of eligible women interviewed (Completion rates)  Number Per cent Number Per cent Administrative unit   FBiH 3,737 71.5 3,614 72.8 96.7 RS 1,422 27.2 1,288 26.0 90.6 BD 66 1.3 61 1.2 92.3 Area   Urban 1,824 34.9 1,726 34.8 94.6 Rural 3,401 65.1 3,238 65.2 95.2 Household size   1-3 1,171 22.4 1,105 22.3 94.4 4-6 3,695 70.7 3,538 71.3 95.7 7+ 360 6.9 321 6.5 89.3 Education of household head   None 99 1.9 88 1.8 88.9 Primary 1,329 25.4 1,258 25.4 94.7 Secondary 3,280 62.8 3,121 62.9 95.2 Higher 516 9.9 495 10.0 95.9 Missing/DK 1 0.0 1 0.0 100.0 Wealth index quintiles   Poorest 740 14.2 685 13.8 92.6 Second 981 18.8 943 19.0 96.1 Middle 1,122 21.5 1,089 21.9 97.1 Fourth 1,202 23.0 1,145 23.1 95.3 Richest 1,181 22.6 1,101 22.2 93.2 Total 5,225 100.0 4,963 100.0 95.0 Table DQ.4M: Men’s completion rates by socio-economic characteristics of households Household population of men aged 15-49, interviewed men aged 15-49 and percentage of eligible men who were interviewed, by selected social and economic characteristics of the household, BiH 2011–2012   Household population of men aged 15-49 years Interviewed men aged 15-49 years Per cent of eligible men interviewed (Completion rates)  Number Per cent Number Per cent Administrative unit   FBiH 3,611 69.2 3,387 70.6 93.8 RS 1,525 29.2 1,331 27.8 87.3 BD 86 1.6 76 1.6 88.3 Area   Urban 1,721 33.0 1,567 32.7 91.0 Rural 3,500 67.0 3,227 67.3 92.2 Household size   1-3 1,286 24.6 1,197 25.0 93.1 4-6 3,600 68.9 3,308 69.0 91.9 7+ 336 6.4 288 6.0 85.8 Education of household head   None 107 2.0 87 1.8 81.2 Primary 1,441 27.6 1,321 27.6 91.7 Secondary 3,133 60.0 2,904 60.6 92.7 Higher 538 10.3 480 10.0 89.2 Missing/DK 2 0.0 2 0.1 100.0 Wealth index quintiles   Poorest 825 15.8 747 15.6 90.6 Second 995 19.1 932 19.4 93.6 Middle 1,170 22.4 1,089 22.7 93.1 Fourth 1,094 20.9 989 20.6 90.5 Richest 1,137 21.8 1,036 21.6 91.1 Total 5,221 100.0 4,793 100.0 91.8 178 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 179 Table DQ.5: Completion rates for under-5 questionnaires by socio-economic characteristics of households Household population of under-5 children, under-5 questionnaires completed and percentage of under-5 children for whom interviews were completed, by selected socio-economic characteristics of the household, BiH 2011–2012   Household population of under-5 children Interviewed under-5 children Per cent of eligible under-5’s with completed under-5 questionnaires (Completion rates)  Number Per cent Number Per cent Administrative unit   FBiH 625 70.1 614 70.4 98.3 RS 251 28.1 242 27.8 96.8 BD 16 1.8 15 1.8 99.0 Area   Urban 299 33.6 294 33.7 98.2 Rural 592 66.4 579 66.3 97.8 Household size   1-3 123 13.8 122 13.9 99.0 4-6 637 71.5 628 72.0 98.6 7+ 131 14.7 123 14.1 93.5 Education of household head   None 19 2.1 19 2.2 100.0 Primary 262 29.4 259 29.7 98.8 Secondary 523 58.7 508 58.2 97.1 Higher 87 9.8 87 9.9 99.6 Missing/DK 0 0.0 0 0.0 100.0 Wealth index quintiles   Poorest 152 17.1 147 16.8 96.2 Second 186 20.9 183 21.0 98.7 Middle 179 20.1 173 19.9 96.6 Fourth 180 20.2 178 20.4 99.0 Richest 194 21.8 191 21.9 98.6 Total 891 100.0 872 100.0 97.9 Table DQ.6: Completeness of reporting Percentage of observations that are missing information for selected questions and indicators, BiH 2011–2012 Questionnaire and type of missing information Reference group Per cent with missing/ incomplete information* Number of cases Household   Age All household members 0.0 20,248 Starting time of interview All households interviewed 0.3 5,778 Ending time of interview All households interviewed 0.4 5,778     Women   Woman’s date of birth All women aged 15-49   Only month 0.1 4,446 Both month and year 0.1 4,446 Date of last birth All women aged 15-49 with a live birth in last 2 years   Only month 0.4 2,865 Both month and year 0.2 2,865 Date of first marriage/union All ever married women aged 15-49   Only month 2.8 3,024 Both month and year 1.2 3,024 Age at first marriage/union All ever married women aged 15-49 with year of first marriage not known 0.1 3,024 Age at first intercourse All women aged 15-24 who have ever had sex 0.0 406 Time since last intercourse All women aged 15-24 who have ever had sex 0.0 406 Starting time of interview All women interviewed 0.6 4,446 Ending time of interview All women interviewed 0.6 4,446     Men   Man’s date of birth All men aged 15-49   Only month 0.0 4,353 Both month and year 0.0 4,353 Date of first marriage/union All ever married men aged 15-49   Only month 3.3 2,336 Both month and year 1.8 2,336 Age at first marriage/union All ever married men aged 15-49 with year of first marriage not known 0.2 2,336 Age at first intercourse All men aged 15-24 who have ever had sex 0.0 699 Time since last intercourse All men aged 15-24 who have ever had sex 0.0 699 Starting time of interview All men interviewed 0.4 4,353 Ending time of interview All men interviewed 0.4 4,353     Under-5   Date of birth All under-5 children   Only month 0.1 2,297 Both month and year 0.0 2,297 Anthropometric measurements All under-5 children   Weight 4.0 2,297 Height 6.1 2,297 Both weight and height 4.0 2,297 Starting time of interview All under-5 children 0.6 2,297 Ending time of interview All under-5 children 0.6 2,297 * Includes “Don’t know” responses 180 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 181 Table DQ.7: Completeness of information for anthropometric indicators Distribution of children under 5 by completeness of information for anthropometric indicators, BiH 2011–2012   Valid weight and date of birth Reason for exclusion from analysis Total Per cent of children excluded from analysis Number of children under 5  Weight not measured Incomplete date of birth Weight not measured, incomplete date of birth Flagged cases (outliers) Weight by age <6 months 92.3 7.7 0.0 0.0 0.0 100.0 7.7 117 6-11 months 94.4 5.6 0.0 0.0 0.0 100.0 5.6 126 12-23 months 96.1 3.7 0.0 0.0 0.2 100.0 3.9 509 24-35 months 96.5 2.9 0.4 0.0 0.2 100.0 3.5 514 36-47 months 95.9 3.6 0.2 0.0 0.4 100.0 4.1 556 48-59 months 96.0 3.6 0.0 0.2 0.2 100.0 4.0 475 Total 95.8 3.8 0.1 0.0 0.2 100.0 4.2 2,297     Valid height and date of birth Reason for exclusion from analysis Total Per cent of children excluded from analysis Number of children under 5 Height not measured Incomplete date of birth Height not measured, incomplete date of birth Flagged cases (outliers) Height by age <6 months 87.2 12.0 0.0 0.0 0.9 100.0 12.8 117 6-11 months 90.5 9.5 0.0 0.0 0.0 100.0 9.5 126 12-23 months 91.9 7.3 0.0 0.0 0.8 100.0 8.1 509 24-35 months 94.7 4.3 0.4 0.0 0.6 100.0 5.3 514 36-47 months 94.6 5.0 0.2 0.0 0.2 100.0 5.4 556 48-59 months 95.4 4.2 0.0 0.2 0.2 100.0 4.6 475 Total 93.6 5.8 0.1 0.0 0.4 100.0 6.4 2,297     Valid weight and height Reason for exclusion from analysis Total Per cent of children excluded from analysis Number of children under 5 Weight not measured Height not measured Weight and height not measured Flagged cases (outliers) Weight by height <6 months 84.6 0.0 4.3 7.7 3.4 100.0 15.4 117 6-11 months 88.1 0.0 4.0 5.6 2.4 100.0 11.9 126 12-23 months 88.8 0.0 3.5 3.7 3.9 100.0 11.2 509 24-35 months 93.4 0.0 1.4 2.9 1.9 100.0 6.2 514 36-47 months 92.6 0.0 1.4 3.6 2.2 100.0 7.2 556 48-59 months 91.2 0.0 0.6 3.6 4.6 100.0 8.8 475 Total 91.0 0.0 2.0 3.8 3.1 100.0 8.9 2,297 Table DQ.8: Heaping in anthropometric measurements Distribution of weight and height/length measurements by digits reported for decimals, BiH 2011–2012 Digits Weight Height or length Number Per cent Number Per cent 0 243 11.0 418 18.9 1 219 9.9 223 10.1 2 301 13.6 278 12.6 3 237 10.7 266 12.0 4 183 8.3 220 10.0 5 281 12.7 231 10.5 6 175 7.9 153 6.9 7 215 9.7 159 7.2 8 198 9.0 142 6.4 9 157 7.1 119 5.4     0 or 5 524 23.7 649 29.4 Total 2,209 100.0 2,209 100.0 Table DQ.9: Observation of places for hand washing Percentage of places for hand washing observed by the interviewer in all interviewed households, BiH 2011–2012 Place for hand washing Total Number of households interviewed Observed Not observed   Not in the dwelling, plot or yard No permission to see Other Administrative unit FBiH 99.1 0.5 0.2 0.1 100.0 3,618 RS 95.9 1.5 1.3 1.1 100.0 1,945 BD 80.9 6.0 8.4 4.7 100.0 215 Area   Urban 97.8 0.1 1.4 0.6 100.0 2,156 Rural 97.1 1.6 0.6 0.6 100.0 3,622 Wealth index quintiles   Poorest 93.7 3.5 1.4 1.3 100.0 1,666 Second 99.1 0.1 0.7 0.1 100.0 1,139 Middle 98.5 0.2 0.8 0.6 100.0 1,052 Fourth 98.6 0.0 0.8 0.7 100.0 909 Richest 99.2 0.0 0.6 0.2 100.0 1,012 Total 97.4 1.1 0.9 0.6 100.0 5,778 Table DQ.10: Observation of vaccination cards Per cent distribution of children under 5 by presence of a vaccination card and the percentage of vaccination cards seen by the interviewers, BiH 2011–2012 Child does not have vaccination card Child has vaccination card DK/Missing Total Per cent of vaccination cards seen by the interviewer (1)/ (1+2)*100 Number of children under age 5  Had vaccination card previously Never had vaccination card Seen by the interviewer (1) Not seen by the interviewer (2) Administrative unit   FBiH 1.1 0.9 93.0 5.1 0.0 100.0 94.8 1,518 RS 3.7 2.0 78.1 16.2 0.0 100.0 82.8 704 BD 1.3 0.0 73.3 25.3 0.0 100.0 74.3 75 Area Urban 1.6 1.4 86.4 10.6 0.0 100.0 89.1 802 Rural 2.1 1.1 88.5 8.4 0.0 100.0 91.4 1,495 Child’s age 0 0.8 2.9 87.0 9.2 0.0 100.0 90.4 239 1 1.9 1.2 89.7 7.2 0.0 100.0 92.6 513 2 2.3 1.0 86.3 10.4 0.0 100.0 89.3 511 3 2.5 0.4 88.9 8.2 0.0 100.0 91.5 559 4 1.3 1.5 86.3 10.9 0.0 100.0 88.7 475 Total 1.9 1.2 87.8 9.1 0.0 100.0 90.6 2,297 MONITORING THE SITUATION OF CHILDREN AND WOMEN 183 Table DQ.11: Presence of mother in the household and the person interviewed for the under-5 questionnaire Distribution of children under fi ve by whether the mother lives in the same household and the person interviewed for the under-5 questionnaire, BiH 2011–2012 Mother in the household Mother not in the household Total Number of children under 5  Mother interviewed Other adult female interviewed Father interviewed Other adult female interviewed Age (years)   0 98.7 0.0 0.0 1.3 100.0 180 1 99.6 0.0 0.4 0.0 100.0 177 2 98.2 0.0 0.5 1.3 100.0 176 3 99.7 0.0 0.2 0.2 100.0 190 4 98.6 0.2 1.1 0.2 100.0 168 Total 99.0 0.0 0.4 0.6 100.0 891 Table DQ.12: Selection of children aged 2-14 years for the child discipline module Per cent of households with at least two children aged 2-14 years where correct selection of one child for the child discipline module was performed, BiH 2011–2012 Per cent of households where correct selection was performed Number of households with 2 or more children aged 2-14 years Administrative unit   FBiH 91.6 808 RS 99.1 426 BD 100.0 46 Area   Urban 95.0 416 Rural 94.1 864 Number of children aged 2-14 years   2 95.1 995 3 93.4 228 4 93.2 44 5+ 61.5 13 Total 94.4 1,280 Figure DQ.1: Number of household population by single ages, BiH 2011–2012 Number Age (years) Male Female Ta bl e D Q .1 3: S ch oo l a tt en da nc e by s in gl e ag e D is tr ib ut io n of h ou se ho ld p op ul at io n ag ed 5 -2 4 by e du ca tio na l l ev el a nd g ra de a tt en de d in th e cu rr en t ( or m os t r ec en t) s ch oo l y ea r, Bi H 2 01 1– 20 12   Cu rr en tl y at te nd in g D K To ta l N um be r o f ho us eh ol d m em be rs N ot at te nd in g sc ho ol Pr es ch oo l Pr im ar y sc ho ol G ra de Se co nd ar y sc ho ol G ra de H ig he r th an se co nd ar y   1 2 3 4 5 6 7 8 9 1 2 3 4 A ge a t b eg in ni ng o f s ch oo l y ea r 5 81 .7 10 .4 7. 9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 23 7 6 11 .7 5. 0 72 .9 10 .4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 26 4 7 0. 0 0. 0 6. 3 81 .2 12 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 22 8 8 1. 2 0. 0 1. 2 8. 7 77 .3 11 .4 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 27 8 9 0. 9 0. 0 0. 0 0. 0 14 .7 73 .4 11 .0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 26 4 10 0. 8 0. 0 0. 0 0. 0 0. 8 10 .9 74 .9 12 .6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 29 4 11 0. 9 0. 0 0. 0 0. 0 0. 0 0. 1 13 .3 73 .2 12 .4 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 35 4 12 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 1. 8 11 .8 73 .8 11 .5 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 32 8 13 0. 3 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 1 14 .6 77 .5 4. 6 2. 2 0. 0 0. 0 0. 0 0. 0 0. 7 10 0. 0 30 8 14 1. 7 0. 0 0. 6 0. 0 0. 0 0. 0 0. 0 0. 0 1. 2 36 .6 16 .2 41 .3 1. 7 0. 0 0. 0 0. 0 0. 6 10 0. 0 40 9 15 1. 4 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 3 2. 0 1. 2 58 .9 35 .6 0. 6 0. 0 0. 0 0. 0 10 0. 0 39 2 16 4. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 5. 1 54 .2 35 .9 0. 7 0. 0 0. 0 10 0. 0 35 3 17 11 .3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 4. 4 53 .2 31 .1 0. 0 0. 0 10 0. 0 28 2 18 28 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 9 6. 3 47 .8 16 .4 0. 0 10 0. 0 24 3 19 53 .8 0. 0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 8 0. 0 0. 0 5. 5 39 .6 0. 0 10 0. 0 29 3 20 56 .9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 42 .6 0. 0 10 0. 0 41 8 21 53 .0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 47 .0 0. 0 10 0. 0 35 9 22 59 .3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 40 .7 0. 0 10 0. 0 32 3 23 68 .9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 1 30 .9 0. 0 10 0. 0 30 0 24 76 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 9 21 .8 0. 9 10 0. 0 31 4 182 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 184 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 185 [M] Indicates that the indicator is also calculated for men in the same age group. Calculations were carried out by using modules in the Men’s Ques- tionnaire 60 Some indicators were constructed by using questions in several modules. In such cases, only the module(s) which contained most of the necessary information is/are indicated 61 4 MDG indicators as of February 2010 62 Infants receiving breast milk but not receiving any other fluids or foods (with the exception of oral rehydration solution, vitamins, mineral supple- ments and medicines) 63 Infants who receive breast milk and certain fluids (water and water-based drinks, fruit juice, ritual fluids, oral rehydration solution, drops, vitamins, minerals and medicines) but do not receive anything else (in particular: non-human milk and food-based fluids) MICS4 INDICATOR Module Numerator Denominator MDG 2.11 Bottle feeding BF Number of children aged 0-23 months who were fed with a bottle during the previous day Total number of children aged 0-23 months 2.12 Introduction of solid, semi-solid or soft foods BF Number of infants aged 6-8 months who received solid, semi-solid or soft foods during the previous day Total number of infants aged 6-8 months 2.13 Minimum meal frequency BF Number of children aged 6-23 months receiving solid, semi- solid and soft foods (plus milk feeds for non-breastfed children) the minimum times64 or more, according to breastfeeding status, during the previous day Total number of children aged 6-23 months 2.14 Age-appropriate breastfeeding BF Number of children aged 0-23 months appropriately fed65 during the previous day Total number of children aged 0-23 months 2.15 Milk feeding frequency for non-breastfed children BF Number of non-breastfed children aged 6-23 months who received at least 2 milk feedings during the previous day Total number of non-breastfed children aged 6-23 months 2.18 Low birth weight infants MN Number of last live births in the 2 years preceding the survey weighing below 2,500 grams at birth Total number of last live births in the 2 years preceding the survey 2.19 Infants weighed at birth MN Number of last live births in the 2 years preceding the survey who were weighed at birth Total number of last live births in the 2 years preceding the survey 3. CHILD HEALTH 3.1 Tuberculosis immunisation coverage IM Number of children aged 18-29 months66 who received BCG vaccine by 12 months of age Total number of children aged 18-29 months 3.2 Polio immunisation coverage IM Number of children aged 18-29 months who received OPV3/IPV3 vaccine by 12 months of age Total number of children aged 18-29 months 3.3 Immunisation coverage for diphtheria, pertussis and tetanus (DPT) IM Number of children aged 18-29 months who received DPT3 vaccine by 12 months of age Total number of children aged 18-29 months 3.4 Measles, mumps and rubella (MMR) immunisation coverage67 IM Number of children aged 18-29 months who received the MMR vaccine by 18 months of age Total number of children aged 18-29 months MDG 4.3 3.5 Hepatitis B immunisation coverage IM Number of children aged 18-29 months who received the third dose of Hepatitis B vaccine by 12 months of age Total number of children aged 18-29 months 3.8 Oral rehydration therapy with continued feeding CA Number of children under age 5 with diarrhoea in the previous 2 weeks who received ORT (ORS packet or increased fluids) and continued feeding during the episode of diarrhoea Total number of children under age 5 with diarrhoea in the previous 2 weeks 3.9 Care-seeking for suspected pneumonia CA Number of children under age 5 with suspected pneumonia in the previous 2 weeks who were taken to an appropriate healthcare provider Total number of children under age 5 with suspected pneumonia in the previous 2 weeks 64 Breastfeeding children: solid, semi-solid or soft foods two times for infants aged 6-8 months, 3 times for children aged 9-23 months. Non-breast- feeding children: solid, semi-solid or soft foods, or milk feeds, four times for children aged 6-23 months. 65 Infants aged 0-5 months who were exclusively breastfed and children aged 6-23 months who were breastfed and ate solid, semi-solid or soft foods. 66 Indicators 3.1, 3.2, 3.3, 3.4, 3.5 and 3.6 in the BiH MICS were calculated for children aged 18-29 months, but can be calculated for a different age group, such as 12-23 months or 15-26 months, depending on the immunisation schedule. 67 The standard MICS indicator refers to measles immunisation only. In BiH the measles vaccine is given as part of the combined MMR vaccine. Appendix E: BiH MICS4 Indicators – Numerators and Denominators MICS4 INDICATOR [M] Module60 Numerator Denominator MDG61 2. NUTRITION 2.1a 2.1b Underweight prevalence AN Number of children under age 5 who (a) fall below minus two standard deviations (moderate and severe) (b) fall below minus three standard deviations (severe) from the median weight for age of the WHO standard Total number of children under age 5 MDG 1.8 2.2a 2.2b Stunting prevalence AN Number of children under age 5 who (a) fall below minus two standard deviations (moderate and severe) (b) fall below minus three standard deviations (severe) from the median height for age of the WHO standard Total number of children under age 5 2.3a 2.3b Wasting prevalence AN Number of children under age 5 who (a) fall below minus two standard deviations (moderate and severe) (b) fall below minus three standard deviations (severe) from the median weight for height of the WHO standard Total number of children under age 5 2.4 Children ever breastfed MN Number of women with a live birth in the 2 years preceding the survey who breastfed the child at any time Total number of women with a live birth in the 2 years preceding the survey 2.5 Early initiation of breastfeeding MN Number of women with a live birth in the 2 years preceding the survey who put the newborn infant to the breast within 1 hour of birth Total number of women with a live birth in the 2 years preceding the survey 2.6 Exclusive breastfeeding under 6 months BF Number of infants under 6 months of age who are exclusively breastfed62 Total number of infants under 6 months of age 2.7 Continued breastfeeding at 1 year BF Number of children aged 12-15 months who are currently breastfeeding Total number of children aged 12-15 months 2.8 Continued breastfeeding at 2 years BF Number of children aged 20-23 months who are currently breastfeeding Total number of children aged 20-23 months 2.9 Predominant breastfeeding under 6 months BF Number of infants under 6 months of age who received breast milk as the predominant source of nourishment63 during the previous day Total number of infants under 6 months of age 2.10 Duration of breastfeeding BF The age in months when 50 per cent of children aged 0-35 months did not receive breast milk during the previous day 186 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 187 MICS4 INDICATOR Module Numerator Denominator MDG 3.10 Antibiotic treatment of suspected pneumonia CA Number of children under age 5 with suspected pneumonia in the previous 2 weeks who received antibiotics Total number of children under age 5 with suspected pneumonia in the previous 2 weeks 3.11 Solid fuels HC Number of household members in households that use solid fuel as the primary source of domestic energy to cook Total number of household members 4. WATER AND SANITATION 4.1 Use of improved drinking water sources WS Number of household members using improved sources of drinking water Total number of household members MDG 7.8 4.2 Water treatment WS Number of household members using unimproved drinking water who use an