Indonesia - Multiple Indicator Cluster Survey - 2000

Publication date: 2000

BPS Catalogue No: 1150 MULTIPLE INDICATOR CLUSTER SURVEY ON THE EDUCATION AND HEALTH OF MOTHERS AND CHILDREN INDONESIA, 2000 BPS-STATISTICS INDONESIA in cooperation with UNITED NATIONS CHILDREN'S FUND AND MINISTRY OF HEALTH I85fFJ:£ STATISTICS INDONESIA unicef JAKARTA, NOVEMBER 2000 PREFACE The UNICEF Headquarters in New York has determined 70 indicators on the situation of mothers and children to be reported in the World Summit for Children (WSC) goals by participating country at the end of the decade. These indicators can be largely derived from regular surveys of BPS-Statistics Indonesia. However, there are still 15 required indicators on such issues as birth histories, the intergrated management of child illness (IMCI), malaria and HIV/AIDs, that can not be produced from the existing data sources. For this reason, BPS-Statistics Indonesia, in close cooperation with the office of UNICEF-Indonesia and the Center for Health Research and Development-Ministry of Health, conducted a specific survey called "Multiple Indicator Cluster Survey on the Education and Health of Mothers and Children" (MICS) in February 2000. The preliminary report of the survey had been presented at MICS-Technical Meeting in Yangoon-Myanmar on 7-12 August 2000. This is the final report and hence presenting a comprehensive results of the survey. We would like to convey our gratitude and appreciation to UNICEF for kindly providing financial supports for this survey, to the team members, chaired by La Ode Syafiuddin, who have spent plenty of their time for the success of the survey, and to those who have contributed, directly or indirectly, in the endeavor to realize this report. Jakarta,November2000 BPS-Statistics Indonesia Director General Series: ISSN Number: Publication Number: BPS Catalogue: Survey Report Team Members: Editor: Data Processing: Typing and Setting: Art Designer: Published by: Printed by: 05410.0022 979-598-808-5 1150. Soeharsono Sumantri Arizal Ahnaf Wynandin lmawan S. Happy Hardjo Virginia Kadarsan Nikensari Setiadi Uzair Suhaimi Aryago Mulia Yaya Setiadi Gaib Hakiki JB Priyono BPS-Statistics Indonesia May be cited with reference to the source 11 TABLE OF CONTENTS Page Preface . . . . . . . . . . . . . . . . . . . . . . i Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Objectives . . . . . . . . . . . . . . . . . . . . . . 2 1.3 Activity Schedule . . . . . . . . . . . . . . . . . 2 II. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.1 Sample Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.2 Sampling Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.3 Development of Survey Instrument . . . . . . . . . . . . . . . . 4 2.4 Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. 5 Data Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.6 Estimation Method . . . . . . . . . . . . . . . . . . . . . 6 2. 7 Estimates of Sampling Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Ill. Household Characteristics and Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.1 Response Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.2 Household Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3.2.1 Population . . . . . . . . . . . . 10 3.2.2 Age Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 3.2.3 Household Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 3.2.4 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 IV. Results of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 4.1 Children's Right . . . . . . . . . . . 16 4.1 .1 Birth Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 4.1.2 Orphans in the Household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 4.1.3 Children Living Arrangement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 lll 4.2 IMCI and Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 4.2.1 Care Seeking Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 4.2.2 Home Management of Illness . . . . 21 4.2.3 Malaria . . . . . . . . . . 22 4.3 HIV/AIDS . . . . . . . . . 25 4.3.1 Knowledge about AIDS and HIV Transmission . . . . . . . . . . . . . . . . . 25 4.3.2 Attitude toward Persons with AIDS . . . 33 4.3.3 Knowledge and Practice of AIDS Test . . . . . . . 35 4.4 Adolescent Sexual Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Appendix 1: List of Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Appendix 2: Activity Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Appendix 3: Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Appendix 4: Data Processing Stages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 lV Table 3.1 3.2 3.2.A 3.2.8 3.2.C 3.3 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 List of Tables T i t I e Number of household samples and response rates Percentage of population for specific target groups Distribution of households by background Distribution of children under-fives by background characteristics Distribution of women aged 15-49 years by background characteristics Distribution of population aged 5 years and over by sex and educational Attainment Percentage of under-fives by types of birth reporting Reasons of not having birth certificate Percentage of children 0-14 years old who are orphans Percentage of children 0-14 years old and their living arrangement Percentage of caretakers of children under-fives who know at least two appropriate sign for seeking care immediately Percentage of under-fives reported ill during the last two weeks who received increased fluids and continued feeding Percentage of under-fives who slept under insecticide-impregnated bednet during the previous night Percentage of under-fives who were ill with fever and shivering in the last two weeks who received anti-malaria drugs Percentage of women aged 15-49 who have heard of AIDS and know the main ways of preventing HIV transmission Percentage of women aged 15-49 who have heard of AIDS, who know the main ways of preventing HIV transmission Percentage of women aged 15-49 who correctly identify misconceptions about HIV/AIDS Percentage of women aged 15-49 who heard of AIDS, who correctly identify misconceptions about HIV/AIDS Percentage of women aged 15-49 who correctly identify means of HIV transmission from mother to child Percentage of women aged 15-49 who have heard of AIDS, who correctly identify means of HIV transmission from mother to child Percentage of women aged 15-49 who express a discriminatory attitudes towards people with HIV/AIDS Percentage of women aged 15-49 who have heard of AIDS, who express a discriminatory attitudes towards people with HIV/AIDS Percentage of women aged 15-49 and women aged 15-49 who heard of AIDS, who know where to get an AIDS test and who have been tested v List of Figures Figure T i t I e 3.1 Age composition by sex 3.2 Population pyramid 4.1 Percentage of women aged 15-49 who have heard of AIDS, who know three ways of preventing HIV transmission 4.2 Percentage of women aged 15-49 who have sufficient knowledge of HIV/AIDS transmission 4.3 Percentage of women aged 15-49 who heard of AIDS, who know where to get an AIDS test and who have been tested . 4.4 Percentage of ever pregnant women aged 15-49 whose age of their first pregnancy was below 20 years V1 EXECUTIVE SUMMARY The 2000 Multiple Indicator Cluster Survey (MICS) is a nationwide household survey conducted by BPS-Statistics Indonesia in close cooperation with the Ministry of Health and UNICEF. The objectives of the survey is to provide the lacking 15 indicators on the education and health of mothers and children that are required for the end-decade goals (EDG) report. One of these indicators that is attendance rate is regarded irrelevant since the survey was conducted just after a long holiday of school calendar. Birth Registration - Overall, only 31 percent of children under five-years are registered at Civil Registration Office. The other 31 percent just have birth document paper, i.e., note issued by hospital, health center, mid-wife, and the like. - The main reason for not having birth registration is "cost too much". Orphanhood and Living Arrangements of Children - About 3.5 percent of children aged 0-14 years are orphans either whose fathers (2.5%) or whose mothers (1.0%) passed away. The percentage of children whose both parents passed away is negligible. - The percentage of children aged 0-14 years who live with both parents is 89 percent. This is true for both boys and girls and in both urban and rural. IMCI - Almost 80 percent of mothers (caretakers) are able to identify at least two symptoms of the serious sickness of their children that they should be taken immediately to any health facility for treatment. The percentage is similar for urban and rural areas. - About 18 percent of under-five children who were reported have had illness in the two weeks preceeding the survey received increased fluids and continued feeding (using category: ate somewhat less, same or more for feeding). Vll Malaria - About one-third of children under five years slept in the night prior to the survey under bednet and only 0.2 percent of the bednets used are impregnated with insecticide. Only about 3 percent of children under five years who suffered a fever with shivering in the last two weeks prior to the survey and only 4.4 percent of them received anti-malaria drugs. HIV/AIDS Only 15 percent of women aged 15-49 years know all three main ways to prevent H IV transmission these are having only one uninfected sex partner, using a condom every time, avoid using unsterilized/used syringes. Among those who have ever heard of AIDS the percentage who know all three main ways is 24.5 percent. - Also about 15 percent of women correctly identified three misconceptions about HIV transmission, that HIV can transmitted through supernatural means, that it can be transmitted by mosquito bites, and that a healthy looking person cannot be infected. Less than 30 percent of women who correctly identified three probabilities of HIV transmission from mother to her child, i.e., during pregnancy, during delivery, and through breastfeeding. - Almost 40 percent of women express at least one discriminatory attitude towards people with HIV/AIDS, i.e., believe that a teacher with HIV should not be allowed to work or not to buy food from a person with HIV/AIDS. The percentage however, tend to increases as the level of education increases. - About one-fourth of women know a place to get tested for AIDS; however, only less than one percent who have been tested. - The percentage of women who have sufficient knowledge of HIV transmission and the percentage who know where to get tested for HIV increases dramatically with the level of education. Vlll I. INTRODUCTION 1.1. Background The World Summit for Children (WSC} 1990 which was attended by more than 150 heads of government worldwide resulted in the adoption of several decisions that would endure the life, development and protection of mothers and children. The summit requires each participating country, including Indonesia, to determine its own goals for the year 2000. In order to monitor the success of the mother and child welfare program, the UNICEF headquarters in New York has determined as many as 55 indicators to be reported in the WSC goals at the end of the decade, in the year 2000. In the End Decade Goals (EDG) report, another 15 additional/ new indicators are also determined, which constitute some baseline data that can be utilized to targeting the mother and child welfare program for the next decade. The aforementioned new indicators are related to the birth registration, Integrated Management of Child Illnesses (IMCI) and malaria, as well as Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). Nearly all data/indicators for WSC goals could be fulfilled from regular surveys of BPS-Statistics Indonesia (BPS) especially the National Socio-economic Survey (Susenas), Indonesia Demographic and Health Survey (IDHS), or from the existing data collection system of ministries such as Ministry of Health and Ministry of National Education. Meanwhile, data for the 15 indicators has to be collected through a survey, referred to as the Multiple Indicator Cluster Survey (MICS), namely the survey collecting data on various indicators using clusters as unit sampling. The MICS for the year of 2000 is being used in Indonesia under the name of "Multi-Indicator Cluster Survey on Mother and Child Education and Health" (MICS) 2000, which are conducted under the cooperation among BPS, Ministry of Health, Ministry of National Education, National Family Planning Board, and UNICEF. The 2000 MICS was designed as an independent survey. However, due to time and financial constraints, some of stages of this survey were integrated with the 2000 Susenas. Integration was specifically conducted on the use of sample framework for selection of households, training of enumerators and data collections including the transportation cost of national instructors, cost of listing households in selected cluster (enumeration area), and part of supervision costs were charged into the 2000 Susenas activities. In the coming years, indicators collected through the 2000 MICS is expected to be collected or integrated through routine surveys conducted by BPS. End Decade Goals (EDG), UNICEF 1.2. Objectives The objectives of this survey is to provide as many as 15 additional indicators for EDG Reports, for which the data/indicators have not yet available from other sources. Appendix 1 presents the list of indicators and their operational definition. 