Findings from Tajikistan Multiple Indicator Cluster Survey 2005: Preliminary Report

Publication date: 2006

Findings from Tajikistan Monitoring the Situation of Children and Women Multiple Indicator Cluster Survey 2005 PRELIMINARY REPORT October 2006 Tajikistan State Committee on Statistics Findings from Tajikistan Multiple Indicator Cluster Survey 2005 PRELIMINARY REPORT Summary Table of Findings MICS and MDG Indicators, Tajikistan, 2005 TOPIC MICS3 INDICATOR NUMBER MDG INDICATOR NUMBER INDICATOR VALUE Child Mortality 1 13 Under-five mortality rate 79 Per 1000 2 14 Infant mortality rate 65 Per 1000 Nutrition 6 4 Underweight prevalence 17.3 Percent 7 Stunting prevalence 26.9 Percent 8 Wasting prevalence 7.2 Percent 15 Exclusive breastfeeding rate 25.5 Percent 16 Continued breastfeeding rate 74.9 Percent 17 Timely complementary feeding rate 15.3 Percent Tajikistan specific Global acute malnutrition 11.1 Percent Child health 25 Tuberculosis immunization coverage 95.1 Percent 26 Polio immunization coverage 79.3 Percent 27 DPT immunization coverage 82.1 Percent 28 15 Measles immunization coverage 85.6 Percent 31 Fully immunized children 69.3 Percent 29 Hepatitis B immunization coverage 68.5 Percent 22 Antibiotic treatment of suspected pneumonia 40.6 Percent 24 29 Solid fuels 35.0 Percent 37 22 Under-fives sleeping under insecticide- treated nets 1.3 Percent 38 Under-fives sleeping under bednets 1.7 Percent 39 Antimalarial treatment (under-fives) 1.2 Percent 41 Iodized salt consumption 46.4 Percent Environment 11 30 Use of improved drinking water sources 69.5 Percent 12 31 Use of improved sanitation facilities 93.7 Percent Reproductive health 21 19c Contraceptive prevalence 38.0 Percent 4 17 Skilled attendant at delivery 83.4 Percent 5 Institutional deliveries 61.8 Percent Education 55 6 Net primary school attendance rate 88.6 Percent 61 9 Female to male education ratio 0.99 Female to Male Ratio Child protection 62 Birth registration 88.3 Percent 67 Marriage before age 15, before age 18 0.8 Percent 68 Young women aged 15-19 currently married or in union 6.4 Percent HIV/AIDS, Sexual behaviour, and orphaned and vulnerable children 82 19b Comprehensive knowledge about HIV prevention among young people 2.9 Percent � Multiple Indicator Cluster Survey 2005 Contents Abbreviations used in the text .5 Acknowledgements .7 I. Background and Objectives. 9 Introduction .9 Survey Objectives .10 II. Sample and Survey Methodology . 13 Sample Design .13 Questionnaires .13 Training . 15 Fieldwork and Data Processing . 15 Fieldwork began at the beginning of September 2005 and concluded in mid October 2005 . 15 Sample Coverage . 15 III. Results . 16 Child Mortality. 16 Nutritional Status. 17 Breastfeeding . 19 Salt Iodization .20 Immunization .22 Antibiotic Treatment of Children with Suspected Pneumonia .24 Solid Fuel Use .24 Malaria .24 Water and Sanitation .27 Contraception .28 Assistance at Delivery .29 Primary School Attendance .30 Birth Registration .31 Early Marriage .32 Knowledge of HIV/AIDS Transmission and Condom Use .33 References .35 Appendix one: Tables .36 Appendix two: MICS3 Indicators and Definitions used in the Tajikistan MICS3 Preliminary Report .66 � Findings from Tajikistan Tables Table 1: Results of household and individual interviews .36 Table 2: Child mortality .36 Table 3: Child malnourishment .37 Table 4: Child acute malnutrition*.39 Table 6: Iodized salt consumption .44 Table 7: Vaccinations in first year of life .45 Table 8: Antibiotic treatment of pneumonia .46 Table 9: Solid fuel use .47 Table 10: Children sleeping under bednets .49 Table 11: Treatment of children with antimalarial drugs.50 Table 12: Use of improved water sources .52 Table 13: Use of sanitary means of excreta disposal .54 Table 14: Use of contraception .56 Table 15: Assistance during delivery .58 Table 16: Primary school net attendance ratio .59 Table 17: Education gender parity .60 Table 18: Birth registration .61 Table 19: Early marriage .63 Table 20: Comprehensive knowledge of HIV/AIDS transmission .64 5 Multiple Indicator Cluster Survey 2005 Abbreviations used in the text ACTED L’Agence d’Aide à la Coopération Technique et au Dévelopement AIDS Acquired Immune Deficiency Syndrome BCG Bacillis- Cereus- Geuerin CDC Centre for Disease Control and Prevention CIS Commonwealth of Independent States DPT Diphtheria- pertussis-tetanus DRD Direct Rule Districts GAVI The Global Alliance for Vaccines and Immunization GBAO Gorno Badakhshan GPI Gender Parity Index HIV Human Immunodeficiency Virus IDD Iodine Deficiency Disorders ITN Insecticide treated Net IUD Intrauterine Device LAM Lactational Amenorrhea Method LSMS Living Standards Measurement Survey MDG Millennium Development Goals MICS Multiple Indicator Cluster Survey MoH Ministry of Health MUAC Mid-Upper Arm Circumference NAR Net Attendance Rate NCHS National Centre for Health Statistics PPM Parts Per Million SCS State Committee on Statistics SD Standard Deviation SP Sulfadoxine-pyrimethamine UNAIDS Joint United Nations Programme on HIV/ AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development WFFC World Fit for Children WHO World Health Organization WHZ Weight for Height Photo Credits: UNICEF Tajikistan/Pirozzi, Aga Khan Foundation, AKHP/Mikhail Romanyuk � Multiple Indicator Cluster Survey 2005 Acknowledgements The 2005 Multiple Indicator Cluster Survey (MICS) provides an excellent picture of the status of children and women in Tajikistan. The MICS was originally developed in 1995 in response to the ‘World Summit for Children’ in order to measure progress towards an internationally agreed-upon set of mid-decade goals. Tajikistan con- ducted its first MICS in 2000. The current round of MICS aims to ascertain where Tajikistan stands in achieving the selected goals of ‘A World Fit for Children’, the Millennium Development Goals (MDGs), as well as other major international commitments. In contrast to the MICS 2000, the MICS 2005 also provides new data on areas such as child discipline, maternal mortality, marriage/union status of women, domestic violence, tuberculosis, vitamin A and nutritional status of children. The MICS 2005 required months of planning and involved over 160 people, four weeks of trainings, six weeks of fieldwork and four weeks of data entry. It could not have happened without the hard work and dedication of those who participated in this project including; statistical experts, trainers, field coordinators, editors, mappers, listers, supervisors, interviewers, drivers, monitors, data entry clerks, and data processors. Special thanks must be given to: Bakhtiya Mukhammadieva, First Deputy Director of the State Committee on Statistics (SCS). As technical director of the project he supported the MICS team by providing valuable advice on both overall and technical issues as well as showing great coordination skills. Thanks also go to Kislitsyna Elena, Head of the Demography Department of SCS, for her analytical skills and insights as well as to Kholma- tov Ikhtier, Head of the Programming Department of SCS, for his technical support in programming and data processing. Thanks also to the supervisors of the field groups in the various regions: Asoev A., Ashurov G., Boymatov K., Stodolya O., Khaitov C., Boboev R., Vorisov A., Shokirov Sh., Shoibragimov A., Zangirbekov D., Kholdorbekov A., Gumaeva R., Mamadkarimova Kh. And finally to those who participated in mapping, field editing, interviewing, including drivers and data entry operators. For the MICS 2005 a Coordinating Committee was established which included the active participation of many government institutions and international organizations such as: the Ministry of Health, the Ministry of Educa- tion, SCS, the Ministry of Labour and Social Protection and the Youth Committee under the Government of Tajikistan provided thoughtful comments and advice at every stage of the implementation. The World Bank was also part of this committee. Needless to say, the MICS 2005 would not have been accomplished without the financial support and under- standing from the Department for International Development in the United Kingdom (DFID), the United Na- tions Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the United Nations Population Fund (UNFPA) and the United States Agency for International Development (USAID). These donors were also part of the steering committee. Many committee members also contributed to the successful implementation of the MICS 2005 in many di- verse ways, such as the World Health Organization (WHO). The Ministry of Health and SCS staff partici- pated in the monitoring of MICS field work in various districts and regions. At training UNFPA gave lectures on contraception and also participated in the monitoring of fieldwork in Sogd. Action Against Hunger pro- vided anthropometric demonstrations for the interviewers as well as the anthropometric fieldwork equipment. L’Agence d’Aide à la Coopération Technique et au Dévelopement (ACTED) carried out the presentations on bed- nets and the Aga Khan Foundation provided the logistical support for fieldwork in GBAO. The following also provided constant support and guidance: the UNICEF New York staff and the Geneva Re- gional Office: the UNICEF Tajikistan staff; Yukie Mokuo, the Tajikistan Country Office Representative who coordinated various partners and always guided the team in the right direction: Niloufar Pourzand, former Pro- gramme coordinator: Naoko Hosaka, M&E officer: Farhod Khamidov, M&E assistant: and Nukra Sinavbarova, MICS-3 assistant. Lastly, constant support and guidance was given by Oleg Benes, the consultant who designed the sample, super- vised trainings, provided advice on fieldwork, created tabulation plans and drafted this report. Head of the MICS project Chairmen of the State Committee on Statistics Shabozov M.Sh. Professor, Member of the Correspondent of the Academy of Sciences � Multiple Indicator Cluster Survey 2005 I. Background and Objectives Introduction This preliminary report is based on the Tajikistan Multiple Indicator Cluster Survey (MICS), conducted in 2005 by the State Committee on Statistics (SCS) supported by its regional-level offices as well as the Ministry of Health, Ministry of Education, Ministry of Labour and So- cial Protection and the Youth Committee under the Government of Tajikistan. The survey was based, in large part, on the need to monitor progress towards goals and targets emanat- ing from recent 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 (WFFC), adopted by 189 Member States at the United Nations Special Session on Children in May 2002. Both of these commitments build upon promises made by the interna- tional community at the 1990 World Summit for Children. In signing these international agreements, governments committed themselves to improving conditions for their children and to monitoring progress towards that end. UNICEF was as- signed a supporting role in this task (see Box). A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the 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 commu- nity 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) 10 Findings from Tajikistan 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, programmes and the specialized 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 prog- ress: “…We request the General Assembly to review on a regular basis the progress made in imple- menting 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.” Over the past years, the Tajikistan government has increased their political commitment and capacity in undertaking social reforms in line with the realization of the Millennium De- velopment Goals (MDGs) and the rights of children and women. In 2005 the government made major progress towards the MDG achievements, with the completion of a MDG Needs Assessment and a draft of a National Development Strategy. However, still much remains to be done especially in the areas of access to quality health, education and child protection services. Tajikistan continues to be in dire need of additional international support in order to meet the MDG targets, as well as fulfil its commitment to the realization of children and women’s rights. The completion of the 2005 MICS will complement this strategically related work by providing updated baseline data for future planning and implementation by all stake- holders and duty-bearers. It is expected that the MICS 2005 findings will further enhance the evidence based policy planning and analysis of the Government, thus, contributing to more systematic policy development and its implementation towards the MDGs and a WFFC. This preliminary report presents selected results on a variety of principal topics covered in the survey and on a subset of indicators1. As specified, the results in this report are prelimi- nary and are subject to change, although major changes are not expected. A comprehensive full report is scheduled for publication in spring 2007. Survey Objectives The 2005 Tajikistan Multiple Indicator Cluster Survey (MICS) has as its primary objectives: To provide up-to-date information for assessing the situation of children and women in Tajikistan; � For more information on the definitions, numerators, denominators and algorithms of Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDGs) indicators covered in the survey: see Chapter �, Appendix � and Appendix 7 of the MICS Manual – Multiple Indicator Cluster Survey Manual 2005: Monitoring the Situation of Children and Women, also available at www.childinfo.org • 11 Multiple Indicator Cluster Survey 2005 To furnish data needed for monitoring progress toward goals established by the Millen- nium Development Goals (MDGs) and the goals of A World Fit For Children (WFFC) as a basis for future action; To contribute to the improvement of data and monitoring systems in Tajikistan and to strengthen technical expertise in the design, implementation, and analysis of such sys- tems. • • 1� Multiple Indicator Cluster Survey 2005 II. Sample and Survey Methodology Sample Design The sample for the Tajikistan Multiple Indicator Cluster Survey (MICS) was designed to provide estimates on a large number of indicators on the situation of children and women at the national level, for both urban and rural areas, and for five regions: Dushanbe (the capital), Direct Rule Districts (DRD), Sogd, Khatlon and Gorno Badakhshan (GBAO). Regions by urban-rural areas were identified as the main sampling domains. The sample followed a two-stage design. At the first stage, 290 primary sampling units were selected with probability proportional to size from a master frame of 17,923 census enumeration ar- eas, produced by a Tajikistan census of the population conducted in 2000. After household listing and mapping was carried out within the selected enumeration areas, a systematic sample of 6,968 households was drawn. All selected enumeration areas were successfully visited. The distribution of clusters between sampling domains is not proportional to the census distribution of population and, consequently neither is the final household distribu- tion. The sample is therefore not a self-weighting household sample. For reporting national level results, sample weights are used. Questionnaires Three questionnaires were used in the survey: a Household Questionnaire, a Questionnaire for Individual Women and a Questionnaire for Children Under-Five. The questionnaires were used to collect data on all household members. Information was collected on all household members to identify and subsequently administer questionnaires to all women aged 15-49 as well as children under-five. For children under-five, the question- naire was administered to the mother or caretaker of the child. Information on the dwelling of the household was also collected. The content of these questionnaires was based on model MICS questionnaires. Consultations with partners were held in Dushanbe to select the most important topics to be covered by the survey. Following these consultations the model MICS questionnaires were adjusted to reflect issues relevant to Tajikistan regarding population, women and children’s health, family planning, domestic violence and other health issues. The Tajikistan MICS questionnaires had a number of important additions as compared to the model MICS questionnaires. In the household questionnaire a number of questions were in- cluded to assess salt acquisition and consumption patterns. The Questionnaire for Individual Women incorporated additional questions on pregnancy outcomes, a larger list of antenatal 1� Findings from Tajikistan health services, knowledge of contraceptives, participation of women in the household deci- sion making and a module