appropriate treatment method Total number of household members in households using unimproved drinking water sources 4.3 Use of improved sanitation WS Number of household members using improved sanitation facilities which are not shared Total number of household members MDG 7.9 4.4 Safe disposal of child’s faeces CA Number of children aged 0-2 years whose last stools were disposed of safely Total number of children aged 0-2 years 4.5 Place for hand washing HW Number of households with a specific place for hand washing where water and soap are present Total number of households 4.6 Availability of soap HW Number of households with soap anywhere in the dwelling Total number of households 5. REPRODUCTIVE HEALTH 5.1 Adolescent birth rate CM Age specific fertility rate for women aged 15-19 years for the one year period preceding the survey MDG 5.4 5.3 Contraceptive prevalence rate CP Number of women aged 15-49 years currently married or in union who are using (or whose partner is using) a contraceptive method (modern or traditional) Total number of women aged 15-49 years who are currently married or in union MDG 5.3 5.4 Unmet need68 UN Number of women aged 15-49 years who are currently married or in union who are fecund and want to space their births or limit the number of children they have and who are not currently using contraception Total number of women aged 15-49 years who are currently married or in union MDG 5.6 5.5a 5.5b Antenatal care coverage MN Number of women aged 15-49 years who were attended during pregnancy in the 2 years preceding the survey (a) at least once by skilled personnel (b) at least four times by any provider Total number of women aged 15- 49 years with a live birth in the 2 years preceding the survey MDG 5.5 5.6 Content of antenatal care MN Number of women aged 15-49 years with a live birth in the 2 years preceding the survey who had their blood pressure measured and gave urine and blood samples during the last pregnancy Total number of women aged 15- 49 years with a live birth in the 2 years preceding the survey 5.7 Skilled attendant at delivery MN Number of women aged 15-49 years with a live birth in the 2 years preceding the survey who were attended during childbirth by skilled health personnel Total number of women aged 15- 49 years with a live birth in the 2 years preceding the survey MDG 5.2 5.8 Institutional deliveries MN Number of women aged 15-49 years with a live birth in the 2 years preceding the survey who delivered in a health facility Total number of women aged 15- 49 years with a live birth in the 2 years preceding the survey 5.9 Caesarean section MN Number of last live births in the 2 years preceding the survey who were delivered by Caesarean section Total number of last live births in the 2 years preceding the survey 68 See MICS4 manual for a detailed description. MICS4 INDICATOR Module Numerator Denominator MDG 6. CHILD DEVELOPMENT 6.1 Support for learning EC Number of children aged 36-59 months with whom an adult has engaged in four or more activities to promote learning and school readiness in the past 3 days Total number of children aged 36-59 months 6.2 Father’s support for learning EC Number of children aged 36-59 months whose father has engaged in one or more activity to promote learning and school readiness in the past 3 days Total number of children aged 36-59 months 6.3 Learning materials: children’s books EC Number of children under age 5 who have three or more children’s books Total number of children under age 5 6.4 Learning materials: playthings EC Number of children under age 5 with two or more playthings Total number of children under age 5 6.5 Inadequate care EC Number of children under age 5 left alone or in the care of another child younger than 10 years of age for more than one hour at least once in the past week Total number of children under age 5 6.6 Early childhood development index EC Number of children aged 36-59 months who are developmentally on track in the literacy-numeracy, physical, social-emotional, and learning domains Total number of children aged 36-59 months 6.7 Attendance at early childhood education EC Number of children aged 36-59 months who are attending an early childhood education programme Total number of children aged 36-59 months 7. LITERACY AND EDUCATION 7.1 Literacy rate amongst young women [M] WB Number of women aged 15-24 years who are able to read a short simple statement about everyday life or who attended secondary or higher education Total number of women aged 15-24 years MDG 2.3 7.2 School readiness ED Number of children in first grade of primary school who attended preschool during the previous school year Total number of children attending the first grade of primary school 7.3 Net intake rate in primary education ED Number of children of school entry age who enter the first grade of primary school Total number of children of school entry age 7.4 Primary school net attendance ratio (adjusted) ED Number of children of primary school age currently attending primary or secondary school Total number of children of primary school age MDG 2.1 7.5 Secondary school net attendance ratio (adjusted) ED Number of children of secondary school age currently attending secondary school or higher Total number of children of secondary school age 7.6 Children reaching last grade of primary ED Proportion of children entering the first grade of primary school who eventually reach last grade MDG 2.2 7.7 Primary completion rate ED Number of children attending the last grade of primary school (excluding repeaters) Total number of children of primary school completion age (age-appropriate to final grade of primary school) 7.8 Transition rate to secondary school ED Number of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year Total number of children attending the last grade of primary school during the previous school year 7.9 Gender Parity Index (primary school) ED Primary school net attendance ratio (adjusted) for girls Primary school net attendance ratio (adjusted) for boys MDG 3.1 7.10 Gender Parity Index (secondary school) ED Secondary school net attendance ratio (adjusted) for girls Secondary school net attendance ratio (adjusted) for boys MDG 3.1 188 MULTIPLE INDICATOR CLUSTER SURVEy 2011–2012 MONITORING THE SITUATION OF CHILDREN AND WOMEN 189 MICS4 INDICATOR Module Numerator Denominator MDG 8. CHILD PROTECTION 8.5 Violent discipline CD Number of children aged 2-14 years who experienced psychological aggression or physical punishment during the past month Total number of children aged 2-14 years 8.6 Marriage before age 15 [M] MA Number of women aged 15-49 years who were first married or in union by the exact age of 15 Total number of women aged 15-49 years 8.7 Marriage before age 18 [M] MA Number of women aged 20-49 years who were first married or in union by the exact age of 18 Total number of women aged 20-49 years 8.8 young women age 15-19 years currently married or in union [M] MA Number of women aged 15-19 years who are currently married or in union Total number of women aged 15-19 years 8.10a 8.10b Spousal age difference MA Number of women currently married or in union whose spouse is 10 or more years older (a) for women aged 15-19 years (b) for women aged 20-24 years Total number of women currently married or in union (a) aged 15-19 years (b) aged 20-24 years 8.14 Attitudes towards domestic violence [M] DV Number of women who state that a husband/partner is justified in hitting or beating his wife in at least one of the following circumstances: (1) she goes out without telling him, (2) she neglects the children, (3) she argues with him, (4) she refuses sex with him, (5) she burns the food Total number of women aged 15-49 years 9. HIV/AIDS, SExUAL BEHAVIOUR AND ORPHANS 9.1 Comprehensive knowledge about HIV prevention [M] HA Number of women aged 15-49 years who correctly identify two ways of preventing HIV infection,69 know that a healthy looking person can have HIV and reject the two most common misconceptions about HIV transmission Total number of women aged 15-49 years 9.2 Comprehensive knowledge about HIV prevention amongst young people [M] HA Number of women aged 15-24 years who correctly identify two ways of preventing HIV infection,69 know that a healthy looking person can have HIV and reject the two most common misconceptions about HIV transmission Total number of women aged 15-24 years MDG 6.3 9.3 Knowledge of mother- to-child transmission of HIV [M] HA Number of women aged 15-49 years who correctly identify all three means70 of mother-to-child transmission of HIV Total number of women aged 15-49 years 9.4 Accepting attitudes towards people living with HIV [M] HA Number of women aged 15-49 years expressing accepting attitudes on all four questions71 towards people living with HIV Total number of women aged 15-49 years who have heard of HIV 9.5 Women who know where to be tested for HIV [M] HA Number of women aged 15-49 years who state knowledge of a place to be tested for HIV Total number of women aged 15-49 years 9.6 Women who have been tested for HIV and know the results [M] HA Number of women aged 15-49 years who have been tested for HIV in the 12 months preceding the survey and who know their results Total number of women aged 15-49 years 69 Using condoms and limiting sex to one faithful uninfected partner 70 Transmission during pregnancy, during delivery and by breastfeeding 71 Women who (1) think that a female teacher with the AIDS virus should be allowed to teach in school, (2) who would buy fresh vegetables from a shopkeeper or vendor who has the AIDS virus, (3) who would not want to keep it as a secret if a family member became infected with the AIDS virus and (4) who would be willing to care for a family member who became ill with the AIDS virus MICS4 INDICATOR Module Numerator Denominator MDG 9.7 Sexually active young women who have been tested for HIV and know the results [M] HA Number of women aged 15-24 years who have had sex in the 12 months preceding the survey, who have been tested for HIV in the 12 months preceding the survey and who know their results Total number of women aged 15-24 years who have had sex in the 12 months preceding the survey 9.8 HIV counselling during antenatal care HA Number of women aged 15-49 years who gave birth in the 2 years preceding the survey and received antenatal care reporting that they received counselling on HIV during antenatal care Total number of women aged 15-49 years who gave birth in the 2 years preceding the survey 9.9 HIV testing during antenatal care HA Number of women aged 15-49 years who gave birth in the 2 years preceding the survey and received antenatal care reporting that they were offered and accepted an HIV test during antenatal care and received their results Total number of women aged 15-49 years who gave birth in the 2 years preceding the survey 9.10 young women who have never had sex [M] SB Number of never married women aged 15-24 years who have never had sex Total number of never married women aged 15-24 years 9.11 Sex before age 15 amongst young women [M] SB Number of women aged 15-24 years who have had sexual intercourse before age 15 Total number of women aged 15-24 years 9.12 Age mixing amongst sexual partners [M] SB Number of women aged 15-24 years who had sex in the 12 months preceding the survey with a partner who was 10 or more years older Total number of women aged 15-24 years who have had sex in the 12 months preceding the survey 9.13 Sex with multiple partners [M] SB Number of women aged 15-49 years who have had sexual intercourse with more than one partner in the 12 months preceding the survey Total number of women aged 15-49 years 9.14 Condom use during sex with multiple partners [M] SB Number of women aged 15-49 years who report having had more than one sexual partner in the 12 months preceding the survey who also reported that a condom was used the last time they had sex Total number of women aged 15-49 years who reported having had more than one sexual partner in the 12 months preceding the survey 9.15 Sex with non-regular partners [M] SB Number of sexually active women aged 15-24 years who have had sex with a non-marital/non- cohabitating partner in the 12 months preceding the survey Total number of women aged 15-24 years who have had sex in the 12 months preceding the survey 9.16 Condom use with non-regular partners [M] SB Number of women aged 15-24 years reporting the use of a condom during sexual intercourse with their last non-marital/non-cohabiting sex partner in the 12 months preceding the survey Total number of women aged 15-24 years who had a non- marital/non-cohabiting partner in the 12 months preceding the survey MDG 6.2 9.17 Children’s living arrangements HL Number of children aged 0-17 years not living with a biological parent Total number of children aged 0-17 years 9.18 Prevalence of children with one or both parents dead HL Number of children aged 0-17 years with one or both parents dead Total number of children aged 0-17 years 190 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 191 MICS4 INDICATOR Module Numerator Denominator MDG 10. ACCESS TO MASS MEDIA AND USE OF INFORMATION/COMMUNICATION TECHNOLOGY Mt.1 exposure to mass media [M] Mt number of women aged 15-49 years who, at least once a week, read a newspaper or magazine, listen to the radio, and watch television total number of women aged 15-49 years Mt.2 use of computers [M] Mt number of young women aged 15-24 years who used a computer during the last 12 months total number of women aged 15-24 years Mt.3 use of internet [M] Mt number of young women aged 15-24 who used the internet during the last 12 months total number of women aged 15-24 years 11. SUBJECTIVE WELL-BEING sw.1 life satisfaction [M] ls number of women aged 15-24 years who are very or somewhat satisfied with their family life, friendships, school, current job, health, where they live, how they are treated by others and how they look total number of women aged 15-24 years sw.2 happiness [M] ls number of women aged 15-24 years who are very or somewhat happy total number of women aged 15-24 years sw.3 perception of a better life [M] ls number of women aged 15-24 years whose life improved during the last one year and who expect that their life will be better after one year total number of women aged 15-24 years 12. TOBACCO AND ALCOHOL USE ta.1 tobacco use [M] ta number of women aged 15-49 years who smoked cigarettes or used smoke or smokeless tobacco products on one or more days during the last one month total number of women aged 15-49 years ta.2 smoking before age 15 [M] ta number of women aged 15- 49 years who smoked a whole cigarette before age 15 total number of women aged 15-49 years ta.3 alcohol use [M] ta number of women aged 15-49 years who had at least one alcoholic drink on one or more days during the last one month total number of women aged 15-49 years ta.4 use of alcohol before age 15 [M] ta number of women aged 15-49 years who had at least one alcoholic drink before age 15 total number of women aged 15-49 years Monitoring the situation of children and woMen 191 Appendix F: BiH MICS4 Questionnaires An identical approach to the MICS4 methodology was applied in the FBiH, RS and BD. Questionnaires adapted to the languages and alphabets used in BiH were administered during fieldwork in the FBiH, RS and BD. The questionnaires presented in this Appendix are examples of the Household Questionnaire (including individual cover pages for the FBiH, RS and BD), the Questionnaire for Women Aged 15-49 administered in the FBiH, the Questionnaire for Men Aged 15-49 administered in the RS and the Under-5 Questionnaire administered in BD.  HouSeHold QueStIonnAIre [Federation of BiH] HouSeHold InForMAtIon pAnel HH HH1. cluster number: ___ ___ ___ HH2. household number: ___ ___ ___ HH3. interviewer name and code: name ______________________ ___ ___ ___ HH4. supervisor name and code: name________________________ ___ ___ ___ HH5. day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ HH6. settlement type: urban . 1 rural . 2 HH7. region fBih canton: una-sana canton.01 Posavina canton .02 tuzla canton .03 Zenica-doboj canton .04 Bosnia-Podrinje canton .05 central Bosnia canton .06 herzegovina-neretva canton .07 west herzegovina canton.08 canton sarajevo .09 canton 10 .10 We are from the Federal ministry oF health – institute oF public health oF the Federation oF bosnia and herzegovina. We are conducting a survey concerned With family health and education. i Would like to talk to you about these subjects. the intervieW Will take up to 20 minutes. all the information We obtain Will remain strictly confidential. may i start noW? ¨ Yes, permission given ð Go to HH18 to record the time and then begin the interview. ¨ No, permission not given ð Complete HH9. Inform your supervisor of this result. Once all questionnaires for this household have been completed, fill in the following information: HH8. name and surname of head of household: __________________________________________ HH9. result of the household interview: household questionnaire completed .01 no household member or no competent respondent at home at time of visit .02 entire household absent for extended period of time .03 household refused the interview .04 dwelling unit vacant / address not a dwelling .05 dwelling unit destroyed .06 dwelling unit not found .07 other (specify) _______________________________ 96 HH10. respondent to household questionnaire: name: ____________________________________ line number from Module hl: ___ ___ HH11. total number of household members: ___ ___ HH12. number of women aged 15-49 years: ___ ___ HH13. number of completed Questionnaires for women aged 15-49: ___ ___ HH13A. number of men aged 15-49 years: ___ ___ HH13B. number of completed Questionnaires for men aged 15-49: ___ ___ HH14. number of children under age 5: ___ ___ HH15. number of completed under-5 questionnaires: ___ ___ HH16. field edited by (name and code): name ______________________ ___ ___ ___ HH17. data entry operator (name and code): name ______________________ ___ ___ ___ Monitoring the situation of children and woMen 193192 MultiPle indicator cluster surveY 2011–2012  HouSeHold QueStIonnAIre [Republic of Srpska] HouSeHold InForMAtIon pAnel HH HH1. cluster number: ___ ___ ___ HH2. household number: ___ ___ ___ HH3. interviewer name and code: name ______________________ ___ ___ ___ HH4. supervisor name and code: name________________________ ___ ___ ___ HH5. day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ HH6. settlement type: urban . 1 rural . 2 HH7. region: republic of srpska .11 We are from the ministry oF health and social welFare oF the republic oF srpska. We are conducting a survey concerned With family health and education. i Would like to talk to you about these subjects. the intervieW Will take up to 20 minutes. all the information We obtain Will remain strictly confidential. may i start noW? ¨ Yes, permission given ð Go to HH18 to record the time and then begin the interview. ¨ No, permission not given ð Complete HH9. Inform your supervisor of this result. Once all questionnaires for this household have been completed, fill in the following information: HH8. name and surname of head of household: __________________________________________ HH9. result of the household interview: household questionnaire completed .01 no household member or no competent respondent at home at time of visit .02 entire household absent for extended period of time .03 household refused the interview .04 dwelling unit vacant / address not a dwelling .05 dwelling unit destroyed .06 dwelling unit not found .07 other (specify) _______________________________ 96 HH10. respondent to household questionnaire: name: ____________________________________ line number from Module hl: ___ ___ HH11. total number of household members: ___ ___ HH12. number of women aged 15-49 years: ___ ___ HH13. number of completed Questionnaires for women aged 15-49: ___ ___ HH13A. number of men aged 15-49 years: ___ ___ HH13B. number of completed Questionnaires for men aged 15-49: ___ ___ HH14. number of children under age 5: ___ ___ HH15. number of completed under-5 questionnaires: ___ ___ HH16. field edited by (name and code): name ______________________ ___ ___ ___ HH17. data entry operator (name and code): name ______________________ ___ ___ ___  HouSeHold QueStIonnAIre [Brcko District of BiH] HouSeHold InForMAtIon pAnel HH HH1. cluster number: ___ ___ ___ HH2. household number: ___ ___ ___ HH3. interviewer name and code: name ______________________ ___ ___ ___ HH4. supervisor name and code: name________________________ ___ ___ ___ HH5. day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ HH6. settlement type: urban . 1 rural . 