1.3. Activity Schedule Data collection of the 2000 MICS was conducted on February 2000 while the submission of the report was scheduled on July 2000. Appendix 2 presents the more detailed time schedule of the 2000 MICS. End Decade Goals (EDG), UNICEF 2 II. METHODOLOGY 2.1. Sample size The sample size (=n) for the MICS is determined by the following formula 4 x r x(1-r) xdeff x 1.1 n=----~~--=---- exexpxHz where: r = anticipated prevalence of key indicator is 25 percent, deff = design effect in cluster survey is 1.5, e = margin of error is determined as 3 percentage points, p = target population is 3 percent Hz = household size is 4.5, Expected non response rate and level of confidence are 10 percent and 95 percent respectively. Using Table 4.2 of Manual MICS II, the sample size will be 10,185 households = 10,000 households. It is expected that the size is representative and adequate to produce national estimates of the 15 indicators in concern for both urban and rural areas. 2.2. Sampling Design Most of indicators used for monitoring and evaluation of the end-decade as described in the WSC goals are provided by community (household) based surveys such as Susenas, IDHS and National Household Health Survey (SKRT) as well as by administrative records from Ministry of Health and other institutions. The MICS is conducted to provide information that cannot be produced by the 2000 Susenas or other existing data sources. In order that the results of the MICS can be related to other indicators produced by the Susenas, it is decided that in terms of household samples the survey will be a sub-sample of 2000 Susenas. Accordingly the sampling design of the survey is similar to the sampling design of 2000 Susenas. Since the indicators will be produced for urban and rural areas, the sample size of the MICS which is 10,000 households were allocated evenly for the urban and rural areas, i.e. about 5,000 households in each area. The sampling design of the 2000 Susenas is a three-stage sampling. In the first stage, some Enumeration Areas (EAs) were selected systematically. In each selected EA, segment groups of approximately 70 contiguous households with clear boundaries were formed, and only one segment group was selected by probability proportional to size. The size is a number of households in the segment groups. In the third stage, 16 households were drawn from each segment group using systematic sampling. End Decade Goals (EDG), UNICEF 3 A complete listing of households in the selected segment groups were carried out prior to the selection of 16 households. The selection was done independently for urban and rural areas. There were 4,907 EAs and 8,135 EAs selected in urban and rural areas respectively for the 2000 Susenas. The sampling design of the MICS is a two-stage sampling which is an alternative # 2, i.e. in the first stage some clusters (segment groups of the 2000 Susenas) were selected, and in the second stage16 households were selected in each cluster by systematic sampling. For about 5,000 households would be selected in urban and rural areas, it was decided that 312 clusters in urban and 313 clusters in rural area would be selected. The list of segment groups selected in the Susenas is used as a sampling frame for selecting 625 clusters. The selection is done independently for urban and rural areas. In the first stage the 312 clusters and 313 clusters are selected by probability proportional to size (pps) in urban and rural areas respectively. The households selected for the survey are the same households as selected by the Susenas. Basically, the second stage is the selection of 16 households by systematic sampling in each of 625 clusters selected in the first stage. In total, there would be 4,992 households and 5,008 households selected for the MICS in urban and rural areas. 2.3. Development of Survey Instrument The indicators produced by the 2000 MICS are considered new since they are not covered by other existing data sources, or, if they are available the representativeness is questionable. The indicators are related to the area of the rights of the children and health care. They are: (a) net primary school attendance, (b) birth registration, (c) orphans in households, (d) home management of illness, (e) care seeking knowledge, (~ malaria treatment, (g) knowledge of preventing and transmitting of HIV/AIDS, (h) misconception of HIV/AIDS, (i) knowledge of mother to child transmission of HIV, 0) attitude to people with HIV/AIDS, (k) women who know the place to test for HIV, (I) women who have been tested for HIV, and (m) adolescent sexual behavior. The information being collected through MICS are considered new in the communitylhousehold based survey. A pre-test of questionnaire was conducted to develop survey instrument Two main objective of the pre-test are to test and evaluate the definitions of variables used to collect the information and to find the best way how the enumerators would interview the households. The pre-test was conducted in urban and rural areas located at Sub-District Citeurep and Sub-District Cibinong, West Java. The enumerators are Mantri Statistik (BPS field officer) and were trained by survey planners in a day training session. The number of households enumerated in the pre-test are 40 households in urban areas and 60 households in rural areas. In order for the planners to have first hand inputs to improve the survey instrument, observations are made by the planners during interview and took some notes on two things: (i) the time required to complete certain questions and the full questionnaire and (ii) how the enumerators and respondents interacted to obtained the good answers from each question, i.e. how frequent the enumerators have to read the question. Also, it is important to note that the enumerators do not direct the possible answers by End Decade Goals (EDG), UNICEF 4 respondents. Main problem found in the interviews was that most respondents could not immediately comprehend the question read by enumerators even when it was translated to local language. Discussion session between the planners and the enumerators was held to assess the results of the pretest and to propose necessary recommendation to be incorporated into the final questionnaire (see, final version of the questionnaire in Appendix 3). The summary recommendations are as follows: No. T epic/Questions Concept and definition applied 1. Orphan Household member aged 0-14 years whose biological parent died Biological mother Mother who is stated as biological mother Biological father Father who is stated as biological father I 2. Birth certificate Proportion of children aged 0-59 months whose births are reported registered at Civil Registration Office. It is required by the law that all persons to have birth certificate. The ownership of birth certificate is relatively small in Indonesia. However, a substantial amount of births are a/so noted in the so called note of birth /birth document paper issued among other by hospital, Public Health Center (Puskesmas), midwife, village or sub-district office. It is recommended, therefore, to incorporate the question on birth document paper in the questionnaire. The enumerators should ask the respondents to show either the birth certificate or birth document paper (in Indonesia name = Surat Kenai Lahir) 3. Care seeking knowledge The knowledge of care taker on the signs/symptoms that the children need medical treatment 4. Home management of illness Proportion of children 0-59 months who were ill during the last two weeks and received increased fluids and continued feeding. It was found that respondents could easily mention the differences of food intake between normal and increased or reduced, but have difficulty in differentiating between somewhat less or much less. Based on this pre-test result, the team decided that these two categories of answer (i.e., somewhat less and much less) were grouped into one category. 5. HIV/AIDS Information collected on knowledge of HIV/AIDS, knowledge of preventing HIV/AIDS, and misconception about the transmission of HIV/AIDS. Enumerators are not allowed to read alternative answers. 6. Malaria treatment and Bednets Information collected include knowledge of symptom of malaria, malaria treatment, the use of bednet. These data will not be collected in specific (malaria-risk) area only, but for all parts of the country 7. Adolescent sexual behavior This data covered ever married women aged 15-49 years only. End Decade Goals (EDG), UNICEF 5 2.4. Data Collection Data collection was conducted through interviews between enumerators and respondents. Information about children under-5 years was gathered from their mother or caretakers. Field workers consist of enumerators and supervisors. Enumerators are BPS organic staffs at sub regency or regency/municipality offices, while supervisors are the Section Head of Population Statistics at selected BPS regency/municipality offices. Supervisors are responsible for the accuracy of all enumeration results in their area, including conducting field supervision in one selected enumeration area. A three stage of training were conducted prior to data collection. The first stage was the training for the national instructors. This training was conducted centrally and facilitated by the EDG team, comprised of BPS, UNICEF, and Ministry of Health Officials. The second stage was training for regional instructors which were conducted in every BPS province offices, followed by training for enumerators and supervisors (the third stage). Regional instructors are BPS officials at province offices. 2.5. Data Processing Data processing was conducted according to the stages recommended by the facilitators of the "MICS2 Data Processing Workshop" which was held in Bangkok-Thailand, on March 27 to April 7, 2000. However, since the MICS 2 data processing has been started prior to that workshop then not all data processing stages can be documented properly. In general, the data processing stages can be divided into two parts, namely primary data processing and secondary data processing. The sequences of the primary data processing are 1) main data entry, 2) structural check, 3) re-entry, 4) verification, 5) editing and back up data. The secondary data processing includes, among others, transferring data into SPSS, receding variables, adding sample weights, and generating tabulation. Details work in data processing stages we presented in Appendix 4. 