on tuberculosis. The final questionnaires were approved by the Coordinating Committee and included the following modules: Household Questionnaire Household listing Education Water and Sanitation Household characteristics Insecticide treated Net (ITN) Child Labour Child Discipline Maternal Mortality Salt Iodization Questionnaire for Individual Women Child Mortality Maternal and Newborn Health Marriage/Union Contraception Attitudes Toward Domestic Violence HIV/AIDS Tuberculosis Questionnaire for Children Under-Five Birth Registration and Early Learning Child Development Vitamin A Breastfeeding Care of Illness Malaria Immunization Anthropometry From the MICS3 model English version, the questionnaires were translated into Tajik and Russian. All aspects of MICS data collection were pre-tested during July 2005. Seventeen people, who were expected to act as fieldwork supervisors and editors during the main field- work, were trained for four days and then dispatched in order to conduct interviews in both on Tajik and Russian. At this time weight and height measurements were also taken. These fieldwork exercises for the pre-testing period were conducted in one urban and one rural area in a district close to Dushanbe. Participants worked in teams composed of two people allow- ing the interviewers to both observe and support each other. Each team performed between four and seven household interviews. The lessons learned from these pre-tests were used to finalize the survey instruments and logistical arrangements. • • • • • • • • • • • • • • • • • • • • • • • • 15 Multiple Indicator Cluster Survey 2005 Training The field staff was trained for nine days in late August 2005. A total of 86 participants were trained as field staff supervisors, editors and interviewers. Only female candidates were se- lected for the positions of interviewers and field editors. Males were recruited to act mainly as field work supervisors. Training included plenary presentations, demonstrations and discus- sions. These were supplemented by small group activities such as role playing, mock inter- views, discussions and performing anthropometry measurements and iodine tests. Resource people from UNFPA, Action Against Hunger, ACTED and UNICEF made presentations on Tajikistan’s programmes on the topics of family planning, anthropometry, insecticide treated nets, maternal and child health, HIV/AIDS and salt iodization. In addition to in-class train- ing, participants practiced their interviewing skills during a two day fieldwork exercise. Once completed, a final session was held to address any lasting concerns or issues that would be faced in the field. Participants selected as field supervisors and editors were given an addi- tional day of training on the topic of how to supervise field work and edit questionnaires. Fieldwork and Data Processing The data was collected by 14 teams; each comprised of three to four female interviewers, one driver, one female editor/measurer and one supervisor. Senior staff from the SCS and two national fieldwork coordinators coordinated and supervised the field work activities. Fieldwork began at the beginning of September 2005 and concluded in mid October 2005 Data was entered on 10 computers using the CSPro software. In order to ensure quality con- trol, all questionnaires were entered twice and consistency checks were performed. Standard programs and procedures, developed under the global MICS3 project and adapted to the Tajikistan questionnaire, were used throughout. An additional set of data control tables was developed by the data collection team and was used on a weekly basis during the data entry period to monitor the quality of incoming data. Data processing began simultaneously with data collection in mid September 2005 and was completed by the end of October 2005. Data was analysed using the SPSS software program and the model syntax and tabulation plans developed for this purpose. Sample Coverage Of the 6,968 households selected for the sample, 6,961 were found to be occupied. Of these, 6,684 were successfully interviewed for a household response rate of 96 percent. In the inter- viewed households, 10,626 women (age 15-49) were identified. Of these, 10,243 were success- fully interviewed, yielding a response rate of 96 percent. In addition, 4,370 children under age five were listed in the household questionnaire. Of these, 4,273 questionnaires were complet- ed by mothers or caretakers of the children, yielding a response rate of 98 percent. Overall response rates of 93 and 94 percent were calculated for the Individual Women and Children Under-Five interviews respectively (Table 1). 16 Findings from Tajikistan III. Results Child Mortality One of the overarching goals of the Millennium Development Goals (MDGs) and A World Fit for Children (WFFC) is to reduce infant and under-five mortality. Monitoring progress towards this goal is an important but difficult objective. Measuring child mortality rates may seem unproblematic in theory. In practice attempts using direct questions, such as “Has anyone in this household died in the last year?” have proven to provide inaccurate results. At the same time, gaining data concerning child mortality rates from birth histories is both time consuming and complicated. Demographers have therefore been forced to devise ways to measure childhood mortality indirectly. These ‘indirect methods’ minimize the danger of memory lapses, inexact or misinterpreted definitions, and poor interviewing techniques. The infant mortality rate is the probability of dying between birth and exactly one year of age expressed per 1.000 live births. The under-five mortality rate is the probability of dying be- tween birth and exactly five years of age expressed per 1.000 live births. In the MICS 3, infant and under-five mortality rates were calculated based on an indirect estimation technique; the so-called ‘Brass method’. “The Brass method allows mortality rates to be estimated from ag- gregate information on the number of children born to women in 5-year age groups (15-19, 20-24 etc), and the proportion of children in each group who die” (Aleshina & Redmond, 2003, 27). The technique converts this data into the probability of dying by taking into ac- count both the mortality risks to which children are exposed as well as the length of their exposure to these risks. Table 2 provides estimates of child mortality by various background characteristics. The infant mortality rate is estimated at 65 per thousand, while the under-five mortality rate is 79 per thousand. These estimates are based on the year 2003. Excess male mortality during the neonatal period is widespread and substantial in some countries, but sex differentials after the neonatal period are generally very small. In Tajikistan both infant mortality and under-five mortality rates are significantly higher among males than females (75 versus 54 and 92 versus 66 respectively). These findings need further analysis, as the gender differ- ence in the under-five mortality rates is significantly different than expected differentials. By region, results indicate the highest level of under-five mortality rate occurs in Khatlon (102 per thousand) while the lowest are seen in DRD, GBAO and Dushanbe (less than 60 per thousand). There are also significant differences in child mortality rates in terms of ed- ucational levels and wealth. Rates are almost five times higher in children born to mothers with little or no secondary education as compared to those with higher levels of education. Children born into the poorer households interviewed are more likely to die during their 1� Multiple Indicator Cluster Survey 2005 first five years of life as compared to those living in wealthier environment. However, both the infant mortality and under-five mortality rates are lower as compared to the MICS 2000 data (126 and 89 per 1000 accordingly). Adjusting for the known biases in national data (under-reporting of vital statistics), WHO Euro estimated the under-five mortality rate in Tajikistan to be around 86 per 1000 live births in 2001 and 63 per 1000 in 2002. The UNICEF report, ‘The State of the World’s Children 2006’ estimates Tajikistan’s infant mortality rate to have been 91 in 2004. The MICS 2005 infant mortality estimates are in line with the findings from the 1999 Ta- jikistan Living Standards Measurement Survey (LSMS). These estimates were 79 per 1000 live births (95 percent confidence interval 65-92). The 2004 research into the main causes of infant death in Tajikistan (using an adaptation of the standard verbal autopsy protocols of the WHO), suggests infant mortality rates to be varied for four surveyed country regions from 58 (Sogd, DRD) to 103 (Dushanbe, Khatlon) during a period of time covering 1998-2002. Conversely, infant mortality rates as reported by the Ministry of Health in Tajikistan are significantly lower (27.9 per 1000 in 2001, 17.2 in 2002, and 13.5 in both 2003 and 2004) as compared to survey estimates for the same years. The existing discrepancy between regis- tered infant mortality rates and survey data may be partially explained by the fact that official estimates of infant mortality use protocols established during the Soviet regime, which do not consider newborns less than 999 grams in weight, those born before 28 weeks of pregnancy and those who do not manifest vital signs other than breath, as live births. At the same time, there is a persistent gap in the registration of births particularly for the first six months of a child’s life (Aleshina & Redmond: 2003). 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. Figure 1: Infant mortality rate estimates, Tajikistan, 2005 40 48 47 41 31 31 31 23 19 16 28 17 14 14 79 89 65 0 20 40 60 80 100 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Pe r 1 00 0 MoH estimates (HFA) LSMS1999 MICS2000 MICS2005 Figure 1: Infant mortality rate estimates, Tajikistan, 2005 40 48 47 41 31 31 31 23 19 16 28 17 14 14 79 89 65 0 20 40 60 80 100 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Pe r 1 00 0 MoH estimates (HFA) LSMS1999 MICS2000 MICS2005 18 Findings from Tajikistan In a well-nourished population there is a standard distribution of height and weight for chil- dren under age five. Under-nourishment in a population can be measured by comparing chil- dren to this standard distribution. The reference for this population distribution that was in use for this survey was the WHO/Centre for Disease Control and Prevention (CDC)/ Na- tional Centre for Health Statistics (NCHS) reference. This reference has been recommended for use by many international organizations such as UNICEF and WHO. Each of the three nutritional status indicators (explained below) can be expressed in standard deviation (SD) units (z-scores) from the median of this reference population. The first indicator, weight for age, can be used as a measure of both acute and chronic malnu- trition. 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. The second indicator, 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 short for their age and are classified as moderately or severely stunted. Those 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 of time and/ or recurrent or chronic illness. Finally, 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. Those who fall more than three standard deviations below the median are severely wasted. 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 and/ or disease prevalence. Table 3 shows the percentages of children in these various categories based on the anthropo- metric measurements that were taken during fieldwork. The table also includes the percent- age of children who are overweight, which takes into account those children whose weight for height is above two standard deviations from the median of the reference population. For this survey, children who were not weighed or measured (approximately one percent of children) as well as those whose measurements were outside a plausible range were excluded form the survey results. In addition, a small number of children whose birth dates are not known were excluded. In Tajikistan, underweight prevalence (moderate and severe) is 17 percent (Table 3). About 4 percent of children under-five are severely underweight. Nearly 27 percent are stunted and 9 percent are severely stunted. Seven percent of those surveyed could be classified as wasted. It is estimated that about 4 percent of children under-five are overweight. The prevalence rates of underweight children were highest in the Khatlon and GBAO re- gions, while the lowest rates were found in Dushanbe. A similar pattern was found for the prevalence rates for stunting. Those children whose mothers had higher educational levels were the least likely to be underweight and/ or stunted as compared to children whose mothers had little or no primary or secondary education. 1� Multiple Indicator Cluster Survey 2005 Underweight and wasting levels are roughly equal between boys and girls, whereas boys are somewhat more likely to be stunted than girls. The age pattern shows that a higher percent- age of children aged 12-23 months are underweight or wasted as compared to children of other ages (Figure 2). However, for stunting the levels reach a plateau during the second to fifth year of life. This pattern is expected and is related to the age at which many children cease to be breastfed and are continuously exposed to contamination from the water, food and the environment. In addition to the three MICS standard indicators used to assess the nutritional status of chil- dren (weight for age, height for age and weight for height) two other indicators were utilized, the mid - upper arm circumference (MUAC) and the presence of oedema. The aim of in- cluding these extra indicators was to assess for the presence of Global Acute Malnutrition in children aged 12 to 59 months (as determined by weight for height below -2SD, MUAC below 12.5 cm or oedema). Countrywide 11 percent of children aged 12 to 59 months were exposed to Global Acute Malnutrition (Table 4). The highest rate was observed in the Khatlon region (14 percent). The prevalence of Global Acute Malnutrition was higher in children from the poorest quintile (13 percent) as compared to children from the richest quintile (10 percent). Breastfeeding Breastfeeding for the first few years of life protects children from infection, provides them with an ideal source of nutrients as well as being economical and safe. However, many moth- ers stop breastfeeding too soon as there are often pressures for them to switch to infant for- mula. This early cessation of breastfeeding can contribute to growth faltering, micronutrient malnutrition and is unsafe if clean water is not readily available. One goal of A World Fit for Children states that children should be exclusively breastfed for six months, followed by breastfeeding combined with safe, appropriate and adequate supplementary feeding to two years of age and beyond. Figure 2: Percentage of children aged 0-59 months who are undernourished, Tajikistan, 2005 0 5 10 15 20 25 30 35 < 6 6-12 12-23 24-35 36-47 48-59 Age (months) Pe rc en t Underweight Stunted Wasted Figure 2: Percentage of children aged 0-59 months who are undernourished, Tajikistan, 2005 0 5 10 15 20 25 30 35 < 6 6-12 12-23 24-35 36-47 48-59 Age (months) Pe rc en t Underweight Stunted Wasted 20 Findings from Tajikistan In Table 5, breastfeeding status was based on information from the children’s mother or care- taker who reported on the child’s consumption of food and/ or fluids in the 24 hours prior to the interview. Exclusively breastfed refers to infants who received only breast milk and vita- mins, mineral supplements, and/ or medicine. Breastfed refers to infants who receive breast milk along with water, non-milk liquids and other complementary foods. Table 5 shows ex- clusive breastfeeding of infants during the first six months of life separated for 0-3 months and 0-5 months. The table also shows complementary feeding of children aged 6-9 months and continued breastfeeding of children at 12-15 and 20-23 months of age. In Tajikistan, approximately 26 percent of children six months of age or less are exclusively breastfed. The remaining percentage of children is subject to the introduction of water and non-milk liquids in addition to breastfeeding, (Figure 3). This practise can be unsafe for the child’s overall health. At age 6-9 months, 15 percent of children were receiving breast milk as well as solid or semi- solid foods. This practise can also be unsafe as it exposes children to insufficient micronutri- ents intake needed for their normal grow and development. By age 12-15 months, 