2 HH7. region: Brcko district of Bih .15 We are from the department oF health and other services oF the government oF the brcko district oF bosnia and herzegovina. We are conducting a survey concerned With family health and education. i Would like to talk to you about these subjects. the intervieW Will take up to 20 minutes. all the information We obtain Will remain strictly confidential. may i start noW? ¨ Yes, permission given ð Go to HH18 to record the time and then begin the interview. ¨ No, permission not given ð Complete HH9. Inform your supervisor of this result. Once all questionnaires for this household have been completed, fill in the following information: HH8. name and surname of head of household: __________________________________________ HH9. result of the household interview: household questionnaire completed .01 no household member or no competent respondent at home at time of visit .02 entire household absent for extended period of time .03 household refused the interview .04 dwelling unit vacant / address not a dwelling .05 dwelling unit destroyed .06 dwelling unit not found .07 other (specify) _______________________________ 96 HH10. respondent to household questionnaire: name: ____________________________________ line number from Module hl: ___ ___ HH11. total number of household members: ___ ___ HH12. number of women aged 15-49 years: . ___ ___ HH13. number of completed Questionnaires for women aged 15-49: ___ ___ HH13A. number of men aged 15-49 years: . ___ ___ HH13B. number of completed Questionnaires for men aged 15-49: ___ ___ HH14. number of children under age 5:. ___ ___ HH15. number of completed under-5 questionnaires: ___ ___ HH16. field edited by (name and code): name ______________________ ___ ___ ___ HH17. data entry operator (name and code): name ______________________ ___ ___ ___ Monitoring the situation of children and woMen 195194 MultiPle indicator cluster surveY 2011–2012 hh18. Record the interview start time hour __ __ Minutes __ __ HouSeHold MeMBer lIStInG ForM first, please tell me the name of each person Who usually lives here, starting With the head of the household. Enter data for the head of household in line 01. List all household members (HL2), their relationship to the head of household (HL3), and their gender (HL4) Then ask: are there any other persons Who live here, even if they are not at home noW? If “yes”, complete the listing for questions HL2-HL4. Then, ask questions starting with HL5 for each person, one person at a time. Use an additional questionnaire if all rows in the household member listing form have been used. For women aged 15-49 For men aged 15-49 godina For children aged 5-14 For children under age 5 for children aged 0-17 years Hl1. line no Hl2. Name Hl3. What is the relation-ship of (name) to the head of house-hold? Hl4. is (name) male or female? 1 Male 2 female Hl5. What is (name)’s date of birth? Hl6. hoW old is (name)? Record in completed years. If age is 95 or above, record ‘95’ Hl7. Circle line no. if woman is aged 15-49 Hl7A. Circle line no. if man is aged 15-49 Hl8. Who is the mother or primary caretaker of this child? Record line no. of mother/ caretaker Hl9. Who is the mother or primary caretaker of this child? Record line no. of mother/ caretaker Hl11. is (name)’s biological mother alive? 1 Yes 2 no hl13 8 dK hl13 Hl12. does (name)’s biological mother live in this house-hold? Record line no. of mother or ‘00’ for “No” Hl13. is (name)’s biological father alive? 1 Yes 2 no next line 8 dK next line Hl14. does (name)’s biological father live in this house-hold? Record line no. of father or ‘00’ for “No” 98 dK 9998 dK line name relationship* M f Month Year age 15-49 15-49 Mother Mother Y n dK Mother Y n dK father 01 0 1 1 2 __ __ __ __ __ __ ___ ___ 01 01 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 02 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 02 02 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 03 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 03 03 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 04 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 04 04 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 05 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 05 05 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 06 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 06 06 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 07 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 07 07 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 08 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 08 08 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 09 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 09 09 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 10 ___ ___ 1 2 __ __ __ __ __ __ ___ ___ 10 10 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ Tick here if additional questionnaire was used ¨ Ask again if there are any additional household members. Probe especially for any infants or small children not listed, and others who may not be members of the family (such as servants, friends) but who usually live in the household. Enter the names of additional members in the list of household members and complete the form according to the instructions. Now for each woman aged 15-49 years, write her name and line number and other necessary information in the information panel of a separate Questionnaire for Women Aged 15 to 49. For each man aged 15-49 years, write his name and line number and other necessary information in the information panel of a separate Questionnaire for Men Aged 15 to 49. For each child under age 5, write his/her name and line number AND the line number of his/her mother or caretaker in the information panel of a separate Under-5 Questionnaire. You should now have a separate questionnaire for each eligible woman, each eligible man, and each child under five in the household. * Codes for HL3: Relationship to the head of household: 01 head 02 wife / husband 03 son / daughter 04 son-in-law / daughter-in-law 05 grandchild 06 Parent 07 Parent-in-law 08 Brother / sister 09 Brother-in-law / sister-in-law 10 uncle / aunt 11 niece / nephew 12 other relative 13 adopted / fostered / stepchild 14 not related 98 don’t know Hl Monitoring the situation of children and woMen 197196 MultiPle indicator cluster surveY 2011–2012 eduCAtIon ed For household members aged 5 and above For household members aged 5-24 years ed1. line number ed2. Name and age Copy from Household Member Listing Form, HL2 and HL6 ed3. has (name) ever attended school or a preschool institution? 1 Yes 2 no  next line ed4A. What is the highest education level (name) has attended? level: 0 Preschool 1 Primary 2 secondary 3 higher 8 dK If level=0, skip to ED5 ed4B. What is the highest grade/ year (name) completed at this level? Grade/Year: 98 DK If less than 1 grade/year, enter ‘00’. ed5. during this school/ academic year (2011- 2012), did (name) attend school/ university or preschool at any time? 1 yes 2 no  ed7 ed6. during this school/academic year, Which level and grade/year is (name) attending? ed7. during the previous school/ academic year, that is (2010- 2011), did (name) attend school or preschool at any time? 1 Yes 2 no  next line 8 dK  next line ed8. during that previous school year, Which level and grade/year did (name) attend? level: 0 Preschool 1 Primary 2 secondary 3 higher 8 dK If level=0, skip to ED7 grade/Year: 98 dK level: 0 Preschool 1 Primary 2 secondary 3 higher 8 dK If level=0, go to next person grade/Year: 98 dK line name age Yes no level grade/Year Yes no level grade/Year Y n dK level grade/Year 01 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 02 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 03 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 04 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 05 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 06 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 07 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 08 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 09 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ 10 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 0 1 2 3 8 ___ ___ 1 2 8 0 1 2 3 8 ___ ___ Monitoring the situation of children and woMen 199198 MultiPle indicator cluster surveY 2011–2012 wAter And SAnItAtIon wS ws1. What is the main source of drinking Water for members of your household? Piped water (main water-supply) Piped water in apartment/house .11 Piped water in estate .12 Piped water at neighbours .13 Public tap / standpipe .14 tube well, Borehole .21 dug well covered (protected) well .31 uncovered (unprotected) well .32 water from spring Protected spring .41 unprotected spring .42 rainwater collection .51 tanker-truck .61 surface water (river, stream, dam, lake, pond, canal, irrigation channel) .81 Bottled water .91 other (specify) ____________________________ 96 11ðws6 12ðws6 13ðws6 14ðws3 21ðws3 31ðws3 32ðws3 41ðws3 42ðws3 51ðws3 61ðws3 81ðws3 96ðws3 ws2. What is the main source of Water used in your household for other purposes such as cooking and Washing hands? Piped water (main water-supply) Piped water in apartment/house .11 Piped water in estate .12 Piped water at neighbours .13 Public tap / standpipe .14 tube well, Borehole .21 dug well covered (protected) well .31 uncovered (unprotected) well .32 water from spring Protected spring .41 unprotected spring .42 rainwater collection .51 tanker-truck .61 surface water (river, stream, dam, lake, pond, canal, irrigation channel) .81 Bottled water .91 other (specify) ____________________________ 96 11ðws6 12ðws6 13ðws6 ws3. Where is this Water source located? in own apartment/house . 1 in own estate. 2 elsewhere . 3 1ðws6 2ðws6 ws4. hoW long does it take to go to the Water source, collect Water, and come back? number of minutes . __ __ __ dK . 998 ws5. Who usually goes to this source to collect Water for your household? Probe: is this person under 15 years of age? What gender? adult woman (age 15+ years) . 1 adult man (age 15+ years) . 2 female child (under 15) . 3 Male child (under 15) . 4 dK . 8 ws6. do you do anything to the Water to make it safer for drinking? Yes . 1 no . 2 dK . 8 2ðws8 8ðws8 ws7. What do you usually do to make the Water safer for drinking? Probe: anything else? Record all items mentioned. Boil .a add chlorine . B strain it through a cloth . c use water filter (ceramic, sand, composite, etc.) .d solar disinfection .e let it stand and settle .f other (specify) _____________________________ X dK . Z ws8. What kind of toilet facility do members of your household usually use? If “flush” or “pour flush”, probe: Where does it flush to? If necessary, ask permission to observe the facility. flush / Pour flush flush to piped sewer system .11 flush to septic tank .12 flush to pit (latrine) .13 flush to somewhere else .14 flush to unknown place / not sure / dK where .15 Pit latrine ventilated improved latrine with pit .21 Pit latrine with slab .22 Pit latrine without slab / open pit .23 ecological toilet (with composting) .31 Bucket .41 no facility, bush, field .95 other (specify) ____________________________ 96 95ðnext Module ws9. do you share this facility With others Who are not members of your household? Yes . 1 no . 2 2ðnext Module ws10. do you share this toilet facility only With members of other households that you knoW, or is the facility for public use? other households only (not public) . 1 toilet facility for public use . 2 2ðnext Module ws11. hoW many households in total use this toilet facility, including your oWn household? number of households (if less than 10) . 0 __ ten or more households .10 dK .98 Monitoring the situation of children and woMen 201200 MultiPle indicator cluster surveY 2011–2012 HouSeHold CHArACterIStICS hc hc1b. What is the mother tongue of the head of household? Bosnian. 1 croatian. 2 serbian . 3 romany . 4 other language (specify) _____________________ 6 hc2. hoW many rooms in this household are used for sleeping? number of rooms . __ __ hc3. Main material of the dwelling floor. Record observation. natural floor earth / sand .11 straw .13 rudimentary floor wood planks .21 finished floor Parquet or polished wood .31 vinyl / linoleum or asphalt strips .32 ceramic tiles .33 cement .34 carpet .35 laminate .36 other (specify) ____________________________ 96 hc4. Main material of the roof. Record observation. natural roofing no roof .11 thatch .12 rudimentary roofing wood planks (shingle) .23 cardboard .24 finished roofing Metal / sheet metal .31 wood .32 calamine roofing / cement fibre .33 ceramic tiles .34 cement (slab) .35 roofing shingles .36 other (specify) ____________________________ 96 hc5. Main material of the exterior walls. Record observation. natural walls trunks .12 dirt .13 rudimentary walls reed and mud .21 stone with mud .22 uncovered adobe .23 Plywood .24 cardboard .25 reused wood .26 finished walls cement .31 stone with lime / cement.32 Bricks .33 cement blocks .34 covered adobe .35 wooden planks / shingles .36 facade (e.g. cement and limestone mortar) .37 other (specify) ____________________________ 96 hc6. What type of fuel does your household mainly use for cooking? electricity .01 liquid propane gas (lPg, gas from a cylinder) .02 natural gas (from the gas mains) .03 coal / lignite .06 charcoal .07 wood .08 straw / shrubs / grass .09 residue from agricultural crops .11 no food is cooked in the household .95 other (specify) ____________________________ 96 01ðhc8 02ðhc8 03ðhc8 95ðhc8 hc7. is the cooking usually done in the house, in a separate building, or outdoors? If “In the house”, probe: is it done in a separate room used as a kitchen? in the apartment/house in a separate room used as kitchen . 1 elsewhere in the house . 2 in a separate building . 3 outdoors . 4 other (specify) _____________________________6 hc8. does your household have: [a] electricity? [b] a radio? [c] a television? [d] a fixed telephone (non-mobile)? [e] a refrigerator? [f] bed? [g] electrical cooker? [h] computer / laptop? [i] internet connection? [j] air-conditioning? [k] digital camera? [l] Washing machine? [m] clothes dryer? [n] dishWasher? [o] vacuum cleaner [p] dvd player? [Q] jacuzzi bathtub? [r] video security system (cctv)? Yes no electricity .1 2 radio .1 2 television .1 2 fixed telephone (non-mobile) .1 2 refrigerator .1 2 Bed .1 2 electrical cooker .1 2 computer / laptop .1 2 internet connection.1 2 air-conditioning .1 2 digital camera .1 2 washing machine .1 2 clothes dryer .1 2 dishwasher .1 2 vacuum cleaner .1 2 dvd player .1 2 Jacuzzi bathtub .1 2 video security system (cctv) .1 2 hc9. does any member of your household oWn: [a] a Watch? [b] a mobile telephone? [c] a bicycle? [d] a motorcycle or scooter? [e] an animal-draWn cart? [f] a car or truck? [g] a tractor? Yes no watch .1 2 Mobile telephone .1 2 Bicycle .1 2 Motorcycle / scooter .1 2 animal drawn-cart .1 2 car / truck.1 2 tractor .1 2 hc10. do you or someone living in this household oWn this dWelling? If “No”, then ask: do you rent this dWelling from someone not living in this household? If “Rented from someone else”, circle ‘2’. For other responses, circle ‘6’. own . 1 rent . 2 other (not owned or rented) . 6 hc11. does any member of this household oWn any land that can be used for agriculture? Yes . 1 no . 2 2ðhc13 hc12. hoW many dunums of agricultural land do members of this household oWn altogether? If less than 1, record ‘00’. If 95 or more, record ‘95’. If unknown, record ‘98’. dunums . ___ ___ hc13. does this household oWn any livestock, herds, other farm animals or poultry? Yes . 1 no . 2 2ðhc15 hc14. hoW many of the folloWing animals does this household oWn? [a] heifers, milk coWs, calves or bulls? [b] horses, donkeys, or mules? [c] goats? [d] sheep? [e] chickens, chicks or roosters? [h] other poultry? [f] pigs [g] bee hives? If none, record ‘00’. If 95 or more, record ‘95’. If unknown, record ‘98’. heifers, milk cows, calves or bulls . ___ ___ horses, donkeys, or mules . ___ ___ goats . ___ ___ sheep . ___ ___ chickens, chicks or roosters . ___ ___ other poultry . ___ ___ Pigs .___ __ Bee hives . ___ ___ hc15. does any member of this household have a bank account? Yes . 1 no . 2 Monitoring the situation of children and woMen 203202 Multiple indicator cluster survey 2011–2012 Child disCipline Cd TABle 1: ChildRen AGed 2-14 YeARs eliGiBle FOR QUesTiOns On Child disCipline • List each of the children aged 2-14 years below in the order they appear in the Household Member Listing Form (module HL). Do not include any household members outside of the age range 2-14 years. • Record the line number, name, gender, and age for each child. • Then record the total number of children aged 2-14 in the box provided (CD6). • If there are no children aged 2-14 years in the household, skip to the next module. Cd1. Rank Cd2. Line number from HL1 Cd3. Name from HL2 Cd4. Gender from HL4 Cd5. Age from HL6 rank line no. name M f age 1 __ __ 1 2 ___ ___ 2 __ __ 1 2 ___ ___ 3 __ __ 1 2 ___ ___ 4 __ __ 1 2 ___ ___ 5 __ __ 1 2 ___ ___ 6 __ __ 1 2 ___ ___ 7 __ __ 1 2 ___ ___ 8 __ __ 1 2 ___ ___ Cd6. total children aged 2-14 years ___ ___ • If there is only one child aged 2-14 years in the household, skip table 2 and go to CD8; enter ‘1’ and continue with CD9. TABle 2: RAndOM seleCTiOn OF Child FOR QUesTiOns On Child disCipline • Use Table 2 to select one child between the ages of 2 and 14 years, if there is more than one child in the household within the specified age range. • Check the last digit of the household number (HH2) from the cover page. This is the row number you should go to in the table below (CD7). • Check the total number of eligible children (2-14) at CD6 in Table 1 above. This is the column number you should go to. • Find the box where the row and the column meet and circle the number that appears in the box. This is the rank of the child (CD1) for which the questions will be asked. Cd7. Total number of eligible children in the household (Cd6) last digit of household number (hh2) 1 2 3 4 5 6 7 8+ 0 1 2 2 4 3 6 5 4 1 1 1 3 1 4 1 6 5 2 1 2 1 2 5 2 7 6 3 1 1 2 3 1 3 1 7 4 1 2 3 4 2 4 2 8 5 1 1 1 1 3 5 3 1 6 1 2 2 2 4 6 4 2 7 1 1 3 3 5 1 5 3 8 1 2 1 4 1 2 6 4 9 1 1 2 1 2 3 7 5 CD8. Record the rank of the selected child from Table 1 (CD1) .___ CD9. Write the name and line number of the child selected for the module from CD3 and CD2, based on the rank in CD8. name________________________________________ line number . __ __ CD10. Adults use certAin wAys to teAch children proper behAviour or to Address A behAviour problem. i will reAd vArious methods thAt Are used And i wAnt you to tell me if you or Anyone else in your household hAs used this method with (name) during the pAst month. CD11. took AwAy privileges, forbAde something (name) liked or did not Allow him/her to leAve the house. yes . 1 no . 2 CD12. explAined why (name)’s behAvior wAs wrong. yes . 1 no . 2 CD13. shook him/her. yes . 1 no . 2 CD14. shouted, yelled At or screAmed At him/her. yes . 1 no . 2 CD15. gAve him/her something else to do. yes . 1 no . 2 CD16. spAnked, hit or slApped him/her on the bottom with bAre hAnd. yes . 1 no . 2 CD17. hit him/her on the bottom or elsewhere on the body with something like A belt, hAirbrush, stick or other hArd object. yes . 1 no . 2 CD18. cAlled him/her dumb, lAzy or A similAr nAme. yes . 1 no . 2 CD19. hit or slApped him/her on the fAce, heAd or eArs. yes . 1 no . 2 CD20. hit or slApped him/her on the hAnd, Arm or leg. yes . 1 no . 2 CD21. beAt him/her up, thAt is hit him/her repeAtedly As hArd As one cAn. yes . 1 no . 2 Cd22. do you believe thAt in order to bring up, rAise or educAte A child properly, the child needs to be physicAlly punished? yes . 1 no . 2 don’t know / no opinion . 8 Monitoring the situation of children and woMen 205204 MultiPle indicator cluster surveY 2011–2012 HAnd wASHInG Hw hw1. please shoW me Where members of your household most often Wash their hands. observed . 1 not observed not in apartment/house / on estate . 2 no permission to observe place . 3 other reason . 6 2 ðhw4 3 ðhw4 6 ðhw4 hw2. Observe the presence of water at the specific place for washing hands. Verify by checking the tap/pump or sink, bucket, water container, etc., for presence of water. water is available . 1 water is not available . 2 hw3. Record if soap or detergent is present at the specific place for washing hands. Circle all that apply. Skip to HH19 if any soap or detergent code has been circled (A, B, C or D). If “None” is circled (Y), continue with HW4. Bar of soap .a detergent (Powder / liquid / Paste) . B liquid soap . c ash / sand .d none . Y aðhh19 Bðhh19 cðhh19 dðhh19 hw4. do you have any soap, detergent or any other cleaning agent in your household used for Washing hands? Yes . 1 no . 2 2ðhh19 hw5. can you please shoW it to me? Record the observation. Circle all that apply. Bar of soap .a detergent (Powder / liquid / Paste) . B liquid soap . c ash / sand .d not able to / does not want to show . Y hh19. Record the interview end time. hour and minutes .