2.6. Estimation Method A Estimation of the total value of y for domain urban, Y u , rural, Y r , areas, and all domains, y Cu+rY using the following formula: and ~ ~ Yu=PuYu' Estimation of the average value of y for each domain urban or rural areas, Y u 1 r is J Wulr 1 16 Ywr = 16wu!r ~~~Yift End Decade Goals (EDG), UNICEF 6 where, Yu ),:', Pu " Pr Yiit Wu Wr is the mean of variable yin urban area is the mean of variable yin rural area is the number of population in urban area is the number of population in rural area. is the value of variable yin the household t, the segment group j, the EAs i is the number of selected EAs in urban area is the number of selected EAs in rural area The estimate for a specific indicator can be computed using its definition and estimation of related variable y. 2.7. Estimates of Sampling Errors In the 2000 MICS , sampling error is measured in term of the standard error of an estimation value of indicator that is the square root of its variance. The Standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For any given indicator value calculated from MICS, the value will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design. The computer software used to calculate sampling errors is the CLUSTERS. The CLUSTERS package treats any percentage or average as a ratio estimate, r=ylx, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance: In which Zhi = Xhi - r Yhi and Zh = Xh - r Yh in which h represents the stratum which varies from 1 to H mh is the total number of enumeration areas selected in the h1h stratum Xhi is the sum of values of variable y in EA i in the h1h stratum Yhi is the sum of the number of cases in EA i in the h1h stratum f is the overall sampling fraction, which is so small that it is ignored End Decade Goals (EDG), UNICEF 7 Sampling errors are presented in table below. ESTIMATION OF SAMPUNG ERRORS OF INDICATORS Standard Confidence Limits Value Relative Indicators error R-2SE R+2SE (R) error (SE) 1. Proportion of chilcren Ounder-fives whose births are 30.6 1.345 0.044 27.910 33.290 reported registered at civil registration office 2. Proportion of chihten aged 0-14 years who are cxphans, 3.5 0.590 0.169 2.320 4.680 one or both parents dead 3. Proportion of children aged 0-14 years who are not living 2.6 0.306 0.118 1.988 3.212 with biological parent 4. Proportion of caretakers of chilcren under-fives who know 78.1 1.429 0.018 75.242 80.958 at least two signs for seeking care immediately 5. Proportion of children under-frves who were Ill during the last two weeks and received increased fluids and continued 24.6 1.445 0.059 21.710 27.490 feeding 6. Proportion of chilcren under-fives who slept under 0.2 0.110 0.550 -0.020 0.420 insecticide-impregnated bednet during the previous night 7. Proportion of chilcren under-frves who were ill with fever and shivering in the last two weeks and received anti- 4.4 0.874 0.199 2.652 6.148 malaria <tugs 8. Proportion of vnnen aged1549 years who correctly state 15.3 0.937 0.061 13.426 17.174 the three main ways of preventing HIV transmission 9. Proportion of v.anen aged 15-49 years who correctly 14.8 0.807 0.055 13.186 16.414 identify three misconceptions about HN/AIDS 10. Proportion of v.anen aged 1549 years who correctly 28.5 1.180 0.041 26.140 30.860 identify means of HIV transmission from mother to child 11. Proportion of v.anen aged 1549 years who express a 37.4 1.253 0.034 34.894 39.906 discrininatory attitudes towards people with HN/AIDS 12. Proportion of \lmlen aged 1549 years who know where to 24.4 1.222 0.050 21.956 26.844 get a HIV test 13. Proportion of v.anen aged 1549 years who have been 0.6 0.094 0.157 0.412 0.788 tested for HIV 14. Median age of gins/women at first pregnancy *) 18 - - - - *) Its sampling error could not be calculated End Decade Goals (EDG), UNICEF 8 Ill. HOUSEHOLD CHARACTERISTICS AND DATA QUALITY 3.1. Response Rate Out of 10.000 the targeted household samples 9.872 or 98.7% of them were successfully interviewed. In fact, the response rates in all provinces were almost 100 percent except in Maluku. In that province, mainly due to social and political instability, the response rate, was only 11 percent For this reason, samples from Maluku are deleted from the data files of the survey and hence ignored in this report. Appendix 4.1 presents the target sample and its realization in each province. Table 3.1 presents individual response rate by a number of characteristics. As shown by the table, the response rate for eligible women (aged 15-49), for example, is almost 100 percent For eligible children (aged under-5), as another example, the response rate is 100 percent Table 3.1. Number of households sample and response rates, MICS 2000, Indonesia Characteristics Urban Rural Total Number of households Sampled 4992 5008 10000 Occupied 4926 4926 9852 Interviewed 4873 +llfl::50/ f 4858 9731 Response rate(%) 98.92 98.62 98.77 Number of women aged 15-49 years Eligible 5956 5232 11188 Interviewed 5953 5230 11183 Response rate (%) 99.95 99.96 99.96 Number of HH member aged 5-17 years Eligible 5354 5832 11186 Interviewed 5349 5832 11181 Response rate(%) 99.91 100.00 99.96 Number of children under 5 years Eligible 1996 2057 4053 Interviewed 1996 2057 4053 Response rate (%) 100.00 100.00 100.00 End Decade Goals (EDG), UNICEF 9 3.2. Household Characteristics 3.2.1. Population For the reason mentioned before, data from Maluku are deleted from the data files. By ignoring that province, the projected total population of Indonesia in February 2000 is 204.7 million. As shown by Table 3.2, about 40.8 percent of them are living in urban areas. Table 3.2 also shows that the percentages of population under-5 and under-15 are 9.8 and 30.6 percent respectively. These percentages are much lower than that of 1 990 when the percentage are 11.7 and 36.6 percent for under-5 and under-15 respectively. The decline in the percentages is mainly attributable to fertility decline during the period. Comparison between urban and rural areas shows that the percentages of both children under-5 and under-15 are higher in rural than urban areas. Table 3.2. The percentage of population for specific target groups, Indonesia, 2000 Target groups Urban Rural Total Children 0-4 years 9.4 10.1 9.8 Children 0-14 years 28.6 32.1 30.6 Women 15-49 years 28.9 25.9 27.1 All ages 100.0 100.0 100.0 Weighted sample 16,632 24,142 40,774 distribution 3.2.2. Age Composition Figure 3.1 shows what so-called age heaping, a preference for certain ages, particularly those ending with 0 and 5, in age reporting in this survey. This is not surprising since it is a common feature in age data in Indonesia and in most other developing countries as well. The figure also shows that age heaping is true for both males and females and it is more obvious for ages 20 or over. Age heaping is the main reason for grouping ages into five-years. End Decade Goals (EDG), UNICEF 10 Figure 3.1. Age composition by sex, Indonesia 2000 400 Q) c. E ca 300 (/) -0 "-Q) .c 200 E :::s z 100 MALE 0~--~~~~~-r~~~~,-,-~~~~~ FEMALE 0 10 20 30 40 50 60 70 80 90 5 15 25 35 45 55 65 75 85 95 AGE Figure 3.2 shows the percentage age-sex distribution of the population by five-year age groups. It resembles pyramid in that it has a narrow top and a wide base, reflecting a pattern of typical countries with relatively still high fertility rate. Nonetheless, relatively lower percentages for the first three age groups indicate fertility decline in Indonesia during the last two decades. End Decade Goals (EDG). UNICEF 11 75+ 65-69 55-59 ~ 45-49 Q . "" ~ 35-39 < 25-29 15-19 5-9 3.2.3. Household Size Figure 3.2 Population Pyramid, Indonesia 2000 6 4 2 0 2 4 6 Percent I m Male m Female I The projected total households in Indonesia (excluded Maluku) is 49.424 million and about 42 percent of them located in urban areas. The number of household member varies but, as shown by Table 3.2.A, it mos~y ranges between 2 and 5. About 20 percent of households may be regarded as big as they have member more than 5 persons. Such households are sligh~y more prevalent in urban than in rural areas. It is worth noting that big household may reflect an extended family and does not necessarily mean a high fertility. Table 3.2.A also shows age composition of household members. It shows that about two-third of households have at least one child aged under-15 years, about one-third have at least one child aged under-5, and mosUy have at least a woman of reproductive ages (15-49). The percentage of households with children under-5 or under-15 is higher in rural than in rural areas. In contrast, the percentage with reproductive mother is higher in urban than in rural areas. End Decade Goals (EDG), UNICEF 12 Table 3.2.A. The percentage distribution of households by background characteristics, Indonesia, 2000 Village Classification Weighted sample Characteristic Urban l Rural I Total disrtibution Number of household members 1 5.3 5.0 5.1 502 2-3 31.7 35.1 33.7 3,320 4-5 41.8 41.8 41.8 4,118 6-7 16.6 14.4 15.4 1,517 8+ 4.6 3.7 4.0 394 Total Household 100.0 100.0 100.0 Weighted sample distribution 4,150 5,702 9,852 At least one child age < 15 64.1 68.7 66.7 6,571 At least one child age < 5 33.6 34.5 34.2 3,369 At least one women age 15-49 85.0 81.9 83.2 8,197 Table 3.2.8. The percentage distribution of children under five by background characteristics, Indonesia, 2000 Characteristic Village Classification Total Weighted sample Urban I Rural distribution Mother's education Not school 2.6 7.2 5.4 216 Primary 38.4 61.1 52.2 2,086 Secondary 18.8 14.2 16.0 639 Senior secondary 29.6 13.1 19.6 783 University 7.9 1.9 4.2 168 Don't know 2.7 2.5 2.6 104 Total 39.2 60.8 100.00 Weighted sample distribution 1,566 2,430 3,996 Age of children under five years 0 19.8 21 .1 20.6 823 1 18.6 17.4 17.9 712 2 20.6 20.3 20.4 815 3 21.0 22.1 21.7 867 4 20.0 19.1 19.5 779 End Decade Goals (EDG), UNICEF 13 Table 3.2.C. The percentage distribution of women aged 15·49 years by background characteristics, Indonesia, 2000 Village classification Weighted sample Characteristic I Total Urban Rural distribution Woman age group 15-19 7.8 10.7 18.5 2,044 20-24 7.9 8.9 16.9 1,867 25-29 7.3 9.0 16.3 1,801 30-34 6.2 8.2 14.5 1,602 35-39 5.8 8.4 14.1 1,558 40-44 4.9 6.8 11.7 1,293 45-49 3.4 4.7 8.0 884 Total 43.4 56.6 100.0 Weighted sam~le distribution 4,796 6,254 11,050 Marital status CurrenHy married 26.6 41.1 67.8 7,492 Widowed 1.0 1.3 2.3 254 Divorced 0.9 1.2 2.1 232 Never married 14.9 12.9 27.8 3,072 Ever been pregnant Yes 26.2 40.2 66.4 7,337 No 2.0 3.1 5.1 564 Not applicable 15.2 13.3 28.5 3,149 3.2.4. Education Level of education is closely associated with other socio-economic factors and demographic behavior such as income, lifestyle, reproductive behavior, health status of children, and housing conditions. Table 3.3 indicates that there are differences in level of education between male and female. As a whole, men are relatively better educated than women. The percentage of male population who have never been enrolled in school (not school) is less than 9 percent compared to almost 15 percent among female population. In addition, while 40 percent of men have at least attained some secondary school, the corresponding figure for women is only 33 percent End Decade Goals (EDG), UNICEF 14 It is worth to mention however, that school participation among young ages is relatively the same, or even slightly better for females than males. For age group 5-9, for example, 28 percent of boys in compared to 