75 percent of children were being breastfed, with this number dropping to 34 percent for children aged 20-23 months. Breastfeeding patterns during the first year of life vary significantly by regions as well as by education level of mothers. Boys were more likely to be exclusively breastfed and receive timely complementary foods than were girls. Children from rural areas, the poor- est quintile and those whose mothers had not completed secondary or higher education were more likely not to receive complementary feeding during their first year of life. Salt Iodization Iodine Deficiency Disorders (IDD) is the world’s leading cause of preventable mental retar- Figure 3: Infant feeding patterns by age: Percent distribution of children aged under 2 years by feeding pattern by age group, Tajikistan, 2005 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 Age (months) Pe rc en t Weaned (not breastfed) Breastfed and complementary foods Breastfed and other milk/ formula Breastfed and non-milk liquids Breastfed and plain water only Exclusiv ely breastfed Figure 3: Infant feeding patterns by age: Percent distribution of children aged under 2 years by feeding pattern by age group, Tajikistan, 2005 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 Age (months) Pe rc en t Weaned (not breastfed) Breastfed and complementary foods Breastfed and other milk/ formula Breastfed and non-milk liquids Breastfed and plain water only Exclusiv ely breastfed 21 Multiple Indicator Cluster Survey 2005 dation and impaired psychomotor development in young children. In its most extreme form, iodine deficiency causes cretinism. It also increases the risks of stillbirth and miscarriage in pregnant women. Iodine deficiency is most commonly associated with visible goitres. IDD also leads to impaired mental growth and development, contributing in turn to poor school performance, reduced intellectual ability, and impaired work performance. The reported incidence of endemic goiter, as a main marker of IDD, increased in Tajikistan from 1.14 per thousand in 1997 to 2.15 in 2002. Examinations carried out revealed a high per- centage of the population is affected by goiters: for the different regions, 45-82 percent among children and 60 percent among women of reproductive age (MoH, 2003). In Tajikistan joint efforts of the Government and the donor community to address IDD were formulated in the National Programme for Elimination of IDD, developed in 1997. The pro- gramme stipulates that all salt must be iodized to 45 parts per million (PPM). The Law № 344 On Salt Iodization, adopted in 2002, regulates the production, distribution and consump- tion of iodized salt in the country. Development of the national standard for iodized salt and the mobilization of the salt producer community, as well as other concerted actions at the national level, aim to achieve a change in iodine intake. This change is measured by the pro- portion of the population consuming an adequate amount of iodized salt, which was as low as 20 percent according to MICS conducted in 2000. In about 99 percent of households, salt used for cooking was tested for iodine content by using salt test kits and testing for the presence of potassium iodate. In a very small proportion of households (less than 1 percent), there was no salt in the household (Table 6). In 46 percent of households, salt was found to contain 15 (PPM) or more of iodine, that reveal an important progress made over the past five years (Figure 4). Use of iodized salt was the highest in Sogd (75 percent) and the lowest in Khatlon (27 per- cent). Some 59 percent of urban households were found to be using adequately iodized salt as compared to 40 percent in rural areas. Iodised salt consumption was nearly as twice as high among richest quintile of the population (63 percent) as compared to the poorest (31 percent). Figure 4: Percentage of households consuming adequately iodized salt (15+PPM), Tajikistan, 2005 20 47 32 59 16 40 0 20 40 60 80 MICS2000 MICS2005 Pe rc en t Total Urban Rural Figure 4: Percentage of households consuming adequately iodized salt (15+PPM), Tajikistan, 2005 20 47 32 59 16 40 0 20 40 60 80 MICS2000 MICS2005 Pe rc en t Total Urban Rural 22 Findings from Tajikistan Immunization According to UNICEF and WHO guidelines, a child should receive; a Bacillis-Cereus- Geuerin (BCG) vaccination to protect again tuberculosis, three doses of the Diphtheria-per- tussis-tetanus (DPT) vaccination, three doses of the polio vaccine, and a measles vaccination. The vaccination schedule followed by the National Immunization Programme of Tajikistan provides all vaccinations mentioned above as well as vaccinations against hepatitis B (three doses). All vaccinations should be received during the first year of life, with the exception of measles which is given soon after the age of 12 months. Taking into consideration this vac- cination schedule, immunization coverage was estimated for the cohort 15-26 months of age, allowing a reasonable interval of three months for children to receive measles vaccine. The information on vaccination coverage was obtained for all children under five years of age. In Tajikistan, as in many other countries from the Commonwealth of Independent States (CIS), child health records are routinely maintained in the local health facilities. The prac- tise of keeping immunization cards in the possession of the child’s parent or guardian has recently started to be implemented with the support from The Global Alliance for Vaccines and Immunization (GAVI). In this survey, data was collected from both these sources as well as from the mother’s verbal report. All mothers were asked to provide immunisation cards and if these were available, interviewers copied the vaccination information onto the MICS3 questionnaire. The interviewer then proceeded to ask the mother if the child had received the BCG, polio, DPT, hepatitis B and measles vaccines as well as how many doses. After completing the interview in the household, information about the address of the local health facility where the child’s immunization record is kept was collected and interviewers or the supervisors visited that health facility in order to obtain the immunization information. Vaccination certificates at home were obtained for 9 percent of children while immuniza- tion records at the health facility were obtained for 82 percent of children. In some cases both sources of information were used for a child. Overall, 85 percent of children had im- munization records either at home or at health facility2. The percentage of children aged 15 to 26 months who received each of the vaccinations is shown in Table 7. The denominator for the table is comprised of children aged 15-26 months meaning that only children who are old enough to be fully vaccinated are counted. In the top panel, the numerator includes all children who were vaccinated at any time previous to the survey according to the vaccina- tion card or the mother’s report. In the bottom panel, only those who were vaccinated before their first birthday are included. For children without vaccination cards, the proportion of vaccinations given before their first birthday is assumed to be the same as for children with vaccination cards. Approximately 95 percent of children aged 15-26 months received a BCG vaccination by the age of 12 months. The first dose of DPT was given to 91 percent of these same children with the percentage declining for subsequent doses of DPT to 87 percent for the second dose, and 82 percent for the third dose (Figure 5). Similarly, 92 percent of children received the first dose of Polio vaccine by age 12 months with this declining to 79 percent by the third dose. The coverage for measles vaccine by 15 months is 86 percent. Overall, the percentage of children 2 These figures are not included in the attached tables 2� Multiple Indicator Cluster Survey 2005 who had all eight recommended vaccinations (three doses of DPT, three doses of Polio (ex- cluding Polio 0), BCG, and Measles vaccine) by their first birthday (in case of measles – by 15 months of age) is low at only 69 percent. It is important to note that 4 percent of the children never received any of the eight doses of vaccines. It is also worth mentioning that none of the latter children had an immunization card available either at home or at the health facility. Coverage with hepatitis B vaccine is analyzed separately taking into consideration its recent introduction (it was started in 2002 small scale in a few districts as well as the maternity hos- pital and has scaled up to cover all districts since 2003). Approximately 83 percent of children aged 15-26 months received the first dose of hepatitis B vaccine by the age of 12 months. As in the case of the polio and DPT coverage, the prevalence of subsequent doses of hepatitis B vaccine drops gradually to 77 percent for the second dose and 69 percent for the third dose. Table 7 also shows the proportions of children who had received the vaccinations at any time before the survey, regardless of the age of the child at the time of vaccination. It includes both timely vaccinations and vaccinations given later than the child’s first birthday. These figures are 1-4 percent higher as compared to timely received doses. Even in this final case, accessibility of routine vaccination services to children measured by proportion of children receiving DPT1 is only 93 percent. The decline in coverage levels reflects drop-out rates of 8 percent for DPT, 11 percent for polio and 14 percent for hepatitis B vaccine. The drop-out rate represents the proportion of children who receive the first dose of vaccine but do not finalize the immunization series getting the third dose. Drop-outs higher than 10 percent are usually related to the lack of continuity of immunization services at the health delivery level. Both accessibility of immunization services and their continuity should be thoroughly addressed in Tajikistan in order to achieve timely vaccination coverage over 90 percent for complete immunization series. * Measles – received by age �5 months ** All = 3 doses of DPT, 3 doses of Polio (excluding Polio 0), BCG, and Measles. Figure 5: Percentage of children 15-26 months who received immunizations by age 12 months, Tajikistan, 2005 91 92 83 95 87 87 77 86 69 82 79 69 0 20 40 60 80 100 BCG DPT Polio HepB Measles* All** Pe rc en t Dose 1 Dose 2 Dose 3 Figure 5: Percentage of children 15-26 months who received immunizations by age 12 months, Tajikistan, 2005 91 92 83 95 87 87 77 86 69 82 79 69 0 20 40 60 80 100 BCG DPT Polio HepB Measles* All** Pe rc en t Dose 1 Dose 2 Dose 3 2� Findings from Tajikistan Antibiotic Treatment of Children with Suspected Pneumonia Pneumonia is the leading cause of death in children and the use of antibiotics in under-five’s with suspected pneumonia is a key intervention. Children with suspected pneumonia are those who had an illness with a cough accompanied by rapid or difficult breathing and whose symptoms were due to a problem in the chest. This question was limited to children who had suspected pneumonia within the previous two weeks and whether or not they had received an antibiotic within this time frame. According to the reports of the Ministry of Health (MoH) and data from the State Commit- tee on Statistics, respiratory system diseases account for 30-40 percent of infant mortality in Tajikistan. Table 8 represents the use of antibiotics for the treatment of suspected pneumonia in under- fives. Taking into consideration the survey was conducted in September to October, when the spread of respiratory diseases is low, the prevalence of children with suspected pneumonia was rather low at 1.6 percent. The limited number of observations allows further disaggregat- ing data only by sex and area. In Tajikistan, 41 percent of under-five children with suspected pneumonia had received an antibiotic during the two weeks prior to the survey. The percent- age was higher among female (46 percent) comparing to male (36 percent) and in urban areas (55 percent) comparing to rural areas (34 percent). Solid Fuel Use Cooking with solid fuels (biomass and coal) leads to high levels of indoor pollution and is a major cause of ill-health in the world, particularly among children under-five, in the form of acute respiratory illness. Overall, more than a third (35 percent) of all households in Tajikistan are using solid fuels for cooking (Table 9). Use of solid fuels is very low in urban areas (8 percent), but very high in ru- ral areas, where almost half of the households (48 percent) are using solid fuels. Differentials with respect to region, household wealth and the educational level of the household head are also significant. The table clearly shows that the percentage is high mainly due to high level of wood usage for cooking purposes. Malaria Malaria is a leading cause of death of children under age five in endemic areas. It also contributes to anaemia in children and is a common cause of school absenteeism. Preven- tive measures, especially the use of insecticide treated nets (ITNs), can dramatically reduce malaria mortality rates among children. In areas where malaria is common, international recommendations suggest treating any fever in children as if it were malaria and imme- diately giving the child a full course of recommended antimalarial tablets. Children with severe malaria symptoms, such as fever or convulsions, should be taken to a health facility. As well, children recovering from malaria should be given extra liquids and food and/ or should continue breastfeeding. 25 Multiple Indicator Cluster Survey 2005 Malaria re-emerged in Tajikistan in 1992 as a result of the social-economic deterioration linked to armed conflict, mass population movement across zones of intensive transmission of malaria (particularly Afghanistan where malaria is endemic), and the disruption of pub- lic health care services as well as vector control activities. Marked changes in agricultural practices, particularly the increase in the cultivation of rice, have led to an increase in vector breeding grounds. The above mentioned activities have led to the formation of standing-wa- ter reservoirs and the establishment of an endemic transmission of the disease particularly in the southern part of Tajikistan. The number of malaria cases reported in Tajikistan peaked in 1997, when nearly 30,000 cases were registered. Despite a 92 percent reduction in reported number of cases since this time, the malaria situation in the country remains serious. The resumption of P. falciparum cases and the expansion of the territory in which this type of malaria is spread is a matter of particular concern. During the last five years more than three quarters of reported cases of malaria occurred in the Khatlon region, 14 percent in DRD and only 2-4 percent in the remaining three regions. The residents of the Khatlon Region, an area bordering Afghanistan which is home to 2.2 million people, bear the highest burden of malaria in the WHO European Region. A survey carried out in this region in 2001 indicated that more than 10 percent of the study population were asymptomatic parasite carriers of P. vivax and P. falciparum. Within the the Khatlon Re- gion, the number of malaria cases was estimated to be as high as 150,000 to 250,000. The total number of malaria cases within the country, including both symptomatic and asymptomatic cases, was estimated to reach up to 300,000-400,000. Based on information provided by MoH Malaria Centre, selected endemic districts of the Khatlon and Sogd regions (the latter has a population of 0.4 million), have been supplied with almost 115,000 bednets over the last eight years. This has been done with support from ACTED and MERLIN with the aim of reducing the risk of mosquito bites. The MICS3 questionnaires (Household and Children Under-five) incorporate questions on the use of bednets, antimalarial treatment as well as intermittent preventive therapy for ma- laria. The MICS3 results in Tajikistan indicate a low rate of bednet use: household availabil- ity of bednets is 5 percent and availability of insecticide treated nets is 2 percent. The highest rates were reported in Khatlon (8 percent) and Sogd (6 percent) while in other regions less than 1 percent of households had a bednet3. Two percent of children under the age of five had slept under a bednet the night prior to the survey and only 1 percent slept under an insecticide treated net (Table 10). ITN use among children under five was only practiced in households from the Khatlon region (3 percent). ITN were not used among children from Dushanbe, Sogd or the GBAO regions. Questions on the prevalence and treatment of fever were asked for all children under the age of five. Seven percent of children under five were ill with fever in the two weeks prior to the MICS3 fieldwork interview (Table 11). Fever prevalence declined with age and peaked at 12-23 months (10 percent). Fever was less common among children living in households from the richest quintile (6 percent) as compared to those from the poorest quintile (10 percent). There is no significant variation by gender, urban/rural area or level of mother’s education. 