__ __ : __ __ hh20. Thank the respondent for his/her cooperation and check the Household Member Listing Form: ¨ A separate Questionnaire for Individual Women has been issued for each woman aged 15-49 years in the household list (HL7) ¨ A separate Questionnaire for Children Under Five has been issued for each child under the age of 5 in the household list (HL9) ¨ A separate Questionnaire for Individual Men has been issued for each man aged 15-49 years in the household list (HL7A) Return to the cover page and make sure that all information has been entered, including the number of eligible women (HH12), children under 5 years of age (HH14) and eligible men (HH13A). Organise the administration of the remaining questionnaire(s) in this household. Interviewer’s observations Field editor’s observations Supervisor’s observations QueStIonnAIre For woMen AGed 15 to 49 [Federation of BiH] woMAn’S InForMAtIon pAnel wM this questionnaire is to be administered to all women age 15 through 49 (see household Member listing form, column hl7 in the household Questionnaire). a separate questionnaire should be used for each eligible woman. wM1. cluster number: ___ ___ ___ wM2. household number: ___ ___ ___ wM3. woman’s name: wM4. woman’s line number: name _________________________________________ ___ ___ wM5. interviewer name and code: name _____________________________ ___ ___ ___ wM6. day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting if not already read to this woman: We are from the Federal ministry oF health – institute oF public health oF the Federation oF bosnia and herzegovina. We are conducting a survey concerned With family health and education. i Would like to talk to you about these subjects. this intervieW Will take about 20 minutes. all the information We obtain Will remain strictly confidential. If greeting at the beginning of the household questionnaire has already been read to this woman, then read the following: noW i Would like to talk to you more about your health and other topics. this intervieW Will take about 20 minutes. again, all the information We obtain Will remain strictly confidential. may i start noW? ¨ Yes, permission given ð Go to WM10 to record the time and then begin the interview. ¨ No, permission not given ð Complete WM7. Inform your supervisor of this result. wM7. result of woman’s interview Questionnaire completed .01 respondent not at home .02 refused .03 Questionnaire partly completed .04 respondent incapacitated .05 other (specify) ____________________________ 96 wM8. field edited by (name and number) name _____________________________ ___ ___ ___ wM9. data entry operator (name and number): name _____________________________ ___ ___ ___ Monitoring the situation of children and woMen 207206 MultiPle indicator cluster surveY 2011–2012 wm10. Record the interview start time. hour and minutes .__ __ : __ __ woMAn’S BACKGround wB wb1. in What month and year Were you born? date of birth Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 wb2. hoW old are you? Probe: hoW old Were you on your last birthday? Compare WB1 and/or WB2 and correct if inconsistent age (in completed years) . __ __ wb3. have you ever attended school or a preschool institution? Yes . 1 no . 2 2ðwB7 wb4. What is the highest education level you attended? Preschool . 0 Primary . 1 secondary . 2 higher . 3 0ðwB7 wb5. What is the highest grade/year you completed at that level? If less than 1 grade, enter ‘00’ grade/year . __ __ wb6. Check WB4: ¨ Secondary or higher. ð Go to Next Module ¨ Primary ð Continue with WB7 wB7. noW i Would like you to read this sentence to me. Show the sentence on the card to the respondent. If the respondent cannot read the whole sentence, probe: can you read part of the sentence to me? cannot read at all . 1 able to read only parts of the sentence . 2 able to read the whole sentence . 3 the sentence isn’t written in a language understood by the respondent _____________________________________________4 (specify language) Blind / mute, visually / speech impaired . 5 ACCeSS to MASS MedIA And uSe oF InForMAtIon/CoMMunICAtIon teCHnoloGY Mt mt1. Check WB7: ¨ Question left blank (Respondent has secondary or more education) ð Continue with MT2 ¨ Able to read or no sentence available in required language (codes 2, 3 or 4) ð Continue with MT2 ¨ Cannot read at all or blind/mute, etc. (codes 1 or 5) ð Go to MT3 mt2. hoW often do you read a neWspaper or magazine: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mt3. do you listen to the radio almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mt4. hoW often do you Watch television: Would you say that you Watch tv almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mt5. Check WB2: Is the respondent aged 15-24 years? ¨ Yes, age 15-24 ð Continue with MT6 ¨ No, age 25-49 ð Go to Next Module mt6. have you ever used a computer? Yes . 1 no . 2 2ðMt9 mt7. in the last 12 months, have you used a computer from any location? Yes . 1 no . 2 2ðMt9 mt8. during the last month, hoW often did you use a computer: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mt9. have you ever used the internet? Yes . 1 no . 2 2ðnext Module mt10. in the last 12 months, have you used the internet? If necessary, probe for use of Internet from any location, with any device, etc. Yes . 1 no . 2 2ð next Module mt11. during the last month, hoW often did you use the internet: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all .4 Monitoring the situation of children and woMen 209208 MultiPle indicator cluster surveY 2011–2012 CHIld MortAlItY CM This module has to be administered to all women aged 15-49. Questions CM0-CM12 refer only to LIVE births. cm0. Check cluster number in WM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Continue with CM0A. ¨ If the cluster number is from 501-562 (Roma survey) ð Go to CM1 cm0a. noW i Would like to ask about all the births you have had during your lifetime. hoW many live born children have you had in your entire life? Probe to determine whether respondent is referring to live born children. by live born children, i mean a child Who ever breathed or cried or shoWed other signs of life – even if he or she lived only a feW minutes or hours. If “None”, circle ‘00’. none .00 number of live-born children . __ __ ðcM12a cm0b. What is the date of your last birth (even if the baby died)? Month and year must be recorded. date of last birth day . __ __ dK day .98 Month . __ __ Year .__ __ __ __ ðcM12a cm1. noW i Would like to ask about all the births you have had during your life. have you ever given birth? Yes . 1 no .2 2ð cM8 cm2. What Was the date of your first birth? i mean the very first time you gave birth, even if the child is no longer living, or Whose father is not your current partner. Skip to CM4 only if year of first birth is given. Otherwise, continue with CM3. date of first birth day . __ __ dK day .98 Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 ðcM4 cm3. hoW many years ago did you have your first birth? completed years since first birth . __ __ cm4. do you have any sons or daughters to Whom you have given birth Who are noW living With you? Yes . 1 no . 2 2ðcM6 cm5. hoW many sons live With you? hoW many daughters live With you? If none, record ‘00’. sons living at home . __ __ daughters living at home . __ __ cm6. do you have any sons or daughters to Whom you have given birth Who are alive but do not live With you? Yes . 1 no . 2 2ðcM8 cm7. hoW many sons are alive but do not live With you? hoW many daughters are alive but do not live With you? If none, record ‘00’. sons living elsewhere . __ __ daughters living elsewhere . __ __ cm8. have you ever given birth to a boy or girl Who Was born alive but later died? If “No” probe by asking: i mean to a child Who ever breathed or cried or shoWed other signs of life – even if he or she lived only a feW minutes or hours? Yes . 1 no . 2 2ðcM10 cm9. hoW many boys have died? hoW many girls have died? If none, record ‘00’. Boys dead . __ __ girls dead . __ __ CM10. Sum answers in CM5, CM7 and CM9. sum . __ __ cm11. just to make sure that i have noted this correctly, you have had in total (total number in cM10) live births during your life. is this correct? ¨ Yes. Check and mark below: ¨ No live births (i.e. the sum in CM10 equals 0) ð Continue with CM12A ¨ One or more live births ð Continue with CM12 ¨ No ð Check responses to CM1-CM10 and make corrections as necessary before proceeding to CM12 cm12. of these (total number in CM10) births you have had, When did you deliver the last one (even if he or she has died)? Month and year must be recorded. date of last birth day . __ __ dK day .98 Month . __ __ Year .__ __ __ __ cm12a. sometimes Women have pregnancies that might not end With a live birth. have you ever had any pregnancy that Was miscarried, ended in a stillbirth, or that Was terminated early (aborted)? Yes . 1 no . 2 2ðcM13 cm12b. hoW many miscarriages have you had during your lifetime? by miscarriage, i mean an early and involuntary end of pregnancy Within the first 5th month of pregnancy. none .00 number of miscarriages . __ __ cm12c. in hoW many cases have your pregnancies ended With a stillbirth? by stillbirth, i mean a birth that took place after the 5th month of pregnancy, but the child did not shoW any signs of life. none .00 number of stillbirths . __ __ cm12d. and hoW many early terminations of pregnancy (abortions) have you had during your lifetime? by early termination of pregnancy (abortion), i mean a pregnancy that Was voluntarily terminated Within the first 5 months of pregnancy. none .00 number of early terminations of pregnancy (abortions) . __ __ 00ðcM13 cm12e. When did your (last) early termination of pregnancy (abortion) take place? Month and year must be recorded. date of (last) early termination of pregnancy (abortion) Month . __ __ Year .__ __ __ __ cm12F. Check in CM12E when the last abortion took place and if: ¨ There are no abortions during the last 2 years. ð Go to CM12J ¨ The last abortion took place during the last 2 years, that is, since (the month of interviewing) in 2009 ð Continue with CM12G cm12g. If the respondent has mentioned more than one early termination (abortion), i.e. CM12D is higher than 1, then ask her for the exact month and year of each mentioned early termination (abortion) that took place during the last 2 years, i.e. since (the month of interviewing) 2009. Write down month and year for each early termination (abortion) in CM12H, starting from the last, and for each recorded early termination (abortion) ask the respondent to tell you how many weeks/months she was pregnant when she had the early termination (abortion) and record this appropriately. last early termination (abortion) Previous to the last early termination (abortion) second last from the last early termination (abortion) third last from the last early termination (abortion) cm12h. What month and year did your (last) early termination (abortion) take place? Don’t ask, it is given in CM12E Month __ __ Year __ __ __ __ Month __ __ Year __ __ __ __ Month __ __ Year __ __ __ __ cm12i. hoW many months (Weeks) Were you pregnant When your pregnancy Was aborted? If the respondent answers in weeks, write down on the appropriate line for weeks, otherwise just record the given months weeks 1 __ __ Months 2 __ __ weeks 1 __ __ Months 2 __ __ weeks 1 __ __ Months 2 __ __ weeks 1 __ __ Months 2 __ __ cm12J. Check total number of early terminations (abortions) in CM12D and if total is: ¨ from 01 to 04 ð Go to CM13 ¨ greater than 04 ð Continue with CM12K cm12k. in What month and year did you have your first early termination of pregnancy (abortion)? date of first abortion Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 ðcM13 cm12l. hoW old Were you When you had your first early termination (abortion)? age (in completed years) . __ __ cm13. Check CM0B or CM12: Last birth occurred within the last 2 years, i.e. since (day and month of interview) in 2009 ¨ No, there were no live births in the last 2 years or no live birth at all. ð Go to ILLNESS SYMPTOM Module. ¨ Yes, one or more live births in the last 2 years. ð Ask for the name of the last-born child Name of last-born child_______________________ If the child has died, take special care when referring to this child by name in the following modules. Continue with the next module. Monitoring the situation of children and woMen 211210 MultiPle indicator cluster surveY 2011–2012 deSIre For lASt BIrtH dB This module is to be administered to all women with a live birth in the 2 years preceding the date of interview. Check CM13 in the child mortality module CM and record the name of the last-born child here ________________. Use this child’s name in the following questions, where indicated. db1. When you got pregnant With (name), did you Want to get pregnant at that time? Yes . 1 no . 2 1ðnext Module dB2. did you Want to have a baby later on, or did you not Want any (more) children? later . 1 did not want more children . 2 2ðnext Module dB3. hoW much longer did you Want to Wait? Months .1 __ __ Years .2 __ __ dK . 998 MAternAl And newBorn HeAltH Mn This module is to be administered to all women with a live birth in the 2 years preceding the date of interview. Check CM13 in the child mortality module CM and record the name of the last-born child here ________________. Use this child’s name in the following questions, where indicated. mn1. did you see anyone for antenatal care during your pregnancy With (name)? Yes . 1 no . 2 2ðMn17 mn2. Whom did you see? Probe: anyone else? Probe for the type of person seen and circle all answers given. health professional: doctor .a nurse / Midwife . B other person traditional birth attendant .f family member/friend .h other (specify) ________________________________ X Mn3. hoW many times did you receive antenatal care during this pregnancy? number of times . __ __ dK .98 Mn4. as part of your antenatal care during this pregnancy, Was any of the folloWing done at least once: [a] Was your blood pressure measured? [b] did you give a urine sample? [c] did you give a blood sample? Yes no Blood pressure .1 2 urine sample .1 2 Blood sample .1 2 mn17. Who assisted With the delivery of (name)? Probe: anyone else? Probe for the type of person assisting and circle all answers given. If respondent says no one assisted, probe to determine whether any adults were present at the delivery. health professional: doctor .a nurse / Midwife . B other person traditional birth attendant .f relative / friend .h other (specify) _____________________________ X no one . Y mn18. Where did you give birth to (name)? Probe to identify the type of source. If unable to determine whether public or private, write the name of the place, institution, organisation, etc. _______________________________________________ (Name of institution, organisation, etc.) home Your home .11 other home .12 Public sector hospital .21 health centre .22 other public facility (specify) ______________ 26 Private Medical sector Private hospital.31 Private clinic .32 Private maternity home .33 other private medical facility (specify) _____________________36 other (specify) ________________________________96 11ðMn20 12ðMn20 96ðMn20 mn19. Was (name) delivered by caesarean section? that is, did they cut your belly open to take the baby out? Yes . 1 no . 2 mn20. When (name) Was born, Was he/she: very large, larger than average, average, smaller than average or very small? very large . 1 larger than average . 2 average . 3 smaller than average . 4 very small . 5 dK . 8 mn21. Was (name) Weighed at birth? Yes . 1 no . 2 dK . 8 2ðMn23 8ðMn23 mn22. hoW much did (name) Weigh? Record weight from health card, if available. from card . 1 (kg) __ . __ __ __ from recall . 2 (kg) __ . __ __ __ dK .99998 mn23. has your menstrual period returned since the birth of (name)? Yes . 1 no . 2 mn24. did you ever breastfeed (name)? Yes . 1 no . 2 2ðnext Module mn25. hoW long after birth did you first put (name) to the breast? If less than 1 hour, record ‘00’ hours. If less than 24 hours, record hours. Otherwise, record days. immediately . 000 hours .1 __ __ days .2 __ __ dK / don’t remember . 998 mn26. in the first three days after delivery, Was (name) given anything to drink other than breast milk? Yes . 1 no . 2 2ðnext Module mn27. What Was (name) given to drink? Probe: anything else? Milk (other than breast milk) .a Plain water . B sugar or glucose water . c homemade anti-colic (cramp) solution .d sugar and salt water solution .e fruit juice .f infant formula .g tea / herbal infusion .h honey .i other (specify) ________________________________ X Monitoring the situation of children and woMen 213212 MultiPle indicator cluster surveY 2011–2012 IllneSS SYMptoMS Il is1. Check Household Member Listing Form, column HL9 in the Household Questionnaire Is the respondent the mother or caretaker of any child under the age of 5? ¨ Yes ð Continue with IS2. ¨ Noð Go to Next Module. is2. 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? Probe: any other symptoms? Keep asking for more signs or symptoms until the mother/ caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, but do NOT prompt with any suggestions child not able to drink or breastfeed .a child becomes sicker . B child develops a fever . c child has fast breathing .d child has difficulties breathing .e child has blood in his/her stool .f child is drinking poorly .g other (specify) _____________________________ X other (specify) ____________________________ Y other (specify) ____________________________ Z ContrACeptIon Cp cp0. i Would like to talk With you about another subject – family planning. couples use different Ways or methods in order to postpone or avoid pregnancy. have you heard of : [a] female sterilisation? Probe: an operation Women undertake in order to avoid pregnancy. [b] male sterilisation? Probe: an operation men undertake in order to avoid pregnancy. [c] iud? Probe: Women can have a coil placed inside the uterus by a doctor. [d] injectibles? Probe: Women can receive injections that have an effect on their hormones and prevent pregnancy over a period of a feW months. [e] implants? Probe: Women can have one or more small implants (rods) implanted in their upper arm by a doctor that prevent pregnancy for a number of years. [f] pill? Probe: Women can take pills on an everyday basis to avoid getting pregnant. [g] male condom? Probe: men can put a rubber cover on their penis before or during sexual intercourse. [h] female condom? probe: Women can put a cover inside their vagina before sexual intercourse. [i] diaphragm? Probe: Women can insert a soft rubber cup in their vagina to block the sperm from entering their uterus or fallopian tubes. [j] foam / jelly? Probe: Women may use spermicidal products (e.g. foam, jelly, cream) that can kill or prevent the sperm from moving and reaching the egg. [k] lactational amenorrhoea method (lam)? [l] periodic abstinence / rhythm method? Probe: the Woman can avoid pregnancy by not having sexual intercourse during fertile days in the month, i.e. days she is most likely to get pregnant. [m] WithdraWal? Probe: men can pull out directly before ejaculating. [n] emergency / postcoital contraception? Probe: as an emergency measure, Within a period of 3 days, after having unprotected sexual intercourse, Women can take special pills to prevent pregnancy. [x] have you heard of any other Ways or methods that men or Women can utilise in order to avoid pregnancy? Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 no . 2 Yes . 1 ___________________________ (specify) ___________________________ (specify) no . 2 Cp1. are you pregnant noW? Yes, currently pregnant . 1 no . 2 unsure or dK . 8 1ðnext Module Monitoring the situation of children and woMen 215214 MultiPle indicator cluster surveY 2011–2012 Cp2. as We mentioned earlier, couples use various Ways or methods to delay or avoid a pregnancy. are you currently doing something or using any method to delay or avoid pregnancy? Yes . 1 no . 2 2ðnext Module Cp3. What are you doing to delay or avoid a pregnancy? Do not prompt. If more than one method is mentioned, circle each one. female sterilisation .a Male sterilisation. B iud . c injectables .d implants .e Pill .f Male condom .g female condom .h diaphragm .i foam / Jelly . J lactational amenorrhoea method (laM) . K Periodic abstinence / rhythm .l withdrawal .M other (specify) ________________________________ X unMet need un un1. Check CP1. Is the respondent currently pregnant? ¨ Yes, currently pregnant ð Continue with UN2 ¨ No, unsure or DK ð Go to UN5 un2. noW i Would like to talk to you about your current pregnancy. When you got pregnant, did you Want to get pregnant at that time? Yes . 1 no . 2 1ðun4 un3. did you Want to have a baby later on or did you not Want any (more) children? later . 1 no more children . 2 un4. noW i Would like to ask some Questions about the future. after the child you are noW expecting, Would you like to have another child or Would you prefer not to have any more children? have another child . 1 no more . 2 undecided / don’t know. 8 1ðun7 2ðun13 8ðun13 un5. Check CP3. Is the respondent currently using “Female sterilisation”? ¨ Yes ð Go to UN13 ¨ No ð Continue with UN6 un6. noW i Would like to ask you some Questions about the future. Would you like to have (another) a child, or Would you prefer not to have any (more) children? have (another) a child . 