23 percent of girls have not yet or never enrolled in school. For age group 10-19 year, the percentage is the same (1.13%) for both boys and girls. Table 3.3. The percentage distribution of population aged 5 years and over by sex, age group and educational attainment, Indonesia, 2000 Education Level Sex/Age group Not Pre Junior Senior College/ Total Primary school school secondary secondary University Male 5-9 28.04 4.22 67.74 0.00 0.00 0.00 100.00 10-19 1.13 0.00 48.67 30.79 18.30 1.12 100.00 20-29 1.47 0.00 35.21 22.57 31.86 8.90 100.00 30-39 3.66 0.00 46.44 16.18 24.84 8.88 100.00 40-49 6.62 0.00 58.25 12.79 15.69 6.65 100.00 50+ 21.62 0.00 58.34 7.37 9.35 3.32 100.00 Total 8.72 0.49 50.77 17.13 18.06 4.83 100.00 Female 5-9 23.32 4.53 72.15 0.00 0.00 0.00 100.00 10-19 1.13 0.00 47.42 32.66 17.56 1.23 100.00 20-29 2.38 0.00 44.99 17.50 26.02 9.11 100.00 30-39 7.64 0.00 55.44 12.83 17.75 6.34 100.00 40-49 15.78 0.00 61.39 10.44 9.56 2.84 100.00 50+ 47.68 0.00 42.18 5.06 4.12 0.96 100.00 Total 14.88 0.52 51.91 15.06 13.96 3.67 100.00 Male +Female 5-9 25.67 4.38 69.95 0.00 0.00 0.00 100.00 10-19 1.13 0.00 48.06 31.70 17.94 1.17 100.00 20-29 1.94 0.00 40.25 19.96 28.85 9.01 100.00 30-39 5.68 0.00 51.01 14.48 21.25 7.59 100.00 40-49 10.98 0.00 59.74 11.67 12.77 4.84 100.00 50+ 35.33 0.00 49.84 6.15 6.60 2.08 100.00 Total 11.82 0.51 51.34 16.09 16.00 4.25 100.00 End Decade Goals (EDG), UNICEF 15 IV. RESULTS OF THE SURVEY 4.1 Children's Right 4.1.1 Birth Registration Not all births of Indonesia's children are registered as required by the law. Table 4.1 shows that in overall, about 31 percent of total births of children under-5 were registered at civil registration office, some other 31 percent were reported by birth document provided by institutions other than civil registration office, and some 37 percent were not reported at all. Comparison between sex and type of residence shows that the percentage of those registered at civil registration office is rather surprisingly slightly higher for girls than for boys and as expectedly much higher in urban than in rural areas. Table 4.1 also shows that the percentage of children who have birth certificate, that is registered at civil registration office, as might expected is higher for higher educational attainment of mothers. As illustration, the percentage is less than five percent for children whose mothers have no education at all, and in contrast, is about 79 percent for those whose mothers graduated from university. Table 4.1. Percentage of under-5 children by types of birth reporting, Indonesia, 2000 Background Type of birth reporting Weighted characteristics Registered at civil Birth document paper from Unreported Don't know sample registration office village/hospitaUothers distribution Sex Male 30.1 30.9 37.6 1.4 2,094 Female 31.2 31 .2 35.7 1.9 1,902 Residence Urban 47.5 31.2 19.9 1.4 1,566 Rural 19.7 31.0 47.5 1.8 2,430 Mother's education None 4.7 28.2 64.2 2.9 216 Primary 17.8 34.0 46.4 1.8 2,086 Junior secondary 35.5 30.8 32.6 1.1 639 Senior secondary 58.2 26.7 14.5 0.6 783 University 79.3 17.1 3.6 0.0 168 Don't know 23.9 34.3 31.5 10.3 104 Age 0-11 months 26.7 33.3 38.8 1.2 823 12-23 months 32.8 31.1 34.1 2.0 712 24-35 months 32.2 30.6 36.3 0.9 815 36-47 months 29.3 30.6 38.2 1.9 867 48-59 months 32.6 29.6 35.7 2.1 779 ~otal 30.6 31.1 36.7 1.6 3,996 End Decade Goals (EDG), UNICEF 16 There are some reasons why children are not protected by birth certificates. Among the reasons is that birth certificate is too expensive that parents cannot afford to acquire it for their children. Table 4.2 shows that 47 percent of parents perceive that birth certificates "cost too much" and about 27 percent they "must travel too far" to acquire it It is worth noting for birth registration office that the percentage of "cost too much" is high in both urban and rural areas and still relatively high even for children whose mothers are well educated. Most parents seem well informed about the importance of birth certificate for their children. This can be shown from a relatively small percentage of respondents who declare that the reason for not acquiring birth certificate for their children is "didn't know it should be registered". Table 4.2. Reasons of not having birth certificate, Indonesia, 2000 Background Cost too Must travel Didn't know it Late, didn't Didn't know characteristic much too far should be want to pay where to Others registered fine register Sex Male 49.1 28.5 17.0 12.4 23.8 42.6 Female 44.7 25.9 15.6 10.9 24.0 46.5 Residence Urban 48.8 19.3 13.5 15.5 19.8 46.5 Rural 45.9 32.4 18.2 9.3 26.6 43.1 Mother's education None 47.2 23.2 28.4 4.0 46.0 18.4 Primary 48.6 33.2 20.8 11.9 28.2 40.2 Junior secondary 54.1 21.4 10.3 13.2 17.8 51.6 Senior secondary 39.0 17.6 6.3 12.6 2.6 55.7 University 20.2 9.7 2.4 11 .7 0.0 79.8 Don't know 45.5 18.0 10.1 6.7 20.6 40.2 Age of child 0-11 months 38.9 21.6 14.5 8.5 21.0 52.8 12-23 months 45.3 24.7 13.1 9.8 23.0 43.6 24-35 months 42.7 25.7 17.0 11.3 25.4 46.6 36-47 months 55.6 30.8 19.2 14.6 23.6 38.7 48-59 months 53.3 34.0 17.6 14.5 27.0 39.6 Total 47.0 27.2 16.4 11.7 23.9 44.5 Note: The figure is among the mother whose child just have birth document paper End Decade Goals (EDG), UNICEF 17 4.1.2 Orphans in the Household Table 4.3 shows that about seven percent of children under-15 are reported orphans in that one or both biological parents passed away. The table also shows that the percentage of children whose fathers passed away is more than twice than that of whose mothers passed away. In addition, not all children whose one of their parents passed away live in the same households with their survived parents. Table 4.3. Percentage of children 0·14 years old who are orphans, Indonesia, 2000 Mother dead Father dead Background Both parents One or both Weighted sample characteristics Living with Living with Living with Living with dead parents dead distribution neither father neither mother Sex Male 0.04 1.09 0.03 2.52 0.01 3.69 6,351 Female 0.05 0.92 0.02 2.37 0.00 3.36 6,126 Residence Urban 0.09 0.93 0.03 2.71 0.00 3.76 4,744 Rural 0.02 1.06 0.02 2.29 0.01 3.40 7,733 Age 0-4 years 0.03 0.25 0.00 0.77 0.00 1.05 3,996 5-9 years 0.03 1.20 0.04 2.07 0.02 3.36 4,277 10-14 years 0.08 1.53 0.03 4.42 0.00 6.06 4,224 Total 0.05 1.01 0.02 2.45 0.01 3.54 12,477 4.1.3. Children Living Arrangement It is obvious that living with both biological parents are important for mental and social development of children. Table 4.4 shows that 89 percent of children aged under-15 live that way. The percentage of those living with mother only is about five times higher that those living with fathers only. In addition, there are 2.6 percent of children in the same age group live without biological parents at all. The percentage is similar for both boys and girls and in both urban and rural areas but is comparatively higher for older age groups. End Decade Goals (EDG), UNICEF 18 Table 4.4. Percentage of children 0-14 years old and their living arrangement, Indonesia, 2000 Background Living with both Living with Living with Not living with Impossible to characteristics parent father only mother only biological parents determine Sex Male 88.6 1.9 6.4 2.7 0.4 Female 89.4 1.6 6.0 2.6 0.4 Residence Urban 89.2 1.5 6.4 2.6 0.3 Rural 88.9 1.97 6.1 2.7 0.4 Age 0-4 years 93.3 0.7 4.4 1.5 0.1 5-9 years 88.7 2.2 6.0 2.5 0.6 10-14 years 85.2 2.4 8.1 3.8 0.5 Total 89.0 1.8 6.2 2.6 0.4 4.2 IMCI and Malaria 4.2.1 Care Seeking Knowledge The majority of caretakers of under-5 children know the signs when they have to seek care immediat~ly. Table 4.5 indicates that 78 percent of caretakers can identify at least two appropriate signs for taking their under-5 children to any health facility. The knowledge of caretakers in care seeking is relatively similar between urban and rural areas. The knowledge of care seeking seems to be less correlated with education of mother. The percentage by education background ranges from 72 percent (the lowest) for mothers with no education to 82.8 percent (the highest) for mother with junior secondary education background. End Decade Goals (EDG), UNICEF 19 Table 4.5 also presents that two most common reasons for seeking care immediately are the child develops a fever or becomes sicker. In urban areas, develops a fever is more prominent sign than becomes sicker. While 81 percent of caretakers in urban areas considered develops a fever as a sign for seeking care immediately, in rural areas the corresponding proportion is 74 percent. In the contrary, while 75 percent of caretakers in urban areas considered becomes sicker as a sign for it in rural areas the figure is 77 percent The least known signs which is considered by both urban and rural residents as the sign for seeking care immediately, is drinking poorly. Only 18 percent in urban areas and 16 percent of rural areas of caretakers mentioned that drinking poorly is the sign to take their children to the health facility immediately. Table4.5. Percentage of caretakers of under-5 children who know at least two appropriate signs for seeking care immediately, Indonesia, 2000 Knows appropriate sign for seeking care immediately, that is: Knows at Background Notableto 8 Has least two characteristics d. kl ecomes Develops Has fast difficult Has blood Is drinking nn 'ck a fever breathing in stool poorly signs breastfeed Sl er breathing Residence Urban 41.6 74.5 81 .3 30.6 41.7 45.9 18.0 78.3 Rural 44.3 76.9 74.1 31 .2 41.5 47.2 16.4 78.0 Mother's education None 33.6 69.0 69.2 25.4 34.7 40.2 10.0 72.0 Primary 41.0 76.0 75.1 29.4 40.7 45.3 14.8 76.6 Junior secondary 47.4 78.2 79.6 34.9 42.5 46.8 21.8 82.8 Senior secondary 47.6 76.1 80,5 31.9 43.3 51 .5 18.9 80.5 University 51.0 75.9 86.8 37.9 48.1 50.1 26.9 79.2 Don't know 38.3 75.6 69.9 32.5 44.5 46.3 15.3 73.0 Total 43.2 76.0 76.9 31.0 41.6 46.7 17.0 78.1 End Decade Goals (EDG), UNICEF 20 4.2.2 Home Management of Illness The knowledge of caretakers for care seeking immediately is not accordance with their knowledge to appropriate management of illness while their child was sick. Among 37 percent of under-5 children reported ill during the last two weeks, only 18 percent who received increased fluids and continued feeding. There is no significant difference in home management of illness among caretakers between urban and rural areas. There are 17 percent of under -5 children in urban areas and 19 percent in rural areas who were reported ill during the last two weeks received appropriate home management of illness. Table4.6. Percentage of under-5 children reported ill during the last two weeks who received increased fluids and continued feeding, Indonesia, 2000 Reported Children with illness who: Background illness in Ate some what Took increased characteristics last two Drank the less, same or Ate none fluids and continued Drank more same or less weeks more eating Sex Male 37.5 16.7 81.4 97.1 1.6 16.6 Female 35.7 20.0 77.5 95.2 2.5 19.7 Residence Urban 38.1 17.4 79.8 95.6 1.9 17.3 Rural 35.7 18.8 79.4 96.6 2.0 18.6 ~other's education None 36.0 10.9 88.2 98.7 1.3 10.9 Primary 35.7 18.2 79.8 97.4 0.9 18.0 Junior secondary 39.6 18.7 78.5 94.6 3.2 18.7 Senior secondary 37.2 20.0 78.4 93.8 4.7 19.5 University 37.0 18.1 78.2 97.4 0.0 18.1 Don't know 33.7 17.7 75.1 94.8 0.0 17.7 ~ge 0-11 months 38.6 15.8 82.7 90.4 8.1 14.8 12-23 months 44.9 19.4 78.9 98.0 1.1 19.4 24-35 months 36.6 17.9 78.8 97.2 0.0 17.9 36-47 months 33.6 20.1 77.6 97.9 0.0 20.1 48-59 months 30.4 18.1 79.8 98.2 0.0 18.1 ~otal 36.6 18.3 79.6 96.2 2.0 18.0 End Decade Goals (EDG), UNICEF 21 4.2.3. Malaria Malaria is one of a cause of death of children under age five in Indonesia, especially in malaria risk areas. It also contributes to anemia in children and is a common cause of school absenteeism. Preventive measures, especially the use of mosquito nets treated