3 The table where these figures came from is not shown in this report, but will be shown in the final report. 26 Findings from Tajikistan Some regional differences in fever prevalence were observed, ranging from 5 percent in Sogd and Dushanbe to 11 percent in Khatlon (Figure 6). Mothers were asked to report all medicines, both those from home and those given/ pre- scribed at a health facility, given to a child to treat fever. Overall, 2 percent of children with fever in the two weeks prior to the field visits were treated with an ‘appropriate’ antimalarial drug and 1 percent received antimalarial drugs within 24 hours of the onset of symptoms. ‘Appropriate’ antimalarial drugs include: Chloroquine, Sulfadoxine-pyrimethamine (SP), ar- timisine combination drugs, etc. In Tajikistan, none of children with fever were given Chlo- roquine, quinine, Armodiaquine and less than 1 percent was given a SP/Fansidar and artimis- ine combination therapy. A large percentage of children (73 percent) were given other types of medicines that are not antimalarials, including anti-pyretics such as Paracetomal, Aspirin or Ibuprofen. Girls were more likely to receive appropriate antimalarial drugs as compared to boys. There was no significant variation of appropriate anti-malaria treatment of children with fever by regions, urban/rural areas, mother’s education or wealth of the households. According to the MICS 2000 data, both the percentage of children who slept under a bednet (6 percent) and percentage of children receiving appropriate anti-malaria treatment (69 percent) were higher as compared to recent estimates in Tajikistan. Figure 6: Percentage of children 0-59 months who slept under a bednet previous night and percent of children who had fever, Tajikistan, 2005 4.8 10.6 4.5 6.2 8 0.1 3.4 0.8 0.3 0 0 3.2 0 0.1 0 0 5 10 15 Dushanbe Khatlon Sogd RRS GBAO Percent Percent of children 0-59 months who slept under an ITN Percent of children 0-59 months who slept under a bednet Percent of children 0-59 months with fever Figure 6: Percentage of children 0-59 months who slept under a bednet previous night and percent of children who had fever, Tajikistan, 2005 4.8 10.6 4.5 6.2 8 0.1 3.4 0.8 0.3 0 0 3.2 0 0.1 0 0 5 10 15 Dushanbe Khatlon Sogd RRS GBAO Percent Percent of children 0-59 months who slept under an ITN Percent of children 0-59 months who slept under a bednet Percent of children 0-59 months with fever 2� Multiple Indicator Cluster Survey 2005 Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a sig- nificant carrier of diseases such as trachoma, cholera, typhoid, and schistosomiasis. Drinking water can also be tainted with chemical, physical and radiological contaminants. In addition to its association with disease, access to drinking water may be particularly important for women and children, particularly in rural areas, who bear the primary responsibility for car- rying water, often for long distances. The distribution of the population by source of drinking water is shown in Table 12. According to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation Assess- ment, conducted in 2000, the population using improved drinking water sources are those who use any of the following types of supply: piped water, public tap, borehole/ tubewell, protected well, protected spring or rainwater. Overall, 70 percent of the population had access to improved drinking water sources – 93 percent in urban areas and 61 percent in rural areas. The situation in the GBAO and Khatlon regions was considerably worse than in other areas; only 52-55 per- cent of the population in these regions got its drinking water from an improved source. The source of drinking water for the population varied strongly by region (Table 12). In Dushanbe, 93 percent of the population used drinking water that was piped into their dwell- ing or into their yard or plot. The National Report for 2005 done by the Dushanbe Sanitary Epidemiological Station showed that 99 percent of the population used piped water. However, it is worth mentioning that supplied pipe water, particularly that in Dushanbe, comes from surface sources without being exposed to routine cleaning procedures. In DRD 39 percent of population used piped water, while in Sogd and Khatlon that proportion was 27 and 28 percent respectively. In contrast, only about 15 percent of those residing in GBAO had piped water. In Sogd the most important source of drinking water was public taps while in Khatlon and GBAO four out of ten households used river or stream water (an unsafe source). The percentage of the population using an improved source of drinking water has in- creased in comparison to the MICS 2000 when the figure was only 57 percent. Use of Figure 7: Percent distribution of the population by source of drinking water, Tajikistan, 2005 Piped into dwelling 22% Piped into yard 13% Public tap 23% Tubwell/ Protected well/ Protected spring 12% River/stream 24% Other 6% Figure 7: Percent distribution of the population by source of drinking water, Tajikistan, 2005 Piped into dwelling 22% Piped into yard 13% Public tap 23% Tubwell/ Protected well/ Protected spring 12% River/stream 24% Other 6% 28 Findings from Tajikistan public taps or standpipes has increased from 8 to 23 percent while surface water use has decreased from 33 to 25 percent. Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases including diarrhoeal diseases, typhoid fever, polio and parasitic invasions. Improved sanitation facilities include: flush toilets connected to a sewage systems septic tanks or pit latrines, ventilated improved pit latrines, pit latrines with slabs, and composting toilets. 94 percent of the population of Tajikistan is living in households using improved sanitation facili- ties (Table 13). This percentage is 97 in urban areas and 92 percent in rural areas. Residents of GBAO were much less likely than others to use improved facilities. Almost eight percent of household population there used bushes, fields, or had no facilities. In Dushanbe the most common facility were flush toilets with connection to a piped sewer system (73 percent), other areas of the country used pit latrines with slabs (62-86 percent). Contraception Information about knowledge and use of contraception methods was collected from female respondents by asking them to mention any ways or methods by which a couple might delay or avoid a pregnancy. Women that were not pregnant at the time of the survey were asked whether or not they were using any method of contraception. Current use of contraception was reported by 38 percent of women currently married or in union. One third of the women used modern methods that include female/male sterilization, the Pill, intrauterin device (IUD), injections, female/male condom and diaphragm/foam/jelly (Table 14). The most popular method is IUD which is used by one in four married wom- en in Tajikistan. The next most popular methods are the Lactational Amenorrhea Method (LAM), injectables and the Pill that accounts each for 2-3 percent of married women. Use of condom and withdrawal was reported by 1 percent of women and less than 1 percent use periodic abstinence, male/female sterilization, vaginal methods. Contraceptive prevalence was highest in the Sogd region at 46 percent. In Khatlon, Du- shanbe and GBAO from 35 to 39 percent of women used a method of contraception In the DRD contraceptive use was the lowest, only 29 percent of married women reported using any method. Adolescents are far less likely to use contraception than older women. Only about 9 percent of married or in union women aged 15-19 currently use a method of contraception compared to 25 percent of 20-24 year olds and 50 percent of women 35 to 49 years of age. Use of any contraception method varies significantly by number of living children from less than 1 per- cent among those with no children to 48 percent among women with 3 living children. Women’s education level is strongly associated with contraceptive prevalence. The percent- age of women using any method of contraception rises from 14 percent among those with no education to 25 percent among women with primary education, and to 30 - 51 percent among women with secondary or higher education. In addition to differences in prevalence, the con- traception method used varies by education. Less than one out of twenty contraceptive users with no or only primary education use the Pill. The Pill and condoms are used mainly by 2� Multiple Indicator Cluster Survey 2005 women with higher education, such as university (5 and 6 percent). LAM is mainly reported by women with little or no primary education (6-7 percent). In terms of trends, in the MICS 2000 the proportion of women using any method was some- what less (34 percent), while the figure for modern methods used was27 percent (Figure 8). Assistance at Delivery The provision of delivery assistance by skilled attendants can greatly improve the outcomes for mothers and infants with the use of technically appropriate procedures, accurate and speedy diagnosis and treatment of complications. Skilled assistance at delivery is defined as assistance provided by a doctor, nurse, midwife or auxiliary midwife. About 83 percent of births occurring in the two years prior to the MICS survey were delivered by skilled personnel (Table 15). This percentage was highest in the Sogd region (95 percent) and lowest in the Khatlon (75 percent) and GBAO (77 percent) regions. Skilled attendance was higher in urban areas (89 percent) as compared to rural areas (81 percent). The more educated a woman is, the more likely she is to have delivered with the assistance of a skilled person. Less than two thirds of women with little or primary education had their deliveries assisted by skilled personnel whereas almost all women with higher education ben- efited from skilled assistance at delivery. The age of women and wealth of the households were also important factors in skilled as- sistance at delivery. The numbers decrease gradually from 94 percent of women 15-19 years of age to less than 75 percent of women over 40 years of age. Only 69 percent of women from the poorest quintile had skilled assistance at delivery, while in the richest quintile this number was 91 percent. Figure 8: Percentage of women aged 15-49 years married or in union who are using (or whose partner is using) a contraceptive method, Tajikistan, 2005 27.3 6.6 33.933.1 4.9 38 0 20 40 Any modern method Any traditional method Any method Pe rc en t MICS 2000 MICS 2005 Figure 8: Percentage of women aged 15-49 years married or in union who are using (or whose partner is using) a contraceptive method, Tajikistan, 2005 27.3 6.6 33.933.1 4.9 38 0 20 40 Any modern method Any traditional method Any method Pe rc en t MICS 2000 MICS 2005 �0 Findings from Tajikistan Doctors assisted with the delivery of 61 percent of births. One in five of the births were delivered with assistance by a nurse or midwife. Overall, about 9 percent of births were de- livered by traditional birth attendants, but these births occurred mainly in GBAO, Khatlon and DRD where the type of personnel providing delivery assistance is noticeably different as compared to the other regions (Figure 9). In GBAO about 17 percent of births are delivered by traditional birth attendants and 5 percent by other persons, including relatives and friends. In Khatlon each of the above two categories accounts for 12 percent while in DRD those proportions are 10 and 7 percent respectively. Less than one out of a hundred births took place with no one in attendance. Unattended births occurred mainly in women over 35 years of age. Provision of delivery assistance by skilled attendants has improved when compared to MICS 2000, when 71 percent of births were assisted by skilled personnel. Percentage of deliveries assisted by a doctor has increased over the last five years by almost a third. Tajikistan has noted an important progress in providing skilled assistance at delivery; how- ever there is still room for further improvement. Primary School Attendance Universal access to basic education and the achievement of primary education for the world’s children is one of the most important aims 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 popu- lation growth. Overall, 89 percent of children of primary school age in Tajikistan are attending primary or secondary school (Table 16). There is no significant variation of the indicator in urban and Figure 9: Percent distribution of women aged 15-49 with a birth in two years before the survey by type of personnel assisting at delivery, Tajikistan, 2005 0% 20% 40% 60% 80% 100% Tajikistan Dushanbe Sogd Khatlon RRS GBAO No attendant Other Traditional birth attendant Nurse / Midwife Medical Doctor Figure 9: Percent distribution of women aged 15-49 with a birth in two years before the survey by type of personnel assisting at delivery, Tajikistan, 2005 0% 20% 40% 60% 80% 100% Tajikistan Dushanbe Sogd Khatlon RRS GBAO No attendant Other Traditional birth attendant Nurse / Midwife Medical Doctor �1 Multiple Indicator Cluster Survey 2005 rural areas. School attendance in the DRD region is the lowest (81 percent), followed by the Sogd region (86 percent). At the national level, there is virtually no difference between male and female primary school attendance rates. There is a significant variation of school attendance by the age of the child and mother’s education level. School attendance rates increase from 65 percent in 7 year old children to 98 percent in 10 year olds. It also rises gradually from 76 percent in children whose mothers have little or no education to 96 percent in children with mothers having attended a high school. The ratio of girls to boys attending primary and secondary education is provided in Table 17. The table shows that gender parity for primary school is close to 1.00, indicating no difference in the attendance of girls and boys to primary school. However, the indicator drops to 0.83 for secondary education. The disadvantage of girls is particularly pronounced in the Khat- lon, Dushanbe and DRD regions, as well as among children living in the poorest households and those whose mothers did not complete secondary school. In households with the head of household using Tajik as their mother tongue the gender parity index is 0.79. There is no significant difference in the gender parity index by urban/rural area. Birth Registration The International Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to protection from being deprived of his or her iden- tity. Birth registration is a fundamental means of securing these rights for children. In Tajikistan, the births of 88 percent of children less than five years of age have been regis- tered (Table 18). For this survey, 2 percent of respondents did not know whether the birth of their child was registered. Children in urban areas are somewhat less likely to have their births registered (85 percent) than children in rural areas (90 percent). The lowest birth reg- istration rates are observed in DRD and Dushanbe (81 and 83 percent) (Figure 10). Birth registration rate is lower in children under one (82 percent) and rises above 90 percent in chil- dren 24-59 months. Mother’s education is also an important determinant of birth registration. There is no significant variation in birth registration by sex. Among those whose children’s births are not registered, cost was the main reason account- ing for 42 percent or unregistered births while lack of time accounted for 16 percent. Missing other required documents (marriage certificate, passport) for birth registration was stated by 8 percent of respondents. Travel distance as well as lack of knowledge, both the need to register the birth and the place where registration is performed, appeared to explain almost one in ten unregistered births. Compared to the MICS 2000 data, where 75 percent of under-fives were registered, birth reg- istration seems to have achieved a noticeable progress in recent years. Costs related to birth registration remains the main reported obstacle to getting a birth certificate for their child. (Figure 10 on next page) �2 Findings from Tajikistan