1 no more / none . 2 says she cannot get pregnant . 3 undecided / don’t know. 8 2ðun9 3ðun11 8ðun9 un7. hoW long Would you like to Wait before the birth of (another) a child? Months .1 __ __ Years .2 __ __ soon / now . 993 says she cannot get pregnant . 994 after marriage . 995 other . 996 don’t know . 998 994ðun11 un8. Check CP1. Is the respondent currently pregnant? ¨ Yes, currently pregnant ð Go to UN13 ¨ No, unsure or DK ð Continue with UN9 un9. Check CP2. Is the respondent currently using a contraceptive method? ¨ Yes ð Go to UN13 ¨ No ð Continue with UN10 un10. do you think you are physically able to get pregnant at this time? Yes . 1 no . 2 dK . 8 1 ðun13 8 ðun13 un11. why do you think you are not physically able to get pregnant? infrequent or no sex .a Menopausal . B never menstruated . c hysterectomy (surgical removal of uterus) .d has been trying to get pregnant for 2 years or more without result .e Postpartum amenorrhea .f still breastfeeding .g too old .h fatalistic .i other (specify) ________________________________ X don’t know . Z un12. Check UN11. “Never menstruated” mentioned? ¨ Mentioned ð Go to Next Module ¨ Not mentioned ð Continue with UN13 un13. When did your last menstrual period start? days ago .1 __ __ weeks ago .2 __ __ Months ago .3 __ __ Years ago .4 __ __ in menopause / has had a hysterectomy . 994 Before last birth . 995 never menstruated . 996 Monitoring the situation of children and woMen 217216 MultiPle indicator cluster surveY 2011–2012 AttItudeS towArd doMeStIC VIolenCe dV dV1. sometimes a husband becomes annoyed or gets angry at things that his Wife does. in your opinion, is a husband justified in hitting or beating his Wife in the folloWing situations: [a] if she goes out Without telling him? [b] if she neglects the children? [c] if she argues With him? [d] if she refuses to have sex With him? [e] if she burns the food? Yes no dK goes out without telling him . 1 2 8 neglects the children . 1 2 8 argues with him. 1 2 8 refuses sex . 1 2 8 Burns the food . 1 2 8 MArrIAGe/unIon MA ma1. are you currently married or living together With a man as if married? Yes, currently married . 1 Yes, living with a man . 2 no, not married . 3 3ðMa5 ma2. hoW old is your husband/partner? Probe: hoW old Was your husband/partner on his last birthday? age in years . __ __ dK .98 ma2a. Check cluster number in WM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to MA7 ¨ If the cluster number is from 501-562 (Roma survey) ð Continue with MA3. ma3. besides yourself, does your husband/partner have any other Wives or partners or does he live With other Women as if married? Yes . 1 no . 2 2ðMa7 ma4. hoW many other Wives or partners does he have? number . __ __ dK .98 ðMa7 98ðMa7 ma5. have you ever been married or lived together With a man as if married? Yes, formerly married . 1 Yes, formerly lived with a man . 2 no . 3 3 ðnext Module ma6. What is your marital status noW: are you WidoWed, divorced or separated? widowed . 1 divorced . 2 separated . 3 ma7. have you been married or lived With a man only once or more than once? only once . 1 More than once . 2 ma8. in What month and year did you first marry or start living With a man as if married? date of first marriage Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 ðnext Module ma9. hoW old Were you When you started living With your first husband/partner? age in years . __ __ SeXuAl BeHAVIour SB Check for the presence of others. Before continuing, ensure you are alone with the respondent. sb1. noW i Would like to ask you some Questions about sexual activity in order to get a better understanding of some important life issues. the information you provide Will remain strictly confidential. hoW old Were you When you had sexual intercourse for the very first time? never had intercourse .00 age in years . __ __ had intercourse for the first time when started living with (first) husband/partner .95 00ðnext Module sb2. the first time you had sexual intercourse, Was a condom used? Yes . 1 no . 2 dK / don’t remember . 8 sb3. When Was the last time you had sexual intercourse? Record ‘years ago’ only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. days ago .1 __ __ weeks ago .2 __ __ Months ago .3 __ __ Years ago .4 __ __ 4ðsB15 sb4. the last time you had sexual intercourse, Was a condom used? Yes . 1 no . 2 sb5. What Was your relationship to the person you last had sexual intercourse With? Probe to ensure that the response refers to the relationship at the time of sexual intercourse. If “boyfriend”, then ask: Were you living together as if married? If response is “yes”, circle ‘2’. If response is “no”, circle‘3’. husband . 1 cohabiting partner . 2 Boyfriend . 3 casual acquaintance . 4 other (specify) _________________________________6 3 ðsB7 4 ðsB7 6 ðsB7 sb6. Check MA1: ¨ Currently married or living with a man as if married (MA1 = 1 or 2) ð Go to SB8 ¨ Not married / Not in union (MA1 = 3) ð Continue with SB7 sb7. hoW old is this person? If response is DK, probe: about hoW old is this person? age of sexual partner . __ __ dK .98 sb8. have you had sexual intercourse With any other person in the last 12 months? Yes . 1 no . 2 2ðsB15 sb9. the last time you had sexual intercourse With this other person, Was a condom used? Yes . 1 no . 2 SB10. What Was your relationship to this person? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If “boyfriend” then ask: were you living together as if married? If “yes”, circle ‘2’. If “no”, circle ‘3’. husband . 1 cohabiting partner . 2 Boyfriend . 3 casual acquaintance . 4 other (specify) _________________________________6 3 ðsB12 4 ðsB12 6 ðsB12 sb11. Check MA1 and MA7: ¨ Currently married or living with a man (MA1 = 1 or 2) AND Married only once or lived with a man only once (MA7 = 1) ð Go to SB13 ¨ Else ð Continue with SB12 SB12. hoW old is this person? If response is DK, probe: about how old is this person? age of sexual partner . __ __ dK .98 SB13. in the last 12 months, have you had sexual intercourse With any other person, other than these tWo persons? Yes . 1 no . 2 2ðsB15 SB14. in total, With hoW many different people have you had sexual intercourse in the last 12 months? number of partners . __ __ SB15. in total, With hoW many different people have you had sexual intercourse in your lifetime? If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write ‘95’. number of lifetime partners . __ __ dK .98 Monitoring the situation of children and woMen 219218 MultiPle indicator cluster surveY 2011–2012 HIV/AIdS HA ha1. noW i Would like to talk With you about something else. have you ever heard of the hiv virus or an illness called aids (or sida)? Yes . 1 no . 2 2 ðnext Module ha2. can people reduce their chance of getting the virus that causes aids by having just one uninfected sex partner Who has no other sex partners? Yes . 1 no . 2 dK . 8 ha3. can people get the virus that causes aids because of Witchcraft or other supernatural means? Yes . 1 no . 2 dK . 8 ha4. can people reduce their chance of getting the virus that causes aids by using a condom every time they have sex? Yes . 1 no . 2 dK . 8 ha5. can people get the virus that causes aids from mosQuito bites? Yes . 1 no . 2 dK . 8 ha6. can people get the virus that causes aids by sharing food With a person Who has aids? Yes . 1 no . 2 dK . 8 ha7. is it possible for a healthy-looking person to have the virus that causes aids? Yes . 1 no . 2 dK . 8 ha8. can the virus that causes aids be transmitted from a mother to her baby: [a] during pregnancy? [b] during delivery? [c] by breastfeeding? Yes no dK during pregnancy . 1 2 8 during delivery . 1 2 8 By breastfeeding . 1 2 8 ha9. in your opinion, if a female teacher has the virus that causes aids but is not sick, should she be alloWed to continue teaching in school? Yes . 1 no . 2 dK / not sure / depends . 8 ha10. Would you buy fresh vegetables from a shopkeeper or salesperson if you kneW that this person had the virus that causes aids? Yes . 1 no . 2 dK / not sure / depends . 8 ha11. if a member of your family got infected With the virus that causes aids, Would you Want it to remain a secret? Yes . 1 no . 2 dK / not sure / depends . 8 ha12. if a member of your family became sick With aids, Would you be Willing to care for him or her in your oWn household? Yes . 1 no . 2 dK / not sure / depends . 8 HA13. Check CM13: Did the respondent have any live births in last 2 years? ¨ No live birth in last 2 years ð Go to HA24 ¨ One or more live births in last 2 years ð Continue with HA14 HA14. Check MN1: Did the respondent receive antenatal care? ¨ Yes, received antenatal care ð Continue with HA15 ¨ No, did not receive antenatal care ð Go to HA24 ha15. during any of the visits as part of antenatal care for your pregnancy With (name), Were you given any information about: [a] babies contracting the virus that causes aids from their mother? [b] things that you can do to prevent getting the virus that causes aids? [c] getting tested for the virus that causes aids? Were you: [d] offered a test for the virus that causes aids? Y n dK contracting virus that causes aids from the mother . 1 2 8 what things can be done . 1 2 8 tested for virus that causes aids . 1 2 8 offered a test . 1 2 8 ha16. i don’t Want to knoW the results, but Were you tested for the virus that causes aids as part of your antenatal care (pregnancy checks)? Yes . 1 no . 2 dK . 8 2ðha19 8ðha19 ha17. i don’t Want to knoW the results, but did you get the results of the test? Yes . 1 no . 2 dK . 8 2ðha22 8ðha22 HA18. regardless of the result, all women who are tested are supposed to receive counselling / attend consultations after getting the result. after you were tested, did you receive counselling / attend consultations? Yes . 1 no . 2 dK . 8 1ðha22 2ðha22 8ðha22 HA19. Check MN17: Was the birth delivered by a health professional (A or B)? ¨ Yes, birth delivered by a health professional ð Continue with HA20 ¨ No, birth not delivered by a health professional ð Go to HA24 ha20. i don’t Want to knoW the results, but Were you tested for the virus that causes aids betWeen the time you Went for delivery but before the baby Was born? Yes . 1 no . 2 2ðha24 ha21. i don’t Want to knoW the results, but did you get the results of the test? Yes . 1 no . 2 ha22. have you been tested for the virus that causes aids since that time you Were tested during your pregnancy? Yes . 1 no . 2 1ðha25 ha23. When Was the most recent time you Were tested for the virus that causes aids? less than 12 months ago. 1 12-23 months ago . 2 2 or more years ago . 3 1ðnext Module 2ðnext Module 3ðnext Module ha24. i don’t Want to knoW the results, but have you ever been tested to see if you have the virus that causes aids? Yes . 1 no . 2 2ðha27 ha25. When Was the most recent time you Were tested? less than 12 months ago. 1 12-23 months ago . 2 2 or more years ago . 3 ha26. i don’t Want to knoW the results, but did you get the results of the test? Yes . 1 no . 2 dK . 8 1ðnext Module 2ðnext Module 8ðnext Module ha27. do you knoW of a place Where people can go to get tested for the virus that causes aids? Yes . 1 no . 2 Monitoring the situation of children and woMen 221220 MultiPle indicator cluster surveY 2011–2012 toBACCo And AlCoHol uSe ta ta1. have you ever tried smoking cigarettes, even taking one or tWo puffs? Yes . 1 no . 2 2ðta6 ta2. hoW old Were you When you smoked an entire cigarette for the first time? never smoked a whole cigarette .00 age. ___ ___ 00ðta6 ta3. do you currently smoke cigarettes? Yes . 1 no . 2 2ðta6 ta4. hoW many cigarettes did you smoke in the last 24 hours? number of cigarettes . ___ ___ ta5. on hoW many days did you smoke cigarettes during the last month? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “everyday” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 every day / almost every day .30 ta6. have you ever tried any smoked tobacco products other than cigarettes, such as cigars (e.g. cuban), a pipe or Waterpipe (narghile/ hookah)? Yes . 1 no . 2 2ðta10 ta7. during the last month, did you use any smoked tobacco products? Yes . 1 no . 2 2ðta10 ta8. What type of smoked tobacco product did you use or smoke during the last month? Circle all mentioned responses. cigars .a water pipe . B cigarillos . c Pipe .d other (specify) ________________________________ X ta9. on hoW many days did you use smoked tobacco products during the last month? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “every day” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 every day / almost every day .30 ta10. have you ever tried any form of smokeless tobacco products, such as cheWing tobacco, tobacco for sniffing (snuff) or dipping tobacco? Yes . 1 no . 2 2 ðta14 ta11. did you use any smokeless tobacco products during the last month? Yes . 1 no . 2 2 ðta14 ta12. What type of smokeless tobacco product did you use during the last month? Circle all mentioned. chewing tobacco .a snuff . B dip . c other (specify) ________________________________ X ta13. on hoW many days did you use smokeless tobacco products during the last month? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “every day” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 every day / almost every day .30 ta14. noW i Would like to ask you some Questions about drinking alcohol. have you ever drunk alcohol? Yes . 1 no . 2 2ðnext Module ta15. We count one drink of alcohol as one can or bottle of beer, one glass of Wine, or one shot of strong drink. hoW old Were you When you had your first drink of alcohol, other than a feW sips? never had one drink of alcohol .00 age. ___ ___ 00ðnext Module ta16. during the last month, on hoW many days did you have at least one drink of alcohol? If respondent did not drink, circle ‘00’. If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “every day” or “almost every day”, circle ‘30’. did not have one drink in last month .00 number of days . 0 ___ 10 days or more but less than a month .10 every day / almost every day .30 00ðnext Module ta17. in the last month, on those days that you drank alcohol, What is the number of drinks did you usually had? number of drinks. ___ ___ lIFe SAtISFACtIon lS ls1. Check WB2: Is the respondent aged between 15 and 24? ¨ Age 25-49 ð Go to Next Module ¨ Age 15-24 ð Continue with LS2 ls2. i Would like to ask you some simple Questions on happiness and satisfaction. first, taking all things together, Would you say you are very happy, happy, neither happy nor unhappy, unhappy or very unhappy? you can also look at these pictures to help you respond. Show side 1 of the showcard to the respondent and explain what each symbol represents. Circle the response code selected by the respondent. very happy . 1 happy . 2 neither happy nor unhappy . 3 unhappy . 4 very unhappy. 5 ls3. noW i Will ask you Questions about your level of satisfaction in different areas of your life. in each case, We have five possible responses: please tell me, for each Question, Whether you are very satisfied, satisfied, neither satisfied nor unsatisfied, unsatisfied or very unsatisfied. again, you can look at these pictures to help you respond. Show side 2 of the showcard to the respondent and explain what each symbol represents. For questions LS3 to LS13, circle the response code shown by the respondent. hoW satisfied are you With your family life? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls4. hoW satisfied are you With your friendships? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls5. during the current (2011-2012) school/academic year, did you attend school/university at any time? Yes . 1 no . 2 2ðls7 ls6. hoW satisfied are you With your school/university? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls7. hoW satisfied are you With your current job? If the respondent says that he/she does not have a job, circle ‘0’ and continue with the next question. Do not ask additional questions to find out how she feels about not having a job, unless she tells you herself. does not have a job . 0 very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls8. hoW satisfied are you With your health? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls9. hoW satisfied are you With Where you live? If necessary, explain that the question refers to the living environment, including the neighbourhood and the dwelling. very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 Monitoring the situation of children and woMen 223222 MultiPle indicator cluster surveY 2011–2012 ls10. hoW satisfied are you With hoW people around you generally treat you? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls11. hoW satisfied are you With the Way you look? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls12. hoW satisfied are you With your life, overall? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls13. hoW satisfied are you With your current income? If the respondent responds that he/she does not have any income, circle ‘0’ and continue with the next question. Do not ask additional questions to find out how she feels about not having any income, unless she tells you herself. does not have any income . 0 very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 ls14. compared to this time last year, Would you say that your life has improved, stayed more or less the same, or Worsened, overall? improved . 1 More or less the same . 2 worsened . 3 ls15. and in one year from noW, do you expect that your life Will be better, Will be more or less the same, or Will be Worse, overall? Better . 1 More or less the same . 2 worse . 3 HeAltH CAre He he0. Check cluster number in WM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to WM11 ¨ If the cluster number is from 501-562 (Roma survey)ð Continue with HE1. he1. do you have a health booklet? Yes . 1 no . 2 he2. do you have health insurance? Yes . 1 no . 2 1ð he9 he3. do you use health care services at the health centre? Yes . 1 no . 2 2ð he5 he4. are you provided With health care services at the nearest health centre of charge? Yes . 1 no . 2 he5. do you use health care services at the hospital? Yes . 1 no . 2 2ð he7 he6. are you provided With health care services at the nearest hospital free of charge? Yes . 1 no . 2 he7. do you use emergency health care services? Yes . 1 no . 2 2ð he9 he8. are you provided With emergency health care services free of charge? Yes . 1 no . 2 he9. do you pay all necessary health care services and medication? Yes . 1 sometimes yes, sometimes no . 2 no . 3 1ð wM11 he10. do you pay only vital/urgently needed health care services and medications? Yes . 1 no . 2 1ð wM11 He11. can you afford medications Without one-off financial assistance? Yes . 1 no . 2 wM11. Record the interview end time. hour and minutes .__ __ : __ __ wM12. Check the Household Member Listing Form, column HL9 in the Household Questionnaire. Is the respondent the mother or caretaker of any child aged 0-4 living in this household? ¨ Yes ð Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE for that child and start the interview with the same respondent. ¨ No ð End the interview with this respondent by thanking her for her cooperation. Check for the presence of any other eligible women, men or children under-5 in the household. Interviewer’s observations Field editor’s observations Supervisor’s observations Monitoring the situation of children and woMen 225224 Multiple indicator cluster survey 2011–2012 Showcards were used to help respondents answer questions for the ‘Life Satisfaction’ module (LS) and the ‘Life Satisfaction’ module (MLS) contained in the Questionnaire for Women Aged 15-49 and the Questionnaire for Men Aged 15-49, respectively. SIDE 1: SHOWCARD LS 1 / MLS 1 Very happy Happy Neither happy, nor unhappy Unhappy Very unhappy SIDE 2: SHOWCARD LS 2 / MLS 2 Very satisfied Satisfied Neither satisfied, nor unsatisfied Unsatisfied Very unsatisfied QUEStIONNAIRE fOR MEN AgED 15 tO 49 [Republic of Srpska] MAN’S INfORMAtION pANEL MWM This questionnaire is to be administered to all men age 15 through 49 (see Household Member Listing Form, column HL7A in the Household Questionnaire). A separate questionnaire should be used for each eligible man. MWM1. cluster number: ___ ___ ___ MWM2. household number: ___ ___ ___ MWM3. Man’s name: name _________________________________________ MWM4. Man’s line number: ___ ___ MWM5. interviewer name and code: name ______________________________ ___ ___ ___ MWM6. day / Month / year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting if not already read to this man: We are from the MInIStRy Of HEALtH AnD SOCIAL WELfARE Of tHE REpubLIC Of SRpSkA. We are conducting a survey concerned With family health and education. i Would like to talk to you about these subjects. the intervieW Will take up to 20 minutes. all the information We obtain Will remain strictly confidential. If greeting at the beginning of the household questionnaire has already been read to this man, then read the following: noW i Would like to talk to you more about your health and other topics. this intervieW Will take up to 20 minutes. again, all the information We obtain Will remain strictly confidential. may i start noW?  