with insecticide, can dramatically reduce malaria mortality rate among children. In areas where malaria is common, international recommendations suggest treating any fever in children as if it were malaria and immediately giving the child a full course of recommended anti-malaria tablets. Children with severe malaria symptoms, such as fever or convulsions, should be taken to a health facility. Also, children recovering from malaria should be given extra liquids and food and should continue breast-feeding. The 2000 MICS questionnaire incorporates questions on the use of bednets and prevalence of malaria among children. Since the 2000 MICS sample design is integrated into Susenas and taking into account that there is no reliable frame of malaria risk area, then the questions about bednets and malaria were applied in all parts of the country. Only 32 percent of under-5 children slept under a bed net the night prior to the survey interview (Table 4.7.). This percentage decline steadily with age. There are about 40 percent of infants under 12 months sleep under a bednet compared to 32 percent of children aged 12-23 months and 28 percent of children aged 48-59 months. Most of the bed nets are not treated with insecticide, however. Overall, only 0.2 percent of the bed nets used are impregnated with insecticide. Considering that one important symptom of malaria is fever with shivering, additional question about shivering is inserted into the 2000 MICS questionnaire. Almost one in four of under-five children were ill with fever during two weeks prior the survey. Among these ill children however, only three percent have a fever with shivering. The prevalence of fever is highest for children aged 0-11 months (29 percent), and the lowest is for children aged 48-59 months (18 percent). Prevalence of fever with shivering is the highest for children aged 24-35 months. Fever is less common among children whose mothers have senior secondary or higher education than among children of less educated mothers. Urban-rural difference in fever prevalence is relatively small, these are 22 percent in urban and 24 percent in rural areas. Mothers were asked to report all of the medicines given to a child during their illness, both any medicine given at home and medicines given or prescribed at a health facility (Table 4.8). Out of three ercent children who have a fever with a shivering only 4.4 percent received any appropriate anti-malaria drug (either chloroquine, fansidar or local anti-malaria drug/eukinine). Meanwhile, about two-third of End Decade Goals (EDG), UNICEF 22 children received any other fever drug, and another 28 percent answered that they don't know the name of the drug. It seems that the higher the age of children the greater the percentage of children who received any appropriate anti-malaria drug. Meanwhile there is no clear pattern with regard to the education of mother. Table 4.7. Percentage of under-5 children who slept under insecticide-impregnated bednet during the previous night, Indonesia, 2000 Slept under a bednet Background Slept under characteristics a bednet Bednetnot Don't know Bednet treated treated if treated Sex Male Female Residence Urban Rural Age4 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Total 32.2 31.8 23.3 37.5 40.1 31.8 30.5 29.6 27.9 32.0 End Decade Goals (EDG), UNICEF 0.2 0.2 0.1 0.3 0.2 0.1 0.0 0.3 0.4 0.2 ~------· 29.9 28.8 20.9 34.8 37.9 29.2 28.0 26.6 25.2 29.4 \ Jt 2.0 2.8 2.3 2.4 2.0 2.5 2.5 2.6 2.3 2.4 .-. Don't know if slept under bed net 3.3 3.5 3.4 3.4 3.1 3.2 2.5 4.0 4.0 3.4 Did not sleep under bed net 64.5 64.7 73.3 59.1 56.8 65.0 67.0 66.4 68.1 64.6 23 Table 4.8. Percentage of under·5 children who were ill with ·fever and shivering in the last two weeks who received anti-malarial drugs, Indonesia, 2000 Background characteristics Sex Male Female Residence Urban Rural Mother's education None Primary Junior secondary Senior secondary University Don't know Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Total Had a fever with shivering in last two weeeks 3.1 3.1 2.2 3.6 4.8 3.7 3.5 1.1 0.3 3.7 1.9 2.6 4.9 3.1 2.8 3.1 Chloro quine 2.4 4.2 3.5 3.2 4.6 2.0 4.4 6.1 2.4 0.0 2.1 2.6 2.5 3.9 6.2 13.3 I \. . _ .~······· End Decade Goals (EDG), UNICEF Children with a fever with shivering who were treated with: Fansidar 0.2 0.4 0.4 0.2 0.0 0.0 1.3 0.4 0.0 0.0 0.0 0.4 0.0 0.7 0.4 0.3 Pil Kina/ Eukinine 1.0 1.4 2.4 0.5 0.0 1.4 0.6 1.3 0.0 6.4 0.4 0.2 1.9 1.5 2.7 1.2 Any other fever drug 68.8 66.3 64.6 69.3 76.2 67.5 67.1 67.9 60.5 60.2 64.0 70.6 67.0 67.7 68.8 67.6 Don't know 27.6 28.6 29.8 27.1 19.2 29.2 28.0 25.4 37.2 33.4 33.5 26.2 28.6 27.6 23.0 28.1 Any appropriate anti-malarial drug 3.6 5.2 5.7 3.6 4.6 3.3 5.0 6.7 2.4 6.4 2.6 3.3 4.4 4.7 8.2 4.4 ':, 24 4.3 Human Immunodeficiency Virus (HIV)/Acquired lmmuno Deficiency Syndrome (AIDS) Various efforts to prevent transmission of the Acquired lmmuno Deficiency Syndrome (AIDS) has been done including public health education through the mass media and non-governmental organizations. The Ministry of Health also established a coordination board for control of the disease caused by the Human Immunodeficiency Virus (HIV) in 1986. Knowledge, attitude and practice of the community related to HIV/AIDS will reflect the achievement of these efforts, which can be assessed from the 2000 MICS. 4.3.1 Knowledge about AIDS and HIV Transmission Table 4.9 shows the proportion of women aged 15-49 years old who have heard about AIDS and know the main ways of preventing HIV transmission. The table also shows that 62 percent of women aged 15-49 reported that they have heard of AIDS. Urban women and women with high education are more likely to have heard about the disease. About 80 percent women in urban have heard of AIDS compared to only 50 percent women in rural. Almost 1 00 percent of women with college or university education have heard of AIDS, but only 15 percent of women with no education have heard of AIDS. Some statements related to ways of preventing HIV transmission were inserted in the 2000 MICS questionnaire to be asked to a vulnerable segment of population that is women aged 15-49. Among of the statements are 'Have only one faithful uninfected sex partner', 'Using a condom every time', and 'Avoid using unsterilized/used syringes'. These statements are regarded reflecting the basic knowledge of women about AIDS. The survey shows that only 39 percent of women aged 15-49 respond correc~y on at least one of the statements and 15 percent of them respond correc~y on all of the three statement Statement of having only one faithful uninfected sex partner was responded correc~y by 35 percent of the women, while the other two statements were correc~y responded by 21-25 percent of them (Table 4.9). Education and residence of the women have likely strong relationship with these basic knowledge. The higher education of the women and · those who stay in urban residence are likely much more have knowledge on HIV transmission. It can be seen that 91 percent of women with college or university education compared to only 26 percent with no education know at least one way of preventing HIV transmission. The percentage for women in urban is 54 percent compared to women in rural, 27 percent. The percentage of those who know all three ways of preventing HIV transmission are much lower, only 53 percent of those with college/university education and 24 percent of those live in urban area (Table 4. 9). End Decade Goals (EDG), UNICEF 25 Table 4.10 shows the respondents' knowledge of preventing HIV transmission of those women who have heard HIV/AIDS. Almost 25 percent of those women who heard of AIDS know all three ways of preventing HIV transmission, and 62 percent of them know at least one of those three ways. Those women live in urban who know all three ways of preventing HIV transmission (30 percent) are much higher than women live in rural (18 percent). Women education likely much have influence on their basic knowledge of preventing HIV transmission than women age. Percentage of women who know all three ways of prevention ranges from the lowest 9 percent to the highest 53 percent by education, compared to the lowest 20 percent to the highest 29 percent by age group of women (see also Figure 4.1 ). Table 4.9. Percentage of women aged 15-49 who heard of AIDS and know the main ways of preventing HIV transmission, Indonesia, 2000 Know the main ways of preventing HIV Characteristics of Heard of Have only Avoid using Knows at Weighted Using a Knows sample women AIDS one faithful condom unsterilizedl all three least one distribution uninfected every time used way sex partner syringes ways Residence: Urban 78.3 47.1 30.4 39.0 23.6 53.5 4,796 Rural 50.1 25.1 13.4 14.7 9.0 27.2 6,254 Education: No school 15.2 4.6 1.8 2.2 1.3 5.0 696 Elementary 47.3 18.7 9.7 10.5 6.1 20.6 5,326 Junior High 73.6 39.7 21.1 26.5 14.3 44.0 1,934 Senior High 89.9 61.3 39.1 49.4 30.0 69.2 2,453 College/Univ. 99.4 81.4 61 .2 76.1 53.0 91.4 641 Age group: 15-19 65.4 37.3 19.5 25.8 14.7 41 .2 2,044 20-24 72.6 42.2 27.4 31.3 19.0 47.5 1,867 25-29 67.9 40.1 25.2 31 .8 19.5 45.5 1,801 30-34 65.9 36.8 22.8 27.6 16.5 41.4 1,602 35-39 57.3 30.1 17.6 20.9 13.0 32.9 1,558 40-44 50.1 23.8 13.5 16.1 10.0 26.2 1,293 45-49 42.8 21 .1 12.8 14.2 9.9 23.3 884 Total 62.4 34.6 20.7 25.2 15.3 38.6 11,050 End Decade Goals (EDG), UNICEF 26 Table 4.1 0. Percentage of women aged 15-49 who have heard of AIDS, who know the main ways of preventing HIV transmission, Indonesia, 2000 Know the main ways of preventing HIV Characteristics of Heard of Have only women AIDS one faithful Using a Avoid using Knows all Knows at least condom unsterilized/ uninfected every time used syringes three ways one way sex pa(tner Residence: Urban 100.0 60.1 38.8 49.8 30.1 68.2 Rural 100.0 50.0 26.7 29.3 17.9 54.4 Education: No school 100.0 30.1 12.1 14.6 8.8 32.7 Elementary 100.0 39.6 20.6 22.2 13.0 43.6 Junior High 100.0 54.0 28.6 35.9 19.4 59.9 Senior High 100.0 68.2 43.5 55.0 33.4 76.9 College/Univ. 100.0 81 .9 61 .5 76.5 53.3 91.9 Age group: 15-19 100.0 57.0 29.9 39.5 22.5 63.0 20-24 100.0 58.1 37.8 43.1 26.2 65.4 25-29 100.0 59.1 37.1 46.8 28.7 66.9 30-34 100.0 55.9 34.7 41.8 25.1 62.8 35-39 100.0 52.6 30.7 36.5 22.7 57.3 40-44 100.0 47.5 27.0 32.1 19.9 52.3 45-49 100.0 49.3 29.8 33.2 23.1 54.4 Total 100.0 55.5 33.3 40.4 24.5 61.9 Knowledge of women on HIV/AIDS may be checked with their knowledge on some misconceptions about HIV/AlDS. The survey asked the response of respondent on some statements of misconceptions about HIV/AIDS. Table 4.11 shows the women's responses on three statements of misconceptions about HlV/AlDS. The statements include 'AIDS can't be transmitted by supernatural means', 'AIDS can't be transmitted by mosquito bites', and 'A healthy looking person can be infected'. Only 15 percent of women respond correctly all three statements of misconceptions, and 48 percent of them respond correctly at least know one of the three statements. The statement of AIDS can't be transmitted by supernatural means was responded correctly by 42 percent of the women, but only 28 percent of them respond correctly on the other two statements. Education and residence of the women have strong relationship with the correct response on the statements. 