Early Marriage Child marriage is a violation of human rights, compromising the development of girls and of- ten resulting in early pregnancy and social isolation, with little education and poor vocational training reinforcing the gendered nature of poverty. Women married at a younger age are more likely to dropout of school, experience higher levels of fertility, domestic violence, and maternal mortality The percentage of women married at various ages is provided in Table 19. In Tajikistan only 1 percent of women reported marriage before the age of 15 years. It is worth mentioning a higher percentage of early marriage (2 percent) among women 25-29. It is also indicative that early marriage is more common to women that have not completed secondary education. Almost 15 percent of women in Tajikistan reported having been married before the age 18. In the GBAO region this indicator is the lowest (8 percent) and differs significantly from the rest of the country. There is also a significant variation in early marriage by woman accord- ing to their educational level. For instance, early marriage is seen in 28 percent of women with primary education and in only 5 percent of women with higher education. As in the case of marriage before 15, the highest prevalence rates of marriage before 18 (23 percent) is ob- served among women 25-29 years old and differs significantly from other age groups. More than one in five women that have not completed secondary education got married before the age of 18 as compared to one in twenty women with secondary, special or higher education. Women from the poorest quintile of households and Tajik women are also more likely to get married early. Figure 10: Percentage of children 0-59 months whose birth is registered, Tajikistan, 2005 75 88 83 90 94 81 91 0 20 40 60 80 100 Tajikistan Dushanbe Khatlon Sogd RRS GBAO Percent MICS2000 MICS2005 Figure 10: Percentage of children 0-59 months whose birth is registered, Tajikistan, 2005 75 88 83 90 94 81 91 0 20 40 60 80 100 Tajikistan Dushanbe Khatlon Sogd RRS GBAO Percent MICS2000 MICS2005 �� Multiple Indicator Cluster Survey 2005 At the time of the survey, 6 percent of women aged 15-19 reported being married or in a union. The lowest percentage was in GBAO (1 percent) and the highest (7-8 percents) was in Sogd and DRD. Woman’s educational level appears to be the most important factor influenc- ing this indicator. Knowledge of HIV/AIDS Transmission and Condom Use 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 toward raising awareness and giving young people the tools to protect themselves from infection. Abstaining from sex, being faithful to one uninfected part- ner, and using condoms are important ways to avoid the spread of HIV/AIDS. Misconcep- tions about HIV are common and can confuse young people and hinder prevention efforts. Different regions are likely to have variations in misconceptions although some appear to be universal (for example that sharing food or mosquito bites or supernatural means such as witchcraft can transmit HIV). Tajikistan currently is faced with an alarming increase in HIV/AIDS cases; the prevalence rate per 100,000 population is 7.8, which makes the country currently within the stage of a concentrated epidemic (Republican Aids Centre Official Data in 2006). According to the estimation from the Joint United Nations Programme on HIV/AIDS (UNAIDS), the real number of HIV cases in Tajikistan is 10 times higher than the official data. Eighty-four percent of HIV infection cases are young people aged 15-29. (UNICEF 2005 Tajikistan Annual Report). Women were asked whether they had heard of an illness called AIDS. As shown in Table 20, awareness of AIDS is rather low at 42 percent. Up to twofold differences of the indicator can be noticed by age group, residence, region and wealth index. However, there is a noticeable increase in awareness by level of education, with numbers rising from 6 to 84 percent. Table 20 presents the percentage of women aged 15-49 years who know at least 2 ways of pre- venting HIV transmission. Knowledge of HIV prevention methods is still fairly low although there are differences by region and area of residence. Overall, 17 percent of women report knowing two prevention methods while in urban areas 27 percent of women identified two methods. In DRD only 12 percent of respondents knew two ways to prevent HIV infection as compared to 23 percent in GBAO and 30 percent in Dushanbe. There is a significant varia- tion in the indicator by age of respondents from those aged 15-19 years (7 percent) to those aged 30-34 years (23 percent). The percent of women who know two prevention methods increased dramatically from 0 to 49 percent as the woman’s education level increased. Wealth of the household index and ethnicity appear to be the other determinants of knowledge of HIV prevention techniques. �� Findings from Tajikistan A key indicator used to measure countries’ responses to the HIV epidemic is the propor- tion of young people 15-24 years of age who know; two methods of preventing HIV, can properly identify two HIV/AIDS misconceptions and are aware of the fact that a healthy looking person can have HIV. Only 3 percent of young women (15-24 years) have compre- hensive correct knowledge of HIV. Generally HIV/AIDS awareness and accurate knowl- edge of how HIV is transmitted is lower among young women comparing to all women of reproductive age (Figure 11 on next page). Awareness of HIV/AIDS has increased two fold in Tajikistan since the MICS 2000 when the figure was 20 percent, yet the figure still remains low. Figure 11: Percentage of women 15-49 years and young women aged 15-24 years who have knowledge of HIV/AIDS transmission 42 17 8 5 30 11 5 3 0 20 40 60 Heard of AIDS Knows 2 ways to prevent HIV transmission Correctly identify 3 misconceptions Have comprehensive knowledge Pe rc en t Women 15-49 years Young women 15-24 years �5 Multiple Indicator Cluster Survey 2005 References Aleshina, Nadezdha & Redmond, Gerry (2003). How High is Infant Mortality Rate in Central and Eastern Europe and the CIS?. Innocenti Working Paper No. 95. Florence: UNICEF Innocenti Research Centre. Analytical and Information Centre, Ministry of Health of the Republic of Uzbekistan, State Department of Statistics, Ministry of Macroeconomics and Statistics (Uzbekistan) & ORC Macro. (2004) Uzbekistan Health Examination Survey 2002. Maryland: Analytical and Information Centre, State Department of Statistics & ORC Macro. Division of Reproductive Health/Centres for Disease Control (DRH/CDC) & ORC Macro/ DHS. (2003). Reproductive, Maternal and Child Health in Eastern Europe and Eurasia: A Comparative. Guerra, R., Ferrelli, R., Coclite, D. & Napoletano, A. (2004, October). Using Verbal Autopsy to Assess the Path to Infant and Maternal Death; A synthesis of two studies conducted in Tajikistan in 2002 and 2003. Dushanbe, Tajikistan: Ministry of Health: Tajikistan, Intituto Superiore di Sanita & UNICEF Tajikistan. http://www.childinfo.org http://www.euro.who.int/highlights http://www.euro.who.int/malaria Ministry of Health of Republic of Tajikistan; Medical Statistics and Information Centre. (2003) Health of population and health care of Republic of Tajikistan �990-2002. Dushanbe, Tajikistan. Report. Atlanta: U.S. Department of Health and Human Services. United Nations Children’s Fund. (2001). The status of women and children: Tajikistan, 2000 Multiple Indicator Cluster Survey. Kazakhstan: UNICEF. United Nations Children’s Fund & Government of Tajikistan. (2002, November 26). Report on the Mid-term Review of the Country Programme of Cooperation. Dushanbe, Tajikistan. World Health Organization. (2006) Highlights on health in Tajikistan 2005, EUR/05/5046415S. (2003, December 1). National Nutrition and Water and Sanitation Survey 2003, Tajikistan: Prelimenary Results. Dushanbe, Tajikistan. �6 Findings from Tajikistan Appendix one: Tables Table 1: Results of household and individual interviews Number of households, women, and children under 5 by results of the household, women’s and under-five’s interviews, and household, women’s and under-five’s response rates, Tajikistan, 2005 Residence Region Urban Rural Dushanbe Khatlon Sogd DRD GBAO Total Number of households Sampled 2,839 4,129 1,711 1,320 1,345 1,296 1,296 6,968 Occupied 2,836 4,125 1,710 1,319 1,342 1,296 1,294 6,961 Interviewed 2,677 4,007 1,594 1,285 1,297 1,269 1,239 6,684 Response rate 94.4 97.1 93.2 97.4 96.6 97.9 95.7 96.0 Number of women Eligible 3,750 6,876 2,074 2,297 2,087 2,200 1,968 10,626 Interviewed 3,593 6,650 2,031 2,244 1,999 2,165 1,804 10,243 Response rate 95.8 96.7 97.9 97.7 95.8 98.4 91.7 96.4 Overall response rate 90.4 93.9 91.3 95.2 92.6 96.4 87.8 92.6 Number of children under 5 Eligible 1,477 2,893 828 1,174 815 924 629 4,370 Mother/Caretaker interviewed 1,437 2,836 814 1,154 794 910 601 4,273 Response rate 97.3 98.0 98.3 98.3 97.4 98.5 95.5 97.8 Overall response rate 91.8 95.2 91.6 95.8 94.2 96.4 91.5 93.9 Table 2: Child mortality Infant and under-five mortality rates, Tajikistan, 2005 Infant mortality rate* Under-five mortality rate** Sex Male 75 92 Female 54 66 Region Dushanbe 50 59 Khatlon 81 102 Sogd 61 73 DRD 47 57 GBAO 46 54 Residence Urban 58 70 Rural 68 83 Women’s education None/Primary 75 95 Incomplete Secondary 73 91 Complete Secondary 63 76 Secondary special 56 67 Higher education 13 14 Wealth index quintiles Poorest 60% 78 98 Richest 40% 48 57 Total 65 79 * MICS indicator 2; MDG indicator 14 ** MICS indicator 1; MDG indicator 13 �� Multiple Indicator Cluster Survey 2005 Table 3: Child malnourishment Percentage of children aged 0-59 months who are severely or moderately malnourished, Tajikistan, 2005 Weight for age Height for age Weight for height Number of children aged 0-59 months % below % below % below % below % below % below % above - 2 SD* - 3 SD* - 2 SD** - 3 SD** - 2 SD*** - 3 SD*** + 2 SD Sex Male 17.6 4.2 28.2 10.4 7.1 2.0 3.5 2,053 Female 17.1 3.0 25.6 7.7 7.2 1.1 3.6 1,983 Region Dushanbe 13.3 2.7 20.6 8.9 6.8 1.4 5.6 322 Khatlon 20.2 4.8 29.0 10.0 9.2 2.5 3.1 1,613 Sogd 15.3 2.4 28.9 9.7 4.0 0.3 5.9 1,126 DRD 16.1 3.4 22.8 6.4 7.8 1.4 0.8 892 GBAO 20.0 4.5 29.7 11.6 5.2 1.1 3.0 83 Residence Urban 17.2 3.2 26.1 9.3 7.4 2.4 4.0 1,064 Rural 17.4 3.8 27.2 9.0 7.1 1.2 3.4 2,972 Age < 6 months 4.6 1.1 10.8 1.2 8.8 1.6 8.5 349 6-11 months 20.1 3.4 19.4 4.7 11.1 1.6 2.6 411 12-23 months 30.2 7.8 28.3 11.8 16.1 3.9 3.8 771 24-35 months 19.8 4.9 28.3 9.9 6.0 1.2 3.4 845 36-47 months 12.5 1.8 30.4 9.8 2.6 0.7 3.2 837 48-59 months 11.8 1.3 31.3 10.6 2.0 0.5 2.3 821 Mother’s education None/Non- standard [26.8] - [27.7] [12.1] [7.6] - [3.2] 38 Primary 13.4 4.5 27.5 6.6 3.6 1.8 6.3 85 Incomplete Secondary 16.7 3.3 25.6 7.7 7.0 0.7 3.0 1,109 Complete Secondary 18.1 4.3 28.8 10.0 7.7 1.9 3.8 2,296 Secondary special 17.6 1.4 22.6 9.7 6.6 2.9 4.4 289 Higher education 12.4 1.0 19.4 6.3 4.4 0.5 2.4 218 Wealth index quintiles Poorest 22.4 4.7 31.9 12.9 7.6 1.4 4.7 837 Second 18.2 4.3 28.2 8.9 7.6 2.4 3.1 770 Middle 18.1 3.5 29.1 7.7 8.6 1.2 2.0 804 Fourth 14.3 3.1 24.7 8.5 6.9 1.4 3.9 818 Richest 13.7 2.5 20.6 7.4 5.1 1.4 4.0 806 �8 Findings from Tajikistan Percentage of children aged 0-59 months who are severely or moderately malnourished, Tajikistan, 2005 Weight for age Height for age Weight for height Number of children aged 0-59 months % below % below % below % below % below % below % above - 2 SD* - 3 SD* - 2 SD** - 3 SD** - 2 SD*** - 3 SD*** + 2 SD Ethnicity/Language Tajik 17.6 4.0 27.5 9.8 8.0 1.8 3.5 2,893 Uzbek 16.9 2.5 25.7 7.5 5.1 0.8 3.7 1,054 Other 14.7 4.1 21.3 6.6 3.9 1.1 4.2 88 Total 17.3 3.6 26.9 9.1 7.2 1.6 3.6 4,036 * MICS indicator 6; MDG indicator 4 ** MICS indicator 7 *** MICS indicator 8 [ ] Figures that are based on 25-49 unweighted cases �� Multiple Indicator Cluster Survey 2005 T ab le 4 : C hi ld a cu te m al nu tr iti on * Pe rc en ta ge o f c hi ld re n 12 t o 59 m on th s of a ge e xp os ed t o ac ut e se ve re o r m od er at e m al nu tr it io n, T aj ik is ta n, 2 00 5 M U A C ** O ed em a W ei gh t fo r he ig ht : (W H Z ** *) G lo ba l A cu te M al nu tr it io n: Se ve re A cu te M al nu tr it io n: N um be r of ch ild re n % < 11 0 m m % 11 0- 11 9 m m % 12 0- 12 4 m m % 12 5- 13 4 m m % > = 13 5 m m % % be lo w -2 SD % be lo w -3 SD % ab ov e + 2S D % W H Z < - 2S D o r M U A C < 12 5m m % W H Z < - 2S D or M U A C < 12 5m m or O ed em a % W H Z < - 3S D o r M U A C < 11 0m m % W H Z < -3 SD o r M U A C < 11 0m m or O ed em a Se x M al e 0. 6 1. 6 2. 1 9. 3 86 .4 1. 5 6. 9 2. 2 3. 3 9. 4 10 .7 2. 8 4. 1 1, 68 8 Fe m al e 1. 0 1. 4 2. 5 9. 9 85 .2 2. 8 6. 1 0. 9 3. 1 9. 2 11 .6 1. 7 4. 5 1, 58 7 R eg io n D us ha nb e - - 1. 9 5. 2 92 .8 2. 8 6. 4 1. 3 5. 2 8. 1 10 .7 1. 3 4. 1 26 1 K ha tl on 1. 4 2. 2 3. 1 11 .1 82 .2 1. 9 8. 4 2. 7 2. 5 12 .4 13 .8 3. 9 5. 6 1, 28 9 So gd 0. 7 1. 5 1. 7 10 .7 85 .4 2. 8 4. 2 0. 3 5. 4 6. 9 9. 4 1. 0 3. 7 92 2 D R D 0. 2 0. 9 1. 7 6. 8 90 .4 1. 4 6. 3 1. 2 0. 9 7. 6 8. 9 1. 4 2. 8 73 5 G B A O 0. 6 0. 7 1. 3 13 .8 83 .6 1. 6 4. 7 1. 2 2. 5 6. 7 7. 9 1. 9 3. 4 68 R es id en ce U rb an 1. 5 1. 3 2. 0 7. 7 87 .5 2. 1 7. 3 2. 5 3. 6 10 .9 12 .6 4. 0 5. 9 90 0 R ur al 0. 5 1. 6 2. 4 10 .4 85 .2 2. 1 6. 2 1. 2 3. 0 8. 7 10 .5 1. 6 3. 7 2, 37 5 A ge 12 -2 3 m on th s 2. 5 4. 8 5. 5 22 .5 64 .7 3. 3 16 .1 3. 9 3. 8 22 .7 25 .5 6. 0 9. 3 77 1 24 -3 5 m on th s 0. 6 1. 3 2. 7 10 .5 84 .9 1. 9 6. 0 1. 2 3. 4 9. 6 11 .0 1. 8 3. 6 84 5 36 -4 7 m on th s - 0. 0 1. 1 5. 0 93 .9 1. 8 2. 6 0. 7 3. 2 3. 6 5. 2 0. 7 2. 6 83 7 48 -5 9 m on th s 0. 2 0. 1 - 1. 3 98 .3 1. 5 2. 0 0. 5 2. 3 2. 3 3. 7 0. 7 2. 2 82 1 H ei gh t < 7 5c m 4. 1 9. 7 9. 9 30 .8 45 .5 3. 6 19 .9 3. 1 8. 0 32 .4 35 .2 6. 5 10 .2 30 0 > = 75 cm 0. 5 0. 7 1. 5 7. 5 89 .9 1. 9 5. 1 1. 4 2. 7 7. 0 8. 7 1. 8 3. 7 2, 97 5 �0 Findings from Tajikistan Pe rc en ta ge o f c hi ld re n 12 t o 59 m on th s of a ge e xp os ed t o ac ut e se ve re o r m od er at e m al nu tr it io n, T aj ik is ta n, 2 00 5 M U A C ** O ed em a W ei gh t fo r he ig ht : (W H Z ** *) G lo ba l A cu te M al nu tr it io n: Se ve re A cu te M al nu tr it io n: N um be r of ch ild re n % < 11 0 m m % 11 0- 11 9 m m % 12 0- 12 4 m m % 12 5- 13 4 m m % > = 13 5 m m % % be lo w -2 SD % be lo w -3 SD % ab ov e + 2S D % W H Z < - 2S D o r M U A C < 12 5m m % W H Z < - 2S D or M U A C < 12 5m m or O ed em a % W H Z < - 3S D o r M U A C < 11 0m m % W H Z < -3 SD o r M U A C < 11 0m m or O ed em a M ot he r’ s ed uc at io n N on e/ N on -s ta nd ar d - - [4 .5 ] [2 1. 0] [7 4. 5] - [6 .2 ] - - [1 0. 7] [1 0. 7] - - 32 Pr im ar y - 2. 4 4. 3 8. 3 85 .0 1. 2 4. 9 2. 5 6. 2 9. 2 10 .4 2. 5 3. 7 63 In co m pl et e Se co nd ar y 0. 3 1. 8 1. 6 10 .1 86 .1 2. 8 5. 9 0. 6 2. 7 8. 2 10 .3 1. 0 3. 6 86 7 C om pl et e Se co nd ar y 0. 8 1. 5 2. 6 9. 7 85 .4 2. 1 7. 0 1. 9 3. 5 9. 8 11 .6 2. 6 4. 6 1, 89 6 Se co nd ar y sp ec ia l 3. 0 0. 6 1. 9 6. 7 87 .7 1. 4 6. 2 3. 0 2. 7 11 .3 12 .7 6. 0 7. 4 23 8 H ig he r ed uc at io n 0. 1 1. 1 1. 6 8. 5 88 .6 0. 6 4. 9 0. 6 2. 5 7. 2 7. 7 0. 7 1. 3 17 9 W ea lt h in de x qu in ti le s Po or es t - 2. 1 4. 2 14 .5 79 .2 1. 5 7. 3 1. 4 4. 2 11 .5 12 .7 1. 4 2. 9 66 3 Se co nd 0. 9 1. 3 2. 1 10 .3 85 .5 3. 0 6. 5 2. 2 3. 4 8. 0 10 .5 3. 0 6. 0 62 5 M id dl e 0. 7 2. 2 1. 4 9. 5 86 .3 1. 9 6. 9 1. 1 1. 8 9. 1 10 .8 1. 7 3. 7 63 9 Fo ur th 1. 1 1. 3 2. 4 8. 4 86 .7 2. 0 7. 1 1. 5 2. 8 10 .0 11 .4 2. 3 4. 0 66 3 R ic he st 1. 3 0. 6 1. 3 5. 6 91 .2 2. 2 4. 8 1. 5 3. 5 7. 8 10 .0 2. 8 5. 0 68 5 �1 Multiple Indicator Cluster Survey 2005 Pe rc en ta ge o f c hi ld re n 12 t o 59 m on th s of a ge e xp os ed t o ac ut e se ve re o r m od er at e m al nu tr it io n, T aj ik is ta n, 2 00 5 M U A C ** O ed em a W ei gh t fo r he ig ht : (W H Z ** *) G lo ba l A cu te M al nu tr it io n: Se ve re A cu te M al nu tr it io n: N um be r of ch ild re n % < 11 0 m m % 11 0- 11 9 m m % 12 0- 12 4 m m % 12 5- 13 4 m m % > = 13 5 m m % % be lo w -2 SD % be lo w -3 SD % ab ov e + 2S D % W H Z < - 2S D o r M U A C < 12 5m m % W H Z < - 2S D or M U A C < 12 5m m or O ed em a % W H Z < - 3S D o r M U A C < 11 0m m % W H Z < -3 SD o r M U A C < 11 0m m or O ed em a Et hn ic it y/ La ng ua ge Ta jik 0. 9 1. 6 2. 7 9. 4 85 .3 2. 3 7. 4 1. 8 3. 2 10 .7 12 .6 2. 7 4. 9 2, 38 0 U zb ek 0. 5 1. 2 1. 0 10 .5 86 .8 1. 5 4. 2 0. 9 3. 1 5. 8 7. 1 1. 2 2. 7 82 5 O th er 0. 6 0. 2 0. 8 7. 1 91 .3 2. 1 4. 0 0. 9 3. 9 5. 1 6. 7 1. 5 3. 6 70 To ta l 0. 8 1. 5 2. 3 9. 6 85 .8 2. 1 6. 5 1. 6 3. 2 9. 3 11 .1 2. 3 4. 