Yes, permission given ð Go to MWM10 to record the time and then begin the interview.  No, permission not given ð Complete MWM7. Inform your supervisor of this result. MWM7. result of man’s interview Questionnaire completed .01 respondent not at home .02 refused .03 Questionnaire partly completed .04 respondent incapacitated .05 other (specify) .96 MWM8. field edited by (name and number): name ____________________________ ___ ___ ___ MwM9. data entry operator (name and number): name _____________________________ ___ ___ ___ Monitoring the situation of children and woMen 227226 MultiPle indicator cluster surveY 2011–2012 mwm10. Record the interview start time. hour and minutes .__ __ : __ __ MAn’S BACKGround MwB mwb1. in What month and year Were you born? date of birth Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 mwb2. hoW old are you? Probe: hoW old Were you on your last birthday? Compare MWB1 and/or MWB2 and correct if inconsistent. age (in completed years) . __ __ mwb3. have you ever attended school or a preschool institution? Yes . 1 no . 2 2ðMwB7 mwb4. What is the highest education level you attended? Preschool . 0 Primary . 1 secondary . 2 higher . 3 0ðMwB7 mwb5. What is the highest grade/year you completed at that level? If less than 1 grade, enter ‘00’. grade/year . __ __ MwB6. Check MWB4: ¨ Secondary or higher. ð Go to Next Module ¨ Primary ð Continue with MWB7 MwB7. noW i Would like you to read this sentence to me. Show the sentence on the card to the respondent. If the respondent cannot read the whole sentence, probe: Can you read part of the sentence to me? cannot read at all . 1 able to read only parts of the sentence . 2 able to read the whole sentence . 3 the sentence isn’t written in a language understood by the respondent _____________________________________________4 (specify language) Blind / mute, visually / speech impaired . 5 ACCeSS to MASS MedIA And uSe oF InForMAtIon/CoMMunICAtIon teCHnoloGY MMt MMt1. Check MWB7: ¨ Question left blank (Respondent has secondary or more education) ð Continue with MMT2 ¨ Able to read or no sentence available in required language (codes 2, 3 or 4) ð Continue with MMT2 ¨ Cannot read at all or blind/mute, etc. (codes 1 or 5) ð Go to MMT3 mmt2. hoW often do you read a neWspaper or magazine: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mmt3. do you listen to the radio almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mmt4. hoW often do you Watch television: Would you say that you Watch tv almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 MMt5. Check MWB2: Is the respondent aged 15-24 years? ¨ Yes, age 15-24 ð Continue with MMT6 ¨ No, age 25-49 ð Go to Next Module mmt6. have you ever used a computer? Yes . 1 no . 2 2ðMMt9 mmt7. in the last 12 months, have you used a computer from any location? Yes . 1 no . 2 2ðMMt9 mmt8. during the last month, hoW often did you use a computer: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 mmt9. have you ever used the internet? Yes . 1 no . 2 2ðnext Module MMt10. in the last 12 months, have you used the internet? If necessary, probe for use of Internet from any location, with any device, etc. Yes . 1 no . 2 2ð next Module MMt11. during the last month, hoW often did you use the internet: almost every day, at least once a Week, less than once a Week or not at all? almost every day . 1 at least once a week . 2 less than once a week . 3 not at all . 4 Monitoring the situation of children and woMen 229228 MultiPle indicator cluster surveY 2011–2012 CHIld MortAlItY MCM mcm0. Check cluster number in MWM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to Next Module ¨ If the cluster number is from 501-562 (Roma survey)ð Continue with MCM1. All questions refer only to LIVE births. MCM1. noW i Would like to ask about all the children you have had in your lifetime. i am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name. have you had any biological children With any Woman? Yes . 1 no . 2 dK . 8 2ðMcM8 8ðMcM8 MCM3. hoW old Were you When your (first) child Was born? age in years . __ __ MCM4. do you have any biological sons or daughters Who are noW living With you? Yes . 1 no . 2 2ðMcM6 mcm5. hoW many sons live With you? hoW many daughters live With you? If none, record ‘00’. number of sons at home . __ __ number of daughters at home. __ __ mcm6. do you have any biological sons or daughters Who are alive but do not live With you? Yes . 1 no . 2 2ðMcM8 mcm7. hoW many sons are alive but do not live With you? hoW many daughters are alive but do not live With you? If none, record ‘00’. sons living elsewhere . __ __ daughters living elsewhere . __ __ mcm8. have you had a biological son or daughter Who Was born alive but later died? If “No” probe by asking additional question: i mean, a child Who ever breathed or cried or shoWed other signs of life – even if he or she lived only a feW minutes or hours? Yes . 1 no . 2 2ðMcM10 mcm9. hoW many boys have died? hoW many girls have died? If none, record ‘00’. Boys dead . __ __ girls dead . __ __ MCM10. Sum answers to questions MCM5, MCM7 and MCM9. sum . __ __ mcm11. just to make sure that i have noted this correctly, in total you have been the biological father of (total number in McM10) live-born children during your life. is this correct? ¨ Yes. Check and note below: ¨ No live-born children ð Go to Next Module ¨ One or more live-born children ð Continue with MCM11A ¨ No ð Check responses to MCM1-MCM10 and make corrections as necessary. MCM11A. did all the biological children you have, have the same biological mother? Yes . 1 no . 2 1ðMcM12 MCM11B. in all, how many women have you had biological children with? number of women. __ __ mcm12. of these (total number in MCM10) biological children, When Was the last one born (even if he or she has died)? Month and year must be recorded. date of last birth day . __ __ dK day .98 Month . __ __ Year .__ __ __ __ AttItudeS towArd doMeStIC VIolenCe MdV MdV1. sometimes a husband becomes annoyed or gets angry at things that his Wife does. in your opinion, is a husband justified in hitting or beating his Wife in the folloWing situations: [a] if she goes out Without telling him? [b] if she neglects the children? [c] if she argues With him? [d] if she refuses to have sex With him? [e] if she burns the food? Yes no dK goes out without telling him . 1 2 8 neglects the children . 1 2 8 argues with him. 1 2 8 refuses sex . 1 2 8 Burns the food . 1 2 8 marriage/union MMA mma1. are you currently married or living together With a Woman as if married? Yes, currently married . 1 Yes, living with a woman . 2 no, not married . 3 3ðMMa5 mma2. hoW old is your Wife/partner? probe: hoW old Was your Wife/partner on her last birthday? age in years . __ __ dK .98 mma2a. Check cluster number in MWM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to MMA7. ¨ If the cluster number is from 501-562 (Roma survey) ð Continue with MMA3. mma3. do you have other Wives or do you live With other Women as if married? Yes (More than one) . 1 no (only one) . 2 2ðMMa7 mma4. hoW many other Wives or live-in partners do you have? number . __ __ ðMMa7 mma5. have you ever been married or lived together With a Woman as if married? Yes, formerly married . 1 Yes, formerly lived in with a woman . 2 no . 3 3 ðnext Module mma6. What is your marital status noW: are you WidoWed, divorced or separated? widowed . 1 divorced . 2 separated . 3 mma7. have you been married or lived With a Woman only once or more than once? only once . 1 More than once . 2 mma8. in What month and year did you first marry or start living With a Woman as if married? date of first marriage Month . __ __ dK month .98 Year .__ __ __ __ dK year .9998 ðnext Module mma9. hoW old Were you When you started living With your first Wife/partner? age in years . __ __ Monitoring the situation of children and woMen 231230 MultiPle indicator cluster surveY 2011–2012 SeXuAl BeHAVIour MSB Check for the presence of others. Before continuing, ensure you are alone with the respondent. msb1. noW i Would like to ask you some Questions about sexual activity in order to get a better understanding of some important life issues. the information you provide Will remain strictly confidential. hoW old Were you When you had sexual intercourse for the very first time? never had intercourse .00 age in years . __ __ had intercourse for the first time when started living with (first) wife/partner .95 00ðnext Module msb2. the first time you had sexual intercourse, Was a condom used? Yes . 1 no . 2 dK / don’t remember . 8 msb3. When Was the last time you had sexual intercourse? record ‘years ago’ only if last intercourse Was one or more years ago. if 12 months or more the ansWer must be recorded in years. days ago .1 __ __ weeks ago .2 __ __ Months ago .3 __ __ Years ago .4 __ __ 4ðMsB15 msb4. the last time you had sexual intercourse, Was a condom used? Yes . 1 no . 2 msb5. What Was your relationship to the person you last had sexual intercourse With? Probe to ensure that the response refers to the relationship at the time of sexual intercourse. if “girlfriend”, then ask: Were you living together as if married? If response is “yes”, circle ‘2’. If response is “no”, circle‘3’. wife . 1 cohabiting partner . 2 girlfriend . 3 casual acquaintance . 4 sex worker . 5 other (specify) _________________________________6 3ðMsB7 4ðMsB7 5ðMsB7 6ðMsB7 MSB6. Check MMA1: ¨ Currently married or living as if married with a woman (MMA1 = 1 or 2) ð Go to MSB8 ¨ Not married / Not in a union (MMA1 = 3) ð Continue with MSB7 msb7. hoW old is this person? If response is DK, probe: about hoW old is this person? age of sexual partner . __ __ dK .98 msb8. have you had sexual intercourse With any other person in the last 12 months? Yes . 1 no . 2 2ðMsB15 msb9. the last time you had sexual intercourse With this other person, Was a condom used? Yes . 1 no . 2 msb10. What Was your relationship to this person? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If “girlfriend” then ask: Were you living together as if married? If “yes”, circle ‘2’. If “no”, circle ‘3’. wife . 1 cohabiting partner . 2 girlfriend . 3 casual acquaintance . 4 sex worker . 5 other (specify) _________________________________6 3ðMsB12 4ðMsB12 5ðMsB12 6ðMsB12 MSB11. Check MMA1 and MMA7: ¨ Currently married or living with a woman (MMA1 = 1 or 2) AND Married only once or lived with a woman only once (MMA7 = 1) ð Go to MSB13 ¨ Else ð Continue with MSB12 msb12. hoW old is this person? If response is DK, probe: about hoW old is this person? age of sexual partner . __ __ dK .98 msb13. in the last 12 months, have you had sexual intercourse With any other person, other than these tWo persons? Yes . 1 no . 2 2ðMsB15 msb14. in total, With hoW many different people have you had sexual intercourse in the last 12 months? number of partners . __ __ msb15. in total, With hoW many different people have you had sexual intercourse in your lifetime? If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write ‘95’. number of lifetime partners . __ __ dK .98 hiv/aids MHA mha1. noW i Would like to talk With you about something else. have you ever heard of the hiv virus or an illness called aids (or sida)? Yes . 1 no . 2 2ð next Module mha2. can people reduce their chance of getting the virus that causes aids by having just one uninfected sex partner Who has no other sex partners? Yes . 1 no . 2 dK . 8 mha3. can people get the virus that causes aids because of Witchcraft or other supernatural means? Yes . 1 no . 2 dK . 8 mha4. can people reduce their chance of getting the virus that causes aids by using a condom every time they have sex? Yes . 1 no . 2 dK . 8 mha5. can people get the virus that causes aids from mosQuito bites? Yes . 1 no . 2 dK . 8 mha6. can people get the virus that causes aids by sharing food With a person Who has aids? Yes . 1 no . 2 dK . 8 mha7. is it possible for a healthy-looking person to have the virus that causes aids? Yes . 1 no . 2 dK . 8 mha8. can the virus that causes aids be transmitted from a mother to her baby: [a] during pregnancy? [b] during delivery? [c] by breastfeeding? Yes no dK during pregnancy . 1 2 8 during delivery . 1 2 8 By breastfeeding . 1 2 8 mha9. in your opinion, if a female teacher has the virus that causes aids but is not sick, should she be alloWed to continue teaching in school? Yes . 1 no . 2 dK / not sure / depends . 8 mha10. Would you buy fresh vegetables from a shopkeeper or salesperson if you kneW that this person had the virus that causes aids? Yes . 1 no . 2 dK / not sure / depends . 8 mha11. if a member of your family got infected With the virus that causes aids, Would you Want it to remain a secret? Yes . 1 no . 2 dK / not sure / depends . 8 mha12. if a member of your family became sick With aids, Would you be Willing to care for him or her in your oWn household? Yes . 1 no . 2 dK / not sure / depends . 8 mha24. i don’t Want to knoW the results, but have you ever been tested to see if you have the virus that causes aids? Yes . 1 no . 2 2ðMha27 MHA25. When Was the most recent time you Were tested? less than 12 months ago. 1 12-23 months ago . 2 2 or more years ago . 3 MHA26. i don’t Want to knoW the results, but did you get the results of this test? Yes . 1 no . 2 dK . 8 1ðnext Module 2ðnext Module 8ðnext Module MHA27. do you knoW of a place Where people can go to get tested for the virus that causes aids? Yes . 1 no . 2 Monitoring the situation of children and woMen 233232 MultiPle indicator cluster surveY 2011–2012 tobacco and alcohol use mta mta1. have you ever tried smoking cigarettes, even taking one or tWo puffs? Yes . 1 no . 2 2ðMta6 mta2. hoW old Were you When you smoked an entire cigarette for the first time? never smoked a whole cigarette .00 age. ___ ___ 00ðMta6 mta3. do you currently smoke cigarettes? Yes . 1 no . 2 2ðMta6 mta4. hoW many cigarettes did you smoke during the last month? number of cigarettes . ___ ___ mta5. during the last month, on hoW many days did you smoke cigarettes? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “everyday” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 everyday / almost every day .30 mta6. have you ever tried any smoked tobacco products other than cigarettes, such as cigars (e.g. cuban), a pipe or Waterpipe (narghile/ hookah)? Yes . 1 no . 2 2ðMta10 mta7. during the last month, did you use any smoked tobacco products? Yes . 1 no . 2 2ðMta10 mta8. What type of smoked tobacco product did you use or smoke during the last month? Circle all mentioned responses. cigars .a water pipe . B cigarillos . c Pipe .d other (specify) ________________________________ X mta9. on hoW many days did you use smoked tobacco products during the last month? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “everyday” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 everyday / almost every day .30 mta10. have you ever tried any form of smokeless tobacco products, such as cheWing tobacco, tobacco for sniffing (snuff) or dipping tobacco? Yes . 1 no . 2 2 ðMta14 mta11. did you use any smokeless tobacco products during the last month? Yes . 1 no . 2 2 ðMta14 mta12. What type of smokeless tobacco product did you use during the last month? Circle all mentioned. chewing tobacco .a snuff . B dip . c other (specify) ________________________________ X mta13. on hoW many days did you use smokeless tobacco products during the last month? If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “everyday” or “almost every day”, circle ‘30’. number of days . 0 ___ 10 days or more but less than a month .10 everyday / almost every day .30 mta14. noW i Would like to ask you some Questions about drinking alcohol. have you ever drunk alcohol? Yes . 1 no . 2 2ðnext Module mta15. We count one drink of alcohol as one can or bottle of beer, one glass of Wine, or one shot of strong drink. hoW old Were you When you had your first drink of alcohol, not counting a feW sips? never had one drink of alcohol .00 age. ___ ___ 00ðnext Module mta16. during the last month, on hoW many days did you have at least one drink of alcohol? If respondent did not drink, circle ‘00’. If less than 10 days, record the number of days. If 10 days or more but less than a month, circle ‘10’. If “everyday” or “almost every day”, circle ‘30’. did not have one drink in last month .00 number of days . 0 ___ 10 days or more but less than a month .10 everyday / almost every day .30 00ðnext Module mta17. in the last month, on those days that you drank alcohol, What is the number of drinks did you usually had? number of drinks. ___ ___ lIFe SAtISFACtIon MlS MlS1. Check MWB2: Is the respondent aged between 15 and 24? ¨ Age 25-49 ð Go to Next Module ¨ Age 15-24 ð Continue with MLS2 mls2. i Would like to ask you some simple Questions on happiness and satisfaction. first, taking all things together, Would you say you are very happy, happy, neither happy nor unhappy, unhappy or very unhappy? you can also look at these pictures to help you respond. Show side 1 of the showcard to the respondent and explain what each symbol represents. Circle the response code selected by the respondent. very happy . 1 happy . 2 neither happy nor unhappy . 3 unhappy . 4 very unhappy. 5 mls3. noW i Will ask you Questions about your level of satisfaction in different areas of your life. in each case, We have five possible responses: please tell me, for each Question, Whether you are very satisfied, satisfied, neither satisfied nor unsatisfied, unsatisfied or very unsatisfied. again, you can look at these pictures to help you respond. Show side 2 of the showcard to the respondent and explain what each symbol represents. For questions MLS3 to MLS13, circle the response code shown by the respondent. hoW satisfied are you With your family life? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls4. hoW satisfied are you With your friendships? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls5. during the current (2011-2012) school/academic year, did you attend school/ university at any time? Yes . 1 no . 2 2ðMls7 mls6. hoW satisfied are you With your school/university? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls7. hoW satisfied are you With your current job? If the respondent says that he/she does not have a job, circle ‘0’ and continue with the next question. Do not ask additional questions to find out how she feels about not having a job, unless she tells you herself. does not have a job . 0 very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 MlS8. how satisfied are you with your health? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls9. hoW satisfied are you With Where you live? If necessary, explain that the question refers to the living environment, including the neighbourhood and the dwelling. very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 Monitoring the situation of children and woMen 235234 MultiPle indicator cluster surveY 2011–2012 mls10. hoW satisfied are you With hoW people around you generally treat you? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls11. hoW satisfied are you With the Way you look? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls12. hoW satisfied are you With your life, overall? very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls13. hoW satisfied are you With your current income? If the respondent responds that he/she does not have any income, circle ‘0’ and continue with the next question. Do not ask additional questions to find out how she feels about not having any income, unless she tells you herself. does not have any income . 0 very satisfied . 1 satisfied. 2 neither satisfied nor unsatisfied . 3 unsatisfied . 4 very unsatisfied . 5 mls14. compared to this time last year, Would you say that your life has improved, stayed more or less the same, or Worsened, overall? improved . 1 More or less the same . 2 worsened . 3 mls15. and in one year from noW, do you expect that your life Will be better, Will be more or less the same, or Will be Worse, overall? Better . 1 More or less the same . 2 worse . 3 HeAltH CAre MHe mhe0. Check cluster number in MWM1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to MWB11 ¨ If the cluster number is from 501-562 (Roma survey)ð Continue with MHE1. MHe1. do you have a health booklet? Yes .1 no .2 MHe2. do you have health insurance? Yes .1 no .2 1ð Mhe9 MHe3. do you use health care services at the health centre? Yes .1 no .2 2ð Mhe5 MHe4. are you provided With health care services at the nearest health centre free of charge? Yes .1 no .2 MHe5. do you use health care services at the hospital? Yes .1 no .2 2ð Mhe7 MHe6. are you provided With health care services at the nearest hospital free of charge? Yes .1 no .2 MHe7. do you use emergency health care services? Yes .1 no .2 2ð Mhe9 MHe8. are you provided With emergency health care services free of charge? Yes .1 no .2 MHe9. do you pay all necessary health care services and medication? Yes .1 sometimes yes, sometimes no .2 no .3 1ð MwB11 MHe10. do you pay only vital/urgently needed health care services and medications? Yes .1 no .2 1ð MwB11 MHe11. can you afford medications Without one-off financial assistance? Yes .1 no .2 mwb11. Record the interview end time. hour and minutes .