65 percent women live in urban versus 35 percent of women live in rural know at least one misconception. Much lower percentage i.e. 21 percent in urban and 1 0 percent in rural know all three misconceptions. The highest educated women (95 percent) versus the no education women (8 End Decade Goals (EDG), UNICEF 27 percent) know at least one misconception and much lower percentage, i.e., 49 percent of the highest educated women and one percent of women with no education know all three misconceptions. Figure 4.1 Percentage of women aged 15-49 who have heard of AIDS, who know three ways of preventing HIV transmission, Indonesia, 2000 lndonnla RESIDENCE Urban Rural EDUCATION NoSchool -7,3 El1111entary -11,8 Junior High SaniorHigh University AGE GROUP 15-19 20·24 25-29 30.34 35-39 45-49 22,9 20,9 23,8 23,8 22,1 19,3 21,5 28,4 28,5 52,1 If we only focus on those women who have heard of AIDS, percentage distribution of women correctly identify misconceptions about HIV/AIDS will change (Table 4.12). About 24 percent of women respond correcijy all three statements of misconceptions, and 77 percent of them at least know one misconception. The statement of AIDS can't be transmitted by supernatural means was responded correc~y by 67 percent of the women, but only 46 percent of them respond correc~y on the other two statements. Meanwhile 83 percent of women live in urban versus 70 percent of women live in rural know at least one misconception. Much lower percentage i.e. 27 percent in urban and 20 percent in rural know all three misconceptions. The highest educated women (95 percent) versus the no education women (53 percent) know at least one misconception and much lower percentage, i.e., 49 percent of the highest educated women and 8.5 percent of women with no education know all three misconceptions. End Decade Goals (EDG), UNICEF 28 Table 4.11 Percentage of women aged 15-49 who correctly identify misconceptions about HIV/AIDS, Indonesia, 2000 Response correctly identify misconception statements Characteristics of AIDS can be AIDS can be A healthy women transmitted by transmitted by looking person Knows all three Knows at least supernatural mosquito bites means can't be infected one Residence: Urban 56.2 38.4 40.7 21.0 64.9 Rural 30.5 20.7 19.2 10.1 35.3 Education: No school 6.7 5.1 3.2 1.3 8.1 Elementary 26.5 17.1 14.7 6.7 31.4 Junior High 47.2 30.5 33.8 15.4 56.1 Senior High 68.3 47.7 49.4 26.9 77.3 College/Univ. 86.4 66.9 74.4 48.6 94.7 Age group: 15-19 44.4 30.8 30.9 16.1 51.2 20-24 49.5 34.2 33.6 16.7 57.0 25-29 48.2 33.1 33.8 19.0 54.8 30-34 44.1 29.9 31.7 17.1 51.0 35-39 36.2 23.8 23.7 11.8 42.2 40-44 30.3 20.2 19.5 9.3 35.6 45-49 26.9 18.2 17.2 8.5 32.2 Total 41.6 28.4 28.5 14.8 48.1 Only small proportion of women aged 15-49 have sufficient knowledge of HIV/AIDS transmission, i.e., those women who know three ways to prevent HIV transmission (Table 4.9) and correctly identify three misconceptions about HIV transmission (Table 4.1 0). Figure 4.2 shows that only three percent of women aged 15-49 have sufficient knowledge of HIV/AIDS transmission. The percentage is higher for women live in urban (5 percent} and women with college/university education (11 percent}. For those women who have heard of AIDS, who have sufficient knowledge of HIV/AIDS transmission is nine percent. The percentage in urban is 11 percent vs~ 6 percent in rural. Women with college/university education who have sufficient knowledge of HIV/AIDS transmission is only 28 percent. End Decade Goals (EDG), UNICEF 29 Table 4.12. Percentage of women aged 15-49 who heard of AIDS, who correctly identify misconceptions about HIV/AIDS, Indonesia, 2000 Correctly identify misconceptions Characteristics of AIDS can't be AIDS can't be A healthy women transmitted by transmitted by looking person Knows all Knows at supernatural mosquito bites can be infected three least one means Residence: Urban 71.7 49.0 51.9 26.8 82.8 Rural 60.8 41.3 38.3 20.1 70.4 Education: No school 44.2 44.2 20.7 8.5 53.1 Elementary 56.0 56.0 31.1 14.2 66.5 Junior High 64.1 64.1 45.9 20.9 76.2 Senior High 76.0 76.0 55.0 30.0 85.9 College/Univ. 86.9 86.9 74.9 48.9 95.2 Age group: 15-19 67.9 47.2 47.3 24.6 78.2 20-24 68.3 47.2 46.3 23.0 78.6 25-29 71.0 48.8 49.8 28.0 80.6 30-34 66.9 45.5 48.1 26.0 77.5 35-39 63.0 41.5 41.3 20.5 73.6 40-44 60.4 40.2 38.9 18.6 71.0 45-49 62.9 42.6 40.2 19.9 75.3 Total 66.8 45.5 45.7 23.8 77.2 An understanding of more in-depth HIV/AIDS related knowledge was obtained by asking every woman with questions which aim to elicit whether the woman knows that the HIV virus can be transmitted vertically. Four questions include whether the woman knows that AIDS virus can be transmitted from a mother to a child, and three means of HIV transmission from mother to child were asked to respondent. Table 4.13 shows percentage of women who correcfiy identify means of HIV transmission from mother to child. Only 38 percent of women aged 15-49 know that AIDS virus can be transmitted from mother to child. Percentage of women know the transmission in urban is almost double than women in rural, i.e., 52 percent vs. 27 percent. The knowledge is related to the education of the women, the higher education of the women the bigger percentage of them knows about the transmission. Among three means of transmission, transmission during pregnancy is known by 42 percent of women followed by transmission through breast-milk (37 percent) and transmission during delivery (34 percent). Only 28 percent of women knows all three means of transmission, and 47 percent of them knows at least one mean of transmission. End Decade Goals (EDG), UNICEF 30 I -I Knowledge for those women who have heard of AIDS are much better than all women in general (Table4.14). 61 percent of women who heard of AIDS know that AIDS can be transmitted from mother to child. Those women live in urban who know the transmission is 67 percent vs. 55 percent for those women in rural. The percentage of women who know all three means of transmission is 46 percent and 75 percent of them know at least one way Figure 4.2 Percentage of women aged 15-49 who have sufficient knowledge of HIVIAIDS transmission, Indonesia, 2000 Indonesia EDUCATION No School r 3•1 Elementary l'.fll! ill 3•5 Junior High -F 5 Senior High ~ University 1$. AGE GROUP 15-19 20-24 25-29 30-34 45-49 Ill li lUlU ue. 11,3 !! ! li 9,4 I• Women aged 15-49 II Women 15-49 who heard of AIDS I End Decade Goals (EDG), UNICEF 28,2 31 Table 4.13. Percentage of women aged 15-49 who correctly identify means of HIV transmission from mother to child, Indonesia, 2000 Know Know means of HIV transmission from mother to child AIDS Transmission Transmission Characteristics of can be Transmission women transmit during at delivery through All three At least one ted pregnancy possible breastrnilk possible possible Residence: Urban 62.7 57.9 48.0 50.3 40.5 62.7 Rural 34.4 30.6 23.4 27.1 19.2 34.4 Education: No school 7.9 6.8 4.2 5.1 3.4 7.9 Elementary 30.1 25.8 19.7 22.8 15.6 30.1 Junior High 55.0 49.4 39.5 45.6 33.5 55.0 Senior High 74.9 70.4 58.5 60.5 49.9 74.9 College/Univ. 93.7 91.0 76.0 76.7 65.8 93.7 Age group: 15-19 48.5 44.0 36.2 38.0 29.8 58.5 20-24 55.5 50.3 38.6 43.3 32.3 45.5 25-29 54.1 50.2 39.7 43.1 33.9 44.1 30-34 49.2 43.7 35.4 40.2 28.9 49.2 35-39 40.8 37.5 29.9 34.0 26.2 40.8 40-44 36.2 32.0 27.4 28.6 22.6 36.2 45-49 30.3 28.1 22.9 23.1 18.1 30.3 Total 46.7 42.4 34.1 37.2 28.5 46.7 End Decade Goals (EDG), UNICEF 32 Table 4.14. Percentage of women aged 15-49 who have heard of AIDS, who correctly identify means of HIV transmission from mother to child, Indonesia, 2000 Know means of HIV transmission from mother to child Characteristics of Know AIDS Transmission Transmission can be Transmission women transmitted during at delivery through All three At least one pregnancy possible breastmilk possible possible Residence: Urban 80.1 73.9 61 .3 64.3 51.8 80.1 Rural 68.6 61.0 46.7 54.1 38.4 68.6 Education: No school 52.0 44.9 27.5 33.9 22.2 52.0 Elementary 63.6 54.6 41.7 48.2 32.9 63.6 Junior High 74.7 67.1 53.7 61.9 45.6 74.7 Senior High 83.3 78.3 65.1 67.3 55.5 83.3 College/Univ. 94.2 91 .6 76.4 77.1 66.2 94.2 Age group: 15-19 74.1 67.4 55.3 58.1 45.6 74.1 20-24 76.5 69.3 53.2 59.7 44.5 76.5 25-29 79.6 73.8 58.5 63.5 50.0 79.6 30-34 74.6 66.3 53.8 60.9 43.9 74.6 35-39 71 .1 65.4 52.1 59.3 45.7 71.1 40-44 72.2 63.9 54.7 57.0 45.0 72.2 45-49 70.8 65.7 53.6 53.9 42.2 70.8 Total 74.9 68.1 54.7 59.6 45.7 74.9 4.3.2. Attitudes towards persons with AIDS Attitudes towards persons with AIDS and discrimination against them will affect efforts to prevent transmission and to care for persons with AIDS. Information about discriminatory attitudes is obtained from responses of women to two statements: 'Believe that a teacher with HIV should not be allowed to work' and 'Would not buy food from a person with HIV/AIDS'. Table 4.15 shows the women's expression towards people with HIV/AIDS. Surprisingly, only 37 percent of women aged 15-49 express a discriminatory attitude towards people with HIV/AIDS, i.e., those women who agree with a least one discriminatory statement This means that 63 percent of women agree with neither discriminatory statement. The percentage of women who agree with the first statement (19 percent) is lower than those who agree of with the second End Decade Goals (EDG), UNICEF 33 statement (35 percent). Also surprisingly that women live in urban and women with higher education tend to agree with the statement (Table 4.15). Table 4.15. Percentage of women aged 15-49 who express a discriminatory attitudes towards people with HIV/AIDS, Indonesia, 2000 Express a discriminatory attitude towards people with HIV/AIDS Characteristics Believe that a Not to buy food Agree with a least Agree with neither of women teacher with HIV should not be from a person with one discriminatory discriminatory allowed to work HIV/AIDS statement statement Residence: Urban 24.6 43.4 46.5 53.5 Rural 15.4 28.3 30.4 69.6 Education: No school 3.9 8.8 9.7 90.3 Elementary 14.4 26.4 28.4 71.6 Junior High 25.2 44.0 46.8 53.2 Senior High 28.3 50.0 53.7 46.3 College/Univ. 26.3 46.4 51.4 48.6 Age group: 15-19 19.6 34.5 36.9 63.1 20-24 20.8 39.4 42.5 57.5 25-29 20.8 36.5 39.7 60.3 30-34 20.3 37.9 40.9 59.1 35-39 19.7 33.4 35.8 64.2 40-44 16.3 31 .7 33.7 66.3 45-49 15.6 23.5 25.0 75.0 Total 19.4 34.8 37.4 62.6 Table 4.16 indicates the discriminatory attitude among those women who have heard of AIDS. Those who agree with at least one of the discriminatory statements is 60 percent, much higher compared with the figure based on Table 4.15. Women in urban and in rural have almost the same percentage of those express a discriminatory attitude towards HIV/AIDS sufferer. 59 percent of women in urban agree with at least one discriminatory statement vs. 61 percent of women in rural. Women with college/university education have lowest percentage of discriminatory attitude {52 percent) compared with other categories of education {60-64 percent). End Decade Goals (EDG), UNICEF 34 Table 4.16 . Percentage of women aged 15-49 who have heard of AIDS, who express a discriminatory attitudes towards people with HIVIAIDS, Indonesia 2000 Express a discriminatory attitude towards people with HIV/AIDS Characteristics of Believe that a Not to buy food Agree with a least Agree with neither teacher with HIV women from a person with one discriminatory discriminatory should not be allowed to work HIV/AIDS statement statement Residence: Urban 31 .3 55.3 59.4 40.6 Rural 30.8 56.4 60.7 39.3 Education: No school 25.5 58.0 63.5 36.5 Elementary 30.4 56.0 60.0 40.0 Junior High 34.3 59.8 63.6 36.4 Senior High 31.4 55.7 59.8 40.2 College/Univ. 26.5 46.6 51.7 48.3 Age group: 15-19 29.9 52.8 56.4 43.6 20-24 28.7 54.4 58.5 41 .5 25-29 30.6 53.8 58.4 41 .6 30-34 30.7 57.6 62.1 37.9 35-39 34.3 58.3 62.4 37.6 40-44 32.5 63.2 67.3 32.7 45-49 36.3 55.0 58.4 41.6 Total 31 .1 55.8 60.0 40.0 4.3.3. Knowledge and practice of AIDS test Table 4.17 depicts that small percentage of women know where to get an AIDS test (24 percent), and much smaller percentage of them (less than one percent) have ever been tested. The percentage of women who know where to get an AIDS test and who have ever been tested are related to place of residence and level of education. Women live in urban and have high education are more knowledgeable about the place to get an AIDS test and more experience being tested. 