3 3, 27 5 * C ou nt ry s pe ci fic in di ca to rs ** M U A C = M id dl e up pe r ar m c ir cu m fe re nc e ** *W H Z - W ei gh t fo r he ig ht Z s co re [ ] Fi gu re s th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s �2 Findings from Tajikistan Ta bl e 5: B re as tf ee di ng Pe rc en ta ge o f l iv in g ch ild re n ac co rd in g to b re as tf ee di ng s ta tu s at e ac h ag e gr ou p, T aj ik is ta n, 2 00 5 C hi ld re n 0- 3 m on th s C hi ld re n 0- 5 m on th s C hi ld re n 6- 9 m on th s C hi ld re n 12 -1 5 m on th s C hi ld re n 20 -2 3 m on th s Pe rc en t ex cl us iv el y br ea st fe d N um be r of ch ild re n Pe rc en t ex cl us iv el y br ea st fe d* N um be r of ch ild re n Pe rc en t re ce iv in g br ea st m ilk a nd so lid / m us hy fo od ** N um be r of ch ild re n Pe rc en t br ea st fe d* ** N um be r of ch ild re n Pe rc en t br ea st fe d* ** N um be r of ch ild re n Se x M al e 43 .2 11 9 27 .9 19 2 17 .8 16 1 79 .0 15 9 40 .5 13 7 Fe m al e 28 .9 12 6 23 .0 20 1 12 .6 14 7 70 .6 14 9 26 .7 11 6 R eg io n D us ha nb e [2 3. 8] 19 17 .0 33 17 .6 21 58 .8 23 [3 6. 4] 19 K ha tl on 33 .5 89 19 .8 17 0 4. 4 14 6 78 .8 10 0 35 .2 11 0 So gd 49 .5 84 44 .5 10 7 [4 2. 3] 69 78 .5 10 9 [2 9. 0] 71 D R D 19 .6 49 12 .6 77 10 .2 68 67 .8 69 38 .0 49 G B A O [6 1. 0] 4 51 .1 7 [2 4. 2] 5 [8 9. 1] 7 [3 9. 2] 4 R es id en ce U rb an 33 .3 56 23 .8 84 23 .5 66 72 .7 80 35 .3 63 R ur al 36 .6 18 9 25 .9 31 0 13 .1 24 3 75 .7 22 8 33 .8 19 0 M ot he r’ s ed uc at io n N on e / P ri m ar y * 7 * 18 * 13 * 12 * 3 In co m pl et e Se co nd ar y 36 .9 94 26 .7 13 5 9. 9 89 73 .3 93 26 .5 79 C om pl et e Se co nd ar y 39 .5 11 0 28 .2 19 2 14 .8 17 1 80 .3 17 3 37 .9 14 6 Se co nd ar y sp ec ia l & hi gh er e du ca tio n [2 8. 0] 34 19 .7 49 [3 1. 5] 36 [5 5. 3] 31 [3 4. 5] 26 W ea lt h in de x qu in ti le s Po or es t [3 1. 1] 59 25 .6 95 13 .4 70 74 .8 71 37 .4 62 Se co nd [3 8. 9] 49 29 .4 80 [1 4. 3] 50 [8 2. 3] 59 [4 0. 8] 40 M id dl e [4 9. 7] 48 29 .9 82 11 .3 72 82 .6 67 33 .8 56 Fo ur th 22 .9 52 15 .9 77 18 .8 64 67 .0 60 [2 6. 5] 42 R ic he st 39 .4 38 26 .1 60 20 .2 52 66 .0 52 32 .1 53 �� Multiple Indicator Cluster Survey 2005 Pe rc en ta ge o f l iv in g ch ild re n ac co rd in g to b re as tf ee di ng s ta tu s at e ac h ag e gr ou p, T aj ik is ta n, 2 00 5 C hi ld re n 0- 3 m on th s C hi ld re n 0- 5 m on th s C hi ld re n 6- 9 m on th s C hi ld re n 12 -1 5 m on th s C hi ld re n 20 -2 3 m on th s Pe rc en t ex cl us iv el y br ea st fe d N um be r of ch ild re n Pe rc en t ex cl us iv el y br ea st fe d* N um be r of ch ild re n Pe rc en t re ce iv in g br ea st m ilk a nd so lid / m us hy fo od ** N um be r of ch ild re n Pe rc en t br ea st fe d* ** N um be r of ch ild re n Pe rc en t br ea st fe d* ** N um be r of ch ild re n Et hn ic it y/ La ng ua ge Ta jik 38 .7 16 6 26 .3 26 9 15 .1 20 7 75 .1 22 5 37 .7 18 7 U zb ek 27 .9 73 21 .8 11 4 13 .1 96 75 .2 79 23 .5 62 O th er * 6 [4 3. 2] 11 [5 7. 7] 6 * 5 * 4 To ta l 35 .9 24 5 25 .5 39 3 15 .3 30 9 74 .9 30 8 34 .2 25 3 * M IC S in di ca to r 15 ** M IC S in di ca to r 17 ** * M IC S in di ca to r 16 * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. [ ] Fi gu re s th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s �� Findings from Tajikistan Ta bl e 6: Io di ze d sa lt co ns um pt io n Pe rc en ta ge o f h ou se ho ld s co ns um in g ad eq ua te ly io di ze d sa lt , T aj ik is ta n, 2 00 5 Pe rc en t of ho us eh ol ds in w hi ch sa lt w as t es te d N um be r of ho us eh ol ds in te rv ie w ed Pe rc en t of h ou se ho ld s w it h To ta l N um be r of h ou se ho ld s in w hi ch s al t w as t es te d or w it h no s al t N o sa lt Sa lt te st r es ul t 0 PP M < 1 5 PP M 15 + P PM * R eg io n D us ha nb e 98 .8 74 9 0. 3 15 .5 28 .8 55 .5 10 0. 0 74 2 K ha tl on 99 .3 2, 09 2 0. 2 40 .4 32 .6 26 .8 10 0. 0 2, 08 1 So gd 99 .3 2, 20 1 0. 4 11 .2 13 .0 75 .4 10 0. 0 2, 19 5 D R D 99 .7 1, 44 0 0. 3 57 .2 16 .2 26 .3 10 0. 0 1, 44 0 G B A O 98 .0 20 2 0. 8 22 .7 32 .1 44 .4 10 0. 0 20 0 R es id en ce U rb an 99 .2 2, 19 8 0. 3 18 .7 21 .7 59 .4 10 0. 0 2, 18 7 R ur al 99 .3 4, 48 6 0. 4 37 .1 22 .4 40 .1 10 0. 0 4, 47 2 Ed uc at io n of h ou se ho ld h ea d N on e 10 0. 0 25 0 - 38 .5 18 .2 43 .3 10 0. 0 25 0 Pr im ar y 99 .4 33 7 0. 4 37 .0 24 .1 38 .5 10 0. 0 33 6 In co m pl et e Se co nd ar y 98 .7 83 2 0. 3 38 .0 20 .8 40 .9 10 0. 0 82 4 C om pl et e Se co nd ar y 99 .2 2, 70 8 0. 5 30 .3 21 .5 47 .7 10 0. 0 2, 70 0 Se co nd ar y sp ec ia l 99 .5 1, 15 5 0. 3 32 .7 24 .9 42 .1 10 0. 0 1, 15 3 H ig he r ed uc at io n 99 .4 1, 38 1 0. 2 24 .3 22 .4 53 .1 10 0. 0 1, 37 6 N on -s ta nd ar d /M is si ng /D K * * * * * * * 21 W ea lt h in de x qu in ti le s Po or es t 99 .2 1, 14 9 0. 4 42 .7 25 .8 31 .0 10 0. 0 1, 14 5 Se co nd 99 .3 1, 22 9 0. 4 40 .7 21 .0 37 .9 10 0. 0 1, 22 7 M id dl e 99 .4 1, 27 1 0. 3 34 .3 22 .7 42 .6 10 0. 0 1, 26 7 Fo ur th 99 .5 1, 29 3 0. 2 29 .3 20 .3 50 .1 10 0. 0 1, 29 0 R ic he st 99 .2 1, 74 1 0. 2 15 .4 21 .6 62 .7 10 0. 0 1, 73 1 To ta l 99 .3 6 ,6 84 0. 3 31 .1 22 .2 46 .4 10 0. 0 6, 65 9 * M IC S in di ca to r 41 A de qu at el y io di ze d sa lt is d efi ne d as s al t th at c on ta in s at le as t 15 p ar ts p er m ill io n of io di ne . If a ho us eh ol d ha s sa lt , b ut it is n ot t es te d (S I1 = 7) , t he se h ou se ho ld s ar e om it te d fr om t he d en om in at or o f t he in di ca to r. * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. �5 Multiple Indicator Cluster Survey 2005 T ab le 7 : V ac ci na tio ns in fi rs t y ea r of li fe Pe rc en ta ge o f c hi ld re n ag ed 1 5- 26 m on th s im m un iz ed a ga in st c hi ld ho od d is ea se s at a ny t im e be fo re t he s ur ve y an d be fo re t he fi rs t bi rt hd ay , T aj ik is ta n, 2 00 5 Pe rc en ta ge o f c hi ld re n w ho r ec ei ve d: N um be r of ch ild re n ag ed 15 -2 6 m on th s B C G * D PT 1 D PT 2 D PT 3* * Po lio 0 Po lio 1 Po lio 2 Po lio 3* ** M ea sl es ** ** H ep B1 H ep B2 H ep B 3* ** ** A ll* ** ** * N on e V ac ci na te d at a ny t im e be fo re t he s ur ve y A cc or di ng t o : V ac ci na tio n ca rd 81 .6 82 .2 81 .3 80 .6 79 .4 81 .8 80 .9 79 .4 72 .1 71 .9 69 .8 66 .9 67 .4 0. 0 78 9 M ot he r’ s re po rt 13 .9 11 .0 8. 9 5. 5 9. 7 11 .1 8. 1 3. 0 16 .5 12 .1 9. 1 5. 3 9. 4 3. 7 78 9 Ei th er 95 .5 93 .2 90 .1 86 .1 89 .1 92 .9 89 .0 82 .4 88 .6 84 .0 78 .9 72 .3 76 .8 3. 7 78 9 V ac ci na te d by 1 2 m on th s of a ge 95 .1 91 .4 87 .0 82 .1 86 .6 91 .6 86 .9 79 .3 85 .6 83 .4 77 .0 68 .5 69 .3 3. 7 78 9 * M IC S in di ca to r 25 ** M IC S in di ca to r 27 ** * M IC S in di ca to r 26 ** ** M IC S in di ca to r 28 ; M D G in di ca to r 15 ** ** M ea sl es v ac ci na tio n be fo re t he a ge o f 1 5 m on th s ** ** * M IC S in di ca to r 29 ** ** ** M IC S in di ca to r 31 ( C hi ld re n w ho r ec ei ve d ‘a ll’ v ac ci na tio ns a re t ho se w ho h av e re ce iv ed 3 d os es o f D PT , 3 d os es o f P ol io ( ex cl ud in g Po lio 0 ), B C G , a nd M ea sl es ) �6 Findings from Tajikistan Table 8: Antibiotic treatment of pneumonia Percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment, Tajikistan, 2005 Percentage of children aged 0-59 months with suspected pneumonia who received antibiotics in the last two weeks* Number of children aged 0-59 months with suspected pneumonia in the two weeks prior to the survey Sex Male [36,3] 38 Female [46,0] 30 Residence Urban [55,1] 22 Rural [33,7] 46 Total 40,6 68 * MICS indicator 22 [ ] Figures that are based on 25-49 unweighted cases �� Multiple Indicator Cluster Survey 2005 Ta bl e 9: S ol id fu el u se Pe rc en t di st ri bu tio n of h ou se ho ld s ac co rd in g to t yp e of c oo ki ng fu el , a nd p er ce nt ag e of h ou se ho ld s us in g so lid fu el s fo r co ok in g, T aj ik is ta n, 2 00 5 Pe rc en ta ge o f h ou se ho ld s us in g: El ec tr ic it y Li qu ifi ed Pe tr ol eu m G as (L PG ) N at ur al G as K er os en e C oa l, lig ni te C ha rc oa l W oo d St ra w , sh ru bs , gr as s A ni m al du ng A gr ic ul tu ra l cr op re si du e O th er so ur ce To ta l So lid fu el s fo r co ok in g* N um be r of ho us eh ol ds R eg io n D us ha nb e 71 .7 17 .2 10 .1 0. 0 0. 0 0. 0 0. 9 0. 0 0. 0 0. 0 0. 0 10 0. 0 0. 9 74 9 K ha tl on 66 .2 3. 5 2. 4 0. 0 0. 7 0. 0 7. 2 6. 0 6. 0 8. 0 0. 1 10 0. 0 27 .9 2, 09 2 So gd 13 .9 0. 7 33 .7 0. 0 1. 4 0. 0 49 .3 0. 0 0. 8 0. 1 0. 1 10 0. 0 51 .6 2, 20 1 D R D 56 .0 5. 9 4. 0 0. 0 0. 2 0. 0 30 .0 0. 2 3. 5 0. 0 0. 0 10 0. 0 34 .0 1, 44 0 G B A O 38 .4 0. 3 0. 0 1. 1 0. 3 0. 0 46 .4 6. 7 6. 6 0. 0 0. 2 10 0. 0 60 .0 20 2 R es id en ce U rb an 52 .0 10 .5 29 .8 0. 0 0. 4 0. 0 6. 5 0. 1 0. 5 0. 0 0. 1 10 0. 0 7. 5 2, 19 8 R ur al 43 .9 1. 6 6. 0 0. 0 0. 9 0. 0 36 .2 3. 1 4. 4 3. 8 0. 0 10 0. 0 48 .4 4, 48 6 Ed uc at io n of h ou se ho ld h ea d N on e 42 .2 3. 3 13 .0 0. 0 0. 0 0. 0 32 .6 0. 7 1. 9 6. 4 0. 0 10 0. 0 41 .6 25 0 Pr im ar y 46 .2 0. 6 10 .7 0. 1 0. 8 0. 0 29 .2 3. 1 5. 1 4. 2 0. 0 10 0. 0 42 .4 33 7 In co m pl et e Se co nd ar y 41 .4 3. 2 11 .2 0. 2 0. 7 0. 0 32 .8 2. 9 5. 3 2. 3 0. 0 10 0. 0 44 .0 83 2 C om pl et e Se co nd ar y 41 .8 4. 0 14 .0 0. 0 0. 9 0. 0 31 .9 1. 7 2. 8 2. 8 0. 1 10 0. 0 40 .1 2, 70 8 Se co nd ar y sp ec ia l 57 .1 5. 1 12 .0 0. 0 0. 1 0. 0 16 .5 3. 0 3. 4 2. 6 0. 1 10 0. 0 25 .6 1, 15 5 H ig he r ed uc at io n 51 .3 7. 1 17 .3 0. 0 1. 2 0. 0 18 .5 1. 8 1. 9 1. 0 0. 0 10 0. 0 24 .3 1, 38 1 N on -s ta nd ar d /M is si ng /D K * * * * * * * * * * * * * 21 W ea lt h in de x qu in ti le s Po or es t 29 .3 - 0. 1 - 0. 9 48 .9 5. 7 9. 0 6. 1 - 10 0. 0 70 .5 1, 14 9 Se co nd 42 .9 0. 4 1. 8 0. 0 1. 5 41 .9 2. 7 4. 5 4. 0 0. 1 10 0. 0 54 .7 1, 22 9 M id dl e 51 .9 1. 1 6. 0 0. 0 1. 0 33 .2 2. 2 2. 2 2. 2 0. 1 10 0. 0 40 .9 1, 27 1 Fo ur th 54 .5 2. 8 18 .5 0. 1 0. 5 19 .3 1. 1 1. 5 1. 6 0. 0 10 0. 0 24 .0 1, 29 3 R ic he st 50 .8 14 .2 33 .6 0. 0 0. 2 1. 2 0. 0 0. 1 - - 10 0. 0 1. 4 1, 74 1 �8 Findings from Tajikistan Pe rc en t di st ri bu tio n of h ou se ho ld s ac co rd in g to t yp e of c oo ki ng fu el , a nd p er ce nt ag e of h ou se ho ld s us in g so lid fu el s fo r co ok in g, T aj ik is ta n, 2 00 5 Pe rc en ta ge o f h ou se ho ld s us in g: El ec tr ic it y Li qu ifi ed Pe tr ol eu m G as (L PG ) N at ur al G as K er os en e C oa l, lig ni te C ha rc oa l W oo d St ra w , sh ru bs , gr as s A ni m al du ng A gr ic ul tu ra l cr op re si du e O th er so ur ce To ta l So lid fu el s fo r co ok in g* N um be r of ho us eh ol ds Et hn ic it y/ La ng ua ge Ta jik 51 .7 5. 1 14 .2 0. 0 0. 6 0. 0 22 .5 1. 5 2. 5 1. 8 0. 1 10 0. 0 28 .9 4, 75 3 U zb ek 32 .4 2. 3 11 .4 0. 0 1. 2 0. 0 39 .4 3. 5 4. 7 5. 1 0. 0 10 0. 0 53 .9 1, 59 8 R us si an 55 .0 11 .9 33 .1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 10 0. 0 0. 1 16 0 K ir gi z 22 .1 0. 0 0. 0 3. 3 2. 8 0. 0 21 .1 40 .4 9. 7 0. 0 0. 6 10 0. 0 73 .9 27 O th er 32 .2 2. 8 9. 1 1. 0 0. 4 0. 0 45 .4 1. 5 7. 6 0. 0 0. 1 10 0. 0 54 .8 14 3 M is si ng * * * * * * * * * * * * * 3 To ta l 46 .6 4. 5 13 .8 0. 0 0. 8 0. 0 26 .5 2. 1 3. 1 2. 5 0. 0 10 0. 0 35 .0 6, 68 4 * M IC S in di ca to r 24 ; M D G In di ca to r 29 * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. �� Multiple Indicator Cluster Survey 2005 Table 10: Children sleeping under bednets Percentage of children aged 0-59 months who slept under an insecticide treated net during the previous night, Tajikistan, 2005 Percentage of children who: Number of children aged 0-59 months Slept under a bednet* Slept under an insecticide treated net** Slept under an untreated net Slept under a net but don’t know if treated Don’t know if slept under a net Did not sleep under a bednet Sex Male 2.1 1.6 0.5 0.0 0.1 97.8 2,168 Female 1.3 1.0 0.2 0.0 0.3 98.4 2,105 Region Dushanbe 0.1 0.0 0.1 0.0 0.1 99.8 336 Khatlon 3.4 3.2 0.2 0.0 0.3 96.3 1,714 Sogd 0.8 0.0 0.8 0.0 0.2 99.0 1,205 DRD 0.3 0.1 0.2 0.0 0.1 99.5 928 GBAO 0.0 0.0 0.0 0.0 0.0 100.0 90 Residence Urban 0.7 0.1 0.6 0.0 0.4 98.9 1,129 Rural 2.0 1.8 0.3 0.0 0.2 97.8 3,144 Total 1.7 1.3 0.3 0.0 0.2 98.1 4,273 * MICS indicator 38 ** MICS indicator 37; MDG indicator 22 50 Findings from Tajikistan Ta bl e 11 : T re at m en t o f c hi ld re n w ith a nt im al ar ia l d ru gs Pe rc en ta ge o f c hi ld re n ag ed 0 -5 9 m on th s w ho w er e ill w it h fe ve r in t he la st t w o w ee ks w ho r ec ei ve d an ti m al ar ia l d ru gs , T aj ik is ta n, 2 00 5 H ad a fe ve r in la st t w o w ee ks N um be r of ch ild re n ag ed 0- 59 m on th s C hi ld re n w it h a fe ve r in t he la st t w o w ee ks w ho w er e tr ea te d w it h: N um be r of c hi ld re n w it h fe ve r in la st t w o w ee ks A nt im al ar ia ls : O th er m ed ic at io ns : SP / Fa ns i- da r C hl or o - qu in e A m od ia - qu in e Q ui ni ne A rt em is - in in b as ed co m bi n- at io ns O th er an ti - m al ar ia l A ny ap pr op ri at e an ti m al ar ia l dr ug Pa ra ce ta m ol / Pa na do l/ A ce ta m in - op he n A sp ir in Ib u- pr o - fe n O th er D on ’t kn ow A ny ap pr op ri at e an ti m al ar ia l dr ug w it hi n 24 ho ur s of o ns et of s ym pt om s* Se x M al e 7. 9 2, 16 8 0. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 73 .1 18 .0 0. 0 7. 9 2. 6 0. 5 17 2 Fe m al e 6. 9 2, 10 5 0. 1 0. 0 0. 0 0. 0 0. 4 3. 1 3. 5 72 .2 12 .8 0. 1 14 .5 4. 2 2. 0 14 5 R eg io n D us ha nb e 4. 8 33 6 [1 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [3 .5 ] [1 .5 ] [5 .0 ] [7 5. 8] [1 1. 9] [0 .0 ] [9 .9 ] [0 .0 ] [1 .0 ] 16 K ha tl on 10 .6 1, 71 4 0. 0 0. 0 0. 0 0. 0 0. 0 2. 3 2. 3 69 .7 16 .8 0. 0 6. 7 3. 8 1. 5 18 2 So gd 4. 5 1, 20 5 [1 .7 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [1 .7 ] [9 3. 4] [1 0. 8] [0 .0 ] [1 2. 6] [2 .9 ] [1 .7 ] 54 D R D 6. 2 92 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 62 .8 16 .9 0. 0 23 .8 3. 1 0. 0 58 G B A O 8. 0 90 [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [6 6. 8] [1 6. 9] [2 .4 ] [1 .9 ] [4 .0 ] [0 .0 ] 7 R es id en ce U rb an 6. 7 1, 12 9 0. 2 0. 0 0. 0 0. 0 0. 8 0. 3 1. 1 80 .5 10 .1 0. 0 10 .7 1. 5 0. 2 76 R ur al 7. 7 3, 14 4 0. 4 0. 0 0. 0 0. 0 0. 0 1. 8 2. 1 70 .3 17 .3 0. 1 10 .9 3. 9 1. 5 24 1 A ge 0- 11 m on th s 9. 2 84 1 0. 2 0. 0 0. 0 0. 0 0. 2 0. 0 0. 2 76 .9 9. 2 0. 2 11 .5 5. 1 0. 2 77 12 -2 3 m on th s 9. 7 83 6 0. 0 0. 0 0. 0 0. 0 0. 0 1. 8 1. 8 79 .2 7. 4 0. 0 14 .7 4. 4 1. 5 81 24 -3 5 m on th s 8. 1 87 8 1. 3 0. 0 0. 0 0. 0 0. 6 2. 1 4. 0 62 .5 20 .9 0. 0 13 .5 0. 0 3. 4 71 36 -4 7 m on th s 5. 9 86 5 [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [6 6. 4] [2 2. 0] [0 .0 ] [2 .9 ] [2 .9 ] [0 .0 ] 51 48 -5 9 m on th s 4. 3 85 3 [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [4 .1 ] [4 .1 ] [7 8. 4] [2 7. 9] [0 .0 ] [7 .2 ] [4 .1 ] [0 .0 ] 37 M ot he r’ s ed uc at io n Pr im ar y/ N on e/ N on -s ta nd ar d 5. 2 14 2 * * * * * * * * * * * * * 7 In co m pl et e Se co nd ar y 7. 4 1, 17 7 0. 0 0. 0 0. 0 0. 0 0. 0 3. 4 3. 4 69 .0 14 .7 0. 0 17 .2 1. 5 1. 4 87 C om pl et e Se co nd ar y 7. 9 2, 42 9 0. 5 0. 0 0. 0 0. 0 0. 0 0. 8 1. 2 70 .6 17 .4 0. 1 8. 5 4. 8 1. 2 19 3 Se co nd ar y sp ec ia l an d hi gh er ed uc at io n 5. 7 52 5 [0 .5 ] [0 .0 ] [0 .0 ] [0 .0 ] [1 .9 ] [0 .0 ] [1 .9 ] [9 6. 9] [4 .3 ] [0 .0 ] [1 0. 7] [0 .0 ] [0 .5 ] 30 51 Multiple Indicator Cluster Survey 2005 Pe rc en ta ge o f c hi ld re n ag ed 0 -5 9 m on th s w ho w er e ill w it h fe ve r in t he la st t w o w ee ks w ho r ec ei ve d an ti m al ar ia l d ru gs , T aj ik is ta n, 2 00 5 H ad a fe ve r in la st t w o w ee ks N um be r of ch ild re n ag ed 0- 59 m on th s C hi ld re n w it h a fe ve r in t he la st t w o w ee ks w ho w er e tr ea te d w it h: N um be r of c hi ld re n w it h fe ve r in la st t w o w ee ks A nt im al ar ia ls : O th er m ed ic at io ns : SP / Fa ns i- da r C hl or o - qu in e A m od ia - qu in e Q ui ni ne A rt em is - in in b as ed co m bi n- at io ns O th er an ti - m al ar ia l A ny ap pr op ri at e an ti m al ar ia l dr ug Pa ra ce ta m ol / Pa na do l/ A ce ta m in - op he n A sp ir in Ib u- pr o - fe n O th er D on ’t kn ow A ny ap pr op ri at e an ti m al ar ia l dr ug w it hi n 24 ho ur s of o ns et of s ym pt om s* W ea lt h in de x qu in ti le s Po or es t 9. 8 91 1 0. 0 0. 0 0. 0 0. 0 0. 0 3. 1 3. 1 77 .7 15 .1 0. 0 6. 8 2. 0 3. 1 89 Se co nd 8. 0 83 2 0. 0 0. 0 0. 0 0. 0 0. 0 2. 3 2. 3 74 .7 15 .7 0. 3 10 .4 3. 3 0. 0 66 M id dl e 6. 3 83 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 53 .9 18 .9 0. 0 17 .3 5. 2 0. 0 52 Fo ur th 7. 1 85 3 1. 5 0. 0 0. 0 0. 0 0. 0 0. 4 1. 9 66 .2 14 .7 0. 0 13 .0 6. 4 1. 5 60 R ic he st 5. 8 84 5 0. 3 0. 0 0. 0 0. 0 1. 2 0. 0 1. 2 88 .9 13 .8 0. 0 9. 6 0. 0 0. 3 49 To ta l 7. 4 4, 27 3 0. 3 0. 0 0. 0 0. 0 0. 2 1. 4 1. 9 72 .7 15 .6 0. 1 10 .9 3. 3 1. 2 31 7 * M IC S in di ca to r 39 ; M D G in di ca to r 22 [ ] Fi gu re s th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. 