__ __ : __ __ mwb12. Check Household Member Listing Form, column HL9 in the Household Questionnaire. Is the respondent the caretaker of any child aged 0-4 living in this household? ¨ Yes ð Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE for that child and start the interview with the same respondent. ¨ No ð End the interview with this respondent by thanking him for his cooperation. Check for the presence of any other eligible men in the household. Interviewer’s observations Controller’s observations Supervisor’s observations Monitoring the situation of children and woMen 237236 Multiple indicator cluster survey 2011–2012 Questionnaire for Children under five [Brcko District of BiH] under-five Child information panel uf This questionnaire is to be administered to all mothers or caretakers (see Household Member Listing Form, column HL9 in the Household Questionnaire) who care for a child that lives with them and is under the age of 5 (see Household Member Listing Form, column HL6 in the Household Questionnaire). A separate questionnaire should be used for each eligible child. uf1. cluster number: ___ ___ ___ uf2. household number: ___ ___ ___ uf3. child’s name: name _________________________________________ uf4. child’s line number: ___ ___ uf5. Mother’s / caretaker’s name: name _________________________________________ uf6. Mother’s / caretaker’s line number: ___ ___ uf7. interviewer name and code: name ____________________________ ___ ___ ___ uf8. day / Month / year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting if not already read to this respondent: we are from tHe DEPARTMENT OF HEALTH AND OTHER SERVICES OF THE GOVERNMENT OF THE BRCKO DISTRICT OF BOSNIA AND HERZEGOVINA. we are working on a project concerned witH family HealtH and education. i would like to talk to you about (child’s name from UF3)’s HealtH and well-being. tHe interview will take up to 20 minutes. all tHe information we obtain will remain strictly confidential. If greeting at the beginning of the household questionnaire has already been read to this respondent, then read the following: now i would like to talk to you more about (child’s name from UF3)’s HealtH and otHer topics. tHis interview will take up to 20 minutes. again, all tHe information we obtain will remain strictly confidential. may i start now? ¨ Yes, permission given  Go to UF12 to record the time and then begin the interview. ¨ No, permission not given  Complete UF9. Inform your supervisor of this result. uf9. result of interview for children under 5 Codes refer to mother/caretaker. Questionnaire completed .01 respondent not at home .02 interview refused .03 Questionnaire partly completed .04 respondent incapacitated .05 other (specify) ________________________________96 uf10. field edited by (name and number): name . ___ ___ uf11. data entry operator (name and number): name . ___ ___ UF12. Record the interview start time. hour and minutes .__ __ : __ __ age of Child ag ag1. now i would like to ask you some questions about tHe (name)’s HealtH. in wHat montH and year was (name) born? Probe: wHat is His / Her birtHday? If the mother/caretaker knows the exact date of birth, also enter the day; otherwise, circle ‘98’ for day Month and year must be recorded. date of birth day . __ __ dK day .98 Month . __ __ year .__ __ __ __ AG2. How old is (name)? Probe: How old was (name) on His / Her last birtHday? Record age in completed years. Record ‘0’ if child is less than 1year old. Compare AG1 and/or AG2 and correct if inconsistent. age (in completed years) . __ birth registration br br0. Check cluster number in UF1. ¨ If the cluster number is from 001-474 (Mainstream survey) ð Go to next module. ¨ If the cluster number is from 501-562 (Roma survey)ð Go to BR1 BR1. does (name) Have a birtH certificate? If “Yes”, ask: may i see it? yes, seen . 1 yes, not seen . 2 no . 3 dK . 8 1ðnext Module 2ðnext Module BR2. Has (name)’s birtH been registered witH tHe registry office? yes . 1 no . 2 dK . 8 1ðnext Module br3. do you know How to register your cHild’s birtH in tHe birtH register? yes . 1 no . 2 Monitoring the situation of children and woMen 239238 Multiple indicator cluster survey 2011–2012 early Childhood development eC EC1. How many cHildren’s books or picture books do you Have for (name)? none .00 number of children’s books .0 __ ten or more books .10 EC2. i am interested in learning about tHe tHings tHat (name) plays witH wHen He/sHe is at Home. does He/sHe play witH: [a] Homemade toys (sucH as dolls, cars, or otHer toys made at Home)? [b] toys from a sHop or manufactured toys? [c] HouseHold objects (sucH as bowls or pots) or objects found outside (sucH as sticks, rocks or leaves)? If the respondent says “YES” to any of the categories above, then probe to learn specifically what the child plays with to ascertain the response. y n dK homemade toys . 1 2 8 toys from a shop . 1 2 8 household objects or outside objects . 1 2 8 EC3. sometimes adults taking care of cHildren Have to leave tHe House to go sHopping, to tHe doctor or for otHer reasons and Have to leave young cHildren. on How many days in tHe past week was (name): [a] left alone for more tHan an Hour? [B] left in tHe care of anotHer cHild, tHat is, someone less tHan 10 years old, for more tHan one Hour? If response is “none” enter ‘0’. If response is “don’t know” enter ‘8’. number of days child was left alone for more than an hour . __ number of days child was left with other child for more than one hour . __ eC4. Check AG2: Age of child ¨ Child aged 3 or 4 years ð Continue with EC5 ¨ Child aged 0, 1 or 2 years ð Go to Next Module EC5. does (name) attend any organised learning or early cHildHood education programme, sucH as a private or public facility, including kindergarten or a cHild care centre in tHe community? yes . 1 no . 2 dK . 8 2ðec7 8ðec7 EC6. witHin tHe last 7 days, about How many Hours did (name) attend? number of hours . __ __ EC7. in tHe past 3 days, were you or any HouseHold member over 15 years of age involved in any of tHe following activities witH (name): If “Yes”, ask: wHo was involved in tHis activity witH (name)? Circle all responses that apply. Mother father other no one [a] read books to (name) or looked at picture books witH (name)? read books a B X y [b] told stories to (name)? told stories a B X y [c] sang songs to (name) or witH (name), including lullabies? sang songs a B X y [d] took (name) outside tHe Home or yard? took outside a B X y [e] played witH (name)? played with a B X y [f] named, counted, or drew tHings to or witH (name)? named/counted/ drew a B X y EC8. i would like to ask you some questions about tHe HealtH and development of your cHild. cHildren do not all develop and learn at tHe same rate. for example, some walk earlier tHan otHers. tHese questions are related to several aspects of your cHild’s development. can (name) identify or name at least ten letters of tHe (latin/ cyrillic) alpHabet? yes . 1 no . 2 dK . 8 EC9. can (name) read at least four simple, popular words? yes . 1 no . 2 dK . 8 EC10. does (name) know tHe name and recognise tHe symbol of all numbers from 1 to 10? yes . 1 no . 2 dK . 8 EC11. can (name) pick up a small object witH two fingers, like a stick or a rock from tHe ground? yes . 1 no . 2 dK . 8 EC12. is (name) sometimes too sick to play? yes . 1 no . 2 dK . 8 EC13. does (name) follow simple directions on How to do sometHing correctly? yes . 1 no . 2 dK . 8 EC14. wHen (name) is given sometHing to do, can He/sHe do it independently? yes . 1 no . 2 dK . 8 EC15. does (name) get along well witH otHer cHildren? yes . 1 no . 2 dK . 8 EC16. does (name) bite or Hit otHer cHildren or adults? yes . 1 no . 2 dK . 8 EC17. does (name) get distracted easily? yes . 1 no . 2 dK . 8 Monitoring the situation of children and woMen 241240 Multiple indicator cluster survey 2011–2012 breastfeeding bf BF1. Has (name) ever been breastfed? yes . 1 no . 2 dK . 8 2ðBf3 8ðBf3 bf2. Is He/sHe stIll beIng breastfed? yes . 1 no . 2 dK . 8 BF3. I would lIke to ask you about lIquIds tHat (name) may Have Had yesterday durIng tHe day or tHe nIgHt. I am Interested In wHetHer (name) Had tHe lIquId even If It was combIned wItH otHer foods. dId (name) drInk plaIn water yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF4. dId (name) drInk Infant formula yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 2ðBf6 8ðBf6 BF5. How many tImes dId (name) drInk Infant formula yesterday, durIng tHe day or nIgHt? number of times . __ __ BF6. dId (name) drInk mIlk, sucH as powdered or fresH anImal mIlk yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 2ðBf8 8ðBf8 BF7. How many tImes dId (name) drInk powdered or fresH anImal mIlk yesterday, durIng tHe day or nIgHt? number of times . __ __ BF8. dId (name) drInk juIce or fruIt drInks yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF9. dId (name) drInk clear soup (yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF10. dId (name) consume vItamIn or mIneral supplements or any medIcInes yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF11. dId (name) drInk an oral reHydratIon solutIon (ors) yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF12. dId (name) drInk any otHer lIquIds yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF13. dId (name) drInk or eat sour-mIlk or yogHurt yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 2ðBf15 8ðBf15 BF14. How many tImes dId (name) drInk or eat sour-mIlk or yogHurt yesterday, durIng tHe day or nIgHt? number of times . __ __ BF15. dId (name) eat tHIn porrIdge or semolIna porrIdge yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 BF16. dId (name) eat solId or semI-solId (soft, musHy) food yesterday, durIng tHe day or nIgHt? yes . 1 no . 2 dK . 8 2ðBf18 8ðBf18 BF17. How many tImes dId (name) eat solId or semI-solId (soft, musHy) food yesterday, durIng tHe day or nIgHt? number of times . __ __ BF18. yesterday, durIng tHe day or nIgHt, dId (name) drInk anytHIng from a bottle wItH a nIpple? yes . 1 no . 2 dK . 8 care for illness ca CA1. In tHe last two weeks, Has (name) Had dIarrHoea? yes . 1 no . 2 dK . 8 2ðca7 8ðca7 CA2. I would lIke to know How mucH (name) was gIven to drInk wHIle He/sHe Had dIarrHoea (IncludIng breastmIlk). durIng tHe tIme (name) Had dIarrHoea, was He/sHe gIven less tHan usual to drInk, about tHe same amount or more tHan usual? If response is “Less”, probe: was He/sHe gIven mucH less tHan usual to drInk, or somewHat less? Much less . 1 somewhat less . 2 about the same. 3 More . 4 nothing to drink . 5 dK . 8 CA3. durIng tHe tIme (name) Had dIarrHoea, was He/sHe gIven less tHan usual to eat, about tHe same amount, more tHan usual or notHIng? If response is “Less”, probe: was He/sHe gIven mucH less tHan usual to eat or somewHat less? Much less . 1 somewhat less . 2 about the same. 3 More . 4 stopped food . 5 never gave food . 6 dK . 8 CA4. durIng tHe perIod of dIarrHoea, was (name) gIven to drInk any of tHe followIng: Read each item aloud and record response before continuing with the next item. [a] a fluId for oral reHydratIon made from a specIal InfusIon called orosal, nelIt or sometHIng sImIlar? [B] a pre-packaged ors fluId for dIarrHoea? y n dK fluid from ors packet . 1 2 8 pre-packaged ors fluid . 1 2 8 ca5. was anytHIng (else) gIven to treat tHe dIarrHoea? yes . 1 no . 2 dK . 8 2ðca7 8ðca7 ca6. wHat (else) was gIven to treat tHe dIarrHoea? Probe: anytHIng else? Record all treatments given. Write the name of every medicine mentioned. _____________________________ (Name of medicine) pill or syrup antibiotic .a Medicine for diarrhoea (antimotility) . B Zinc . c other (excluding antibiotic, medicine for diarrhoea (antimotility) or zinc) .g unknown pill or syrup .h injection antibiotic .l not an antibiotic .M unknown injection .n intravenous infusion .o home remedy / herbal medicine .Q other (specify)_________________________________X CA7. durIng tHe last two weeks, Has (name) Had an Illness wItH a cougH? yes . 1 no . 2 dK . 8 2ðca14 8ðca14 CA8. wHen (name) Had an Illness wItH a cougH, dId He/sHe breatHe faster tHan usual wItH sHort, rapId breatHs or Have dIffIculty breatHIng? yes . 1 no . 2 dK . 8 2ðca14 8ðca14 Monitoring the situation of children and woMen 243242 Multiple indicator cluster survey 2011–2012 CA9. was tHe fast or difficult breatHing due to a problem in tHe cHest or a blocked or runny nose? problem in chest only . 1 Blocked or runny nose only . 2 Both . 3 other (specify) . 6 dK . 8 2ðca14 6ðca14 CA10. did you seek any advice or treatment for tHe illness from any source? yes . 1 no . 2 dK . 8 2ðca12 8ðca12 CA11. from wHere did you seek advice or treatment? Probe: anywHere else? Circle all service providers mentioned, but do NOT prompt with any suggestions. Probe to identify each type of source. If unable to determine if public or private sector, write the name of the institution/organisation. _____________________________ (Name of institution/organisation) public sector hospital .a health centre . B Mobile (visiting) clinic .e other public institution (specify) .h private medical sector private hospital / clinic .i private physician . J private pharmacy . K private mobile (visiting) clinic .l other private medical institution (specify) .o other source relative / friend . p shop .Q traditional practitioner . r other (specify)_____________________________X CA12. was (name) given any medicine to treat tHis illness? yes . 1 no . 2 dK . 8 2ðca14 8ðca14 CA13. wHat medicine was (name) given? Probe: any otHer medicine? Circle all medicines given. Write the name of every medicine mentioned. _____________________________ (Names of medicines) antibiotic pill / syrup .a injection . B paracetamol / panadol . p aspirin .Q ibuprofen . r other (specify) . X dK . Z Ca14. Check AG2: Is the child aged under 3? ¨ Yes ð Continue with CA15 ¨ No ð Go to Next Module CA15. tHe last time (name) passed stools, How were tHe stools disposed of? child used toilet / latrine .01 put / rinsed into toilet or latrine .02 put / rinsed into drain or ditch.03 thrown into garbage (solid waste) .04 Buried .05 left in the open .06 other (specify) .96 dK .98 immunisation im If a health booklet / immunisation card is available, copy the dates in IM3 for each type of immunisation recorded in the booklet / on the card. Questions IM6-IM16 are for registering the vaccinations that are not recorded in the booklet / on the card. IM6-IM16 will only be asked when a card is not available. IM1. do you Have a HealtH booklet / vaccination card immunisations (name) received are recorded? (If “Yes”) may i see it please? yes, seen . 1 yes, not seen . 2 no booklet / card . 3 1ðiM3 2ðiM6 IM2. did you ever Have a HealtH booklet / vaccination card for (name)? yes . 1 no . 2 1ðiM6 2ðiM6 im3. a) Copy dates for each vaccination from the booklet. b) Write ‘44’ in day column if booklet shows that vaccination was given but no date recorded. date of immunisation day Month year [a] Bcg bcg [B] polio 1 ipv1/opv1 [c] polio 2 ipv2/opv2 [d] polio 3 ipv3/opv3 [e] polio 4 ipv4/opv4 [f] di-te-per1 dpt1 [g] di-te-per2 dpt2 [h] di-te-per3 dpt3 [i] di-te-per4 dpt4 [J] hepB1 at birth H1 [K] hepB2 H2 [l] hepB3 H3 [M] hib1 Hib1 [n] hib 2 Hib2 [o] hib 3 Hib3 [p] hib 4 (Only for RS & BD) Hib4 [Q] Mo-ru-pa (MMr) mmr IM4. Check IM3. Have all vaccines (BCG to MMR) been recorded? ¨ Yesð Go to UF13 ¨ No ð Continue with IM5 Monitoring the situation of children and woMen 245244 Multiple indicator cluster survey 2011–2012 IM5. in addition to wHat is recorded in tHis book / on tHis card, did (name) receive any otHer vaccines? Record ‘Yes’ only if respondent mentions vaccines listed in the table above. yes . 1 (Probe for vaccinations and write ‘66’ in the corresponding column for the day for each vaccine mentioned. Then skip to UF13) no . 2 dK . 8 2ðuf13 8ðuf13 IM6. Has (name) ever received any vaccinations to prevent Him/Her from contracting diseases? yes . 1 no . 2 dK . 8 2ðuf13 8ðuf13 IM7. Has (name) ever received a bcg vaccination against tuberculosis – tHat is, an injection in tHe arm or sHoulder tHat usually causes a scar? yes . 1 no . 2 dK . 8 IM8. Has (name) ever received any vaccination drops in tHe moutH or injection to protect Him/Her from getting cHild paralysis (polio)? yes . 1 no . 2 dK . 8 2ðiM11 8ðiM11 im10. How many times was tHe vaccine against cHild paralysis (polio) received? number of times . __ IM11. Has (name) ever received a dpt vaccination – tHat is, an injection in tHe tHigH or arm (sHoulder) – to prevent Him/Her from getting tetanus, wHooping cougH, or dipHtHeria? Probe by explaining that the DPT vaccination is sometimes given at the same time as the polio vaccination. yes . 1 no . 2 dK . 8 2ðiM13 8ðiM13 im12. How many times was a dpt vaccine received? number of times . __ IM13. Has (name) ever been given a Hepatitis b (infectious jaundice) vaccination – tHat is, an injection in tHe tHigH or arm (sHoulder) – to prevent Him/Her from getting Hepatitis b (infectious jaundice)? Probe by indicating that the Hepatitis B vaccine is sometimes given at the same time as Polio and DPT vaccines yes . 1 no . 2 dK . 8 2ðiM15a 8ðiM15a im14. was tHe first Hepatitis b (infectious jaundice) vaccine received witHin 24 Hours after birtH, or later? within 24 hours . 1 later . 2 im15. How many times was a Hepatitis b (infectious jaundice) vaccine received? number of times . __ IM15A. Has (name) ever been given two vaccinations at tHe same time, – tHat is, two injections in tHe arm (sHoulder) or one in tHe tHigH and one in tHe arm (sHoulder) – to prevent Him/Her from getting HaemopHilus influenzae type b (Hib)? yes . 1 no . 2 dK . 8 2ðiM16 8ðiM16 im15b. How many times was tHe HaemopHilus influenzae type b (Hib) vaccine received? number of times . __ IM16. Has (name) ever received an mmr (mo-ru-pa ) injection – tHat is, a sHot in tHe arm at tHe age of 12 montHs or older - to prevent Him/Her from getting measles, rubella or mumps? yes . 1 no . 2 dK . 8 UF13. Record the interview end time. hour and minutes .__ __ : __ __ uf14. Is the respondent the mother or caretaker of another child aged 0-4 living in this household? ¨ Yes ð Indicate to the respondent that you will need to measure the weight and height of the child later on. Go to the next QUESTIONNAIRE FOR CHILDREN UNDER FIVE to be completed with the same respondent. ¨ No ð End the interview with this respondent by thanking them for their cooperation and telling them that you will need to measure the weight and height of the child. Check to see if there are other women’s, men’s or under-5 questionnaires to be administered in this household. Move to another women’s, men’s or under-5 questionnaire, or start making arrangements for anthropometric measurements of all children under 5 in the household. anthropometriC data an After questionnaires for all children are complete, the measurer has to weigh and measure the length/height of each child. Record the weight and length/height in the questionnaire below, ensuring that you record the measurements on the correct questionnaire for each child. Check the child’s name and line number on the Household Member Listing Form in the Household Questionnaire before recording the measurements. an1. Measurer’s name and number: name _____________________________ ___ ___ ___ an2. Result of height / length and weight measurement either or both measured . 1 child not present . 2 child or mother/caretaker refused . 3 other (specify)_________________________________6 2ðan6 3ðan6 6ðan6 an3. Child’s weight Kilograms (kg) . __ __ . __ weight not measured . 