34 percent women in urban compared to 17 percent women in rural know a place to get tested. For women with college or university education the percentage is 64 percent For women who have heard of AIDS, their knowledge and practice are better (see also Figure 4.3). About 40 percent of them know a place to get tested and one percent of them have ever been tested. End Decade Goals (EDG), UNICEF 35 Table 4.17. Percentage of women aged 15·49 and women aged 15·49 who heard of AIDS, who know where to get an AIDS test and who have been tested, Indonesia, 2000 Characteristics of Women aged 15-49 Women aged 15-49 who heard of AIDS women Know a place to Have been tested Know a place to Have been tested get tested get tested Residence: Urban 34.4 1.0 44.0 1.2 Rural 16.6 0.3 33.2 0.6 Education: No school 3.8 0.0 25.0 0.0 Elementary 13.5 0.2 28.5 0.5 Junior High 27.0 0.5 36.7 0.7 Senior High 41.3 1.2 46.0 1.3 College/Univ. 64.0 2.2 64.4 2.2 Age group: 15-19 25.5 0.4 39.0 0.6 20-24 27.9 0.8 38.5 1.0 25-29 28.4 1.0 41.8 1.4 30-34 26.0 0.4 39.5 0.6 35-39 22.0 0.7 38.4 1.2 40-44 18.5 0.6 36.8 1.1 45-49 15.8 0.6 37.0 0.7 Tot a I 24.4 0.6 39.1 1.0 End Decade Goals (EDG), UNICEF 36 Figure 4.3 Percentage of women aged 15-49 who have heard of HIVIAIDS, who know where to get an AIDS test and who have been tested, Indonesia, 2000 . . "139,1 ··- .J 25 . M . O . -: . o.L .• AZO-Z. __ J 38,5 @41,8 ~~~~~~~~~~J36,8 ~~~~~~~~~~137 864,4 • Have been tested e Know to get an AIDS test End Decade Goals (EDG), UNICEF 37 4.4. Adolescent sexual behavior The 2000 MICS collected data on pregnancy of ever married women aged 15-49 years. In country where pregnancy outside marriage is rare, median age of ever married women's first pregnancy can be used as estimate of median age of women's first pregnancy. Median age of ever married women's first pregnancy is 18 years with the lowest age of first pregnancy 12 years and highest age at first pregnancy 41 years. Figure 4.4 depicts percentage of ever pregnant women aged 15-49 years whose age of their first pregnancy was 20 years. 46 percent of women ever pregnant have first pregnancy at age below 20 years. Women in rural have higher percentage (51 percent) at first pregnancy below 20 years (51 percent) than women in urban (37 percent). Women with higher education tend to have lower percentage of first pregnancy below 20 years. Figure 4.4 Percentage of ever pregnant women aged 15-49 whose age of their first pregnancy was below 20 years, Indonesia, 2000 Indonesia RESIDENCE Urban Rural EDUCATION No School Elementary Junior High Senior High University 113,8 End Decade Goals (EDG), UNICEF 45,7 51,4 55,8 38 APPENDICES Appendix 1 LIST OF INDICATORS COLLECTED THROUGH The 2000 MICS No. Indicator 1 . Birth registration 2. Children's living arrangements 3. Orphans in households 4. Home management of illness 5. Care-seeking knowledge 6. Bed nets 7. Malaria treatment Description Proportion of children aged 0-59 months whose birth are reported registered Proportion of children in households aged 0-14 years not living with a biological parent Proportion of children in households aged 0-14 years who are orphans Proportion of children aged 0-59 months who were ill during the last two weeks and received increased fluids and continued feeding Proportion of caretakers of children aged 0-59 months who know at least two of the following signs for seeking care immediately: child not able to drink or breastfeed, child becomes sicker, child develops a fever, child has fast breathing, child has difficult breathing, child has blood in the stools, child is drinking poorly Proportion of children aged 0-59 months who slept under an insecticide-impregnated bed net during the previous night Proportion of children aged 0-59 months who were ill with fever in the last two weeks and received anti-malarial drugs 8. Knowledge of preventing HIV/AIDS Proportion of women who correctly state the three main ways of avoiding HIV infection 9. Knowledge of misconceptions of HIV/AIDS 10. Knowledge of mother-to child transmission of HIV 11. Attitude to people with HIVIAIDS 12. Women who know where to be tested for HIV Proportion of women who correctly identify three misconceptions about HIV/AIDS Proportion of women who correctly identify means of transmission of HIV from mother to child Proportion of women expressing a discriminatory attitude towards people with HIVIAIDS Proportion of women who know where to get a HIV tested 13. Women who have been tested for Proportion of women who have been tested for HIV HIV 14. Adolescent sexual behaviour Median age of girls/women at first pregnancy 15. Net primary school attendance rate Proportion of children of primary school age attending primary school 41 12 Preparation and submission of BPS & EDG team report *) Conducted in Provincial/Regency/Municipal BPS **) Conducted by Susenas 2000 officer Appendix 2 42 . . --·- - - ---- - - -- Appendix 3 REPUBLIC OF INDONESIA STATISTICS INDONESIA, MINISTRY OF HEALTH, MINISTRY OF EDUCATION AND CULTURE, BKKBN, AND UNICEF MULTI-INDICATOR CLUSTER SURVEY ON THE EDUCATION AND HEALTH OF MOTHERS AND CHILDREN YEAR 2000 Confidential Province DO 2 Regency/Municipality*) DO 3 District DOD 4 Subdistrict/village*) DOD 5 Subdistrict/village classification 1. Urban 2. Rural D 6 Enumeration Area Number 7 Group Segment Number 8 Sample Code Number Name of 5 Number ofHms aged 5-17 years D Household head: 2 Number of Household Members (HM) DO 6 Number of women aged 15-49 years D 3 Number ofHMs aged 0-59 months D 7 Number of women aged 15-49 years and D 4 Number ofHms Aged 5 years or more has married Name and Reg, Number of DDDDD 6 Has this questionnaire been filled out D enumerator completely? 1. Yes 2. No 2 Rank of enumerator: 7 If Q.6= "No", why? 1. BPS Provincial Staff 3. BPS interviewer D 0. Household not found D 1. Respondent refuses 2. BPS Reg.!Mun.staff 4. BPS partner 2. HM not at home 3 Date of Enumeration: 4. Others Name and Reg. Number of DDDDD 4 Signature of Enumerator: 8 supervisor/inspector: 5 9 Rank of Supevisorllnspector: D Length of interview per visit 1. BPS Provincial staff 3. BPS interviewer Visit No. Minutes 2. BPS Reg.!Mun. staff 4. BPS partner DOD 10 Date of supervision./inspection D 2 DOD 3 DOD 11 Signature of supervisor/inspector D 4 ODD *) Delete the unnecessary 43 Copied from Column 1-6, Block IV.A, VSEN2000.K Only for children aged 0-14 years (specifically Column 5 (birth date) asked on enumeration] Biological Is biological If alive. Mother still father still with Sex Age alive? alive? biological father live · No. Name of household (years) Yes 1 this members head M 1 1 household? No 2 household? F 2 Birth date 2 Not (Code) If yes, her known 9 If yes, his number*) number*) 01 D D DD D D DO D DO . ./. . ./. . . 02 D D DO D D DD D DO 0 0 0 0 ./ •••• ./ . 0 0 •• 03 D D DD D D DO D DO . . ./. . ./. . 04 0 D DO 0 D DO D DO 0 0 0 0 ./. 0 •• ./ . 0 0 • • 05 D D DD D D DO D DO . ./. . ./. . . 06 D D DO D D DO D DO 0 0 0 0 ./ . 0 0 0 ./ . 0 0 0 0 07 D D DO D D DO D DO 0 0 0 0 ./. 0 0 0 ./ . 0 0. 0 08 D D DO D D DO 0 DO 0 0 0 • ./ •••• ./ ••• • • 09 D 0 DO 0 0 DO 0 DO 0 0 0 • ./ . 0 0 0 ./ . 0 0 0 0 10 D 0 DO 0 D DO 0 DO . ./. . ./. . REMARKS Column 3 Code: Relationship with household head Column 6 Code: Marital Status Head 1 Child-in-law 4 Other family 7 Single 1 Divorced 3 Spouse 2 Grandchild 5 Housekeeper 8 Married 2 Widowler 4 Child 3 Parent-in-law 6 Other 9 *)This question refers to the relationship of biological parents and children. Code "00" if parent are not members of the household 44 AU Underfives, Q.1and Q.2is filkd out the same if answered by the sameparenVsitter Does parents know that children must have Birth Certificate by Civil Registration Office? D 1. Yes 2. No Does Parents know the process to obtain Births Certificate? 1. Yes 2. No D Has (name) had any of the following health complaints in the laste 2 weeks? (Read from a- o) (Use code 1 if "Yes" , code 0 if"No"] a. Fever D 1. Hepatitis/liver D b. Coughs D J. Recurring Headaches D c. Flu D k. Epilepsy/spasms D d. Asthma D I. Cripple D e. Breathing dificulty D m. Accidents D f. Diarhea D n. Toothaches D g. Measles D o. Others D h. WaxyEar D [If all coded 0, -+ Q.ll] 8 . During ilness (if Q.7 is coded 1), does (name) have t--------------------1------f reduced,the same or increased liquid intake from Does (name) have a Birth Certificate issued by Civil Registration Office? May I see it? I. Yes, can show it } 2. Yes, cannot show it 3. Do not have 9. Do not know w {to Q.7} Does (name) have a Birth Document Paper? May I see it? 1 . Yes, can show it 2. Yes, cannot show it 3. Do not have } .r {Go to Q.6} 9. Do not know D D normal? 1. Reduced 2. The same 3. Increased 9. Do not know 9. Diring illness deos (name) have reduced, the same or increased food intake from normal? 1. Reduced 2. The same 3. Increased 4. Has not eaten 9. Do not know t-------------------1----f 10. IfQ.7.f= 1, during such diarhea, has (name) drank/ 5. From where did you obtain such Birth Document Paper? I. Subdistrict/village 2. Hospital/Health Center/Midwife 9. Do not know Why (name) does not have a Birth Certificate from Civil Registrattion office? (Do not read the alternative answers, ask "any others") [Use code 1 if"Yes", codeO if"No"] I . Expensive 2. Too far to go 3. Do not know if births must be registered 4. Late, do not want to pay fme 5. Do notknow where to register 6. Others(. . . . . ) 9. Do not know D 45 eaten the following deverage? [Use code 1 if "Yes", code 0 if"No" and 9 if "unknown"] a. Breastfed b. Other milk c. Yoghwtlstarch water d. Poridge e. Oral rehydration/intravenous feeding f. Water and food g. Only water h. Carbonated beverages i. Other( . . . . . . . . . . . ) j . Not given food/drink D D a.D b.D c.D d.D e.D r.D g.D h.D i.D j.D AU undetfives, Q.11 contents the same if answered by the same Father/Mother/sitter 11 . Opinion of the Father/Mother/Sitter: 19. Does (name) sleep with bed nets? Sometimes children fall very ill as to require immediate treE1tm1::n1l 1. yes D in health facilities,what are the signs that promt you 2 No } children fot treatment at health facilities (Hospital/Health 9: Unknown rr {Go to next HM} Subsidiary Health CenterNillage Polyclinic/BDD/Doctor'st------------------------t practice)? 20. Is the bed net dipped in insecticide? Do not read the alternative answers, ask "any others" 1. Yes [Fill in code 1 if "Yes", code 0 if "No"] 2. No } Go HM} 1. Cannot drink or suckle 9. Unknown rr { to next D 2. Becomes more sick 21 . When was it dipped? 3. High Temperature/fever . . month ago 4. Shallow breathing 99. Unknown 5. Difficulty in breathing t--------------------+----1 22. Respondent answering questions Q.1 to Q.21 6. Bloody faeces above is: 7. Drinks too little 8. Others( . . . . . ) Does (name) have fever with shivering 1. Yes 2. No 9. Unknown 1. Has (name) been/still in school? ~------------------~----1 13. During illness does (name) seek treatment at health 1. No/Not yet w {Go to B. VID!Next HM} facilities (Hospitals/Health Centers/Subsidiary Health 2. Still attend school CenterNillage Poluclinic/BDD/ Doctor's Practice)? ·O 3. No in school 1. Yes 2. Highest level and type of education ever or being ~ : ~~own }rr {Go to Q.17} attended 07. General High 08. Islamic High 00. Pre-school/play group 14. Was (name) given fever medications or malaria 01 . General Elementary- . medications provided or prescribed at health facilities 02. Islamic Elementary 09. Vocational High 10. Diploma IIII 11 . Diploma ill 12. Diploma IV/Univ (Hospital/Health Centers/Subsidiary Health Center/ D 03. Package A or equivalent Village Polyclinics/BDD/Doctor' s Practice)? 04. Gtn!mi/Voc Juni<r High 1. Yes 05. Islmic Junior High 13 . Graduate School 2 N } 06. Package B or equivalent 9: Unkno own rr {Go to Q.16} t---------------------'L-----1 3. Highest level education ever or being attended 15. What medicines are administered to (name) at the afore 0 1 2 3 4 5 6 7 8 (graduated) mentioned Health Facility? w {Go to Q.4/next HM/B. VIII} 16. 