52 Findings from Tajikistan Ta bl e 12 : U se o f i m pr ov ed w at er s ou rc es Pe rc en t di st ri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d ri nk in g w at er a nd pe rc en ta ge o f h ou se ho ld p op ul at io n us in g im pr ov ed d ri nk in g w at er s ou rc es , T aj ik is ta n, 2 00 5 M ai n so ur ce o f d ri nk in g w at er To ta l Im pr ov - ed so ur ce of dr in ki ng w at er * N um be r of ho us eh ol d m em be rs Im pr ov ed s ou rc es U ni m pr ov ed s ou rc es Pi pe d in to dw el lin g Pi pe d in to ya rd / pl ot Pu bl ic ta p/ st an d- pi pe Tu be - w el l/ bo re - ho le Pr o - te ct ed w el l Pr o - te ct ed sp ri ng R ai n- w at er B ot tl ed w at er 1 U np ro - te ct ed w el l U np ro - te ct ed sp ri ng Ta nk er tr uc k C ar t w it h ta nk / dr um Su r- fa ce w at er B ot tl ed w at er 1 O th er R eg io n D us ha nb e 79 .7 13 .6 1. 3 0. 1 0. 5 0. 6 0. 0 0. 0 0. 0 0. 7 0. 0 0. 1 2. 4 0. 0 1. 0 10 0. 0 95 .7 3, 41 4 K ha tl on 11 .8 16 .3 16 .7 5. 8 2. 9 1. 0 0. 1 0. 0 1. 9 1. 5 1. 2 0. 3 38 .9 0. 0 1. 5 10 0. 0 54 .6 14 ,6 84 So gd 18 .3 8. 5 42 .8 3. 5 2. 6 2. 3 0. 0 0. 0 0. 4 1. 9 1. 2 0. 1 15 .5 0. 0 2. 8 10 0. 0 78 .1 12 ,8 33 D R D 24 .8 14 .6 11 .4 3. 3 3. 1 16 .3 0. 0 0. 0 0. 4 1. 3 1. 5 0. 0 20 .5 0. 0 2. 7 10 0. 0 73 .6 9, 61 5 G B A O 2. 9 12 .2 24 .6 0. 0 3. 5 8. 3 0. 0 0. 0 0. 3 5. 2 0. 0 0. 0 43 .1 0. 0 0. 0 10 0. 0 51 .5 1, 14 6 R es id en ce U rb an 54 .8 21 .0 14 .0 1. 1 1. 7 0. 4 0. 0 0. 0 0. 0 0. 2 1. 5 0. 1 4. 4 0. 0 0. 7 10 0. 0 93 .1 11 ,3 01 R ur al 10 .0 10 .2 25 .6 4. 9 3. 1 6. 9 0. 0 0. 0 1. 2 2. 2 1. 0 0. 2 32 .1 0. 0 2. 6 10 0. 0 60 .7 30 ,3 92 Ed uc at io n of h ou se ho ld h ea d N on e 16 .0 11 .4 22 .7 6. 7 6. 0 3. 8 0. 0 0. 0 0. 5 2. 2 0. 0 0. 0 25 .4 0. 0 5. 2 10 0. 0 66 .7 1, 69 9 Pr im ar y 11 .6 15 .5 24 .6 2. 6 1. 4 7. 2 0. 0 0. 0 0. 0 2. 2 0. 7 0. 3 29 .5 0. 0 4. 4 10 0. 0 62 .9 2, 33 3 In co m pl et e Se co nd ar y 18 .2 11 .5 25 .2 4. 4 2. 3 5. 3 0. 0 0. 0 1. 0 3. 3 1. 1 0. 1 25 .8 0. 0 2. 0 10 0. 0 66 .8 5, 57 8 C om pl et e Se co nd ar y 20 .3 11 .9 24 .9 3. 5 2. 7 5. 9 0. 1 0. 0 0. 6 1. 7 1. 2 0. 0 25 .2 0. 0 2. 0 10 0. 0 69 .2 16 ,5 56 Se co nd ar y sp ec ia l 21 .0 15 .8 20 .6 4. 0 2. 6 3. 8 0. 1 0. 0 0. 9 1. 2 1. 5 0. 5 26 .2 0. 0 1. 8 10 0. 0 67 .9 7, 29 5 H ig he r ed uc at io n 34 .1 14 .4 16 .8 4. 0 2. 3 4. 5 0. 0 0. 0 1. 8 0. 5 1. 0 0. 2 19 .3 0. 0 1. 1 10 0. 0 76 .1 8, 07 5 N on st an d. / M is si ng /D K 10 .1 2. 3 20 .2 6. 7 23 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 37 .2 0. 0 0. 0 10 0. 0 62 .8 15 7 5� Multiple Indicator Cluster Survey 2005 Pe rc en t di st ri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d ri nk in g w at er a nd pe rc en ta ge o f h ou se ho ld p op ul at io n us in g im pr ov ed d ri nk in g w at er s ou rc es , T aj ik is ta n, 2 00 5 M ai n so ur ce o f d ri nk in g w at er To ta l Im pr ov - ed so ur ce of dr in ki ng w at er * N um be r of ho us eh ol d m em be rs Im pr ov ed s ou rc es U ni m pr ov ed s ou rc es Pi pe d in to dw el lin g Pi pe d in to ya rd / pl ot Pu bl ic ta p/ st an d- pi pe Tu be - w el l/ bo re - ho le Pr o - te ct ed w el l Pr o - te ct ed sp ri ng R ai n- w at er B ot tl ed w at er 1 U np ro - te ct ed w el l U np ro - te ct ed sp ri ng Ta nk er tr uc k C ar t w it h ta nk / dr um Su r- fa ce w at er B ot tl ed w at er 1 O th er W ea lt h in de x qu in ti le s Po or es t 0. 8 6. 7 29 .1 1. 3 1. 7 8. 4 0. 1 0. 8 1. 7 3. 8 2. 0 0. 4 43 .4 0. 0 0. 8 10 0. 0 48 .0 8, 33 9 Se co nd 4. 7 13 .0 28 .5 4. 0 3. 1 8. 7 0. 0 4. 7 1. 2 2. 1 1. 1 0. 0 31 .5 0. 0 2. 1 10 0. 0 62 .1 8, 33 9 M id dl e 10 .3 10 .3 27 .6 7. 0 2. 9 6. 7 0. 0 10 .3 0. 8 1. 0 0. 7 0. 0 29 .2 0. 0 3. 5 10 0. 0 64 .8 8, 34 6 Fo ur th 22 .8 21 .0 21 .5 5. 6 4. 3 1. 4 0. 0 22 .8 0. 8 0. 9 1. 3 0. 3 16 .6 0. 0 3. 5 10 0. 0 76 .6 8, 32 8 R ic he st 72 .0 14 .9 5. 7 1. 6 1. 3 0. 3 0. 1 72 .0 0. 0 0. 4 0. 6 0. 1 2. 4 0. 0 0. 4 10 0. 0 96 .0 8, 34 3 Et hn ic it y/ La ng ua ge Ta jik 24 .4 13 .6 21 .2 3. 2 2. 2 5. 6 0. 0 0. 0 0. 9 1. 4 1. 0 0. 2 24 .1 0. 0 2. 2 10 0. 0 70 .2 30 ,2 12 U zb ek 14 .1 12 .7 27 .1 6. 1 4. 2 3. 1 0. 0 0. 0 0. 7 2. 1 1. 6 0. 1 26 .3 0. 0 1. 9 10 0. 0 67 .3 10 ,1 79 R us si an 86 .2 4. 0 2. 0 5. 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 6 0. 0 0. 0 1. 4 0. 0 0. 0 10 0. 0 98 .0 37 3 K ir gi z 0. 0 0. 0 0. 0 1. 5 23 .1 55 .1 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 20 .1 0. 0 0. 0 10 0. 0 79 .6 14 5 O th er 14 .3 11 .3 26 .8 0. 0 0. 5 5. 4 0. 0 0. 0 0. 4 6. 3 0. 0 0. 0 35 .1 0. 0 0. 0 10 0. 0 58 .3 75 5 M is si ng * * * * * * * * * * * * * * * * * 29 To ta l 22 .1 13 .2 22 .5 3. 9 2. 7 5. 1 0. 0 0. 0 0. 9 1. 6 1. 1 0. 2 24 .6 0. 0 2. 1 10 0. 0 69 .5 41 ,6 93 * M IC S in di ca to r 11 ; M D G in di ca to r 30 * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. 5� Findings from Tajikistan Ta bl e 13 : U se o f s an ita ry m ea ns o f e xc re ta d isp os al Pe rc en t di st ri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to t yp e of t oi le t fa ci lit y us ed b y th e ho us eh ol d, a nd t he p er ce nt ag e of h ou se ho ld p op ul at io n us in g sa ni ta ry m ea ns of e xc re ta d is po sa l, Ta jik is ta n, 2 00 5 Ty pe o f t oi le t fa ci lit y us ed b y ho us eh ol d To ta l Pe rc en ta ge of p op ul a- tio n us in g sa ni ta ry m ea ns o f ex cr et a di sp os al * N um be r of ho us eh ol d m em be rs Im pr ov ed s an it at io n fa ci lit y U ni m pr ov ed s an it at io n fa ci lit y Fl us h/ po ur fl us h to : Ve nt ila te d im pr ov e- ed p it la tr in e Pi t la tr in e w it h sl ab C om - po st - ti ng to ile t Fl us h/ po ur t o so m e- w he re e ls e Pi t la tr in e w it ho ut sl ab / op en p it B uc ke t H an gi ng to ile t/ ha ng in g la tr in e N o fa ci lit ie s / b us h / fie ld O th er Pi pe d se w er sy st em Se pt ic ta nk Pi t la tr in e R eg io n D us ha nb e 73 .0 0. 2 1. 5 0. 2 24 .3 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 3 10 0. 0 99 .2 3, 41 6 K ha tl on 6. 9 0. 1 0. 0 0. 0 83 .7 0. 0 0. 0 8. 8 0. 0 0. 0 0. 4 0. 0 10 0. 0 90 .7 14 ,6 89 So gd 11 .3 0. 4 0. 1 0. 0 83 .0 0. 0 0. 0 5. 2 0. 0 0. 0 0. 0 0. 0 10 0. 0 94 .8 12 ,8 18 D R D 5. 6 0. 0 3. 4 0. 4 86 .4 0. 0 0. 0 3. 7 0. 0 0. 0 0. 3 0. 0 10 0. 0 95 .8 9, 62 6 G B A O 5. 4 15 .1 2. 7 0. 7 62 .4 0. 0 0. 4 4. 0 0. 0 0. 0 7. 8 1. 4 10 0. 0 86 .3 1, 14 6 R es id en ce U rb an 45 .8 0. 7 1. 1 0. 3 49 .6 0. 0 0. 0 1. 8 0. 0 0. 0 0. 1 0. 2 10 0. 0 97 .4 11 ,3 03 R ur al 1. 2 0. 5 1. 0 0. 1 89 .5 0. 0 0. 0 7. 1 0. 0 0. 0 0. 5 0. 0 10 0. 0 92 .3 30 ,3 92 Ed uc at io n of h ou se ho ld h ea d N on e 4. 5 0. 0 0. 7 0. 0 87 .3 0. 0 0. 0 7. 2 0. 0 0. 0 0. 1 0. 2 10 0. 0 92 .5 1, 69 9 Pr im ar y 2. 8 0. 1 1. 6 0. 0 89 .3 0. 0 0. 3 5. 7 0. 0 0. 0 0. 1 0. 1 10 0. 0 93 .8 2, 33 3 In co m pl et e Se co nd ar y 7. 2 0. 4 1. 2 0. 0 85 .0 0. 0 0. 0 5. 8 0. 0 0. 0 0. 2 0. 0 10 0. 0 94 .0 5, 57 8 C om pl et e Se co nd ar y 11 .2 0. 3 1. 1 0. 1 79 .1 0. 0 0. 0 7. 5 0. 0 0. 0 0. 5 0. 0 10 0. 0 91 .9 16 ,5 55 Se co nd ar y sp ec ia l 14 .2 1. 2 0. 8 0. 2 76 .9 0. 0 0. 0 5. 5 0. 0 0. 0 0. 6 0. 1 10 0. 0 93 .4 7, 29 6 H ig he r ed uc at io n 25 .9 0. 9 0. 8 0. 3 69 .8 0. 0 0. 0 1. 9 0. 0 0. 0 0. 3 0. 2 10 0. 0 97 .6 8, 07 5 N on -s ta nd ar d / M is si ng /D K 10 .1 0. 0 0. 0 0. 0 89 .9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 15 7 55 Multiple Indicator Cluster Survey 2005 Pe rc en t di st ri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to t yp e of t oi le t fa ci lit y us ed b y th e ho us eh ol d, a nd t he p er ce nt ag e of h ou se ho ld p op ul at io n us in g sa ni ta ry m ea ns of e xc re ta d is po sa l, Ta jik is ta n, 2 00 5 Ty pe o f t oi le t fa ci lit y us ed b y ho us eh ol d To ta l Pe rc en ta ge of p op ul a- tio n us in g sa ni ta ry m ea ns o f ex cr et a di sp os al * N um be r of ho us eh ol d m em be rs Im pr ov ed s an it at io n fa ci lit y U ni m pr ov ed s an it at io n fa ci lit y Fl us h/ po ur fl us h to : Ve nt ila te d im pr ov e- ed p it la tr in e Pi t la tr in e w it h sl ab C om - po st - ti ng to ile t Fl us h/ po ur t o so m e- w he re e ls e Pi t la tr in e w it ho ut sl ab / op en p it B uc ke t H an gi ng to ile t/ ha ng in g la tr in e N o fa ci lit ie s / b us h / fie ld O th er Pi pe d se w er sy st em Se pt ic ta nk Pi t la tr in e W ea lt h in de x qu in ti le s Po or es t 0. 0 0. 3 0. 0 0. 0 91 .2 0. 0 0. 0 6. 8 0. 0 0. 0 0. 8 0. 0 10 0. 0 92 .4 8, 33 5 Se co nd 0. 0 0. 5 0. 3 0. 0 87 .8 0. 0 0. 0 10 .8 0. 0 0. 0 0. 4 0. 0 10 0. 0 88 .8 8, 34 3 M id dl e 0. 0 0. 6 2. 2 0. 0 91 .6 0. 0 0. 1 5. 5 0. 0 0. 0 0. 3 0. 0 10 0. 0 94 .1 8, 33 5 Fo ur th 0. 7 0. 5 1. 7 0. 2 92 .0 0. 0 0. 0 4. 7 0. 0 0. 0 0. 4 0. 1 10 0. 0 94 .5 8, 34 2 R ic he st 65 .7 0. 9 0. 8 0. 5 30 .8 0. 0 0. 0 0. 6 0. 0 0. 0 0. 2 0. 2 10 0. 0 98 .6 8, 33 8 Et hn ic it y/ La ng ua ge Ta jik 15 .0 0. 6 1. 0 0. 1 77 .7 0. 0 0. 0 4. 9 0. 0 0. 0 0. 3 0. 0 10 0. 0 94 .5 30 ,2 16 U zb ek 5. 3 0. 3 1. 1 0. 1 84 .8 0. 0 0. 0 8. 2 0. 0 0. 0 0. 2 0. 0 10 0. 0 91 .5 10 ,1 77 R us si an 90 .8 0. 0 1. 1 0. 0 8. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 10 0. 0 99 .9 37 3 K ir gi z 0. 0 0. 0 0. 0 0. 0 70 .2 0. 0 0. 0 11 .7 0. 0 0. 0 18 .1 0. 0 10 0. 0 70 .2 14 5 O th er 17 .6 4. 9 0. 4 0. 4 68 .8 0. 0 0. 0 3. 1 0. 0 0. 0 2. 6 2. 1 10 0. 0 92 .2 75 5 M is si ng * * * * * * * * * * * * * * 29 To ta l 13 .3 0. 6 1. 0 0. 1 78 .7 0. 0 0. 0 5. 7 0. 0 0. 0 0. 4 0. 1 10 0. 0 93 .7 41 ,6 93 * M IC S in di ca to r 12 ; M D G in di ca to r 31 * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. 56 Findings from Tajikistan Ta bl e 14 : U se o f c on tr ac ep tio n Pe rc en ta ge o f w om en a ge d 15 -4 9 ye ar s cu rr en tl y m ar ri ed o r in u ni on w ho a re u si ng ( or w ho se p ar tn er is u si ng ) a co nt ra ce pt iv e m et ho d, T aj ik is ta n, 2 00 5 N ot us in g an y m et ho d Pe rc en t of w om en ( cu rr en tl y m ar ri ed o r in u ni on ) w ho a re u si ng : N um be r of w om en cu rr en tl y m ar ri ed o r in u ni on Female sterilization Male sterilization Pill IUD Injections Implants Condom Female condom Diaphragm/ foam/ jelly LAM Periodic abstin- ence Withdrawal Other Any modern method Any traditional method Any method* R eg io n D us ha nb e 62 .3 0. 4 0. 0 3. 5 29 .4 0. 6 0. 0 1. 9 0. 0 0. 0 1. 0 0. 5 0. 2 0. 2 35 .8 1. 9 37 .7 51 2 K ha tl on 64 .9 0. 3 0. 0 1. 9 24 .3 3. 8 0. 1 0. 6 0. 0 0. 0 3. 8 0. 0 0. 3 0. 0 31 .0 4. 1 35 .1 2, 04 8 So gd 53 .7 0. 7 1. 0 2. 4 28 .2 2. 0 0. 0 2. 7 0. 0 0. 0 4. 9 0. 5 3. 7 0. 2 36 .9 9. 4 46 .3 2, 16 6 D R D 71 .1 0. 0 0. 0 1. 1 24 .8 1. 6 0. 0 0. 6 0. 1 0. 2 0. 3 0. 3 0. 0 0. 0 28 .3 0. 5 28 .9 1, 36 5 G B A O 60 .8 0. 0 0. 0 3. 4 31 .1 3. 7 0. 0 0. 8 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 39 .2 0. 0 39 .2 15 4 R es id en ce U rb an 57 .6 0. 6 0. 0 2. 7 29 .8 2. 0 0. 1 2. 7 0. 0 0. 0 1. 7 0. 7 1. 7 0. 3 38 .0 4. 4 42 .4 1, 72 7 R ur al 63 .7 0. 3 0. 5 1. 8 25 .0 2. 6 0. 0 0. 9 0. 0 0. 1 3. 6 0. 1 1. 3 0. 0 31 .2 5. 1 36 .3 4, 51 8 A ge 15 -1 9 91 .4 0. 0 0. 0 1. 0 2. 9 0. 0 0. 0 0. 0 0. 0 0. 0 4. 1 0. 0 0. 6 0. 0 3. 9 4. 7 8. 6 15 5 20 -2 4 75 .4 0. 3 0. 3 0. 5 13 .3 0. 6 0. 0 1. 1 0. 0 0. 0 6. 8 0. 3 1. 2 0. 2 16 .1 8. 5 24 .6 1, 05 2 25 -2 9 61 .4 0. 2 0. 1 2. 6 24 .1 2. 0 0. 0 2. 5 0. 0 0. 1 5. 3 0. 3 1. 4 0. 0 31 .6 7. 0 38 .6 1, 14 6 30 -3 4 52 .8 0. 1 0. 4 2. 8 33 .4 3. 6 0. 0 1. 9 0. 0 0. 1 3. 2 0. 3 1. 4 0. 0 42 .2 4. 9 47 .2 1, 12 8 35 -3 9 50 .2 0. 8 0. 6 3. 3 35 .3 4. 1 0. 0 1. 8 0. 0 0. 0 1. 5 0. 5 1. 9 0. 0 45 .9 3. 9 49 .8 1, 07 3 40 -4 4 62 .3 0. 2 0. 2 2. 1 30 .2 2. 7 0. 0 0. 4 0. 1 0. 0 0. 3 0. 1 1. 5 0. 0 35 .9 1. 9 37 .7 1, 01 0 45 -4 9 69 .3 1. 0 0. 7 0. 7 24 .2 1. 6 0. 3 0. 5 0. 0 0. 0 0. 0 0. 2 1. 2 0. 3 28 .9 1. 8 30 .7 68 0 N um be r of li vi ng c hi ld re n* * 0 99 .1 0. 0 0. 0 0. 0 0. 6 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 9 0. 0 0. 9 54 4 1 79 .2 0. 3 0. 3 1. 1 8. 2 0. 1 0. 0 1. 1 0. 0 0. 0 7. 9 0. 3 1. 1 0. 3 11 .2 9. 6 20 .8 69 3 2 57 .1 0. 5 0. 4 2. 7 27 .8 1. 4 0. 0 3. 0 0. 0 0. 0 4. 4 0. 4 2. 2 0. 2 35 .8 7. 2 42 .9 1, 08 7 3 52 .4 0. 1 0. 2 2. 9 32 .7 3. 0 0. 0 2. 2 0. 0 0. 0 3. 9 0. 6 2. 1 0. 0 41 .1 6. 6 47 .6 1, 30 2 4+ 56 .7 0. 5 0. 5 2. 1 32 .7 3. 7 0. 1 0. 7 0. 0 0. 1 1. 5 0. 2 1. 2 0. 0 40 .5 2. 9 43 .3 2, 61 7 Ed uc at io n N on e/ N on - st an da rd 86 .5 0. 0 0. 0 2. 0 4. 8 0. 5 0. 0 0. 0 0. 0 0. 0 6. 2 0. 0 0. 0 0. 0 7. 2 6. 2 13 .5 66 Pr im ar y 75 .3 0. 0 0. 0 0. 0 13 .2 2. 6 0. 0 0. 0 0. 0 0. 0 7. 1 0. 0 1. 8 0. 0 15 .8 8. 9 24 .7 10 3 5� Multiple Indicator Cluster Survey 2005 Pe rc en ta ge o f w om en a ge d 15 -4 9 ye ar s cu rr en tl y m ar ri ed o r in u ni on w ho a re u si ng ( or w ho se p ar tn er is u si ng ) a co nt ra ce pt iv e m et ho d, T aj ik is ta n, 2 00 5 N ot us in g an y m et ho d Pe rc en t of w om en ( cu rr en tl y m ar ri ed o r in u ni on ) w ho a re u si ng : N um be r of w om en cu rr en tl y m ar ri ed o r in u ni on Female sterilization Male sterilization Pill IUD Injections Implants Condom Female condom Diaphragm/ foam/ jelly LAM Periodic abstin- ence Withdrawal Other Any modern method Any traditional method Any method* In co m pl et e Se co nd ar y 70 .1 0. 5 0. 1 1. 7 20 .7 1. 5 0. 0 1. 0 0. 0 0. 1 3. 3 0. 2 0. 6 0. 2 25 .6 4. 3 29 .9 1, 31 3 C om pl et e Se co nd ar y 61 .0 0. 3 0. 5 1. 8 27 .6 2. 7 0. 0 1. 2 0. 0 0. 0 2. 9 0. 3 1. 6 0. 0 34 .2 4. 8 39 .0 3, 88 6 Se co nd ar y sp ec ia l 53 .0 0. 8 0. 0 2. 8 32 .8 3. 1 0. 0 1. 0 0. 0 0. 0 3. 6 0. 4 2. 6 0. 0 40 .4 6. 6 47 .0 49 0 H ig he r ed uc at io n 49 .3 0. 6 0. 0 5. 2 31 .8 1. 9 0. 5 6. 0 0. 3 0. 0 1. 5 1. 1 1. 3 0. 6 46 .3 4. 4 50 .7 38 7 W ea lt h in de x qu in ti le s Po or es t 66 .6 0. 3 0. 0 2. 0 22 .4 3. 1 0. 0 0. 4 0. 0 0. 0 4. 5 0. 3 0. 4 0. 0 28 .2 5. 2 33 .4 1, 17 3 Se co nd 64 .4 0. 2 0. 4 2. 4 24 .5 2. 4 0. 0 0. 5 0. 0 0. 1 3. 7 0. 0 1. 4 0. 0 30 .5 5. 1 35 .6 1, 19 1 M id dl e 62 .6 0. 7 0. 7 1. 6 25 .5 2. 7 0. 0 0. 8 0. 0 0. 0 3. 6 0. 3 1. 3 0. 0 32 .2 5. 2 37 .4 1, 25 3 Fo ur th 61 .0 0. 4 0. 5 1. 5 28 .3 2. 2 0. 0 1. 5 0. 1 0. 1 2. 4 0. 1 1. 9 0. 0 34 .6 4. 4 39 .0 1, 30 7 R ic he st 56 .4 0. 2 0. 1 2. 9 30 .3 1. 7 0. 2 3. 7 0. 0 0. 0 1. 5 0. 7 2. 0 0. 4 39 .0 4. 5 43 .6 1, 32 1 Et hn ic it y/ La ng ua ge Ta jik 63 .3 0. 3 0. 4 2. 3 25 .1 2. 3 0. 0 1. 5 0. 0 0. 0 3. 0 0. 3 1. 3 0. 1 32 .1 4. 7 36 .7 4, 48 8 U zb ek 59 .0 0. 6 0. 2 1. 2 29 .5 2. 6 0. 0 1. 1 0. 0 0. 1 3. 6 0. 2 1. 8 0. 0 35 .4 5. 6 41 .0 1, 59 4 R us si an 45 .0 0. 0 0. 0 5. 0 36 .1 0. 0 0. 0 11 .8 0. 0 0. 0 0. 0 1. 1 0. 0 1. 0 53 .0 2. 0 55 .0 42 K ir gi z [8 9. 9] [0 .0 ] [0 .0 [2 .9 ] [7 .3 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [0 .0 ] [1 0. 1] [0 .0 ] [1 0. 1] 17 O th er 59 .1 0. 0 0. 0 3. 8 27 .6 4. 1 0. 0 0. 8 0. 0 0. 3 2. 2 0. 0 0. 0 2. 2 36 .5 4. 4 40 .9 10 3 To ta l 62 .1 0. 4 0. 4 2. 1 26 .3 2. 4 0. 0 1. 4 0. 0 0. 0 3. 1 0. 3 1. 4 0. 1 33 .1 4. 9 37 .9 6, 24 5 * M IC S in di ca to r 21 ; M D G in di ca to r 19 C [ ] Fi gu re s th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s * R ep la ce s fig ur es t ha t ar e ba se d on fe w er t ha n 25 u nw ei gh te d ca se s. 58 Findings from Tajikistan Table 15: Assistance during delivery Percent distribution of women aged 15-49 with a birth in two years preceding the survey by type of personnel assisting at delivery, Tajikistan, 2005 Person assisting at delivery No attendant Total Any skilled personnel* Delivered in health facility** Number of women who gave birth in preceding two years Medical doctor Nurse/ midwife Auxiliary midwife Traditional birth attendant Other Region Dushanbe 75.0 12.1 0.3 6.4 5.6 0.6 100.0 87.4 68.9 133 Khatlon 44.4 28.9 2.0 11.6 12.4 0.8 100.0 75.2 42.3 682 Sogd 86.3 8.4 0.0 3.4 1.8 0.0 100.0 94.7 88.5 501 DRD 55.1 26.8 0.2 10.3 7.2 0.3 100.0 82.1 60.3 361 GBAO 51.8 23.5 1.9 16.6 4.8 1.4 100.0 77.2 45.8 34 Residence Urban 72.9 15.7 0.8 4.4 6.0 0.2 100.0 89.4 72.1 427 Rural 57.6 22.8 0.9 10.0 8.1 0.6 100.0 81.3 58.3 1,284 Age 15-19 [68.8] [20.5] [4.6] [5.7] [0.5] [0.0] 100.0 [93.8] [86.6] 57 20-24 68.6 17.0 1.0 7.0 6.1 0.3 100.0 86.6 68.4 605 25-29 59.5 22.8 0.3 9.2 8.1 0.0 100.0 82.7 58.3 499 30-34 55.8 24.4 0.7 9.1 9.9 0.1 100.0 80.9 58.6 334 35-39 55.5 20.9 1.5 11.7 8.7 1.8 100.0 77.9 50.1 170 40-44 47.2 [27.7] [0.0] [14.8] [5.8] [4.5] 100.0 [74.9] [49.4] 39 45-49 * * * * * * * * * 6 Education None/Primary/ Non-standard/ [47.9] [15.1] [3.4] [17.8] [15.8] [0.0] [100.0] [66.4] [41.6] 55 Incomplete Secondary 57.1 22.0 0.9 12.3 7.4 0.3 100.0 80.0 56.6 529 Complete Secondary 60.6 22.1 0.9 7.4 8.3 0.7 100.0 83.7 61.8 928 Secondary special 73.3 19.5 0.0 3.2 4.0 0.0 100.0 92.8 75.2 116 Higher education 91.4 8.4 0.0 0.2 0.0 0.0 100.0 99.8 88.8 83 Wealth index quintiles Poorest 45.8 22.1 1.4 15.7 14.5 0.5 100.0 69.3 43.3 387 Second 56.4 24.6 1.1 9.7 7.9 0.4 100.0 82.1 51.8 338 Middle 59.8 25.2 0.0 7.6 6.3 1.0 100.0 85.0 64.8 335 Fourth 68.8 21.7 1.3 2.8 5.3 0.2 100.0 91.8 72.3 335 Richest 79.7 10.8 0.6 6.2 2.6 0.2 100.0 91.0 80.1 315 Ethnicity/Language Tajik 58.9 22.1 0.8 9.8 7.9 0.6 100.0 81.7 58.6 1,225 Uzbek 67.6 18.5 1.3 5.8 6.6 0.2 100.0 87.4 70.1 448 Other 70.8 18.1 0.0 4.1 7.0 0.0 100.0 88.9 64.7 38 Total 61.4 21.0 0.9 8.6 7.6 0.5 100.0 83.4 61.8 1,711 * MICS indicator 4; MDG indicator 17 ** MICS indicator 5 [ ] Figures that are based on 25-49 unweighted cases * Replaces figures that are based on fewer than 25 unweighted cases. 