99.9 an4. Child’s length or height Check age of child in AG2: ¨ Child under 2 years old. ð Measure length (lying down) ¨ Child age 2 or more years. ð Measure height (standing up) length (cm) lying down .1 __ __ __ . __ height (cm) standing up .2 __ __ __ . __ length / height not measured .9999.9 an6. Is there another child in the household who is eligible for measurement? ¨ Yes ð Record measured values for the next child. ¨ No ð Check if there are any other individual questionnaires to be completed in the household. End the interview with this household by thanking everyone for their cooperation Collate all the questionnaires for this household and check that all the ID numbers have been recorded in the information panel on every questionnaire. On the Household Questionnaire, record the total number of completed women’s, men’s and under-5 questionnaires. interviewer’s observations field editor’s observations supervisor’s observations Monitoring the situation of children and woMen 247246 Multiple indicator cluster survey 2011–2012 In the BiH MICS4 two country specifi c modules that are not part of the standard MICS set of questionnaires were used: 1) Questionnaire form for residency status; 2) Questionnaire for drug use assessment. An analysis of the data collected using these questionnaires is not presented in this report. mainstream population survey Questionnaire form for residenCy status residenCy status Questionnaire form rs rs1. cluster number: ___ ___ ___ rs2. household number: ___ ___ ___ rs3. name of respondent: name _________________________________________ rs4. line number of respondent: ___ ___ rs5. interviewer name and number: name ___________________________ ___ ___ ___ rs6. day / Month / year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting if not already read to this respondent: we are from tHe (name of institution). we are conducting a survey concerned witH family HealtH and education. i would like to talk to you about your residency status. tHis will take only a few minutes. all tHe information we obtain will remain strictly confidential. If greeting has already been read to this respondent, then read the following: now i would like to talk to you more about your residency status. tHis will take only a few minutes. again, all tHe information you give me will remain strictly confidential. may i start now? ¨ Yes, permission is given  Go to RS10 to record the time and then begin the interview. ¨ No, permission is not given  Complete RS7. Inform your supervisor of this result. rs7. result of interview for residency status completed .01 not at home .02 refused .03 partly completed .04 incapacitated .05 other (specify) ________________________________96 rs8. field edited by (name and code): name _____________________________ ___ ___ ___ rs9. data entry operator (name and number): name _____________________________ ___ ___ ___ RS10. Record the interview start time. hour and minutes .__ __ : __ __ residenCy status rs This module has to be administered to the respondent of the Household Questionnaire or another knowledgeable adult. rs11. Check HL5 and HL6, row1: ¨ Respondent born before 30 April 1991 ð Continue with RS12 ¨ Respondent born after 30 April 1991 ð Tell the respondent „For questions referring to the period of 30 April 1991 and before, please respond in reference to the situation of your family (parents).” RS12. are you a citizen of biH? yes .1 no .2 RS13. on 30 april 1991, did you live in tHe same municipality as today, a different municipality in biH, a different republic in yugoslavia or outside yugoslavia? the same municipality . 1 a diff erent municipality in Bih . 2 a diff erent republic in yugoslavia. 3 outside yugoslavia . 4 1ðrs16 2ðrs15 RS14. wHere did you live on 30 april 1991? on the territory of the sr croatia .01 on the territory of sr serbia (excluding the socialist autonomous province of Kosovo) .02 on the territory of the socialist autonomous province of Kosovo .03 on the territory of the sr Montenegro .04 other .96 01rs16 02rs16 03rs16 04rs16 96rs16 RS15. in wHicH entity (district) is tHe municipality you lived in on 30 april 1991 located? in the federation of Bih .1 in the republic of srpska .2 in the Brcko district of Bih .3 RS16. since 30 april 1991 until today, Have you fled to anotHer municipality in biH or abroad? yes, to another municipality in Bih .1 yes, abroad .2 no .3 1ðrs17 3ðrs17 rs16a. where did you fl ee to after 30. april 1991? on the territory of the sr croatia .01 on the territory of sr serbia (excluding the socialist autonomous province of Kosovo) .02 on the territory of the socialist autonomous province of Kosovo .03 on the territory of the sr Montenegro .04 germany .05 sweden .06 norway .07 switzerland .08 france .09 great Britain .10 australia .11 canada .12 united states of america .13 other .96 rs17. Check RS13, if: ¨ codes 2, 3 or 4 ð Continue with RS18 ¨ code 1, check RS16 and if code 3 ð Go to RS20 RS18. in wHicH year did you move (return) to tHis municipality after 30 april 1991? If respondent says they returned more than once, ask additional question: in wHicH year did you first move (return) to tHis municipality? year .__ __ __ __ RS19. wHy did you move to tHis municipality? Because of the war . 1 for economic reasons (employment, etc.) . 2 for family reasons (marriage/union, children’s education, etc.) . 3 other . 6 Monitoring the situation of children and woMen 249248 Multiple indicator cluster survey 2011–2012 RS20. can you please tell me wHetHer in tHe municipality wHere you live today, your nationality: [a] represents a significant majority of tHe population [b] does not represent a significant majority of tHe population [c] tHe etHnic composition is balanced If respondent says the do not want to declare their nationality, circle code ‘4’. represents a signifi cant majority of the population .1 does not represent a signifi cant majority of the population .2 the ethnic composition is balanced .3 not applicable as i do not want to declare my nationality .4 dK .8 RS21. wHicH of tHe following documents do you Have? Complete the fi rst column only, indicating whether the respondent has the document or not. Later on you will be asking the respondent to show you all the documents he/she names and recording whether the document was seen or not in the second column. [a] id card for biH citizens (valid for 10 years)? [b] biH id card for aliens? [c] id card for displaced persons – for biH citizens? Valid for 2 years. yes . 1 1ðrs21f no . 2 yes . 1 1ðrs21f no . 2 yes . 1 1ðrs21f no . 2 seen .3 not seen .4 seen .3 not seen .4 seen .3 not seen .4 [d] official decision on dp status? [e] identification document for displaced persons? [f] biH passport? [g] passport from otHer country? [H] id card from otHer country? [i] HealtH insurance booklet issued in biH? yes . 1 1ðrs21f no .2 yes . 1 no . 2 yes . 1 no . 2 yes . 1 no . 2 yes . 1 no . 2 yes . 1 no . 2 seen . 3 not seen . 4 seen . 3 not seen . 4 seen . 3 not seen . 4 seen . 3 not seen . 4 seen . 3 not seen . 4 seen . 3 not seen . 4 rs22. Check RS12: ¨ code 1 ð Go to RS24 ¨ code 2ð Continue with RS23 rs23. do you Have any of tHe following documents do you Have? [a] refugee card (issued in biH)? [b] international protection seeker card? [c] confirmation of identity for stateless persons? yes . 1 no . 2 yes . 1 no . 2 yes . 1 no . 2 seen . 3 not seen . 4 seen . 3 not seen . 4 seen . 3 not seen . 4 rs24. can you please sHow me tHe documents tHat you said you Have? yes .1 no .2 2ðrs26 rs25. Check RS24 if: ¨ code 1 ð return to questions RS21 and RS23 code whether the documents were seen or not in the second column (codes 3 or 4) for all documents coded as 1 in the fi rst column. ¨ code 2ð Continue with RS26 RS26. Record the interview end time. hour and minutes .__ __ : __ __ Questionnaire form for drug use assessment drug use Questionnaire form du This questionnaire should be used for all women/men aged 15-49. du1. cluster number: ___ ___ ___ du2. household number: ___ ___ ___ du3. interviewer name and code: du4. day / Month / year of interview: name _____________________________ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ du5. Is respondent: ¨ Female ð DU6 ¨ Male ð DU7 du6. woman’s line number: ___ ___ du7. Man’s line number: ___ ___ du8. Check WB7 / MWB7 in the Women’s / Men’s questionnaire for this respondent: ¨ Question left blank or code 3 ð Give the form and envelope to respondent and ask them to complete the form and return it to you in the sealed envelope. ¨ Codes 1, 2, 4 or 5 ð DU9 du9. result of completion of form Completed by interviewer. respondent not at home .01 refused .02 respondent incapacitated .03 other (specify) .96 du10. result of completion of form Completed by fi eld editor. Questionnaire completed . 1 Questionnaire partially completed . 2 respondent left questionnaire blank . 3 du11. field edited by (name and number) name _____________________________ ___ ___ ___ du12. data entry operator (name and number): name _____________________________ ___ ___ ___ drug use (self-administered) du now we would like to ask you for information on tHe use of narcotic substances. again, all tHe information we obtain will remain strictly confidential. please complete tHe following form and return it to tHe interviewer in tHe envelope provided to you. du13. Have you ever used any drugs (narcotic substances) in your life? Circle only one code and follow the instructions. yes.1 ð if “yes”, answer the questions below. no . 2 ð if “no”, place the form in the envelope, seal the envelope and return it to the interviewer. DU14. wHen did you last take any of tHe following substances / drugs? Circle one code for each row. never during the last 12 months earlier than 12 months ago don’t know or don’t remember [a] cannabis (marijuana and/or HasHisH) 1 2 3 8 [b] ecstasy 1 2 3 8 [c] ampHetamine and/or metHampHetamine, most commonly referred to as “speed” 1 2 3 8 [d] cocaine or crack 1 2 3 8 [e] Heroin 1 2 3 8 [f] lsd (trip / acid) 1 2 3 8 [g] magic musHrooms 1 2 3 8 [H] substances wHicH are inHaled, sucH as glue and otHer industrial products wHicH are deliberately inHaled 1 2 3 8 THANK YOU FOR TAKING THE TIME TO ANSWER THESE QUESTIONS. PLEASE PLACE THE COMPLETED FORM IN THE ENVELOPE PROVIDED TO YOU AND RETURN THE SEALED ENVELOPE TO THE INTERVIEWER. 250 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 251 Appendix G: Nutritional Status of Children (NCHS/CDC/WHO standard) Table NU.1 (a): Nutritional status of children (NCHS/CDC/WHO standard) percentage of children under age 5 by nutritional status according to three anthropometric indices: weight for age, height for age, and weight for height, Bih 2011–2012   Weight for age number of children under age 5 Height for age number of children under age 5 Weight for height number of children under age 5 Underweight Mean Z-score (sd) Stunted Mean Z-score (sd) Wasted Overweight Mean Z-score (sd)per cent below per cent below per cent below per cent above - 2 sd - 3 sd - 2 sd - 3 sd - 2 sd - 3 sd + 2 sd Sex   Male 1.5 0.4 0.7 1,083 4.8 1.2 0.4 1,034 2.4 0.6 12.8 0.6 1,027 female 1.5 0.6 0.7 1,109 6.3 1.5 0.4 1,062 1.9 0.7 15.8 0.7 1,065 Administrative unit fBih 1.9 0.6 0.7 1,571 6.0 1.6 0.5 1,514 2.5 0.9 15.3 0.6 1,511 rs 0.4 0.1 0.6 591 4.7 0.8 0.2 553 1.3 0.0 11.7 0.6 552 Bd 0.0 0.0 1.0 29 1.4 1.4 0.9 29 1.4 0.0 17.5 0.7 29 Area urban 1.8 0.8 0.8 734 6.1 1.1 0.5 681 2.2 1.0 16.8 0.7 677 rural 1.3 0.3 0.6 1,458 5.3 1.5 0.4 1,416 2.1 0.5 13.2 0.6 1,415 Age (months) 0-5 0.7 0.0 0.4 220 8.4 3.3 0.2 210 3.6 0.0 11.9 0.4 215 6-11 4.3 2.9 0.7 209 8.5 1.0 0.3 197 4.8 3.1 15.5 0.7 197 12-23 1.5 0.4 0.8 438 9.0 1.6 0.2 397 1.8 0.0 22.1 0.9 393 24-35 0.7 0.0 0.7 446 4.8 2.2 0.5 435 1.2 0.0 10.1 0.6 435 36-47 0.9 0.3 0.7 468 3.4 0.6 0.7 457 1.6 0.2 14.8 0.6 454 48-59 2.1 0.4 0.7 411 2.6 0.2 0.5 401 2.1 1.7 11.6 0.5 398 Mother’s education* primary 1.5 0.2 0.5 508 6.5 2.6 0.3 497 1.1 0.0 13.7 0.6 502 secondary 1.6 0.7 0.7 1,349 5.3 1.0 0.5 1,278 2.7 1.1 14.1 0.6 1,272 higher 0.8 0.3 0.8 316 5.4 0.8 0.6 302 1.6 0.0 17.8 0.7 299 Wealth index quintile poorest 1.1 0.2 0.5 373 6.0 1.1 0.1 359 1.7 0.0 9.4 0.6 358 second 1.5 0.4 0.6 457 5.8 0.9 0.4 444 2.8 0.2 13.5 0.5 443 Middle 0.6 0.2 0.7 426 5.2 1.7 0.6 417 0.9 0.0 13.3 0.6 420 fourth 0.7 0.2 0.9 448 4.1 2.0 0.6 419 1.3 0.0 17.2 0.8 414 richest 3.3 1.4 0.8 488 6.7 1.1 0.5 458 3.7 2.9 17.6 0.7 457 Total 1.5 0.5 0.7 2,192 5.6 1.4 0.4 2,097 2.2 0.7 14.4 0.6 2,092 * figures for the education category “none” are based on fewer than 25 unweighted cases and are not shown in the table. 252 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 253 Appendix H: Education Tables by ISCED Education in BiH according to the International Standard Classification of Education (ISCED) The methodology applied in MICS4 is designed to respond to the needs and standards of the country in which the survey is being implemented and to respond to global reporting criteria on the situation of women, men and children. For this reason, the BiH MICS4 presents data on education based on the official standards for preschool, primary and secondary education at the BiH, FBiH, RS and BD level. In addition, relevant data on education according to ISCED is presented in order to enable global comparison of BiH achievements in the area of education. ISCED establishes the following standards: 1. preschool education (ISCED0) that includes education programmes for children aged 3-6; 2. primary education (ISCED1) that includes children aged 5, 6 and 7 and generally lasts from three to four years; 3. lower secondary education (ISCED2) that starts after four to six years (most commonly six) of primary education and most often lasts for three years; 4. upper secondary school (ISCED3) that includes children of secondary school entry age, aged 15 or 16, and lasts from two to five years. In order to present data on education in BiH according to ISCED the following criteria were used: z preschool education covers children aged 3-5, including age 5; z primary education covers children aged 6-10; z lower secondary school covers children aged 11-13; z upper secondary school covers children aged 14-18. Indicators presented by ISCED for primary school net attendance, lower and upper secondary school net attendance and gender parity in education are shown in Tables ED.1 ISCED, ED.2 (a) ISCED, ED.2 (b) ISCED and ED.3 ISCED. Table ED.1 ISCED: Primary school attendance percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), Bih 2011–2012 Male Female Total net attendance ratio (adjusted) number of children net attendance ratio (adjusted) number of children net attendance ratio (adjusted) number of children Administrative unit fBih 96.2 488 93.5 360 95.0 848 rs 99.2 257 98.0 204 98.7 461 Bd (72.9) 13 (*) 6 (79.3) 20 Area   urban 95.2 228 94.3 190 94.8 418 rural 97.5 530 95.5 380 96.6 910 Age at beginning of school year 6 85.7 146 80.2 118 83.2 264 7 100.0 138 100.0 90 100.0 228 8 99.2 157 98.1 121 98.8 278 9 100.0 150 98.0 115 99.1 264 10 98.6 168 100.0 126 99.2 294 Mother’s education*   primary 96.6 223 98.2 176 97.3 399 secondary 97.7 461 94.4 343 96.3 804 higher 96.1 66 93.7 46 95.1 112 Wealth index quintile poorest 94.1 133 92.5 107 93.4 240 second 99.0 144 97.4 131 98.2 275 Middle 99.1 161 93.5 127 96.6 287 fourth 98.4 159 96.9 111 97.8 270 richest 93.2 161 94.9 95 93.8 256 Total 96.8 758 95.1 570 96.1 1,328 (*) figures that are based on fewer than 25 unweighted cases ( ) figures that are based on 25–49 unweighted cases * figures for the education category “none” are based on fewer than 25 unweighted cases and are not presented in the table. 254 Multiple indicator cluster survey 2011–2012 Monitoring the situation of children and woMen 255 Table ED .2 (a) ISCED : Low er secondary school attendance percentage of children of low er secondary school age attending low er secondary school or higher (adjusted net attendance ratio) and percentage of children attending prim ary school, Bih 2011–2012 M ale Fem ale Total n et attendance ratio (adjusted) per cent attending prim ary school n um ber of children n et attendance ratio (adjusted) per cent attending prim ary school n um ber of children n et attendance ratio (adjusted) per cent attending prim ary school n um ber of children A dm inistrative unit fBih 90.1 8.4 366 92.6 6.1 335 91.3 7.3 701 rs 97.6 0.9 139 97.0 0.7 132 97.3 0.8 271 Bd (*) (*) 10 (*) (*) 8 (*) (*) 18 A rea u rban 93.8 4.6 141 93.2 4.8 162 93.5 4.7 302 rural 91.7 6.9 375 93.9 4.3 313 92.7 5.7 687 A ge at beginning of school year 11 85.2 13.7 195 86.4 13.0 159 85.7 13.4 354 12 96.7 3.3 165 97.7 0.2 162 97.2 1.8 328 13 96.7 0.0 155 96.9 0.2 153 96.8 0.1 308 M other’s education* prim ary 95.0 4.6 206 95.4 4.1 181 95.2 4.4 387 secondary 91.0 7.4 275 92.2 5.5 246 91.6 6.5 521 h igher (92.0) (8.0) 28 99.2 (0.8) (38.3) 96.1 3.9 67 W ealth index quintile poorest 95.1 1.9 75 89.6 7.1 68 92.5 4.3 143 second 91.7 8.3 129 91.9 3.0 86 91.8 6.2 214 M iddle 94.0 0.3 92 96.2 3.8 101 95.2 2.1 193 fourth 93.9 6.1 95 95.8 4.2 115 94.9 5.1 210 richest 88.7 11.3 124 93.1 4.9 106 90.7 8.3 230 Total 92.3 6.2 515 93.7 4.5 475 93.0 5.4 990 (*) figures that are based on few er than 25 unw eighted cases ( ) figures that are based on 25–49 unw eighted cases * figures for the education category “n one” are based on few er than 25 unw eighted cases and are not presented in the table. Ta bl e ED .2 (b ) I SC ED : U pp er s ec on da ry s ch oo l a tt en da nc e pe rc en ta ge o f c hi ld re n of lo w er s ec on da ry s ch oo l a ge a tt en di ng lo w er s ec on da ry s ch oo l o r h ig he r ( ad ju st ed n et a tt en da nc e ra tio ) a nd p er ce nt ag e of c hi ld re n at te nd in g pr im ar y sc ho ol o r l ow er se co nd ar y sc ho ol , B ih 2 01 1– 20 12 M al e Fe m al e To ta l n et a tt en da nc e ra tio (a dj us te d) pe r c en t at te nd in g pr im ar y or lo w er se co nd ar y sc ho ol n um be r of ch ild re n n et a tt en da nc e ra tio (a dj us te d) pe r c en t at te nd in g pr im ar y or lo w er se co nd ar y sc ho ol n um be r of ch ild re n n et a tt en da nc e ra tio (a dj us te d) pe r c en t at te nd in g pr im ar y or lo w er se co nd ar y sc ho ol n um be r of ch ild re n A dm in is tr at iv e un it fB ih 92 .7 14 .7 55 8 93 .7 11 .6 63 6 93 .3 13 .0 1, 19 4 rs 93 .6 3. 0 25 3 95 .9 1. 6 21 2 94 .6 2. 3 46 5 Bd (* ) (* ) 10 (* ) (* ) 10 (8 5. 5) (0 .8 ) 20 A re a u rb an 92 .7 11 .3 25 5 95 .7 10 .4 27 8 94 .3 10 .9 53 3 ru ra l 93 .0 10 .7 56 7 93 .4 8. 3 57 9 93 .2 9. 5 1, 14 6 A ge a t b eg in ni ng o f s ch oo l y ea r 14 97 .5 41 .2 20 8 94 .2 35 .6 20 1 95 .9 38 .5 40 9 15 98 .5 1. 8 19 2 98 .0 2. 8 20 0 98 .3 2. 3 39 2 16 97 .1 0. 0 15 6 95 .1 0. 0 19 8 96 .0 0. 0 35 3 17 84 .9 0. 0 14 3 92 .7 0. 0 13 9 88 .7 0. 0 28 2 18 80 .4 0. 0 12 3 87 .8 0. 0 12 0 84 .1 0. 0 24 3 M ot he r’s e du ca ti on * pr im ar y 95 .3 16 .1 26 7 92 .2 8. 3 29 3 93 .7 12 .0 55 9 se co nd ar y 97 .7 10 .5 30 6 99 .0 12 .6 34 0 98 .4 11 .6 64 5 h ig he r (* ) (* ) 41 (1 00 .0 ) (2 0. 5) 46 10 0. 0 24 .4 87 M ot he r n ot in h ou se ho ld (9 9. 4) (5 .3 ) 49 (* ) (* ) 22 95 .3 3. 6 71 ca nn ot b e de te rm in ed 75 .6 0. 0 15 5 88 .7 0. 0 15 3 82 .1 0. 0 30 7 W ea lt h in de x qu in ti le po or es t 89 .2 13 .4 11 1 85 .8 7. 4 15 0 87 .2 9. 9 26 1 se co nd 91 .8 10 .4 14 5 92 .4 6. 0 14 4 92 .1 8. 3 28 9 M id dl e 91 .1 10 .8 19 4 94 .2 8. 0 17 9 92 .6 9. 5 37 3 fo ur th 95 .3 11 .3 20 5 96 .6 11 .6 20 2 96 .0 11 .4 40 7 ri ch es t 95 .6 9. 1 16 6 99 .6 10 .7 18 3 97 .7 10 .0 34 9 To ta l 92 .9 10 .9 82 1 94 .1 9. 0 85 8 93 .5 9. 9 1, 67 9 (* ) f ig ur es th at a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s ( ) f ig ur es th at a re b as ed o n 25 –4 9 un w ei gh te d ca se s * fi gu re s fo r t he e du ca tio n ca te go ry “n on e” a re b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ar e no t p re se nt ed in th e ta bl e. 256 Multiple indicator cluster survey 2011–2012 Table ED.3 ISCED: Education gender parity ratio of adjusted net attendance ratios of girls to boys in primary and secondary school, BiH 2011–2012 primary school adjusted net attendance ratio (nar) girls primary school adjusted net attendance ratio (nar) boys Gender parity index (Gpi) for primary school adjusted nar secondary school adjusted net attendance ratio (nar) girls secondary school adjusted net attendance ratio (nar) boys Gender parity index (Gpi) for secondary school adjusted nar Administrative unit FBiH 93.5 96.2 0.97 52.9 46.9 1.13 rs 98.0 99.2 0.99 47.6 49.2 0.97 Bd (*) (72.9) (*) (53.4) (27.4) (1.95) Area urban 94.3 95.2 0.99 51.9 48.8 1.06 rural 95.5 97.5 0.98 51.4 46.7 1.10 Education of mother/caretaker*   primary 98.2 96.6 1.02 50.1 41.9 1.19 secondary 94.4 97.7 0.97 47.7 43.7 1.09 Higher 93.7 96.1 0.98 40.5 35.4 1.15 Mother not in household – – – (*) (94.1) (*) cannot be determined n/a n/a n/a 76.3 68.1 1.12 Wealth index quintile   poorest 92.5 94.1 0.98 49.1 39.4 1.25 second 97.4 99.0 0.98 53.2 40.6 1.31 Middle 93.5 99.1 0.94 51.8 52.3 0.99 Fourth 96.9 98.4 0.98 50.1 56.6 0.89 richest 94.9 93.2 1.02 53.4 44.3 1.21 Total 95.1 96.8 0.98 51.5 47.3 1.09 (*) Figures that are based on fewer than 25 unweighted cases ( ) Figures that are based on 25–49 unweighted cases * Figures for the education category “none” are based on fewer than 25 unweighted cases and are not presented in the table. n/a: “not applicable” Bosnia and Herzegovina Multiple Indicator Cluster Survey 2011–2012 Cover Page Citation Title Page Summary Table of Findings Table of Contents List of Tables List of Figures List of Abbreviations Acknowledgments Executive Summary I Introduction II Sample and Survey Methodology III Sample Coverage and the Characteristics of Households and Respondents IV Nutrition V Child Health VI Water and Sanitation VII Reproductive Health VIII Child Development IX Literacy and Education X Child Protection XI HIV/AIDS and Sexual Behaviour that Increases the Risk of HIV Transmission XII Access to Mass Media and Use of Information/Communication Technology XIII Tobacco and Alcohol Use XIV Subjective Well-Being Appendix A: Sample Design Appendix B: List of Personnel Involved in the Survey Appendix C: Estimates of Sampling Errors Appendix D: Data Quality Tables Appendix E: BiH MICS4 Indicators – Numerators and Denominators Appendix F: BiH MICS4 Questionnaires Appendix G: Nutritional Status of Children (NCHS/CDC/WHO standard) Appendix H: Education Tables by ISCED

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