17. 18. [Fill in code 1 if"Yes", code 0 if"No"] ----. I. Chloroquine 2. Fansidar 3. Pi! kina/eukinine 4. Panadol 5. Tempraltermorex D D D D D 6. Bodrexin D 7. Paracetamol D 8. Others D ( . ) 9. Unknown D Was (name) given fever medications or malaria medications before being taken? I. Yes rr {Go to Q.18} D ; : ~~own } rr {Go to Q.19} During illness, was (name) given fever medications or malaria medications? D I. Yes 2. No }rr {Go to Q.19} 9. Unknown What medications were given? 4. In his academic year (1999-2000), has (name) ever been absent from school (other than holidays)? 5.a. b. c. 1. Yes 2. No w {Go to Q.6} During the last week, how many days was absent . . days During the last month, in how many days absent from school? . . . hari, if 0 days w {Go to Q.6} Reason for absence from school during the last month: [Fill in code 1 if "Yes", code 0 if "No"] 1. illness 2. Assisting fmding income 3. Funds 1. Chloroquine [Fill in code 1 if"Yes", code 0 if"No"] D 4. Taking case of siblings/managing household 5. Perlaiizedlsuspended DO D DD D D D DD 2 3 4 5 6 2. Fansidar D 6. Bodrexin D 7. Paracetamol D 8. Others D 6. Others r----------------------r--, D 3. Pi! kinaleukinine 4. Panadol 5. Tempraltermorex D (. . . . ) D 9. Unknown D 6. Was (name) enrolled during the previous academic year (199811999)? I. Yes 2. No 46 D To prevent the spread of the HIVIAIDS virus, we require infomration concenming several matters connected with mother's knowledge concerning the HIVIAIDS virus, please understand if some of our questions offend you . 1. Have you ever heard of/read about the HIV virus or the disease called AIDS? 1. Yes 2. No ar {Go to B.IX/next HM} D 6. Can the HIV/AIDS virus spread from mother to her child? l. Yes 2. No 9. Unkno\\111 7. Can the HIV I AIDS virus spread from mother to her foetus during pregnancy? l. Yes 2. No 9. Unkno\\111 8. Can the HIV/AIDS virus spread from mother to child during birth? 1. Yes 2. No 9. Unkno\\111 9. Can the HIV I AIDS virus spread from mother to child through breastfeeding? l. Yes 2. No 9. Unkno\\111 t--------------------t----110. If a teacher becomes infected with HIV/AIDS but is .a. Do you know of any way to avoid contracting HIV, the virus causing AIDS? I. Yes ; : ~~o\\111 } ar {Go to Q.3} b. If Q.2.a= "Yes," what ways do you know of! (Then ask as many as possible on the ways that the respondent can answer, for example by t?nttnnrunu.uv• asking "any others? " but don 'tread to them or direct them) [Fill in code 1 if "Yes" dan code 0 if "No"] 1. Avoid sexual contact with persons infected by HIV/AIDS 2. Avoid changing partners in sexual intercourse 3. Use condoms in sexual intercourse 4. Avoid using unsterile/used syringes 5. A void using blood already infected with HIV I AIDS in transfusions 6. Others ( . . . . . . . . . . . . . ) Can someone become infected with the HIV/AIDS virus due to : [Fill in code l if "Yes" dan code 0 if "No" and code 9 if"Unknown"] D not ill, cav (he) still teach? l. Yes 2. No 9. Unkno\\111 11 . If you know of a storekeeper or a ffod vendor who has AIDS or the HIV virus, would you buy from him? l. Yes 2.No 9. Unkno\\111 12. Do you know of places where a person might be examined to determine whether or not he has the HIV I AIDS virus? 1. Yes (mention . . . . . . . . . . . . . . . . . . . . . . . . . . . . ) 2. No w {Go to B.IX/next HM} 13 . Have you ever had yourself examine to determine whether or not you have the HIV I AIDS virus? 1. Yes 2. No ar {Go to B.IX/next HM} D D D D D D D D 1. Bed bites 1. On what month and year was your ftrst marriage? DODD 2. Shaking hands with AIDS sufferers 3. Using thisngs (clothes, towel, glass, plate) of AIDS sufferers 4. Coughs of AIDS sufferers 5. Witchcraft and the like 2. Have you ever been pregnant? 1. Yes 2. No w {Go to next HM} t---------------------1-----t 3. At what age was your first pregnancy? If there is no sexual contact, can the HIV I AIDS virus be avoided? 1. Yes 2: No 9. Unkno\\111 Is it possible that someone who appears to be healthy to be infected with the HIV I AIDS virus? 1. Yes 2.No 9. Unkno\\111 D . . . . . . Years (First pregnancy,including miscarriage, stillbirth or child not of current husband) O 4. Are you currently pregnant? 1. Yes 2. No 9. Unkno\\111 47 D DO D Appendix 4 Data Processing Stages a. Primary Data Processing There are 5 major stages of primary data processing of the 2000 MICS as follows: 1. Main data entry As usually planned for such a big sample size survey as Susenas, data entry process for the 2000 MICS was planned only once. The data entry program, facilitated with some basic consistency checking procedures, was constructed using ISSA version 3.0. 2. Structure Check The identity of enumeration area and the sequence number of selected households are stored in a file called "File Master" that control the process of data entry for each questionnaire. By facilitating the process of data entry with file master the completeness of questionnaires being entered are directly monitored. Those questionnaires with identity other than stored in the file master or unmatched will be rejected by data entry programme. 3. Re-entry All questionnaires of the 2000 MICS are entered twice in order to follow recommendation given by the facilitator of the MICS 2 workshop. For each questionnaire the main and the second data entry were done by different operators. The ISSA version 5.0 that was provided (received) during the workshop was applied in the second data entry. The facilitators of the workshop have provided some suggestions and directions that make the output of the second data entry program much better than the first one. 4. Verification After the second data entry finished, the two files are compared and a list of differences is produced. The verification process was undertaken by different but and more qualified personnel than that of data entry personnel. Correction of errors was done only in the second data entry file because the outputs of the second data entry are assumed more reliable or less errors than that of the main (the first) data entry and in order to accelerate the whole data process. 5. Editing Data entry program is not facilitated with the procedure of consistency checking between variables and between records. For this reason a specific effort was made to check the 48 consistency of the data as exemplified by a number of frequency tables. The final and clean data in ISSA file is stored in a file called "final data back up". b. Secondary Data Processing In order to follow the planned tabulation prepared by UNICEF, the ISSA data file was transferred into SPSS package. In this regard, the data file are separated into 4 different files, consist of children under five file, women file, household listing file, and household data file. The next step was converting variable labels and value labels into English version, included creating new variables and receding existing variables. Following the sampling design of MICS 2 for Indonesia, the sample weights are calculated by province and differentiated between urban and rural areas. The sample weights are calculated by dividing the population/household projection with the sample of household/household members (see Appendix 4.2 and 4.3). 49 Appendix 4.1 Target Sample and Response Rate of the 2000 MICS, Indonesia Target Question Question Question Question Province naire % naire naire % naire % sample receive ncomplete entered clean (1) (2) (3) (4) (5) (5) (6) (8) (9) Dista Aceh 176 176 100.00 0 176 100.00 176 100.00 Sumatera Utara 480 480 100.00 0 480 100.00 480 100.00 Sumatera Barat 272 272 100.00 0 272 100.00 272 100.00 Riau 256 256 100.00 0 256 100.00 256 100.00 Jambi 160 160 100.00 0 160 100.00 160 100.00 Sumatera Selatan 320 320 100.00 0 320 100.00 320 100.00 Bengkulu 160 160 100.00 0 160 100.00 160 100.00 Lampung 320 320 100.00 0 320 100.00 320 100.00 DKI Jakarta 608 608 100.00 0 608 100.00 608 100.00 Jawa Barat 1344 1344 100.00 0 1344 100.00 1344 100.00 Jawa Tengah 1168 1168 100.00 0 1168 100.00 1168 100.00 DIYogyakarta 400 400 100.00 0 400 100.00 400 100.00 Jawa Timur 1360 1360 100.00 1 1359 100.00 1359 99.93 Bali 304 304 100.00 0 304 100.00 304 100.00 NTB 320 320 100.00 0 320 100.00 320 100.00 NTT 240 240 100.00 0 240 100.00 240 100.00 Kalimantan Barat 272 272 100.00 0 272 100.00 272 100.00 Kalimantan Tengah 176 176 100.00 0 176 100.00 176 100.00 Kalimantan Selatan 288 288 100.00 0 288 100.00 288 100.00 Kalimantan Timur 176 176 100.00 0 176 100.00 176 100.00 Sulawesi Utara 208 208 100.00 2 206 100.00 206 99.04 Sulawesi Tengah 176 176 100.00 0 176 100.00 176 100.00 Sulawesi Selatan 336 336 100.00 0 336 100.00 336 100.00 Sulawesi Tenggara 176 176 100.00 0 176 100.00 176 100.00 Maluku*) 144 16 11.11 0 16 11.11 0 0.00 Irian Jaya 160 159 99.38 0 159 99.38 159 100.00 Indonesia 10.000 9871 98.71 3 9868 98.68 9852 98.52 Note: *) Exclude from data file 50 Appendix 4.2 Calculating Weights for Population Estimates Population projection Sample of household Weights Provincei in the year 2000 members Urban Rural Urban Ruarl Urban Rural (1J (21 (3) (4) (5) (6) (7) Dista Aceh 1074533 3138283 266 500 4040 6277 Sumatera Utara 5454067 6338033 1229 924 4438 6859 Sumatera Barat 1366833 3215100 441 768 3099 4186 Riau 1644567 2850100 565 552 2911 5163 Jambi 888850 1817933 287 420 3097 4328 Sumatera Selatan 2493400 5495750 576 878 4329 6259 Bengkulu 502333 1125617 341 298 1473 3777 Lampung 1383933 5816250 391 1008 3539 5770 DKI Jakarta 9911133 0 2550 0 3887 Jawa Barat 21357617 21265183 3577 1883 5971 11293 Jawa Tengah 11116817 19307000 2237 2460 4970 7848 Dl Yogyakarta 2006950 895267 922 446 2177 2007 Jawa Timur 12659767 22149017 2433 2725 5203 8128 Bali 1253983 1736217 618 527 2029 3295 NTB 789317 3081533 341 881 2315 3498 NTT 627733 3191183 358 878 1753 3635 Kalimantan Barat 926367 3059733 398 863 2328 3545 Kalimantan Tengah 504700 1339667 250 489 2019 2740 Kalimantan Selatan 1044017 2107950 487 642 2144 3283 Kalimantan Timur 1422517 1340300 461 241 3086 5561 Sulawesi Utara 828233 1965383 271 456 3056 4310 Sulawesi Tengah 589583 1569067 306 521 1927 3012 Sulawesi Selatan 2559467 5495667 717 861 3570 6383 Sulawesi Tenggara 503017 1301950 289 505 1741 2578 Maluku 691533 1599400 59 27108 Irian Jaya 602000 1626433 297 440 2027 3696 Indonesia 84203267 122828017 20608 20225 51 Appendix 4.3 Calculating Weigths for Household Estimates Estimated Sample of household Weigths Propince Households in 2000 members Urban Rural Urban Rural Urban Rural (1) (2) (3) (4) (5) (6) (7) Oista Aceh 234050 674750 64 112 3657 6025 Sumatera Utara 1239550 1318100 272 208 4557 6337 Sumatera Barat 363283 725383 96 176 3784 4121 Riau 423533 647833 128 128 3309 5061 Jambi 223500 434517 64 96 3492 4526 Sumatera Selatan 595850 1252433 128 192 4655 6523 Bengkulu 168217 232650 80 80 2103 2908 Lampung 322150 1353850 80 240 4027 5641 DKI Jakarta 2319267 0 608 0 3815 Jawa Barat 5486717 4882367 832 512 6595 9536 Jawa Tengah 2698733 4677017 544 624 4961 7495 01 Yogyakarta 610433 174850 272 128 2244 1366 Jawa Timur 3275783 5882517 639 720 5126 8170 Bali 350100 395233 160 144 2188 2745 NTB 184100 775833 96 224 1918 3464 NTT 131450 636733 64 176 2054 3618 Kalimantan Barat 188367 697167 80 192 2355 3631 Kalimantan Tengah 142767 328767 64 112 2231 2935 Kalimantan Selatan 273500 556450 128 160 2137 3478 Kalimantan Timur 399800 296217 112 64 3570 4628 Sulawesi Utara 207567 477983 79 127 2627 3764 Sulawesi Tengah 141450 356650 64 112 2210 3184 Sulawesi Selatan 567350 1164417 144 192 3940 6065 Sulawesi Tenggara 116817 272933 64 112 1825 2437 Maluku 162067 327200 0 16 20450 Irian Jaya 151917 392733 64 95 2374 4134 Indonesia 20978317 28934583 4926 4942 52

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