5� Multiple Indicator Cluster Survey 2005 Table 16: Primary school net attendance ratio Percentage of children of primary school age** attending primary or secondary school (NAR), Tajikistan, 2005 Male Female Total Net attendance ratio Number of children Net attendance ratio Number of children Net attendance ratio* Number of children Region Dushanbe 95.9 177 93.8 170 94.9 347 Khatlon 95.1 842 92.9 763 94.1 1,605 Sogd 86.5 621 84.9 622 85.7 1,242 DRD 80.4 551 82.3 460 81.2 1,011 GBAO 93.9 54 90.7 49 92.4 103 Residence Urban 87.9 543 90.5 560 89.2 1,104 Rural 89.5 1,702 87.3 1,503 88.5 3,205 Age** 7 63.3 541 66.2 553 64.8 1,094 8 93.9 586 93.1 528 93.5 1,114 9 99.9 508 98.3 415 99.2 924 10 98.5 609 97.6 568 98.0 1,177 Mother’s education None/Primary/ Non- standard 80.3 61 [70.6] 56 75.6 117 Incomplete Secondary 88.4 380 85.8 305 87.2 685 Complete Secondary 88.9 1,502 88.7 1,417 88.8 2,919 Secondary special 91.2 181 88.6 175 89.9 356 Higher education 95.6 121 96.5 111 96.0 232 Wealth index quintiles Poorest 91.2 497 89.6 437 90.5 934 Second 88.9 494 85.3 447 87.2 942 Middle 86.3 430 83.7 391 85.0 820 Fourth 88.0 401 89.6 380 88.8 782 Richest 90.9 422 92.7 409 91.8 831 Ethnicity/Language Tajik 88.1 1,648 87.1 1,529 87.6 3,177 Uzbek 92.1 555 91.1 486 91.6 1,041 Other 90.9 42 91.8 48 91.4 91 Total 89.1 2,245 88.2 2,063 88.7 4,308 * MICS indicator 55; MDG indicator 6 [ ] Figures that are based on 25-49 unweighted cases * Replaces figures that are based on fewer than 25 unweighted cases. 60 Findings from Tajikistan Table 17: Education gender parity Ratio of girls to boys attending primary education and ratio of girls to boys attending secondary education, Tajikistan, 2005 Primary school net attendance ratio (NAR), girls Primary school net attendance ratio (NAR), boys Gender parity index (GPI) for primary school NAR* Secondary school net attendance ratio (NAR), girls Secondary school net attendance ratio (NAR), boys Gender parity index (GPI) for secondary school NAR* Sex Male na 89.1 na na 88.0 na Female 88.2 na na 72.7 na na Region Dushanbe 93.8 95.9 0.98 73.0 92.8 0.79 Khatlon 92.9 95.1 0.98 68.7 90.7 0.76 Sogd 84.9 86.5 0.98 79.5 84.3 0.94 DRD 82.3 80.4 1.02 68.5 86.4 0.79 GBAO 90.7 93.9 0.97 90.2 92.5 0.98 Residence Urban 90.5 87.9 1.03 76.1 89.8 0.85 Rural 87.3 89.5 0.97 71.5 87.4 0.82 Mother’s education None/Primary/ Non-standard 66.8 80.4 0.8 46.1 73.3 0.6 Incomplete Secondary 85.8 88.4 0.97 64.6 86.6 0.75 Complete Secondary 88.7 88.9 1.00 74.0 87.8 0.84 Secondary special 88.6 91.2 0.97 72.6 91.4 0.79 Higher education 96.5 95.6 1.01 93.1 96.2 0.97 Wealth index quintiles Poorest 89.6 91.2 1.0 68.7 86.0 0.8 Second 85.3 88.9 1.0 67.0 88.2 0.8 Middle 83.7 86.3 1.0 72.0 86.3 0.8 Fourth 89.6 88.0 1.0 76.0 86.9 0.9 Richest 92.7 90.9 1.0 81.5 93.2 0.9 Ethnicity/Language Tajik 87.1 88.1 0.99 70.0 88.6 0.79 Uzbek 91.1 92.1 0.99 79.9 85.6 0.93 Other 91.4 83.5 1.1 86.4 92.6 1.0 Total 88.2 89.1 0.99 72.7 88.0 0.83 * MICS indicator 61; MDG indicator 9 61 Multiple Indicator Cluster Survey 2005 Table 18: Birth registration Percent distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration, Tajikistan, 2005 Birth is Regis- tered* Number of children aged 0-59 months Birth is not registered because: Total Number of children aged 0-59 months without birth registra- tion C os ts t oo m uc h M us t tr av el t oo fa r D id n’ t kn ow c hi ld s ho ul d be R eg is te re d La te , d id n ot w an t to pa y fin e D oe sn ’t kn ow w he re t o re gi st er La ck o f t im e M is si ng o th er do cu m en ts O th er D on ’t kn ow Sex Male 87.6 2,168 41.8 3.7 4.0 0.3 4.8 18.9 8.7 2.9 15.0 100.0 217 Female 88.9 2,105 41.4 9.0 2.6 1.4 3.0 13.5 8.5 1.5 19.0 100.0 192 Region Dushanbe 82.7 336 24.1 1.2 2.4 1.4 5.0 24.1 4.4 5.4 31.8 100.0 54 Khatlon 89.5 1,714 59.3 4.8 6.2 0.0 3.3 9.7 6.6 0.0 10.1 100.0 128 Sogd 93.6 1,205 [18.3] [21.0] [3.4] [2.0] [0.0] [28.7] [19.1] [1.4] [6.1] 100.0 62 DRD 80.9 928 42.4 2.9 1.2 0.6 5.9 15.0 7.9 3.1 21.1 100.0 157 GBAO 90.8 90 [41.0] [14.4] [4.0] [4.6] [0.0] [2.0] [2.4] [5.2] 26.4] 100.0 7 Residence Urban 84.9 1,129 40.5 0.4 2.4 0.5 4.1 20.8 5.7 2.5 23.1 100.0 151 Rural 89.5 3,144 42.2 9.6 3.8 1.0 3.9 13.8 10.4 2.1 13.2 100.0 257 Age 0-11 months 82.1 841 25.3 4.9 4.5 0.0 4.7 32.2 7.8 3.4 17.3 100.0 126 12-23 months 86.8 836 47.7 5.1 3.2 1.0 3.6 6.4 11.6 3.6 17.8 100.0 94 24-35 months 90.0 878 40.7 7.7 4.8 1.9 5.1 13.9 7.0 0.3 18.6 100.0 74 36-47 months 90.5 865 58.6 9.3 0.4 1.3 0.0 13.0 8.4 0.0 9.0 100.0 62 48-59 months 91.8 853 51.0 5.4 2.1 0.3 5.9 3.9 8.0 2.4 20.9 100.0 53 Mother’s education None/ Primary/ Non- standard/ 79.7 142 * * * * * * * * * * 20 Incomplete Secondary 83.7 1,177 41.3 6.5 2.5 1.2 5.1 12.2 10.4 3.8 18.1 100.0 148 Complete Secondary 90.1 2,429 41.6 7.5 3.6 0.8 2.7 18.6 6.6 2.3 16.5 100.0 202 Secondary special & higher education 92.4 525 34.3 1.7 3.1 0.0 3.2 25.0 11.8 0.4 20.4 100.0 39 Wealth index quintiles Poorest 88.6 911 47.9 19.4 3.7 0.0 0.0 13.8 4.0 0.1 11.1 100.0 76 Second 87.3 832 54.1 8.1 0.0 0.4 0.0 14.0 13.6 0.0 9.8 100.0 87 Middle 88.0 832 50.6 1.7 5.0 1.7 2.7 8.5 8.3 7.2 14.3 100.0 73 Fourth 91.2 853 24.0 2.5 8.3 2.5 13.2 15.9 10.9 0.7 22.1 100.0 69 Richest 86.2 845 32.0 0.6 1.3 0.0 4.9 26.1 6.7 3.2 25.2 100.0 104 62 Findings from Tajikistan Percent distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration, Tajikistan, 2005 Birth is Regis- tered* Number of children aged 0-59 months Birth is not registered because: Total Number of children aged 0-59 months without birth registra- tion C os ts t oo m uc h M us t tr av el t oo fa r D id n’ t kn ow c hi ld s ho ul d be R eg is te re d La te , d id n ot w an t to pa y fin e D oe sn ’t kn ow w he re t o re gi st er La ck o f t im e M is si ng o th er do cu m en ts O th er D on ’t kn ow Ethnicity/Language Tajik 86.5 3,076 40.9 6.3 3.7 0.6 4.0 15.3 9.8 2.5 16.9 100.0 353 Uzbek 92.7 1,103 48.0 6.5 0.0 2.4 4.0 21.4 1.5 0.0 16.3 100.0 51 Other 95.2 94 * * * * * * * * * * 4 Total 88.3 4,273 41.6 6.2 3.3 0.8 4.0 16.4 8.6 2.2 16.9 100.0 409 * MICS indicator 62 [ ] Figures that are based on 25-49 unweighted cases * Replaces figures that are based on fewer than 25 unweighted cases. 6� Multiple Indicator Cluster Survey 2005 Table 19: Early marriage Percentage of women aged 15-49 years in marriage or union before their 15th birthday, percentage of women aged 20-49 years in marriage or union before their 18th birthday and the percentage of women aged 15-19 years currently married or in union, Tajikistan, 2005 Percentage married before age 15* Number of women aged 15- 49 years Percentage married before age 18* Number of women aged 20- 49 years Percentage of women 15-19 married or in union** Number of women aged 15- 19 years Number of women aged 15-49 years currently married or in union Region Dushanbe 0.6 876 14.8 692 4.7 183 512 Khatlon 0.7 3,480 15.9 2,622 5.5 857 2,048 Sogd 0.9 3,246 12.8 2,543 7.6 703 2,166 DRD 0.9 2,344 16.8 1,709 7.1 635 1,365 GBAO 0.5 297 7.8 231 1.0 66 154 Residence Urban 0.8 2,891 13.6 2,252 6.7 639 1,727 Rural 0.8 7,352 15.2 5,546 6.2 1,806 4,518 Age 15-19 0.0 2,445 na na 6.4 2,445 155 20-24 1.0 1,981 12.7 1,981 na na 1,052 25-29 2.1 1,428 23.4 1,428 na na 1,146 30-34 0.7 1,270 16.4 1,270 na na 1,128 35-39 0.8 1,192 10.6 1,192 na na 1,073 40-44 0.7 1,137 12.2 1,137 na na 1,010 45-49 0.6 790 11.5 790 na na 680 Education None/ Non- standard/ 0.0 161 13.9 86 9.5 75 66 Primary 2.7 267 27.7 140 12.1 127 103 Incomplete Secondary 1.2 3,145 21.7 1,762 5.2 1,383 1,313 Complete Secondary 0.6 5,334 14.3 4,587 7.5 747 3,886 Secondary special 0.2 704 5.1 660 [8.6] 45 490 Higher education 0.0 632 4.5 563 2.9 68 387 Wealth index quintiles Poorest 0.9 1896 17.0 1402 4.6 493 1173 Second 0.8 1995 13.6 1487 5.0 508 1191 Middle 0.8 2075 14.3 1589 6.0 486 1253 Fourth 0.9 2116 14.4 1614 9.7 502 1307 Richest 0.6 2162 14.6 1707 6.4 455 1321 Ethnicity/Language Tajik 0.9 7,472 16.2 5,610 6.6 1,862 4,488 Uzbek 0.5 2,440 11.3 1,920 6.2 520 1,594 Russian 0.5 90 8.1 81 * 9 42 Kirgiz 0.8 31 13.1 24 * 8 17 Other 1.5 210 7.9 163 0.0 47 103 Total 0.8 10,243 14.7 7,798 6.4 2,445 6,245 * MICS indicator 67 ** MICS indicator 68 [ ] Figures that are based on 25-49 unweighted cases * Replaces figures that are based on fewer than 25 unweighted cases. 6� Findings from Tajikistan Table 20: Comprehensive knowledge of HIV/AIDS transmission Percentage of women aged 15-49 years who have comprehensive knowledge of HIV/AIDS transmission, Tajikistan, 2005 Heard of AIDS Know 2 ways to prevent HIV transmission Correctly identify 3 misconceptions about HIV transmission Have comprehensive knowledge (identify 2 prevention methods and 3 misconceptions)* Number of women Region Dushanbe 57.1 30.2 19.4 13.7 876 Khatlon 28.5 16.2 6.3 3.7 3,480 Sogd 58.4 16.8 7.1 4.4 3,246 DRD 29.0 11.5 6.1 3.3 2,344 GBAO 65.9 22.8 26.6 11.9 297 Residence Urban 55.6 26.8 14.6 9.6 2,891 Rural 36.1 12.7 5.7 3.1 7,352 Age 15-19 23.5 7.3 3.9 2.2 2,445 20-24 38.9 14.5 7.2 3.8 1,981 15-24 30.4 10.5 5.4 2.9 4,426 25-29 48.3 21.5 10.0 6.5 1,428 30-34 54.1 23.1 11.9 6.7 1,270 35-39 51.5 21.2 11.3 7.1 1,192 40-44 49.1 20.7 9.5 5.3 1,137 45-49 46.9 19.6 8.8 6.2 790 Education None/ Non-standard/ 5.1 0.0 0.0 0.0 159 Primary 9.4 3.6 2.9 1.8 267 Incomplete Secondary 26.5 8.5 3.0 1.6 3,145 Complete Secondary 43.8 15.8 6.9 3.6 5,334 Secondary special 75.1 39.8 22.3 14.2 704 Higher education 83.9 48.5 34.2 24.5 632 Wealth index quintiles Poorest 36.0 10.2 3.7 1.8 1,896 Second 33.0 12.4 3.7 1.8 1,995 Middle 35.0 12.4 5.5 2.9 2,075 Fourth 44.0 18.6 9.9 5.7 2,116 Richest 58.5 28.6 17.4 11.6 2,162 Ethnicity/Language Tajik 40.7 16.6 8.1 4.7 7,472 Uzbek 40.7 14.0 5.7 3.5 2,440 Russian 96.1 59.8 47.1 30.9 90 Kirgiz 18.4 7.8 1.9 1.9 31 Other 66.8 35.1 27.9 17.8 210 Total 41.6 16.7 8.2 4.9 10,243 * MICS indicator 82; MDG indicator 19b * Replaces figures that are based on fewer than 25 unweighted cases. 66 Findings from Tajikistan Appendix two: MICS3 Indicators and Definitions used in the Tajikistan MICS3 Preliminary Report� MICS 3 INDICATOR NUMERATOR DENOMINATOR 1 Under-five mortality Rate Probability of dying by exact age 5 years 2 Infant mortality rate Probability of dying by exact age 1 year 4 Skilled attendant at delivery Number of women 15-49 with a birth in the 2 years preceding the survey who were attended during childbirth by skilled health personnel Total number of women surveyed aged 15-49 years with a birth in 2 years preceding the survey 5 Institutional deliveries Number of women 15-49 with a birth in the 2 years preceding the survey who were delivered in health facility Total number of women surveyed aged 15-49 years with a birth in 2 years preceding the survey 6 Underweight prevalence Number of children under 5 years of age who fall below -2 standard deviations (SDs) from the median weight-for-age of the NCHS/WHO standard (moderate and severe); number who fall below -3 SDs (severe) Total number of children under five years of age weighed 7 Stunting prevalence Number of children under 5 years of age who fall below -2 standard deviations (SDs) from the median height-for-age of the NCHS/WHO standard (moderate and severe); number who fall below -3 SDs (severe) Total number of children under five years of age measured 8 Wasting prevalence Number of children under 5 years of age who fall below -2 standard deviations (SDs) from the median weight-for-height of the NCHS/WHO standard (moderate and severe); number who fall below -3 SDs (severe) Total number of children under five years of age weighed and measured and examined Global Acute Malnutrition4 Number of children under 5 years of age with weight for height below -2SD, MUAC below 12.5 cm or oedema Total number of children under five years of age weighed, measured and examined 11 Use of improved drinking water sources Number of household members living in households using improved sources of drinking water Total number of household members in households surveyed 12 Use of improved sanitation facilities Number of household members using improved sanitation facilities Total number of household members in households surveyed 15 Exclusive breastfeeding rate Number of infants less than 6 months (and less than 4 months) of age who are exclusively breastfed Total number of infants 0-5 (and 0-3) months old surveyed 16 Continued breastfeeding rate Number of infants 12-15 months, and 20-23 months of age who are currently breastfeeding Total number of children aged 12-15 months; children aged 20-23 months surveyed 17 Timely complementary feeding rate Number of infants 6-9 months old who are receiving breast milk and complementary foods Total number of infants 6-9 months old surveyed � Tajikistan Specific Indicator 6� Multiple Indicator Cluster Survey 2005 MICS 3 INDICATOR NUMERATOR DENOMINATOR 21 Contraceptive prevalence Number of women currently married or in union aged 15-49 years who are using (or whose partner is using) a contraceptive method (either modern or traditional) Total number of women aged 15-49 years who are currently married or in union 22 Antibiotic treatment of suspected pneumonia Number of children 0-59 months old with suspected pneumonia in the previous 2 weeks receiving antibiotics Total number of children aged 0-59 months old with suspected pneumonia in the previous 2 weeks 24 Solid fuels Number of residents in households that use solid fuels (wood, charcoal, crop residues and dung) as the primary source of domestic energy to cook Total number of residents in households surveyed 25 Tuberculosis immunization coverage Number of 15-26 month-olds receiving BCG vaccine before first birthday Total number of children aged 15-26 months surveyed 26 Polio immunization coverage Number of 15-26 -month-olds receiving OPV3 vaccine before first birthday Total number of children aged 15-26 months surveyed 27 DPT immunization coverage Number of 15-26 month-olds receiving DPT3 vaccine before first birthday Total number of children aged 15-26 months surveyed 28 Measles immunization coverage Number of 15-26 month-olds receiving measles vaccine before first birthday Total number of children aged 15-26 months surveyed 29 Hepatitis B immunization coverage Number of children aged 15-26 months immunized against hepatitis B (HepB3) before their first birthday Total number of children aged 15-26 months surveyed 31 Fully immunized children Number of 15-26 month-olds receiving DPT1-3, OPV-1-3, BCG and measles before first birthday Total number of children aged 15-26 months surveyed 37 Under-fives sleeping under insecticide treated nets Number of children aged 0-59 months who slept under an insecticide treated net the previous night Total number of children aged 0-59 months surveyed 38 Under-fives sleeping under bednets Number of children aged 0-59 months who slept under a bednet the previous night Total number of children aged 0-59 months surveyed 39 Antimalarial treatment (under-fives) Number of children aged 0-59 months reported to have fever in previous 2 weeks who were treated with an appropriate antimalarial within 24 hours of onset Total number of children aged 0-59 months reported to have fever in previous two weeks 41 Iodized salt consumption Number of households with salt testing 15 parts per million or more of iodine/ iodate Total number of households surveyed 55 Net primary school attendance rate Number of children of primary-school age currently attending primary school Total number of children of primary school age surveyed. 61 Female to male education ratio Proportion of girls in primary, secondary, and tertiary education Proportion of boys in primary, secondary, and tertiary education 62 Birth registration Number of children aged 0-59 months whose births are reported registered Total number of children aged 0-59 months surveyed 68 Findings from Tajikistan MICS 3 INDICATOR NUMERATOR DENOMINATOR 67 Marriage before age 15, before age 18 Number of women who were first married or in union by exact age 15, 18 by age groups. Total number of women aged 15-49, 20-49 surveyed, respectively, by age groups 68 Young women aged 15-19 currently married or in union Number of women aged 15-19 currently married or in union Total number of women aged 15-19 surveyed 82 Comprehensive knowledge about HIV prevention among young people Number of women aged 15-24 who correctly identify 2 ways of avoiding HIV infection and reject 3 common misconceptions Total number of women aged 15-24 surveyed UNFPA

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